Primary Care Clinic

Orientation for First Year Residents

Heather Thompson, M.D.:  athompson@utmem.edu; 901-418-6005 (pager); 901-258-0675 (cell)

  • PCC is your primary care practice.
    • Primary care includes:
      • Well-child care and sick care. In each clinic session, you see well patients who are assigned to your care as well as sick patients whose PCP is not there.
      • Outpatient and inpatient care. We tell each other when each other's patients get admitted.
      • Doing things for patients even when they are not present. Check your folder in Barbara’s office each week to see what went on and what needs to be done for your patients.
    • Our patients tend to be:
      • Poor
      • Insured by TennCare
      • Urban
  • You attend the practice for one session (half day) on each practice week
    • For pediatric residents, every week is a practice week, unless you are on vacation.  You do not report to clinic if you are post-call on an inpatient service (note: the ED is not an inpatient service).
    • For med-peds residents, you attend on alternate weeks.
    • Your assigned session (half day) does not change over the course of your residency.
  • To build your practice, you recruit patients. If you do not recruit patients, then clinic is boring and useless.
    • Patients you can recruit:
      • Tenncare, as long as we are (or can become) their assigned primary care provider
        • TLC
        • Tenncare Select
        • OmniCare
        • Better Health
      • Privately insured, as long as we are (or can become) their assigned PCP
    • Patients you cannot recruit:
      • Mississippi Medicaid (Mississipi forbids payment to out-of-state doctors for primary care)
      • Arkansas Medicaid (Arkansas forbids payment to out-of-state doctors for primary care)
  • PCC includes some learning time at the beginning of every clinic.  We discuss articles from Pediatrics in Review from the month piror.  The conference schedule will be posted on the blog.  You can access this by going to our clinic webpage, clicking on “education” then clicking “conferences.”:
    Reading the articles weekly is a great way to keep up and avoid a pile of journals you need to read.
  • Well-child care in PCC always includes (but is not limited to):
    • Formal screening for developmental and psychosocial problems with written instruments
    • A complete, unclothed physical examination
    • All screening interventions mandated by the federal EPSDT program
    • Reach Out and Read intervention, as appropriate for age (6 mo - 5 yr)
  • Sick-child care in PCC always includes (but is not limited to):
    • Assessment and correction of immunization status
    • Assessment and correction of EPSDT status
  • You need to learn coding in order to make an insurance claim. This may seem like an administrative headache now, but it is an important skill you will need in practice.
    • There are 5 levels of care for an office visit.
    • Most visits are coded as level 3.
    • Diagnosis codes are vague and inaccurate, but code as many of them as apply to the encounter.