Orientation

Welcome to CCC for the Academic Year 2005-2006! We are glad to have you with us and feel privileged to be a part of your medical education. Please review this information thoroughly.

If you need a hard-copy, you will find this information in the purple Comprehensive Care Clinic Orientation Manual for Students.


Definition:  CCC is the clinic where 3rd and 4th year students follow their own patients. It is a clinical "laboratory" in which the student is the primary care physician, assisted by the clinic staff and supervised by faculty physicians (preceptors).

The Comprehensive Care Clinic, though not a family practice clinic, is based upon the tenets of Family Medicine. In the CCC, we see all ages and sexes of patients with diverse medical problems. We focus on the biopsychosocial model, looking at our patients are individuals, rather than as a disease process. In addition, we practice preventive medicine, in accordance with accepted guidelines.


Clinic Hours:  0800-1200 and 1300-1700, Monday-Friday.

Clinic days and times for each group vary according to each group's clinical rotation. They usually change with each change of rotation.


Continuity of Care:  Our goal is that each student will see the same patients over time. This is at times difficult to achieve, and it takes the efforts of ALL to accomplish this goal of continuity. In scheduling patients for follow-up, it is helpful to give a range of time (e.g., "return to clinic in 4-6 weeks") to allow the clerks more flexibility.

All patients should have an annual History and Physical within the first 3 visits of the year. Preventive medicine issues should be addressed at each visit, and the purple Preventive Medicine Flowsheet should be updated. The blue Outpatient Clinic Summary also should be updated each visit.


Clinic Map: A map of the Comprehensive Care Clinic is available here.


Patient Scheduling:  Patients are scheduled with a particular student for ongoing follow-up, acute illnesses, and preventive care. Occasionally patients need to be seen on a "work-in" basis for an urgent problem. They are seen for that "problem only," and any other urgent or emergent problem that may surface. They should then be referred back to their primary physician for routine matters.

Patients are scheduled for appointments at 0800, 0845, 0930, and 1015 for morning clinics. For afternoon clinics, they are scheduled at 1230, 1315, 1400, and 1445. When necessary, overbooks will be scheduled at 0800 and 1230.

Students should be in clinic and ready to see patients at 0800 for the morning clinics or 1300 for the afternoon clinics. "Work-in" patients can be seen if they present to the clinic by 1030 in the mornings and 1530 in the afternoons. See section on attendance policy for "on-call physician" responsibilities.


Patient sources:  Most are long-standing patients of the clinic. Students may refer to themselves patients that they wish to follow whom they meet on other services. This can be done if those patients are not already being followed in a primary care clinic, and if they meet screening criteria for admission into CCC. Simply fill out a consult to the clinic, requesting that the patient be scheduled to see you.

Patients are also referred from other clinics, by family members of the clinic patients, from allied health agencies, and by preceptors from their private practices.


Patient load:  As a junior, the student's first clinic will include an orientation by faculty and clinic staff. You will be scheduled no patients. After that, you will be scheduled one patient per clinic. As the year progresses, you will work up to having 4 patients scheduled, with the possibility of one overbook. 

As a senior, you will be scheduled 4 patients, with an opening for one overbook in addition to those already routinely scheduled. 

Initially, you may not have any patients scheduled, as we are trying to avoid overwhelming you. As in private practice, we have approximately a 20% patient no-show rate. Work with your preceptor to use this "down-time" wisely. If you are not being scheduled an adequate quantity of patients, you may work with the clerical personnel to see that the situation is remedied.


Medical records:  These are legal documents and must be legible, complete and signed by both the student and the preceptor. Medical records, if altered, must be done so properly and must not be destroyed. You should have your notes completed to the best of your ability prior to presenting to the preceptor, including an assessment and plan. The student should sign and attempt to complete the professional charge ticket as this is part of your medical education.


Clinic support staff:  The staff includes clinic clerks, RNs, nursing assistants, a dietitian, a patient education/diabetic teaching nurse and the medical records staff. You will find all of the staff most helpful and can feel free to seek their assistance. They can help you in many ways.


Laboratory:  We send specimens to the hospital lab. The student can do wet preps and U/As in the CCC lab. The nursing staff performs UPTs , rapid strep screens, and dextrastix.


Reference materials:  General references are available at the preceptor stations. Students are encouraged to utilize these freely. Computers with internet access and/or the Invision system are available in several areas of the clinic. Your preceptor or nursing staff can assist you in learning to use these systems.



Medication samples:  Many samples are available, but these must be kept secure and be properly dispensed from the Diebold. You can receive assistance in obtaining these from your hall preceptor.

Except in the most unusual circumstances, no more that a one-week supply of sample medication may be given. In this manner we can do the greatest good for the greatest number. Your preceptor must assist you in this and must approve exceptions.


Admissions and consults: Initiate only after discussion with the preceptor.


Attendance policy:  Attendance is mandatory, and students are expected to be present, on time, and in appropriate attire. Students may not leave their clinic until cleared to do so by the nurse on their hall. Students will rotate as the "on-call physician" to see late "work-ins." These students must remain in clinic until 1100 for a morning clinic and 1600 for an afternoon clinic.

A. Absences from Clinic

Absences from clinic must be planned and excused in advance, and are coordinated through Debbie Henry (see Absences from CCC and CCC Absence Make-Up form - pp 11-14). If absences are not planned in advance, other members of your group will be required to see the patients you have scheduled. We do not have the capability of canceling or rescheduling appointments at the last moment.

B. Block Rotation Schedule Changes

Block rotation schedule changes can only be made according to policy and must be coordinated through Sarah Miller (see Senior Block Rotations).


Questions or problems regarding clinic function? If you have questions or problems, ask your clinic staff or preceptor. You may also contact Dr. J. German, the Clinic Medical Director, at ext. 55645, D. Dietrich at ext. 55640, or D. Henry at ext. 55347.

You may also contact us at our email address: shvccc@lsuhsc.edu


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updated 10/11/05 - dlp