Departments

Our program, focused on adult primary care, is known for its excellence and emphasis on prevention and wellness. We efficiently manage potential medical problems as they arise, and collaborate with specialists when needed. Our practice includes internal medicine physicians, advanced nurse practitioners, a clinical psychologist, a social worker, registered-nurse patient care coordinators, licensed practical nurses, medical assistants, clerical office staff, and a practice supervisor. Our goal is to provide patients with the highest quality, personalized healthcare in the Patient-Centered Medical Home (PCMH) model of care. The PCMH model of care focuses on five areas: Building strong, collaborative health care teams that work together to meet the needs of patients Providing patient-centered care addressing the whole person, respecting patients’ values and preferences Coordinating comprehensive health care through clear communication among patients, families, caregivers, medical and behavioral health providers, hospitals, and other facilities Improving patients’ access to care, through such initiatives as expanded office hours and providing email access to electronic medical records Improving health care quality and standards by providing evidence-based care, patient and family education, and self-management support We would like to hear your direct feedback regarding your experience as a patient/family member of our clinic. Please visit the YIMA Patient/Family Comment Box to provide your feedback. Sign up for MyChart , our secure online patient portal, that gives you access to all of your Yale health information whenever you need it, wherever you may be.

Since 2003, asylum seekers requiring a medical evaluation have been referred to the Yale Center for Asylum Medicine (YCAM) by attorneys from law schools, including Yale, the University of Connecticut, and Columbia, as well as human rights groups, including Physicians for Human Rights, HealthRight International, the American Friends Service Committee, the Center for Immigrants and Refugees, and Integrated Refugee and Immigrant Services, among others. These applicants describe experiencing unlawful detention, torture, harassment, domestic violence, female genital cutting, and homophobic hate crimes and come to the United States to seek safety and build a new life. The Center’s trained clinicians perform a forensic medical interview and examination to document physical and psychological scars and functional impairments. These objective findings are presented to immigration authorities and judiciary members in the form of an affidavit and/or testimony. Medical students, residents, and fellows assist YCAM faculty as they perform medical examinations of asylum applicants at Yale School of Medicine or a nearby detention facility. Trainees complete formal training to assist with evaluations. Residents, fellows, and students at the School of Medicine and Yale School of Public Health learn about asylum medicine and local global health through lectures, workshops, trainings, and presentations on campus and at regional and national meetings. YCAM has hosted national meetings to teach physicians from the U.S. and Canada about forensic evaluations. YCAM collaborates extensively with legal and human rights professionals to advance knowledge and research in the field of asylum medicine.

At Laboratory Medicine, we study the molecular and cellular components of blood and other body fluids. This work is crucial to diagnosing and managing illness and understanding the mechanisms and origins of disease.Our physicians, known as clinical pathologists, provide consultations to other doctors regarding optimal laboratory diagnostic approaches and the interpretation of complex laboratory tests. Our team includes pathologists, scientists, phlebotomists, medical technicians, technologists, and others who perform important support functions for our state-of-the-art laboratory. We are available every day, 24 hours a day, for physicians. We perform approximately 10 million tests each year, and also provide specialized high-tech testing to other hospitals in the Yale New Haven Health System and institutions throughout New England, and as far away as Puerto Rico. We also operate multiple satellite facilities and patient service centers located throughout the state. We ensure that every test we offer—at every location—is accurate and reliable. When physicians request to have patients’ blood drawn, here is what happens: Collection: A doctor, nurse, technician, or phlebotomist will draw the patient’s blood. Several tubes may be needed for different types of tests. Depending on what illness the patient might have, his or her doctor may want to obtain a urine sample, throat swab, or other sample. After the sample is collected, the container is labeled with the patient’s name and other information. The sample is received and processed by the Laboratory, and testing begins: Chemistry Testing Blood and other bodily fluids are tested for chemicals, drugs, and substances that indicate disease. We check cholesterol and other tests for risk of heart disease, glucose to monitor diabetes, or thyroxin to monitor the thyroid gland. Hematology Testing We analyze the amount and function of blood cells and plasma. Examples include the Complete Blood Count (CBC) that tells the doctor how many cells of each type are in the patient’s blood, and the prothrombin time (PT) to measure the time it takes for the blood to clot. Microbiology Testing We test a variety of specimen samples for infections caused by bacteria, fungi, or parasites. We often do urine cultures for urinary tract infections. Virology Testing We test for viral infections. This includes rapid tests for respiratory viruses such as influenza, molecular tests for noroviruses, and antibody tests for HIV. Immunology/Molecular Diagnostics Some tests are used to determine whether the immune system is functioning properly. State-of-the-art analysis of DNA and RNA is used to test for a variety of diseases and for the risk of developing certain diseases. Other specialized tests include the ANA, used to screen for autoimmune disease, and Factor V Leiden genotyping for patients with blood clots. Tumor Profiling Laboratory This lab analyzes tumor DNA to predict the sensitivity or resistance of tumors to a

