I am working for a brand-new clinic in Clearwater, Florida. They just opened one month prior to me starting. They are a Medicare advantage plan clinic, seeing geriatric patients only. My orientation and training was one week long which was nice. I had a full day of EHR training which was needed. I had used this EHR before but 7 years ago. Part of the reason I decided to move forward with this assignment instead of postponing it when I was tired from my travels, was because I knew the first week I wouldn’t be seeing patients.
I shadowed the other providers and completed HIPPA and OSHA training for the millionth time. There is only one physician at my clinic but he is really nice. I am covering a nurse practitioner that is on maternity leave. Everyone is really friendly and welcoming. The clinic itself is big, but the staff size is small. I am used to working in a similar geriatric clinic with 50 employees in one clinic vs 8 employees here. The company has multiple new clinics in the Tampa area. The company has been around for a couple of years and have other clinics throughout the USA, but they are still learning/growing.
It has been very interesting working at a brand new clinic vs the geriatric clinic I normally work at that has been around for 30+ years. The MAs are very helpful here during the new patient visits in gathering the intake. They do half of my job by asking about the patients screenings, fall risk, ADLs, dementia screening, social/family/medical history, and medications etc. It takes them an hour to gather all of this information. This may be an issue once the clinic is busier seeing several new patients per day. So far I only see 2 new patients per day and maybe 1 or 2 follow ups. I believe in January it will be a bit busier, but no where as busy as what I am accustomed to.
In the other geriatric clinic, I would often see 4-5 new patients per day and 8-10 follow ups. This clinic provides 1 hour visits for new patients and 30 minutes for follow ups which is nice. Since it hasn’t been that busy, it has given the staff time to figure things out. I am not a big fan of the EHR for this model. We are using e-clinical works here. For a patient that has 35 diagnoses and 15 medications, the EHR makes it difficult to multitask within the chart. So, if I am typing in my assessment and plan I cannot simply refer back to the labs. I would have to exit that area and click into the labs separately. This makes the documentation pretty time consuming.
I prefer the other geriatric clinic’s EHR because it is an internal one they created, so it is very PCP friendly. Also, we have to send our consult notes to billing to review before we can sign off on them which is weird. Especially for managed care since we do not bill per encounter.
My current clinic is less strict about referrals which is nice. They do not have to be approved by management (for now). We don’t have a nurse to oversee the MAs or a social worker/case manager yet. I believe they will hire for this when the clinics get more busy. In fact, the MAs even have to process referrals since we do not have a referrals coordinator yet.
The patients have been very pleasant and not as complex as I am used to. Probably because the Clearwater, FL area has a higher socioeconomic community than other areas I have practiced (in regards to the geriatric population).
It’s nice not being super busy, and being able to spend as much time as I want with complex patients. I think about how the other geriatric clinic has PCPs seeing 18-20 patients per day, which is crazy. I think the maximum patients per day seen with this company is 10-12. I do appreciate how well organized the other geriatric clinics are, but they’ve had decades to figure things out. Working for a newer company/clinic definitely has its challenges.
For example, we do not have all the typical in house medications we would need yet such as Kenalog for joint injections or even lidocaine. The MAs are not IV therapy trained so if a patient needs IV fluids either the physician or I would have to start an IV, even though it has been years since either of us have done one. We don’t have an xray tech or an ECHO tech. We are just practicing at a limited capacity.
I am enjoying my time so far, but I will see how things go to see if I would want to help them at other clinics in the future.
