What is a Residency Clinic and How Does It Help Your Primary Care Experience?

Featuring: Jonathan Bechard
In 2013, Eisenhower Health established a residency program, training new physicians in Internal Medicine and Family Medicine. The Center for Internal Medicine program is now at full capacity with more than 50 first, second and third year residents in training.

Dr. Jonathan Bechard, Medical Director at Eisenhower Center for Internal Medicine, discusses treatment options available at a residency clinic and how the clinic operates.


Jonathan Bechard, MD, Board Certified in Internal Medicine, oversees the Center for Internal Medicine at the Eisenhower Health Center at Cathedral City - North, where physician residents see patients in the Internal Medicine Residency Clinic. In addition, Dr. Bechard is seeing patients at the Eisenhower Health Center at Rimrock in Palm Springs. After receiving his undergraduate degree at Loma Linda University, Dr. Bechard went on to earn is medical degree at Loma Linda University School of Medicine. He then completed a residency program in internal medicine at Michigan State University.

Learn more about Jonathan Bechard, MD


Bill Klaproth (Host): Five years ago, Eisenhower Health established a residency program training new physicians in internal medicine and family medicine. The Center for Internal Medicine Program is now in full capacity with more than 50 first, second, and third year residents in training. Here to tell us more about the residency clinic is Dr. Jonathan Bechard, medical director, Eisenhower Center for Internal Medicine and Eisenhower Health. Dr. Bechard, thank you so much for your time. First off, can you explain to us how a residency clinic works?

Dr. Jonathan Bechard (Guest): Yes, I'd be happy to do that. An internal medicine residency is a program that is designed to train doctors that have graduated from medical school in an area of specialization and prepares them to get board certified in a particular area of medicine. Our particular program is in general internal medicine, so after our physicians have graduated from medical school, they go through a match process and we match 20 residents per year that come into our program, and they enter a three year training program that prepares them to independently treat patients in internal medicine and pass their boards so they can enter private practice and have a seamless and enter a successful career in medicine.

Bill: So, this gives residents practice in actual patient care where everything is overseen by an attending physician. Is that right?

Dr. Bechard: That's correct, they've done the medical school piece where they learn the basic sciences and then move on to the medical sciences and then integrate into the various aspects of medical healthcare, and then once they're on their residency program, they are involved in direct patient care under the direct supervision of a board certified physician with experience in medicine, so that's the experience we provide here. We have these 60 residents who rotate through our clinic throughout the year and they develop a patient panel, which means that they have a certain number of patients that are assigned to them whom they are that patients primary care provider, and the residents are providing the direct care under the direct supervision of an attending physician who is engaged in every patient encounter with that resident.

Bill: Well I can see that day to day seeing patients would be really, really important to them, and can you tell us about your role in overseeing the clinic.

Dr. Bechard: Yes, my job is to coordinate. I have a team of staff members here that assist me so I don't do every piece myself, but ensure that our residents have a regular schedule of patients that they have availability to see their patients and that they have the clinical expertise that's overlooking and helping to provide support and guidance and direction when needed. Our ultimate goal is for the residents to be that primary person that is taking care and interacting with the patients but our attendants do also see the patients in some fashion as part of the encounter. So typically what happens is the resident will go in and begin the appointment with the patient and will gather historical healthcare information, do a physical examination, talk with the patient, and then once the resident has completed that, they will come out of the room and they will get together their information that they've accumulated and develop a treatment plan, and then they'll review that with the attending physician, and then most of the time they'll go back in the room. The attending physician will go with the resident and will interact with the patient and allow the encounter to be completed so there's direct supervision throughout the process.

Bill: So it's easy to see the benefits of this type of program for the residents. Let's flip the card. What about the benefits of the residency clinic for the community. With many physician residents, that means appointments are available sometimes same days, is that right?

Dr. Bechard: That's right, that's right. One of the things I will point out, that the whole purpose for having this residency clinic here in the Coachella Valley is to improve our opportunity for attracting and retaining highly qualified physicians in our community for our patient population. Right now across the nation there is a lack of enough physicians for everybody and that's contributed to a lot of wait times and difficulty for patients getting access to physicians when they need it. So Eisenhower has decided to participate in this residency program to help, hopefully, ensure in our future that we'll have enough physicians for our community. The way our program is setup, we have nearly 60 residents in our program right now, so we have got a lot of capacity to see patients on the same day or the next day, and our primary goal is to link patients with a specific resident so they have that one point resident that they're establishing their care with and can establish a relationship and see them when they need them. Since they're in a training program, there are times when they're on rotations or on leave or might not be available every single day, and what we've developed is a small team of residents, or grouping of residents. So if, for instance, a patient who's established with resident A calls in and says, "I need to be seen this day because I've got a problem that needs to be addressed today." Most of the time we'll try to get them linked up with that specific resident, but if we can't then there's a team member physician resident that can see that patient. So we feel like we've got a high quality product and the ability to adapt to the needs of our patients.

Bill: And the benefit of this again, and it sounds like if they come in and they see a team member, if resident A isn't available, again all appointments are overseen by the attending physician.

Dr. Bechard: That's correct, yep. So often times, even if there wasn't continuity with the resident, which is the exception not the rule, then there's often continuity with the overseeing attending physician. I'm not the only one that does it. I'm the Director and I do participate daily with the supervision, but we also have seven or eight additional attending physicians who come through our clinic and oversee the residents as well so there's a great opportunity for patients. Also, the attending physicians here, we have attending physicians that have expertise in infectious disease, and HIV care, chronic hepatitis C management, rheumatology, so that is the background of some of these attendings, so we have the capability to assist with the care of many patients.

Bill: So many different specialties, and for someone who wants to use the clinic, what type of insurance do you take?

Dr. Bechard: Our program follows the insurers that Eisenhower accepts, which includes most PPO and private insurance plans. We are also a member of the Desert Oasis Healthcare Network, so we can see patients that are under that umbrella program within our clinic.

Bill: And Dr. Bechard, you oversee the location in Cathedral City, which is the Eisenhower Center for Internal Medicine, but Eisenhower Health also has a family medicine residency clinic at La Quinta. Can you briefly tell us about that?

Dr. Bechard: Sure, I'd be happy to. The main difference between internal medicine and family medicine is that family medicine is also a primary care specialty that designed to address the healthcare needs of the entire family and typically provides care from birth all the way up to geriatric and senior end of life. Internal Medicine is primarily focused on adult medicine, so we don't take care of pediatrics or obstetrics and internal medicine is typically the launching pad for specialties such as cardiology, nephrology, pulmonary medicine, infectious disease, things like that, so we're kind of the foundation for specialty care. The family medicine program is located in La Quinta and they have a beautiful clinic there and an excellent program that is an option for patients that are interested in the family medicine program.

Bill: Well Dr. Bechard, thank you so much for your time, really great information. To learn more or to make an appointment at the Center for Internal Medicine, please call 760-837-8993. That's 760-837-8993. You can also visit eisenhowerhealth.org, that's eisenhowerhealth.org. This is Living Well with Eisenhower Health. I'm Bill Klaproth, thanks for listening.