Clinical Component

Navigating the Clinical Component

The clinical work at this practice runs heavier than a typical Family Medicine panel. Patients arrive with multiple active diagnoses, often presenting like Internal Medicine cases despite the FM framing. You will spend most of your time managing chronic disease, complex polypharmacy, and the cardiovascular, endocrine, and renal comorbidities that come with an older, underserved population in the Central Valley. The Medical Director describes the patient mix as "everyone who comes through the door has at least five diagnoses attached to it."

Practice Setting

You practice on the 4th floor of the Dignity Health Medical Group building, attached to Mercy Medical Center Merced. The floor houses primary care alongside cardiology, orthopedic surgery, ENT, and an incoming urology service. Specialist consultation happens by walking down the hall. The one-stop clinical environment is one of the more distinctive features of the role.

Patient Mix and Acuity

Category Detail
Patient ages Adults and geriatrics; no pediatric base
Average diagnoses per patient 5 or more
Payer mix Roughly 50% Medicare and Medi-Cal, 50% commercial
Commercial sources Local employer groups including police, fire, sheriff, county, and hospital staff
Common conditions Hypertension, type 2 diabetes, COPD, CHF, CKD, hyperlipidemia, obesity, depression, chronic pain
Language needs Spanish support available; cultural and language diversity reflects the Central Valley

The local market has long been underserved. The clinic has been working to grow its commercial book through targeted outreach to employer groups, including a Saturday-only commercial clinic. New patients see "next available" with most providers; Dr. Tabrizi runs three months out.

Procedures

Dr. Tabrizi will personally train you on procedures you want to add to your practice. The clinic operates a dedicated procedure room and stocks the equipment for whatever scope you want to build. You decide how procedural you want to be; there is no set minimum.

Current procedure offerings include:

  • Joint injections
  • Skin biopsies and lesion excisions
  • Incision and drainage
  • IUD insertion and removal
  • Subcutaneous contraceptive implants
  • Allergy injections
  • PRP therapy

If you want to add procedures the practice does not yet offer, the equipment will be ordered. Dr. Tabrizi mentors hands-on alongside the APPs and is open to building out the procedural scope.

Call

There is no call schedule. The hospitalist service admits and manages inpatients. For occasional urgent results, providers self-cover through the EMR; this is not a structured rotation and does not require coming in after hours.

Clinical Support

You work alongside a 4-provider APP team and dedicated MA and LVN support. The APP team supervises through Dr. Tabrizi and Dr. Quach for the APPs who require oversight.

Role Function
APP team (4 providers) See their own panels; serve as primary care for their patients
MA Rooming, vitals, triage, basic intake
LVN Quality measure follow-ups for uncontrolled hypertension; expanding into diabetes education and exercise counseling
Referrals team Manages incoming and outgoing referrals

The LVN workflow is one of the practice's more useful features. For uncontrolled hypertensives, the LVN sees the patient first, takes the BP, runs through the education and lifestyle review, and then you spend the last five minutes of the visit confirming the plan and adjusting medications. The same model is rolling out for diabetes.

Specialty Access

Direct same-floor access to:

  • Interventional Cardiology (5 cardiologists; do some general cardiology as well)
  • Orthopedic Surgery (1 surgeon, 2 more starting July)
  • ENT (Dr. Carter, part time)
  • Endocrine Surgery
  • Urology (in active recruitment)

For specialties not on site, referrals flow to broader CommonSpirit network providers and community partners.

Quality Program

Quality measures are tracked and tied to the annual quality bonus. The current measures are:

  • Hypertension control
  • Diabetes control
  • Medicare annual wellness completion rates
  • Patient experience scores

Targets are percentile-based, with higher payouts as you move further above the threshold. The LVN-led workflow is designed to help you hit these marks without adding to your visit time.

EMR and Technology

Tool Status
EMR Cerner; transition to Epic underway, projected over the next several years
Dictation Dragon
AI scribe Pilot underway with Augmedix and Abridge; Augmedix is the current provider preference
Imaging and labs Onsite, downstairs through the hospital; Quest also contracted; all results in EMR
Pharmacy No onsite pharmacy; patients use community pharmacies of their choice

Teaching and Academic Environment

Mercy Medical Center hosts the Merced Family Medicine Residency Program, an 8-per-class, 24-resident program affiliated with UC Davis. UC Merced is also building out its medical school nearby. Residents currently rotate primarily through the affiliated Family Care Clinic rather than this primary care suite, but informal shadowing is available for residents who request it. The clinic leadership is working to bring residents into a more structured rotation through the suite.

If teaching is something you want to be part of, there is opportunity to engage, though it is currently informal rather than a credentialed faculty role.

Practice Culture

The team protects the chemistry of the group carefully. Dr. Tabrizi screens every candidate personally and uses a two-step interview process: a formal interview followed by a lunch with the APPs and DO. Candidates with attitude or poor bedside manner do not make it through. The culture is collaborative, humble, and patient-first, with an open-door dynamic between physicians, APPs, and support staff.

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