Rotenstein Lisa, Wong Jeanette, Schmidt Stacie, LaVine Nancy, Oyler Julie, Sarkar Urmimala
University of California San Francisco, San Francisco, CA, USA.
Emory University, Atlanta, GA, USA.
J Gen Intern Med. 2025 Apr;40(5):985-995. doi: 10.1007/s11606-024-09013-0. Epub 2024 Oct 2.
While prior studies have explored staffing infrastructure for primary care practices in general, little is known about the range of academic primary care practice models and supports available for academic general internists.
To characterize the range of practice arrangements and expectations for attending academic physicians in general internal medicine (GIM) practices at the top 22 medical schools across the USA.
Cross-sectional survey administered electronically between October 30, 2022, and December 28, 2022.
Clinical leaders in GIM at the top 22 primary care medical schools, as identified by the 2023 US News and World Report Rankings.
Clinical load, productivity expectations, cross-coverage, and team-based care models.
Twenty-two leaders responded, representing 68% (15/22) of medical schools surveyed. The practices were mostly in urban locations (18/22, 82%) and 86% (19/22) included residents. Practices ranged from 7 to 200 PCPs and from 3 to 112 clinical FTEs. A full-time (1.0 FTE) clinical role for academic attending GIM physicians entailed a median of 9 (IQR 8, 10) weekly half-day clinic sessions, with a median panel size expectation of 1600 (IQR 1450, 1850) patients and a median yearly RVU expectation of 5200 (IQR 4161, 5891) yearly RVUs generated. Staff support was most commonly present for prescription refills and patient portal message checks. It was less commonly available for time sensitive form completion. Occasional clinical coverage for other physicians was an expectation at all practices.
In this study, we characterize the organization of and supports available in academic GIM practices affiliated with the top primary care medical schools. Our findings provide comparative information for leaders of academic GIM practices seeking to enhance primary care delivery for their faculty and trainees. They also highlight areas where standardization may be beneficial across academic GIM.
虽然先前的研究总体上探讨了初级保健机构的人员配备基础设施，但对于学术性初级保健实践模式的范围以及为学术性普通内科医生提供的支持却知之甚少。
描述美国排名前22的医学院中，普通内科（GIM）实践中主治学术医生的实践安排范围和期望。
于2022年10月30日至2022年12月28日以电子方式进行横断面调查。
2023年《美国新闻与世界报道》排名中确定的排名前22的初级保健医学院中GIM的临床负责人。
临床工作量、生产力期望、交叉覆盖和基于团队的护理模式。
22位负责人做出了回应，占调查医学院的68%（15/22）。这些机构大多位于城市地区（18/22，82%），86%（19/22）包括住院医师。机构的初级保健医生人数从7人到200人不等，临床全时当量从3人到112人不等。学术性GIM主治医生的全职（1.0全时当量）临床角色，平均每周需要进行9次（四分位间距8，10）半天的门诊诊疗工作，预期平均患者量为1600人（四分位间距1450，1850），每年预期产生的相对价值单位（RVU）中位数为5200（四分位间距4161，5891）。员工支持最常见于处方续签和患者门户消息检查。对于时间敏感表格的填写，员工支持则较少。所有机构都期望为其他医生提供偶尔的临床覆盖。
在本研究中，我们描述了与排名靠前的初级保健医学院相关的学术性GIM实践的组织情况和可用支持。我们的研究结果为寻求为其教职员工和实习生加强初级保健服务的学术性GIM实践领导者提供了比较信息。它们还突出了学术性GIM中可能有益的标准化领域。
