Residents will have regularly assigned office hours at DFM and the monthly schedules of assignments will be distributed by the residency. Clinic office hours preempt all other resident duties, except emergent care and OB/deliveries.

Clinic routine involves following the procedures of a private practice. The problem-oriented office chart is to be utilized and chart summaries and up-to-date medication lists are expected. Because of ongoing statistical analysis of many aspects of patient care, complete documentation is imperative.

Delivering one of your obstetrical patients or assisting at a clear-cut emergency will necessitate provision of coverage at the Clinic. Notify the clinic chief and your nurse immediately of such events.

Clinic Hours

The clinic is open Monday through Friday, 9 - 12, 2 - 5.

Clinic Schedule Changes

All changes in the clinic schedule need to be approved by the clinic chief.

Laboratory

Laboratory and other tests that can be run on site include:

Hematocrit

Hemoccult

Postvascular sperm count

Complete urinalysis

O2 Saturate

Quick Strep

Gram stain for GC

EKG

KOH preparation for fungi

Tympanogram

Wet mount

Audiogram

Pregnancy test

NST

Dextrostix for blood sugar

Peak Flows

Fern test on cervical mucus (performed by resident)

Stat laboratory tests and work must be sent to Swedish Lab of Path. Routine blood work can be drawn at DFM and results are usually back the next day.

DFM Pharmacy

The DFM pharmacy is open Monday through Friday, 8 - 5. A specific formulary is kept on site at the DFM pharmacy; Many patients obtain medication through a variety of indigent drug programs, coordinated through the pharmacy. The pharmacy does have patient drug records on computer. Patients can call in for refills.

Behavioral Scientist Faculty

Jonathan Wulf, Psy.D., and Wendy Freed, MD are the psychologist and psychiatrist available at DFM, respectively. Their primary role is to teach residents to identify and appropriately manage the psychological and psychosocial issues of patients. Jonathan Wulf is at the clinic Monday afternoons and Wendy Freed is there on Wednesday afternoons. At other times they can be contacted by pager. They both are available as co-therapists for individuals, couples, and families seen with the primary resident.

Dictation

Dictation is done by Dictaphone and outsourced. Dictations need to be done within 24 hours of patient visit with A/P on the chart in the meantime. Dictations are usually available 2-3 days later and reviewed by faculty. Faculty reviewers provide suggestions that allow residents to learn from a variety of management styles.

Chart Summary

The computer system allows quick access to patient medication lists and problem lists. Each new patient's problem list and medications will be dictated into computer format when seen first by a resident. Chart summaries on complicated patients are to be completed by outgoing R-3s. Patient's problem list and medications are entered into the computer system using a specific dictation style.

Teaching in the Clinic

Faculty supervision is always available in the clinic. Preceptors are available to answer questions, to aid with patient diagnosis, and to assist and teach procedures. Procedures that can be performed at DFM include most minor surgeries ("lumps and bumps," biopsies), colposcopy, vasectomy and rigid sigmoidoscopy.

  • Family Medicine Daily

  • Behavioral Science Thursday afternoons

  • OB/GYN (colposcopy) Check for schedule

  • Psychiatry Wednesday afternoons

  • Minor surgery Any clinic

  • Vasectomy With appropriate preceptor

DFM patients may be scheduled for other procedures (i.e. orthopedics, flex sigs) at the Swedish Family Medicine clinic.