University at Buffalo - The State University of New York

Published: May 11, 2006

By LAUREN NEWKIRK MAYNARD
Reporter Contributor

The new Jefferson Family Medicine Center is proud of its "firsts."

When the former Deaconess Family Medicine practice on Humboldt Avenue closed and the new practice opened at 1315 Jefferson Ave. last November, it was the first site to hang a UBMD sign on its building and publicly represent the brand identity developed for UB's faculty-practice plans. As part of the Department of Family Medicine in the School of Medicine and Biomedical Sciences, this practice has been training medical residents since 1969, making it one of the first three family-medicine residency programs in the United States.

The Jefferson Avenue site also is the first UB family medicine facility to "go paperless" with an electronic medical record (EMR) system to increase office efficiency and improve patient care.

"Our Sheridan Drive site also uses EMR technology, but we were the first to go completely paperless from day one," says Vinod R. Patel, Jefferson's medical director.

Jefferson Family Medicine Center is the Department of Family Medicine's fifth outpatient training center and its newest residency training site. The center's medical staff includes five physicians, three licensed practical nurses, two medical office assistants and 11 residents.

A busy, community-based ambulatory clinic in the heart of the city, the new practice serves patients in a traditionally underserved, urban neighborhood where disease rates—especially of diabetes and heart disease—are well above the national norms. The clinic is housed in a remodeled, 6,600-square-foot former Rite-Aid building in a small strip mall anchored by a Tops Market.

Inside the medical center, a spacious and comfortable waiting room boasts a flat-screen television at one end and large, welcoming reception windows at the other. Beyond those are 13 examination rooms and one room for on-site procedures such as flexible sigmoidoscopy, colposcopy, cryotherapy and minor surgery. The five attending physicians—Patel; Thomas Rosenthal, chair of the Department of Family Medicine; Jeanette Figueroa; Chester Fox; and Sandra Yale—bring a wide range of expertise. "There's a common misconception that general medicine is not a 'specialty.' But it is our specialty; family medicine is what we do," says Rosenthal.

The move to Jefferson Avenue came in response to belt-tightening at Kaleida Health, which announced that it was closing the Deaconess Center in 2002. "It's generally very expensive for hospitals to keep outpatient centers open," says Rosenthal, referring to the subsidized care of under- or uninsured patients. "Kaleida was looking for a less expensive, alternative model. Since then they've partnered with us and with the medical school in coming up with a solution."

The result is the new Jefferson Avenue location. Only a few blocks away from the first center, it enabled most of the physicians to transfer from Deaconess and provide consistent care to the same patients while attracting new ones. Despite the smooth relocations, the practice treats fewer uninsured patients—only five percent—than it did under Kaleida. Still, Rosenthal sees some positives.

"We have to think about our viability, our ability to survive," he says. "But since we basically operate like a private practice, we are able to give our residents the unique opportunity to learn the ins and outs of keeping a small family practice running efficiently."

The switch to EMR was another plus for the new site, both as a private health-care facility and as a resident training center.

The office sends all of its records to hospitals electronically, but currently accepts paper records as well. Patel and office manager Irvette Horgan are working with patients' prior health-care providers to gradually transfer all incoming records to the new digital system; faxes are transferred electronically via computer to other providers or to Buffalo General Hospital, where Jefferson sends patients for inpatient care.

"Our goal is to eventually use completely paperless records to streamline forms and appointments and to get patients in and out faster," says Patel. "As long as we have an Internet connection, we can access EMRs through our tablet PCs. Now, I can look at 100 diabetes patient records and instantly see who needs blood work or lab tests."

Patel says that the predominantly African-American neighborhood has responded enthusiastically to the new clinic. "Previously, we lost patients because of the long wait to see a doctor. Now, they say how nice it is here, how well people treat you. It's been a stimulus for other patients to come here."

Rosenthal is cautiously optimistic about how the UBMD brand may help the faculty physicians interact. "I think it's a good direction," he says, but cited a 2003 study of all the practice plans showing that nearly half of the referrals from the general medicine sites went outside the UBMD network. Rosenthal says that capacity issues were the main reason why the current UBMD practice plans can't always take patients referred by in-network family medicine or primary care clinics.