Core Rotation: Adult Medicine

Contact:  Cheryl (Cherie) GreenRick Flinders

Location: Sutter Santa Rosa Regional Hospital

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The goals of the adult medicine service are: 1) to know, and 2) to care. Knowledge-driven, evidence-based medicine reflects our commitment to the importance of basic science in the management of clinical problems. Compassion in the practice and delivery of that care reflects our purpose. We recognize these goals as life-long challenges of medicine and they comprise the educational foundation of the adult medicine service. First year and second year residents take primary call, admitting patients through the emergency room and from the intensive care unit (ICU). A night float system is employed to reduce the burden of call and comply with work hours standards.

Two Family Medicine attendings round with the team, seeing each patient on the service daily. This additional attending presence has substantially improved resident education, supervision and patient care on the service. Family physicians from our core faculty and from community practices serve as attendings on the Adult Medicine Service. The inpatient medicine experience is complemented by a longitudinal didactic lecture series provided by the attendings on the service, and visiting specialists. Topics include common inpatient diagnoses such as management of pneumonia, alcohol withdrawl and acute renal failure, as well as best practices for safety and quality in hospital medicine. In addition, technical and procedural skills, including radiology, ultrasound, mock codes and EKG reading are taught by our faculty and subspecialty physicians in diagnostic imaging, cardiology, nephrology, gastroenterology, and intensive care.

The admitting Adult Medicine resident becomes the Family Physician to all unassigned patients admitted through the ER and, ideally, will continue to follow these patients after discharge in his/her own continuity practice. Residents on the Adult Medicine Service also follow patients admitted to our ICU, and often serve as medicine consulting service for patients admitted by specialist physicians from the community. Finally, residents care for established patients from our Santa Rosa Community Health Centers when they are admitted to the hospital. These arrangements provide us a diverse patient population from a wide range of medical problems and healthcare needs.

Adult Medicine residents meet twice daily with the service attendings: individually during morning work rounds, and as a team at noon sign-out to review the status of all patients on the service. Pharmacy interns round and work daily with the medicine team and the chief attends interdisciplinary team rounds to assist residents with optimal discharge planning and follow-up. Twice monthly, the Team Chief and Attending Chief of Service make house calls to follow up on patients recently discharged from the Adult Medicine Service