ZSFG Primary Care

About the Richard Fine People's Clinic

The Richard Fine People's Clinic (RFPC) provides care for over 30,000 patient visits each year, serving approximately 8,000 individuals, most of whom are low-income and have complex medical conditions. The clinic is staffed by UCSF faculty from the ZSFG Division of General Internal Medicine and Internal Medicine residents from UCSF’s Primary Care and Categorical Residency Programs. Additional support is provided by ZSFG, including nurse practitioners, nursing staff, behavioral health specialists, nutritionists, medical evaluation assistants, and clerical personnel. Pharmacist services are offered by faculty, residents, and students from the UCSF School of Pharmacy.

The clinic utilizes Epic, a comprehensive electronic health record system integrated with hospital data, encompassing notes, medications, allergies, lab and diagnostic results, as well as an electronic referral and consultation system.

Clinical Services

Every RFPC patient is assigned a Primary Care Provider (PCP), ensuring continuity of care and enabling residents to build longitudinal relationships with their patients. To support residents in delivering care, RFPC employs a team-based model that includes a practice partner, a primary attending preceptor, a resident continuity nurse practitioner, medical evaluation assistants, behavioral assistants, and clerical staff dedicated to each team.

RFPC offers a comprehensive range of services, including primary care, urgent care, telehealth visits, nurse triage, nutritional counseling, pharmacist consultations, and behavioral health services. With nearly 30% of its patients managing diabetes, the clinic has prioritized chronic disease management through programs like registry support, nurse care management, group visits, and referrals to the Wellness Center at San Francisco General Hospital.

As a core clinic in Healthy San Francisco, the city’s universal access to care program, RFPC collaborates with its sister clinic, the Family Health Center, and various specialty services to develop co-management programs. These programs aim to improve care for chronic conditions such as diabetes, asthma/COPD, chronic low back pain, and congestive heart failure.

Hours of Operation

The clinic is open from 8:00 a.m. to 9:00 p.m., Monday through Friday (5:00 p.m. to 5:00 p.m. on Fridays)

Special Features

Patient Diversity

RFPC serves a highly diverse patient population with significant medical and social complexities, including many individuals from vulnerable and underserved communities. The clinic frequently provides care for patients discharged from ZSFG inpatient wards who lack established primary care providers. 

By race/ethnicity, RFPC's patient population includes 39% Latino, 24% Asian, 18% White, 14% African American, 2% American Indian/Alaska Native, and 1% Native Hawaiian/Pacific Islander. The vast majority of patients are low-income and face multiple chronic illnesses, such as diabetes, heart disease, arthritis, depression, and cancer, alongside psychosocial challenges.

Approximately 10% of patients experience homelessness, 25% have a history of substance use, and 45% of female patients report a history of domestic violence. Nearly half (48%) speak a primary language other than English, and less than 50% have adequate functional health literacy. Many patients also face psychiatric illnesses, poor social support, and barriers due to low English proficiency. The patient population reflects immense linguistic diversity, with over 60 languages spoken, emphasizing the clinic's commitment to serving a wide range of communities.

The primary insurance coverage of RFPC patients is distributed as follows: 49% are covered by Medi-Cal, 22% by Medicare, 12% by Healthy Worker (a program administered by San Francisco Health Plan for providers of In-Home Support Services, Public Authority, Homebridge, or temporary exempt San Francisco employees), 9% by Healthy San Francisco (for uninsured adults in San Francisco without access to affordable health insurance), 6% are uninsured, and 1% have commercial insurance.

Approximately 20% of RFPC patients are hospitalized at ZSFG at least once annually, a rate similar to that of older Medicare patients. Additionally, 23% of RFPC’s patients are aged 65 or older.

Excellent Teaching Environment

RFPC has consistently been recognized as one of the top sites for resident continuity clinics by UCSF residents over the years. While the complexity and fast pace of patient care can be demanding, attending physicians are readily available both on-site and after hours to offer consultation and guidance.

Residents’ clinical experience is further enriched by daily pre-clinic conferences that address a wide range of outpatient medicine topics. Additionally, RFPC benefits from a team of experienced and dedicated nursing and clinic support staff who play a vital role in enhancing the learning experience for residents.

Quality Improvement

RFPC is deeply committed to quality improvement and actively encourages resident and fellow participation in enhancing our care processes. Resident-led projects have focused on critical areas such as colorectal cancer screening, women’s health and cervical cancer screening, weight management, Hepatitis C, advanced directives, and other significant clinical topics. RFPC provides each primary care provider with individualized quality metrics on a quarterly basis.

Research

RFPC offers access to both clinical and non-clinical data for its diverse patient population. Residents, fellows, and attending physicians wishing to conduct research involving RFPC patients must seek approval from the RFPC Medical Director or Nurse Manager, as well as other relevant members of the Division of General Internal Medicine at ZSFG. For more information, download the detailed process for applying to RFPC for research studies here.

San Francisco Health Network

RFPC is part of the larger San Francisco Health Network (SFHN), which includes a network of clinics and hospitals committed to providing quality healthcare to all residents of San Francisco, regardless of immigration status or insurance coverage. To learn more about the San Francisco Health Network, click here.