Frequently Asked Questions

Family Physicians provide comprehensive, cost-effective, and high-quality health care for individuals and families. Unlike most medical specialties, which focus narrowly on specific conditions or parts of the body, Family Medicine takes a broad approach that integrates biological, clinical, and behavioral science. This discipline is foundational to the concept of Primary Care. Doctors specializing in Family Medicine care for all types of people:

  • Children, adults, and the elderly
  • Men and women with diverse socio-cultural, and economic backgrounds
  • Expectant families, delivering mothers and newborns
  • Healthy individuals as well as those facing serious health challenges

To Family Physicians, accessible, safe, affordable, evidence-based care that is respectful of patient preferences and culture is essential to optimal physical and mental health.

The educational path of Family Physicians includes four years of medical school with the achievement of an M.D. or D.O. degree, followed by at least three years of post-graduate training at a family medicine residency. Residency training culminates in board certification, where candidates must demonstrate immense competency in a broad range of skills. Ongoing certification requires extensive continuing medical education and quality improvement activities. FMSW has eight residents per class, totaling twenty-four residents.

During Family Medicine residency training, residents are engaged in a wide variety of activities to prepare them for their broad scope of practice. The most important part of that training is working as part of a team in the Family Medicine Clinic. Residents care for a panel of patients throughout residency under the direct supervision and mentorship of faculty physicians. Outside of the clinic, residents hone their skills in several ways:

  • Extensive work in hospitals, taking care of adult and pediatric patients as well as following laboring women and delivering babies.
  • Working with experienced physicians in both general and specialty areas of medicine and surgery.
  • Performing procedures ranging from laceration repairs to delivering babies, first through training in simulation labs and then with patients under the guidance of supervising physicians.
  • Caring for communities and populations of patients, monitoring quality outcomes in their practices, and working with others in the health system.
  • Learning how to maintain and update skills in the rapidly changing field of medical information and technology.

Family Medicine of Southwest Washington is an 8/8/8 program. It is a three-year training program, with eight first-year residents, eight second-years and eight third-years. Having completed the 36-month curriculum, residents are eligible to sit for the American Board of Family Medicine board exam. They then become board certified family physicians, and fully employable.

Our program opened its doors for establishment of a clinic in 1995, and we graduated our first residents in 1997. As of June 30, 2018, we have 150 graduates. The program is sponsored by PeaceHealth Southwest Medical Center, supported by PeaceHealth Medical Group, and is academically affiliated with the University of Washington School of Medicine. As of June 30, 2018, we have 150 graduates;

  • 82 practice in the Vancouver/Portland metropolitan area:
  • 34 are located in Clark County
  • 16 work for PeaceHealth Medical Group
    • 7 at FMSW (residency), Vancouver
    • 5 at Fisher’s Landing, Vancouver
    • 1 Memorial Campus Urgent Care, Vancouver
    • 1 at PHSW Wound Care Clinic
    • 1 in Florence, Oregon
    • 1 in Bellingham, Washington

Yes, specialty clinics and curriculum offered by core residency faculty incudes:

  • Endocrinology consultation
  • Women’s Health Consultation and Procedures
  • General Procedures/Vasectomy
  • Musculoskeletal and Sports Medicine
  • Integrated Mental Health Program with comprehensive counseling and prescribing
  • Mental Health Medication Consultation
  • HIV, Hepatitis C, and Transgender Care
  • OMT (Osteopathic Manipulation Therapy)
  • Integrative Medicine Consultation
  • Suboxone Clinics for MAT (Medication Assisted Treatment) of opioid addiction and also for chronic pain.
  • "Bloom" Clinic, a collaboration with Lifeline Connections Women’s Recovery Center, to provide Maternity, Newborn, Pediatric care for women in residential substance abuse treatment.
  • "NOWS" leadership/chair, faculty Heidi Radlinski, MD: Transitioning to East Sleep and Console Model. Babies born after intrauterine exposure to opioids have both short- term and long-term effects. Historically, Neonatal Opioid Withdrawal Syndrome (NOWS) with significant withdrawal symptoms is treated with opiates, requiring NICU admission and intensive nursing involvement and extended length of stay. In 2010, Dr. Grossman at Yale School of medicine implemented a new method called Eat, Sleep, Console (ESC) keeping infants in a low-stimulation environment focused on keeping mother and child together. Breastfeeding is encouraged and skin to skin used as a treatment method. An integral part of the Eat, Sleep and Console model involves increased caregiver/parent involvement and normalizing the at-risk infant’s environment. A multidisciplinary workgroup lead by Family Medicine Southwest has been developed to transition to the ESC Model at the Family Birth Center at PHSW.
  • Pharmacy consultative services for patients with complex medication profiles.
  • Dedicated anticoagulation clinic for warfarin (coumadin) management

