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