The PCG Acute Care Clinic

Educational Purpose

Allow the residents to gain experience in the rapid and efficient assessment and management of important common general medical problems in the acute care setting.

-recognize and treat urgent and emergent problems expediently

-follow-up on urgent and emergent problems appropriately

-refer chronic problems for continuity follow up

Description of the Rotation

The Acute Care Clinic sees patients with same day or 48 hour appointments.  It operates from 8:00 am – 5:00 pm Monday through Friday, and 8:00 am – 12:00 pm on Saturday.  It is open to patients who have a primary care physician in the PCG or patients who use the Primary Care Group as their assigned primary care site.  The acuity is of a wide range.  One can expect to evaluate patients with problems as simple as cold and as serious as the acute abdomen.

Patients are seen in twenty minute appointments by the interns and residents supervised by a single faculty preceptor.

All patients are initially evaluated by the interns and residents and subsequently by the attending preceptor.  The most efficient means of accomplishing these tasks is as follows:  1) the intern completes an initial evaluation on his/her own;  2) the intern presents the case at the bedside while the attending examines the patient;  3) the intern and attending develop a plan of care and discharge the patient from the clinic.

General Internal Medicine Curriculum – The PCG Acute Care Clinic

Expectations

The interns and residents will be expected to:

1) review all of cases with the preceptor.

2) provide detailed documentation of the patient encounter.

3) communicate information about the encounter to the appropriate primary care physician through either email or voicemail.

4) be absolutely meticulous about scheduling follow-up visits for both acute and chronic processes.

5) follow-up any necessary labs or studies performed on patients.

6) be very aggressive about communicating results of procedures and tests with patients.

Note that the preceptor is responsible for checking the proper billing code and diagnosis at the time of the encounter.

Knowledge Areas

The resident needs to be able to evaluate and manage the following common medical problems in an acute care setting:

abdominal pain

allergic reactions

asthma

alcohol related problems

cerebral vascular accident

chronic obstructive pulmonary disease

congestive heart failure

coronary artery disease

dementia

delerium

depression

dermatology- rashes,ulcers,abscesses etc

diabetes

dizziness

gastroenteritis

gastrointestinal bleeding

headache

hypertension

musculoskeletal injuries/strains

pneumonia

seizures

sexually transmitted disease

sinusitis

sports related injuries

syncope

upper respiratory infections

urinary tract infection-cystitis, pyelonephritis

women’s health issues- vaginitis, dysfunctional uterine bleeding, pelvic pain