We provide expert evaluation and treatment to adult and pediatric patients across the entire spectrum of allergic and immunologic disorders. Our board-certified specialists have specific clinical and scientific expertise, and are highly capable of providing comprehensive, thoughtful care from the most common to the rarest conditions. Our physicians meet weekly to discuss the management of complicated cases. Yale has been the site of several key research breakthroughs in the field, including the discovery of new inherited immunological diseases and the development of a crucial understanding of the underlying causes of allergies. We offer comprehensive evaluation of both common and rare allergy and immunology conditions, including allergy skin and blood testing, oral food challenges, drug allergy testing, and contact dermatitis patch testing. We offer allergic rhinitis and asthma care through recommendations for environmental controls and pharmacological controller therapy, and biologic therapies for severe asthma, chronic rhinosinusitis with nasal polyposis, as well as chronic urticaria and hereditary angioedema. We have expertise in management of immune deficiencies with intravenous and subcutaneous immunoglobulin replenishment. We also provide consultations for drug allergy desensitization when needed. Among the conditions we treat are: Allergic rhinoconjunctivitis (nasal and eye allergies) Asthma Chronic rhinosinusitis Food allergy Insect sting allergy Medication allergy Urticaria (hives) Angioedema Hereditary angioedema Atopic Dermatitis Contact Dermatitis Common variable immunodeficiency Secondary immune deficiencies Our service has specific strength in the management of inherited immune deficiencies, with a dedicated service that closely collaborates with experts across other specialties. Through a long-standing collaboration with Yale Laboratory Medicine, patients have access to a broad array of state-of-the-art immunological testing. Our care for children and adolescents includes treatment for: Asthma Our doctors collaborate with colleagues in the Pediatric Asthma Program to ensure that our patients receive comprehensive asthma care, including: Evaluation, diagnosis, and management of childhood asthma for patients with varying degrees of severity Testing for allergic precipitants Mechanical analysis of respiratory function Outreach care at patients' homes when needed Allergy Testing for allergens, desensitization, and immunotherapy Allergic rhinoconjunctivitis Drug allergy Food allergy Insect venom allergy Urticaria (hives), mastocytosis, anaphylaxis Hereditary angioedema Primary Immunodeficiency and Recurrent Infections Testing for antibody deficiency, cellular immunodeficiency, and complement disorders Treatment of primary immunodeficiency diseases, including intravenous immunoglobulin therapy Evaluation and management of recurrent infections, including fungal infections

The physicians in our General Internal Medicine section are national leaders in their fields, and provide dedicated, comprehensive patient care in both inpatient and outpatient settings at several sites across Connecticut: At Yale Internal Medicine Associates in New Haven, we provide state-of-the-art general medical care for adults. At the New Haven Primary Care Consortium (NHPCC), located at 150 Sargent Drive in New Haven, CT, we provide comprehensive primary care, as well as specialized programs in traveling health, rheumatology, dermatology, podiatry, mental health, and addiction medicine. The Occupational and Environmental Medicine clinic focuses on the diagnosis, treatment, and prevention of diseases due to chemical, biological, and physical hazards in the workplace and environment. The Primary Care Center located at the VA Connecticut Healthcare System in West Haven is also a major clinical and teaching site, and provides specialized Women’s Health and stroke care. The Medicine-Pediatric Clinic is located at St. Mary’s Hospital, 133 Scovill Street, in Waterbury. The Yale Addiction Medicine Consult Services provide hospital-based addiction assessment and treatment to patients who are hospitalized at Yale New Haven Hospital. Specialized programs in dermatology, mental health, rheumatology, and health care for travelers Medical forensic exams for individuals with claims of torture who are seeking asylum in the U.S. Specialized program for the treatment of substance use disorders We are also involved in community outreach and service programs that expand the reach of our research and clinical programs. Our research programs in such areas as substance abuse, occupational medicine, and chronic disease management provide our patients in the community with a variety of opportunities to access care and improve their health. Many of our faculty members are graduates of the Robert Wood Johnson Clinical Scholars Program.

At the Yale Pediatric Infectious Diseases Consultation Program, our internationally recognized team of clinicians focuses on treating a wide array of viral, bacterial, and parasitic infections. Through our outpatient clinical services, we diagnose and treat infectious diseases in children. In addition to HIV/AIDS, tuberculosis, and Lyme disease, our doctors are experts in: Acquired and congenital infections in newborns Infections in immunocompromised patients Fungal infections Respiratory tract infections Tropical medicine and parasitology Transplant ID Outpatient consultations in Infectious Diseases are provided at The Children's Hospital at Yale New Haven, the major teaching hospital of the Yale School of Medicine. Appointments require a referral from a Primary care provider. To schedule a consultation, physicians should call the YM CARE Center at 1-877-925-3637 (1-877-YALE MDS).

