Northwest Tucson CBOC, Tucson, AZ

Northwest Tucson Community-Based Outpatient Clinic
2945 W. Ina Rd
Tucson, AZ 85741
Southern Arizona VA Health Care System
Tucson

Externship Supervisor
Robert D. Spruance, OD, FAAO
Phone: (520) 792-1450 ext. 3427
Fax: (520) 838-3656
Email: robert.spruance@va.gov

Program Description
In July 2007, the Southern Arizona VA Health Care System opened a new 10,000 square foot community based clinic in urban Tucson.  The clinic scope of care includes Primary Care, Optometry, Mental Health, Social Work, Laboratory, Physical Therapy, and Nutrition.  The Optometry Clinic consists of two exam rooms, an auxiliary test room, and fundus photography room.  New equipment includes the following:  exam chairs, instrument stands, phoropters, Haag Streit slit lamps, pachymeters, Humphrey Visual Field Analyzer, OCT Stratus, auto lensometer, autorefractor, Topcon Fundus Cameral, and a full assortment of diagnostic fundus and contact lenses.  Staff includes one full-time optometrists and one full-time ophthalmic assistant.

Under the direction of the attending optometrist, externs will have the opportunity to provide comprehensive eye care with access to the computerized medical record system including the ability to order interdisciplinary consultations, medications, lab work, and imaging studies (CT, MRI, and Ultrasonography).  There is an excellent working relationship with the primary care physicians and nurse practitioners.

Patient Services Provided

  • Primary care
  • Gatekeeper for all eye-related consultations including walk-in and urgent-care cases such as red eyes, sudden loss of vision, foreign bodies, ocular pain
  • Anterior Segment
  • Plethora of clinical conditions including infections, inflammations, degenerations, dystrophies
  • Wide variety of topical and some oral medications can be prescribed
  • Glaucoma diagnosis and treatment
  • Optometry manages all non-surgical glaucoma patients
  • Wide array of therapeutics available
  • Posterior Segment
  • Diabetic retinopathy, macular degeneration, peripheral retinal abnormalities, retinal vascular diseases

Educational Objectives

  • Increase ability to perform advanced procedures such as gonioscopy, scleral depression, peripheral 90D exam
  • Integrate key concepts from didactic courses into clinical setting
  • Increase decision making and management ability

Prerequisites for Externs

  • Current on vaccinations; CPR certification required.
  • Complete required VA forms prior to starting rotation.

Demographics

  • Mostly middle aged to elderly males
  • Majority of patients are Caucasian
  • Minority representation of Hispanic, African American, Asian, and Native American
  • Socioeconomic status variable
  • Patients typically have multiple medical problems; there are frequent ocular diagnoses of cataract, glaucoma, diabetic retinopathy, age related maculopathy

Extern Responsibilities

  • Provide prompt, quality eye/vision care
  • Complete accurate patient records in computer system in a timely matter
  • Review pathophysiology and treatment of disorders seen in clinics and presented during didactic activities
  • Externs are not required to bring any equipment; a white clinic jacket is optional
  • All equipment, including condensing lenses, provided

Faculty Responsibilities

  • Provide feedback
  • Identify strengths and weakness & suggestions for improvement
  • Conduct didactic activities
  • Provide formal evaluation in the middle and at the end of rotation

Miscellaneous Information

  • Normal clinic hours are Monday through Friday from8:00-4:30, although urgent care and charting may occasionally result in staying later; no Saturday or Sunday clinic
  • At least 9 scheduled patients per day Monday thru Friday excluding one-half day for  didactic activity
  • Online medical reference databases, including Medline, access at each CBOC in each exam room
  • Can contact librarians for articles at Tucson VA medical library

Clinic Hours
8:00am to 4:30pm Monday through Friday, closed Weekends

Clinic Schedule
Externs are scheduled approximately 35 to 40 patient visits per week with 1 half day a week devoted to educational activities.


Housing

Not provided (see below)

Equipment Required

None; optional white clinic jacket


Housing
Housing is not provided.  Numerous apartment complexes near by clinics

Additional Requirements
Automobile required.

Parking
Free parking at all sites.

Patient Population
Predominantly a geriatric population with common ocular problems of glaucoma, macular degeneration, diabetic retinopathy, anterior segment disease, cataracts, peripheral retinopathies, etc.

Directions
Clinic is located in Tucson approximately 9 miles northwest of the main hospital facility.


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