Medical Practice (MP) is the flagship primary care clinic of the SF VA Healthcare System (SFVAHCS) caring from 9,000 patients.
MP clinic is located on the main SFVAHCS campus and is staffed by more than 60 providers including 19 physicians, 6 nurse practitioners and 44 trainees (internal medicine residents, nurse practitioner residents and students) The attending physicians who provide care to Veterans are all faculty in the Division of General Internal medicine at UCSF. MP Clinic is a leader in innovative patient centered and team based care and as a patient centered medical home is structured as nine Patient Aligned Care Teams (PACT). This model includes dedicated ancillary support staff for enhanced chronic care management and to support coordination of care for complex patients. Each PACT consists of a primary care provider, nurse, LVN and medical assistant which work together in the same clinic space to provide high quality patient centered care. To support the PACT care of veterans, the clinic has numerous embedded services including clinical pharmacists, social workers, nutritionists, mental health providers including psychiatric nurse practitioners, psychologists and psychology and psychiatry trainees, and social workers. UCSF Residents assigned to the SFVA have their continuity clinic in Medical Practice.
The clinic (https://www.sanfrancisco.va.gov/services/primary.asp) hosts multiple clinical programs outlined as follows:
- Post 9/11 Integrated Care Clinic providing holistic multidisciplinary (social work, mental health and internal medicine) healthcare services for newly returning Veterans
- Integrated Pain Team (IPT) Clinic – primary care specialty clinic receiving referrals for team-based chronic pain management. The biopsychosocially-oriented team includes a pain psychologist, pain-trained physician and nurse practitioner and a pain pharmacist. IPT also prescribes buprenorphine (suboxone) to veterans with chronic pain and opioid misuse.
- Musculoskeletal Clinic –– primary care specialty clinic receiving referrals for shoulder and knee pain. This clinic off loads orthopedics and arthritis clinic and provides access to corticosteroid injections and physical therapy consultation in primary care, while training residents in MSK physical exam, management, and injection.
- MP Complex Care Interdisciplinary Case Conference “The Worry Group”, interdisciplinary (social work, mental health, nursing, geriatrics, palliative care) providing individualized care planning and follow through for patient’s MP providers are worried about.
- Palliative care, geriatrics and addiction medicine consultations
- A daily clinic wide QI Huddle and QI board the serves as focus for continuous quality improvement and clinic communication