Practice Management and Public Health (PMPH) is a required, four-week rotation that is augmented by other learning experiences over the course of the residency. The rotation integrates multiple dimensions of the curriculum and includes self-directed, didactic and experiential learning, occurring in multiple sites in the community and the health care system.
In the experiential segment of the rotation, time is divided between public health agencies, educational facilities, occupational medicine facilities, clinics which serve underserved and minority populations, and management and financial services offices of the healthcare system. Teaching is provided on site by authorized individuals. Self-directed learning occurs with dedicated readings from sources such as family medicine practice management journals. The curriculum is augmented by longitudinal didactics presented at noon conferences. The rotation is supervised by one of the full-time faculty of the program.
Goals
The PMPH rotation experience shall:
- provide structured experiences in multidisciplinary settings which impact the health of the community
- provide the resident with tools necessary to operate and manage a primary care office
- train the resident in healthcare practices that optimize the health of diverse populations
- provide training in leadership roles
- develop attitudes and skills, which will enable the resident to identify and use aspects of the community that affect patient health and practice
Objectives
At the completion of this rotation, the resident will have demonstrated to the satisfaction of the faculty supervisor:
- Medical knowledge in community medicine pertinent to the practice of family medicine, including:
- assessment of risks for abuse, neglect and family and community violence and how address those risks
- how and where to file epidemiological reports in cases of reportable diseases
- how and where to obtain and interpret epidemiological information
- how to recognize and address environmental threats to safety and health in his/her community
- procedures and functions of the School Health Program regarding medication policies, ADD/ADHD referral and treatment and special education issues
- disease prevention through immunization strategies
- disaster responsiveness
- community-based disease screening, prevention and health promotion
- factors associated with differential health status among sub-populations
- Participation in clinical experiences pertinent to community health, including:
- using community resources appropriately for individual patients who have unmet medical or social support needs
- structured interactions with the public health system
- occupational medicine clinic
- community health assessment
- programs to address community health needs
- community-based health education of children and adults
- Knowledge and tools regarding the management of the multiple elements of the specific practice of a physician, including:
- administration and organization
- communication
- marketing
- quality assurance
- regulatory compliance
- patient care
- Development of practice management skills in:
- selection of practice type (location, professional interrelationships, lifestyle issues), selection and use of advisors and vendors and personnel selection and management
- computer literacy
- time management
- personal and public (verbal and written) communications
- resource management
- management of medical and business records
- patient care management
- Leadership skills in a variety of roles, including:
- clinical practice
- hospital medical staff
- professional organizations
- community leadership
Implementation
This is a multifaceted rotation that provides multiple training experiences in a variety of settings, which is augmented by self-directed readings, noon conference didactics and longitudinal learning in the behavioral science curriculum.
Experiential-Based Learning Components
Residents meet with professionals in the areas of: physician office management; managed care contracts; health maintenance organizations; professional liability insurance; hospital administration; quality assurance; coding and billing; Medicare laboratory medical necessity compliance; hospital chart review; physician employee contracts; the county health department; occupational health; domestic/child abuse; addictions resources; developmental disabilities; HIV/AIDS; minority health; school health; and hospice. Residents also are required to participate as a member of a hospital committee, participate in quality improvement meetings and projects at the FMC, participate in community health screenings and complete a home visit with the behavioral scientist.
The program administrator assists the resident in scheduling time with the various sites and professionals. The resident must continue to meet the usual residency obligations to his/her Family Medicine Center population, including attending scheduled clinics, caring for continuity patients admitted to Memorial Hospital and rounding in the nursing home. The resident is expected to attend noon conferences and abide by duty-hour restrictions in keeping with usual program policies. Upon completion of the rotation, the resident must complete and return the evaluation form provided by the program.
Didactics
Portions of the curriculum are also taught at noon conferences on a regular basis over the three years of training. The conferences are presented by physicians, business management personnel and experts in use of computer technology in office medicine, use of community health resources, quality improvement and resources for underserved and special populations. The behavioral science curriculum addresses related issues such as building the doctor-patient relationship, office relations and patient satisfaction, leadership, values in decision making, interviewing and gifts from the industry.
Self-directed Learning
The faculty facilitator will provide family practice articles to augment the resident’s experience. Adequate time is made available in the rotation schedule for the resident to become familiar with this material.
Evaluation
A rotation evaluation is completed by the supervising faculty based on input from the resident, supervisors at the various agencies, and professionals met with during experiential components.
