The department consists of approximately 1,200 faculty, 350 residents and fellows, and a staff of 400. Over the past decade, the department has experienced significant growth in both its clinical and research mission with a total operating budget exceeding $300 million. The clinical practice represents more than 50% of the department’s operating revenue. In line with Yale Medicine, the Department of Internal Medicine is furthering the ambulatory COVID-19 recovery planning tailored to the specific needs of our diverse clinical practice. Each section has developed plans as outlined within Yale New Haven Health guidance for provider-based sites and within Yale Medicine guidance for our office-based locations. Important areas to be addressed include: social distancing within practice sites; PPE needs; availability of clinic staff; availability of provider staff (faculty, APPs, trainees); impact of telehealth on patient engagement; potential financial impact of telehealth/payer mix; and future telemonitoring needs. These plans are to ensure that the department’s extensive clinical practice continues to meet the needs of both our external and internal stakeholders while also continuing to monitor the financial consequences of this paradigm shift in delivery of care.
The research efforts of the Department of Internal Medicine have grown significantly during the 2019–2020 academic year. More than two-thirds of the department’s faculty are actively involved in research, spanning the spectrum from clinical outcomes and epidemiologic studies to translational and basic science investigations. The department is the single largest research unit at Yale University, with a total of $124 million in sponsored funding.
Under the leadership of Vice Chair Mark A. Holter, CMPE, CPA, the department is restructuring the business office through centralizing operations to alleviate the operation manager’s burden and create an infrastructure solely dedicated to financial management and reporting. The creation of a centralized business unit falls in line with School of Medicine initiatives to develop model business office recommendations.
Pandemic Response
Due to the pandemic, many of the department and section staff were dismissed from campus on Friday, March 13, 2020. They were instructed to vacate their offices and work from home until further notice. Holter, along with section-dedicated operations managers and human resources personnel, developed a work-from-home plan for staff. Challenges included the need to supply and distribute laptops and other equipment to employees as quickly as possible. Many staff took on additional responsibilities to assist with tasks that arose during the pandemic, such as the department health survey. Excellent service continuity was maintained while operations moved to remote locations.
The finance team was asked to update budget projections at the start of the pandemic, with the possibility of budget cuts and a hiring freeze looming. Department finances were affected due to revenue losses because of the shift in patient volumes, as well as budget cuts. Recruiting for open positions was put on hold and a hiring freeze was instituted.