November 2012 CIN Webinar
Team-based Primary Care in an Academic Clinic - Lessons from the General Medical Clinic at San Francisco General Hospital

Presenters: Dr. Reena Gupta, Dr. Claire Horton and Dr. David Margolius

November's clinical innovation netowrk webinar call invited guest innovators from the General Medical Clinic at San Francisco General Hospital. The experts shared anecdotes and lessons from their experiences with the transformation of the SFGH residency clinic to a PCMH. The SFGH clinic, which serves as a continuity site for 50 SFGH residents, started the process of transforming into PCMH in 2011. Following site visits to high performing clinics, Dr. Gupta and her team identified the building blocks required to improve access & continuity, expand population management, and improve overall care coordination. The creation of multidisciplinary teams was the essential first step and required redefining roles, establishing new communications practices, and redesigning the clinic to support enhanced communication. Dr. Gupta and Dr. Horton discussed the process her team employed including some of the unique challenges faced by a residency clinic. Dr. Margolius shared his first-hand perspective on the unique role residents can play in practice transformation.

Reena Gupta, MD
Assistant Medical Director, General Medicine Clinic, SFGH
Assistant Clinical Professor of Medicine, UCSF

Dr. Gupta is Assistant Medial Director for the General Medicine Clinic at San Francisco General Hospital (SFGH) and Assistant Clinical Professor of Medicine in the Division of General Internal Medicine at SFGH, UCSF.  As Assistant Medical Director, Dr. Gupta oversees patient-centered medical home transformation at the General Medicine Clinic (GMC), an urban safety net practice site for approximately 50 UCSF internal medicine residents and 20 general internal medicine faculty at UCSF.  GMC is the medical home for over 6500 ethnically diverse, low-income patients with complex medical illness.  Dr. Gupta’s professional interests include primary care redesign, innovation in the safety net, and improving primary care delivery for vulnerable populations in the US and abroad.  Dr. Gupta works with the Center for Excellence in Primary Care at UCSF and serves on numerous San Francisco Department of Public Health committees to promote primary care transformation across 28 clinics in the San Francisco safety net.  She is core faculty for the San Francisco General Primary Care Residency Program and Site Director for the internal medicine resident continuity clinic at GMC.   Dr. Gupta graduated from Yale University, Harvard Medical School, and completed primary care internal medicine residency and chief residency at San Francisco General Hospital, UCSF.

Claire Horton, MD, MPH
Medical Director, General Medicine Clinic, SFGH

Dr. Horton is the Medical Director of General Medicine Clinic (GMC) at San Francisco General Hospital.  GMC is a primary care home in the San Francisco DPH network of safety net clinics; it serves a patient population of 6500 and serves as a major training site for University of California-San Francisco internal medicine residents.  In addition to overall oversight of the clinic, Dr. Horton oversees all quality improvement (QI) activities of GMC and is a project lead on several individual projects and grants.  She co-directs the Quality Improvement, Patient Safety and Leadership (QIPSL) curriculum for primary care residents and works closely with other GMC lead preceptors to deliver clinic-based ambulatory education for all residents in GMC.  In close collaboration with Dr. Reena Gupta and other clinic leadership, she has worked to transform GMC into a Patient-Centered Medical Home and to launch a care management program for GMC’s most complex and vulnerable patients.   Prior to working at SFGH, Dr. Horton worked as a primary care clinician and Medical Director for QI at La Clinica de la Raza in Oakland, CA.  She completed internal medicine residency training at UCSF-SFGH and medical school at Duke and an MPH in Maternal and Child Health from UNC-Chapel Hill.  Her interests include primary care redesign, QI, QI education of medical trainees, women’s health, and the health of immigrant populations.

David Margolius, MD

David is a resident at UCSF and is pursuing a career in internal medicine primary care. Between his third and fourth years of medical school, David spent a year working with community health center staff and physicians in San Francisco to improve their delivery of primary care. David has appeared in numerous panels and conferences as an expert in the area of primary care clinical innovation and team-based care.
Previous Clinical Innovation Webinars

April 2015: Collaboration and Transformation in Residency Education

January 2015Launching a Student-Run Free Clinic

July 2014: Atlas MD: Engaging Medical Students in the Practice of Free Market Medicine

June 2014: The Challenge of Lifestyle Modification and the Power of Group Visits

May 2014: Using Tech Innovation to Enhance Best Practices in Patient Care

April 2014: Interprofessional Education in Action: Realigning Education with Changes in Clinical Practice

March 2014: Beyond the 15-Minute Doctor Visit: Bringing Back the Familiar Physician

January 2014: Kaiser Permanente: Training to Deliver High Quality Care in an Integrated Delivery System

December 2013: The New Face of Primary Care: What Type of Care Do We All Want?

November 2013: Student Innovators: Improving Workflow, Empowering Patients and Finding Inspiration for the Future

October 2013: Preparing the Next Generation of Health Professionals for Our Rapidly Transforming Health System

September 2013: Culinary Extra Clinic: Health Coaching, Relationship-Building, and Collaboration to Care for Our Sickest Patients

August 2013: Direct Primary Care: A New Financing Model for a Quality Primary Care Experience

July 2013: Project ECHO: A New Paradigm for Primary Care and Specialty Collaboration