The University of Colorado Internal Medicine Primary Care Track at Denver Health

On July 1, 2020, Denver Health will become the official clinical home base for the Primary Care program – all primary care trainees will have their continuity clinics based in the Denver Health system, and their outpatient clinical focus will live in the Denver Health system as much as possible. This will include an expanded array of exciting ambulatory electives and offerings in Colorado’s premiere safety net institution.

Denver Health has a longstanding commitment to care of underserved populations and proven experience in training generations of physicians in partnership with the School of Medicine. Denver Health faculty and staff are eager to welcome primary care trainees to an integrated system that serves as a model for safety net institutions across the nation.

With this change, outpatient clinical activities will largely shift to Denver Health, and the primary care program will continue to be a track of the University of Colorado Internal Medicine Residency Program, governed by the School of Medicine's Graduate Medical Education office. Resident schedules will largely look the same as they always have for wards and ICU, with a continuation to be intermingled at all sites with all tracks of internal medicine residents as before.

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Continuity Clinic

Common to all three Denver Health Primary Care resident sites:

  • Caring for patients in a Federally Qualified Health Center with level 3 Patient Centered Medical Home distinction, we are able to provide access to the highest quality health care, whether for prevention, or acute and chronic diseases, regardless of ability to pay.
  • There is diversity in patient populations, including age, ethnicity and socioeconomic status. There are large Medicaid and Medicare populations and organizational discount savings programs available to uninsured and undocumented patients. Greater than 70% of each clinic’s population lives below the federal poverty level.
  • There are clinic teaching faculty and leaders who are committed to developing future primary care physicians. In fact, each location has a few primary care track graduates who have opted to make their careers at Denver Health. There is significant emphasis on developing primary care practices with vulnerable populations.  Some faculty at each site have specialized training in buprenorphine prescribing, long acting reversible contraceptive placement, hepatitis C treatment, pre- and post- exposure HIV prophylaxis and hormone therapy for gender-affirming care, to name a few.
  • EPIC electronic medical record is used for patient care and documentation. Clinicians are able to analyze clinical data in order to improve health outcomes and manage population health.
  • We have the capability of referring patients (including Medicaid/Medicare and uninsured) to:
    • Denver Health medical and surgical subspecialists 
    • Dental services, Optometry and physical/occupational therapy
    • Electronic consulting services are also available for dermatology, endocrinology, rheumatology, neurology and more.
  • You will learn integrated care services with on-site ability to do warm hand-offs with behavioral health, social work services, pharmacists, patient care navigators and certified addiction counselors.
  • You will learn the ability to refer patients to unique shared Denver Health supported programs: LGBTQ Center of Excellence, Diabetes Prevention Program, Mindfulness Meditation and Healthy Lifestyles Clinic (team-based approach to losing weight).
  • There are on-site laboratory and pharmacy services.
  • Spanish speaking skills are a plus but not mandatory. Telephone interpreters for Spanish and many other languages are easily accessible.  Clinic residents have the opportunity to take the Spanish certification exam, if desired, to communicate independently of interpreter.

Unique Aspects of Each Site

Eastside Adult Clinic

Located in the historic Five Points area of Denver, Eastside clinic is the oldest community health center west of the Mississippi River and has been caring for generations of families since 1966. Eastside has a traditionally higher African American and formerly incarcerated populations. The health center also houses Women’s health, pediatric, WIC, early intervention services (HIV), physical therapy, and dental clinics.

Webb Adult Clinic

As a part of Denver Health’s main campus, Webb has the benefit of being centrally located near the hospital. The clinic has same-day access to radiography, ultrasound, and certain labs.  Proximity can also drive relationships with nearby subspecialists or clinics, such as the Intensive Outpatient Clinic, which cares for high utilizers of medical care, and the Hospital Transitions Clinic. Webb clinic also serves the most diverse population for refugees and other (non-Spanish) languages of the three clinics.

Westside Adult Clinic

 Located just south of Bronco’s Mile High Stadium and established in 1968, Westside provides comprehensive primary care services including women’s health, pediatrics, WIC, and dental clinics. The clinic has an approximately 70% Spanish speaking population and also a notable presence of Vietnamese and Hmong patients.

Curriculum

Interns in the primary care track attend weekly dedicated curricular sessions during two months out of their first year (seven to eight Tuesday mornings in June/July and March/April). For our upper level residents, there are weekly Wednesday morning conferences on outpatient or elective months and six Wednesday mornings each year (12 Wednesdays in total) are dedicated to the Primary Care track.

Curriculum Sessions

Behavioral Health and Communication

  • Challenging Patient Conversations
  • Mental Health I: Case-based Approach to the Diagnosis and Treatment of Anxiety and Depression
  • Mental Health II: Behavioral and medical Treatment of Insomnia
  • Mental Health III: Initial Diagnosis and Management of Serious Mental Illness in the Primary Care Setting
  • Motivational Interviewing*
 
 Career
  • Career Panel, Special Populations Career Panel
  • Evaluating an Employment Contract
  • Updating your CV
 Ethics and Professionalism
  • Negotiating Treatment at the End-of-Life
  • End-of-Life Ethics and Colorado Law
  • DNR Discussions
  • Giving Bad News
  • Palliative Care & Hospice
  • Board of Medical Examiners
     
 Health Services Research/Evidence Based Medicine & Information
  • Basic EBM for the internist*
  • Introduction to Library Resources 
  • PC Research I: Introduction to Primary Care Research Track
  • PC Research II & III: Study Design and Writing an Abstract 
  • Screening 101 
 
 Managed Care & Office Practice
  • Email Medicine/Telephone Medicine
  • Office Management I: Introduction to Billing
  • Office Management II: Coordinating Your Practice
  • Office Management III: Billing Education and Office
  • Physician Profiling
  • Reimbursement 
  • Who Pays Medicare/Medicaid 
 
 Self-Care
  • Focus Group
  • Self Care I: Understanding burnout, compassion fatigue and resiliency
  • Self Care II: Creating effective environments for self- and team-care
  • Self Care III: Reconnecting with values
  • Wrap-up 
 
 Underserved & Special Populations
  • Adolescent Medicine Case Study
  • Advocacy I: 1- Caring for Patients in a Broken System
    2- Health Care and the Medically Underserved 
  • Advocacy II: Beyond the Bedside
  • Advocacy III: Medicine & Megaphones- Using the Media to Promote Health
  • Centers of Obesity Research & Education (CORE) 
  • Elderly Driver
  • Eating Disorders
  • Health Literacy
  • Rural Health Opportunity and Loan Repayment
 
 Primary Care Workshops
  • Derm Workshop
  • Multiple Chronic Disease
  • Ophthalmology
  • Oral Health
  • Pain Management
  • Physical Therapy for Primary Care Residents 
  • Sports Medicine/MSK*