Jamaica Family Medicine

Small Practices Deliver Big Results

“Small practices are the heartbeat of their communities and often the only health care option for people in low-income, rural, and low-resource communities. PCDC is proud to have created a program that empowers staff at small practices with the tools they need to thrive in a changing health care market,” said Isaac Kastenbaum, Managing Director, Clinical and Quality Partners at PCDC

Small, independent health care practices are anchors in their communities, with uniquely strong relationships with patients and their families. Nationally, almost 45% of primary care doctors work in small practices, with four or fewer clinicians.

Small practices often reflect the cultural, ethnic and linguistic make-up of the communities they serve. In New York City, for example, approximately half of all small independent practices that are part of the city health department’s practice network are located in medically underserved areas. However, the health care landscape is changing. The American Medical Association reports that the number of independent, small, physician-owned practices has been steadily decreasing in recent years.

The Primary Care Development Corporation (PCDC) supports small practices to sustain their vital role in underserved communities and keep pace with changing health care payment models and requirements. PCDC has worked with private practices across the country, providing individualized coaching and advice on practice management, workflows, billing, electronic health records (EHRs) and quality improvement. In 2018-2019, PCDC provided support and coaching to 27 primary care practices in New York City to improve their clinical performance. Approximately 80% of participating practices saw improvements in at least one clinical metric, such as increased cancer screening rates or increased immunization rates.

One small physician-owned practice that received advice and support through this project was Jamaica Family Medicine in Queens, New York. The practice has two locations in a diverse community located on a major commercial corridor and patients come in seeking walk-in appointments nearly every day.

But, the clinical provider at the site was serving many roles at once – front desk receptionist, medical assistant, and biller – in addition to serving as a clinical provider. As a result, the practice could only see a small number of patients every day and often had to turn people away.

To remedy this workflow, PCDC assigned a dedicated coach to Jamaica Family, providing bi-weekly calls and visits to the practice. PCDC retrained front desk and medical assistant staff, clearly defining roles and responsibilities for different team members and developing workflow protocols to address patient needs from the moment of arrival until discharge. PCDC also coached staff on ways to improve their use of the practice’s EHR. By the end of their engagement with PCDC, the practice had increased its efficiency so much that the site doubled its daily patient volume.

And now, this training is available to small practices across the country. Building on its real-world experience supporting small practices like Jamaica Family, PCDC developed the Small Practice Management Essentials self-paced online course, designed especially for staff at small practices. In 2022, the Small Practice Management Essentials course was launched nationally.