Welcome to the San Francisco Free Clinic! We’re looking forward to having you join us over the next few weeks in this primary care outpatient rotation. We’ve included a few notes below to help orient you to the clinic and let you know what the general expectations of this rotation are: 

# Please consider yourself the primary medical provider. The ultimate goal is for you to take on responsibility for the patients that you see, from interviews, physicals, and presentations, to ensure the plan is carried through. You will need to present each case to an attending, but it’s helpful to think of the attending as a consultant (and your continuity after your rotation is done) -- try to take on as much responsibility as possible.   

# Please watch this orientation video about our EPIC workflows. Though many of you come with experience using EPIC, these work flows are specific to our version of EPIC and our clinic. Please see this sample progress note for what to include in notes.

#Please be on time (9:30 am for morning clinic, 1:00pm for afternoon clinic) and let us know if you are unable to be in clinic -- we schedule patients based on the number of students and residents in clinic. (Check the bulletin board in the docs’ lounge for the posted schedule -- if you cannot come and your name is listed, please let Paula the clinic manager know by emailing her pmartin@sffc.org.) If you need to call us on short notice, the best phone number to call is 415-750-9087 (back line). 

# Masks: Masks are required for anyone experiencing URI symptoms, but otherwise optional.

# Morning rounds happen on Fridays, 9:30-10 am. This is a fairly informal educational session, during which you will present a case (ideally something you saw during the week in clinic and had a chance to read up on). Your presentation should last 5-7 minutes — ideally, presenting the case in the first couple of minutes, then spending the last few minutes teaching people what you learned. (Some of our staff who are pre-medical often join us for morning rounds.)

# Stay home if you are sick. In this age of COVID-19, you may not come into clinic if you are not feeling completely well, in particular if you have fever, cough, sore throat, shortness of breath, loss of smell, chills, body aches, headache, fatigue, diarrhea, runny nose, and congestion. If you are having symptoms, please call our office to let us know at 415-750-9087. After hours, please contact Dr. Ashley Tsang AND Paula Martin.

# TRIAGE. It doesn’t come up often, but if your patient looks severely ill or is complaining of something urgently worrisome, please interrupt the attending immediately (don’t wait to get a full history/exam — time is of the essence!).

# Please try to minimize patient wait times. If patients are waiting to be seen, please do not finish your prior note before seeing the next patient.  

# No lab orders past 12:00pm for AM clinic or 4:30pm for PM clinic. This gives our staff enough time to leave on time. If a patient needs labs, feel ask the patient to come back in the afternoon or another day. If a patient needs a follow up visit, please send a message to the front desk pool.

# Please ask about health insurance and, if visiting from out of their country, how long they will be in the U.S. This information often informs our management and disposition. New patients should be asked about prior health care (e.g. where and when they last saw a doctor), and the reason they do not have health insurance.

# Run all labs by the attending before ordering them. Also, if you add labs after the initial order, you MUST verbally alert the MAs, or they will not be sent! 

# For patient forms/paperwork, always ensure the clinic has a copy before handing it to the patient 

# Communicate to the MAs when the patient is ready for discharge. Patients often don’t know when they’re supposed to leave — be clear with patient/MA’s so they don’t end up sitting there for a long while.

# Please shut down laptops when you are done. Closing the screen does not shut the computer down! This is for security purposes and for battery life.