Family Medicine of Southwest Washington sponsors interdisciplinary training in healthcare professions critical to the Patient Centered Medical Home. This includes:

  • 6 Masters level graduate students in Marriage and Family Therapy through an educational collaboration with Lewis and Clark College
  • 2 Masters level Medical Social Worker (MSW) interns
  • 2 PGY-1 (post-doctoral first year) Pharmacy Residents
  • 1 PGY-2 (post-doctoral second year) Pharmacy Residents

FMSW serves diverse ethnic groups in Vancouver, which includes a large Latino and Russian population. FMSW focuses on other "high-needs" vulnerable populations, such as those with chemical dependency, mental illness and homelessness. FMSW and PeaceHealth sponsor the programs below, providing residents with additional opportunities for contribution to the local community:

  • Community Free Clinic
  • Grant-supported Cervical and Breast Health Screening program
  • Procedure Clinic for the Uninsured
  • New Heights Free Clinic
  • Annual Sports Physical Clinics for the Vancouver School District
  • Medical staffing at local high school football games, wrestling tournaments, mixed martial arts matches, and high school lacrosse games
  • Medical staffing for the Vancouver Marathon other community sporting events throughout the year
  • Primary Care medical services and Medical Directorship for Adolescent residential substance abuse treatment center, Daybreak Youth Services

Since 2004, Family Medicine Residency has been a leader in the Patient-Centered Medical Home environment, teaching and living in a quality improvement, advanced/open access care model. FMSW has team care pods that are protocol-driven for standardized processes. Our clinic incorporates systems-based disease management and chronic care model programs, including anticoagulation management, diabetes, medical management of chronic pain, and childhood ADHD.

FMSW’s newest PCMH enhancement is a robust model of integrated mental healthcare. Led by marriage and family therapist Layne Prest, PhD, the team consists of an inter-professional group of one MFT PhD intern, six master’s level graduate student therapists, a social worker, pharmacist, care coordinator, and a Family Medicine physician with additional training and expertise in mental health prescription management. This model optimizes bi-directional clinical integration of mental and physical health activities on site, within the context of an individual’s Family Medicine health home.

Summary of Quality Improvement Efforts at Family Medicine Residency since launching Advanced Access (second generation Open Access) care environment in 2004:

2004- Advanced Access care environment. "Today’s work Today". Taken from Clinicalmicrosystem.org. Adapted from IHI Practice Redesign Project.

2004- Team Care/ standardized processes and care pods/ mini practices. LPN- managed

2006- Group Visits for Diabetes

2006- Initiation of LPN team leaders for station (care pod)-based teams, including complex care management outreach. Creation of Non-RN team leadership environment

2007- 2009- Washington St. DOH/Qualis Diabetes Learning Collaborative.

2009-2011- Washington St. DOH/Qualis Learning Collaborative for PCMH model development

2010-2011 Team-based LPN- led InBasket management for HAC (McKesson)-EMR

2011- Chronic Disease Management program for Childhood ADHD utilizing IHI Chronic Care Model

2012- Group Visits for Childhood Obesity

2012 to the Present-Development of Interdisciplinary Integrated Mental Health program as part of PCMH

2013- Group Visits for Childhood Obesity in Spanish

2013- NCQA PCMH recognition, Level II

2013- Development of standardized Clinician/MA huddle

2013- Group Visits for Chronic Pain

2014 Group Visits for Eating Disorders

2014- Development of the standardized rooming checklist, adopted by PeaceHealth’s PCT (primary care transformation) team

2015- Registry Development and structured Care Coordination for HIV patients, leading to reduction in viral loads/CD4 counts

2016-2018- Participant in WPRN (WWAMI Practice-based Research Network) Grant project, Health Hearts Northwest. Participating with UWSOM, OHSU Medical School, multiple residencies and community practices in the 5 state WWAMI (Washington/Wyoming/Alaska/Montana/Idaho) region, with aim of cardiovascular morbidity and mortality reduction.

2016-2018- Participant in PHMG ACT Advisory Committee. This is the group working with Robin Virgin, MD and Eric Blake to create the system practice changes required for CPC Plus in Oregon, and PCMH (Patient Centered Medical home) development, for which PeaceHealth received a multimillion dollar TCPI grant from CMS

2017, October- NCQA PCMH recognition, Level III

**Disease Management / Chronic Care Model programs, including Anticoagulation Management, Diabetes, Medical Management of Chronic Pain. All are Interdisciplinary, LPN-managed. Ongoing since their development and launch.