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Specialty Residency in Primary Care For additional information, please contact the Residency Director: Anne VanHaaren, Pharm D, CDOE
vancanals@cox.net Phone: (401) 421-4000, ext
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Coastal Medical is a physician-directed, patient-centered medical group comprised of 16 individual physicians’ offices. The clinical staff includes over sixty practicing physicians, twenty nurse practitioners and physician assistants, a nurse care manager, and three clinical pharmacists. There are over 400 employees of the company. Coastal Medical, Inc. offers primary care and medical subspecialty care to a patient base of over 160,000 patients in Rhode Island and Southeastern Massachusetts. Specialty care is available in the areas of Cardiology, Pulmonology, Infectious Diseases (HIV/AIDS), Women's Health, and Pediatrics. As an organization, Coastal Medical is involved in several discrete activities including: shared operational and managerial functions, community wide billing services, development of contracts and other relationships with health insurers, development and maintenance of an innovative Pharmacy Care Management Program, medical management and pharmacy management risk strategies, maintenance of a preferred drug formulary for Coastal Medical providers, and coordination of continuity-of-care through a Hospitalist program. Coastal Medical physicians are recognized leaders in primary care, internal medicine, and selected medical subspecialties. They are members of the Medical Staffs at Rhode Island Hospital, The Miriam Hospital, St. Joseph’s Hospital and Roger Williams Medical Center in Providence, Newport Hospital in Newport, RI, and Landmark Medical Center in Woonsocket, RI. Most hold faculty appointments at the Brown University School of Medicine and Boston University School of Medicine. The physicians at Coastal Medical also hold a wide array of physician leadership roles in the state’s healthcare system, as well as medical education and research. The Pharmacy Care Management Program at Coastal Medical, Inc. The Pharmacy Care Management Program was developed in 1998 through a partnership between Coastal Medical and the University of Rhode Island. Clinical pharmacists, residents, and students are integrated into the primary care practice settings of several physicians' offices in order to enhance collaborative patient care, to improve patients’ therapeutic, humanistic, and economic outcomes; and to develop an innovative training site for URI residents and students. The Coastal Medical Pharmacy Care Management Program has been recognized by APhA and the Health Care Quality Alliance with the Pinnacle Award for its innovation in advancing pharmaceutical care into a private medical group, establishing a continuity of care program, and improving medication use. Clinical pharmacists, pharmacy residents, and Pharm.D. students from the University of Rhode Island College of Pharmacy, provide direct pharmaceutical care to patients in eight of the 16 Coastal Medical offices. The clinical pharmacists and the pharmacy students conduct chart reviews to identify patients at risk for medication related problems. Medical providers refer patients directly to the pharmacists. The clinical pharmacists meet with patients one-on-one in the physicians’ offices to conduct medication histories, assess medication schedules, assess patients’ knowledge of and adherence with medications, identify medication-related problems, counsel patients on their prescription and over-the-counter medications, and provide education on non-pharmacologic therapies for their disease states. Under collaborative practice agreements, the pharmacists are able to modify and manage drug therapy. The pharmacists also pursue pharmacy management initiatives by maintaining a drug formulary and advising physicians on cost-effective drug therapy decisions. The pharmacists communicate their findings and recommendations to medical providers, both verbally and in writing via medical chart progress notes. High-risk patients are followed on a regular basis by the pharmacists. There are additional innovative patient care programs at Coastal Medical, Inc. which involve the full integration of clinical pharmacists. One is an extended, multidisciplinary Custom Care Program, whereby clinical pharmacists work closely with nurse case managers and other medical team members to provide direct, medical management in a cost-effective manner to high-risk medical patients. Another is a Rhode Island statewide Collaborative for improving chronic illness care for patients with diabetes. In the chronic illness model, the clinical pharmacists are team members with physicians, nurse practitioners, and office staff and work together to improve the delivery of chronic care to patients in an outpatient office setting. “Planned diabetes visits” are one component of change that has been implemented to date. Other programs include various quality of care initiatives. For example, there is a group-wide effort to enhance medication safety. Efforts are being made to increase documentation of accurate and up-to-date medication lists in the medical records, to encourage patients to be advocates for their own healthcare, to encourage patients to learn the names and doses of their medications and carry lists of their medications with them. A framework within the medical group is also being created in which medication errors can be identified, reported and addressed appropriately. The Residency Coastal Medical, Inc., in collaboration with the URI College of Pharmacy, is recruiting a candidate for a primary care residency position available in July. The residency program was developed with an approach based on the ASHP Residency Learning System. This 12-month specialty residency provides a unique experience to highly motivated individuals interested in providing high level clinical care to patients in private physician's office settings. The resident will work collaboratively with physicians, nurse practitioners, physician assistants, case managers, and office staff to prevent and alleviate medication-related problems and optimize patient outcomes. The resident will receive training in the provision of direct patient care, the establishment of disease-specific collaborative practice agreements with physicians, the enhancement of professional communication and interpersonal skills, academic teaching, and management skills. The resident will be trained to adapt two important governing principles into their practice: leadership and teamwork. Clinical experiences may include adult internal medicine, pulmonology, smoking cessation, cardiology, HIV/AIDS, hepatitis C, pediatrics, and women's health. The resident will also precept PharmD students from the URI College of Pharmacy and will network with other residents from local affiliated residency programs. Resident’s Ultimate Goal To become an advanced-trained, confident, well-rounded, balanced healthcare professional who can improve the lives of patients, be a role model and teacher for pharmacy students, and lead the expansion of the role of pharmacists in the healthcare system. Specific objectives of this residency are to:
The Coastal Medical/URI resident will be located at one or more of the eight Coastal Medical offices that are currently participating in the Pharmacy Care Management Program. As the program expands, the resident may assist in establishing new services in the other Coastal Medical offices. Elective rotations are available through our affiliations with other Rhode Island residency programs. The Coastal/URI Resident, along with the other residents from the URI College of Pharmacy affiliated residency programs, are involved with all of our current initiatives to promote excellence in pharmaceutical care in the private physicians’ setting. The Faculty Team players in the Coastal Medical/URI College of Pharmacy Partnership are:
Benefits A competitive stipend will be offered. Part of the stipend will be allotted towards the expense of health insurance. The resident will be entitled to 10 vacation days, 5 conference days, and 5 sick days. The resident will receive a travel allowance, which includes reimbursement for attendance at the ASHP Midyear Clinical Meeting in December and attendance at the Eastern States Residency Conference in the Spring. Qualifications Candidates must possess a Doctor of Pharmacy degree from a school of pharmacy accredited by the American Council on Pharmaceutical Education (ACPE) and be eligible for licensure in Rhode Island. Candidates who have completed a Pharmacy Practice Residency through a program accredited by the American Society of Health-System Pharmacy will be given special consideration. Application Requirements The deadline for receipt of all application materials is January 15th. An interview is required and will be scheduled during January or February. Completed applications should contain all of the following: (1) completed application form, (2) letter of intent describing personal goals as they relate to specialized residency training, (3) curriculum vitae, (4) three letters of reference (2 faculty, 1 employer), and (5) college transcript. Application forms:
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