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First Choice Community Health Center University of New Mexico. History Long history of graduates practicing in the CHC, large Spanish speaking population, often co-located with public health
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First Choice Community Health Center University of New Mexico • History • Long history of graduates practicing in the CHC, large Spanish speaking population, often co-located with public health • Convergence of missions (addressing health disparities, primary care for underserved, frontline of caring for community) • CHC focus on clinical care- little education or research or leadership skills • First cohort of two residents/year in 1995 • CEO and Medical Director(DeFelice and Sava), Department and HSC Leadership • Recruitment improved if could offer academic activity
Collaborations • Family Medicine: • Four residents per year • Health Commons opened in 2008 residents/year) Medical, Dental, Public Health, Community room, WIC) • Faculty from FC attend primarily • CHC “Buys” two faculty from UNM part-time (0.6 time) • Admit to FM Inpatient and MCH services • Obstetric and Inpatient Linkage • HSC • UNM Cares • Tutoring and Foundations of Clinical Practice • Pediatric and IM clinic attending • Community Scholarly work
Challenges • Two separate entities- merging cultures • Resources • Who pays who for what? • Who bills patients for what? • Salary disparities • Non-Spanish speaking residents cannot be there • Fluctuating resident schedules in a busy CHC • UNM EHR is read-only. • Federal Tort Claims Act • Problem-solving • Recruitment of CHC faculty to become preceptors
Successes • CHC docs received highest outpatient attending evaluations • Following highest numbers of OB patients per resident • Placement of students on the FM clerkship • Highly requested by students and residents • Academic role for community docs (all have academic appointments) • CHC docs continue to practice OB and inpatient • Enhances shared mission • Continuity from hospital to community for our patients • Movement of faculty between sites • Increased opportunity to do work in the community
La Familia- Santa Fe -1+ 2 program -Three governance structures -Successes -Higher degree of rural placement than UNM -Mission congruence for underserved- HPSA site Challenges -Mission conflict between education and service- HRSA has helped -Unsatisfying connection with UNM