Tell us about the growth of the Medicine Service Line.
Since I joined this team in 2017, the outpatient Medicine Service Line has grown in both size and scope, and today is spread geographically across Suffolk and Nassau counties, Queens and Manhattan, with partnerships in medical outpatient groups in Staten Island and Westchester.
We have doubled the amount of nursing staff, both registered nurses and nurse practitioners, as these roles have become essential to effective patient management and facilitation of access to care.
Our team is highly structured to provide support to individuals and keep everyone connected. Communication is valued and opinions are sought from all. Talent is welcomed from all areas, and existing team members are encouraged to grow through opportunities for promotion.
Could you talk about the various types of Medicine Service Line practices and locations?
The majority of Medicine Service Line practices are centered on primary care in internal and family medicine. Many specialties exist within the service line, including: endocrinology, rheumatology, GI, pulmonology, gerontology, hepatology, nephrology, infectious disease, and occupational health.
Services include preventive health measures, annual assessments, treatment of acute illness, and overall health promotion. Scope has expanded during the past decade as the focus of medicine has shifted to promoting wellness rather than solely treating illness. More care is delivered out of the hospital, and attention given to lifestyle changes and holistic measures.
A portion of our practices support academic partnerships. Medical residents treat patients in supervised clinics and participate in ongoing grant and research activity.
Thus, Medicine is the largest and most diverse service line within Northwell Health!
What types of positions are available within the Medicine Service Line?
The ambulatory team is centered around the office site, whether a two-person or 30-person practice.
The team is typically led by a practice manager, with physicians and advanced care providers (NP, PA, CNM) treating patients. Other positions include medical office assistants, licensed practical nurses, practice office associates, front desk staff, billers, and other support functions. On-site teams may also include registered dietitians, certified diabetes educators, pharmacists, and behavioral health coaches.
The role of the registered nurse is shaped in ambulatory locations to add value to the patient visit and facilitate achievement of health care goals. RNs practice at the top of their license; they administer medication, provide patient counseling, and enable care through medication/treatment renewals, referrals, and preventive care services. Patients may also have “Nurse Visits” which capitalize on expertise in nursing science and allow enhanced access to provider appointments. These visits allow patients to receive care directly from nurses and may include Coumadin management, blood pressure checks, vaccination, and diagnosis-specific education.
And, there is a huge amount of behind the scenes support in the areas of project management, finance, leadership, quality review, and business development.
What are some of the advantages of working in an ambulatory practice?
Ambulatory is an exciting and rewarding opportunity for career and skill development.
- Smaller teams than inpatient counterparts mean that the work environment is truly collaborative, and all disciplines learn from each other.
- Relationships developed over time with patients and their families contribute to professional reward and purpose, where one can see the effect of invested effort.
- All staff have a great impact on quality output, patient experience, patient empowerment, improved health outcomes, and quality of life for our customers.
- Cognitive and critical thinking skills, as well as engagement of technological advancements, are essential to success.
- Ambulatory setting provides work-life balance for those who wish to make a difference in health care yet have personal home and/or family obligations to juggle.
- Schedules tend to be more regular, without overnight shifts, most major holidays are off, and the weekend and evening obligations are reduced, depending on the site.
Do you have any advice for people looking to get into internal medicine?
Understand the environment. Visit a practice if you can and note what you think works or does not work. We are always looking for new solutions.
Nurses can check out the Ambulatory Nurses’ Association (AAACN) website. Ask colleagues or interviewers to describe the differences between inpatient and outpatient settings. If you are looking for a supportive role, achieve certification if offered, such as for a medical assistant.
We look for individuals who have a passion for people, and demonstrate creative thinking, excellent customer service, and the ability to work well with team members.