We provide preventive and urgent health care to children and adolescents in the greater New Haven community. Our pediatricians work in the Yale New Haven Hospital Pediatric Primary Care Centers at three locations: York Street, St. Raphael campus, and at Chapel Pediatrics in Hamden. We offer routine vaccinations and wellness exams, screening for childhood illness, and positive parenting support and programs. We also have particular expertise in handling conditions that occur during adolescence. Our physicians are highly trained and committed to advocating for children. In our offices, we see children with Husky or commercial insurance, and offer a sliding scale for those without insurance. In our specialty programs, we treat infants and children with a broad range of childhood problems, including: Developmental and behavioral disorders Physical and sexual abuse Rheumatologic conditions, such as arthritis and lupus

Covering every aspect of health care for adults, Internal Medicine is the largest department in the Yale School of Medicine, and the largest clinical service at Yale New Haven Hospital. We provide comprehensive and specialized services in all areas in a variety of outpatient settings as well as the Veterans Affairs (VA) Connecticut Health Care System campus in West Haven. Our culture of collaboration and research gives patients access to expert opinions from nearly 1,000 doctors, as well as opportunities to get tomorrow’s health care today through more than 100 clinical trials. Most importantly, we attend to our diverse community of patients with compassionate, thorough care. Specialized care is offered in the following areas: Allergy & clinical immunology Cardiovascular medicine Digestive diseases Endocrinology General internal medicine Geriatrics Hematology Infectious diseases Medical oncology Occupational health & environmental medicine Nephrology Pulmonology, critical care & sleep medicine Rheumatology International reputation for work in understanding function, independence, and quality of life in older persons Key research breakthroughs of the past decade that include the development of a protective Lyme bacillus disease vaccine, exploration of the underlying causes of allergic disease, and the discovery of novel inherited immunological diseases Largest interventional cardiology program in Connecticut Major referral center for patients with type 1 and type 2 diabetes, as well as other metabolic conditions Nationally ranked program in kidney diseases and the largest kidney transplant program in New England, with multidisciplinary care clinics One of the largest peripheral vascular programs in the country, with leadership and participation in multiple new percutaneous device trials Once of only a few motility centers in Connecticut to provide all motility procedures and services Unique medical forensic exams for individuals with claims of torture who are seeking asylum in the U.S.

Our multidisciplinary group of physicians and health providers are committed to providing state-of-the-art therapy to our patients with hepatitis B and hepatitis C infections. We have a 50-year tradition of excellence in liver research and patient care, and continue to be international leaders on the study and treatment of liver disorders. As a partner of the Yale School of Medicine Liver Center, one of only four liver research centers in the country sponsored by the National Institutes of Health, ours is the premier program in Connecticut offering comprehensive patient care for individuals with viral hepatitis. The key to effective disease management of acute and chronic viral hepatitis is our coordinated care among specially trained physicians, as well as a specialized nurse who provides teaching and psychological support. We enjoy close relationships with specialists in adult and pediatric gastroenterology, transplant hepatology, medical and transplant nephrology, transplant surgery, gastrointestinal pathology, diagnostic and interventional radiology, gastrointestinal surgery, rheumatology, OB/GYN, medical and surgical oncology, infectious diseases, the AIDS Care Program, psychiatry, and addiction medicine. The Gastrointestinal Pathology program at Yale is the only subspecialty program of its kind in Connecticut, and provides expert consultative services for the most challenging liver pathology examinations in the region. We partner with Yale New Haven Hospital’s Nathan Smith Clinic in the management of patients with HBV/HIV and HCV/HIV co-infections, and with the Yale Liver Transplant Program in the pre- and post-transplant evaluation and management of patients with liver cirrhosis and end-stage liver disease. We have four areas aimed at improving treatment and outcomes for viral hepatitis: Education: Providing formal education classes and individualized instruction sessions for patients with chronic hepatitis C infection prior to the initiation of antiviral therapy Treatment: Maintaining high standards of practice in treatment protocols and close coordination of care with referring physicians to provide the most advanced and scientifically based approaches to the management of viral hepatitis Research: Ensuring the opportunity for patient access to novel approaches in the treatment of viral hepatitis and liver disorders through clinical trials Community outreach: Building relationships with the surrounding communities of Greater New Haven and Connecticut to raise awareness about viral hepatitis, and to promote screening and education Special services offered by the Yale Viral Hepatitis Program include: Weekly multidisciplinary patient care conferences and liver pathology conferences to draw upon the varied expertise of our Yale Medicine physicians Coordination with the liver and kidney transplant programs Comprehensive services for diagnostic and interventional GI endoscopy, percutaneous and trans-jugular liver biopsy, paracentesis and trans

Our internationally recognized team of clinicians focuses on treating a wide array of viral, bacterial, and parasitic infections. Through our outpatient clinical services, we diagnose and treat infectious diseases in children from throughout New England and the Mid-Atlantic states. In addition to HIV/AIDS, tuberculosis, and Lyme disease, our doctors are experts in: Acquired and congenital infections in newborns Infections in immunocompromised patients Fungal infections Respiratory tract infections Tropical medicine and parasitology

Yale Medicine serves as Connecticut’s premier primary immunodeficiency center for pediatric and adult patients. Primary immunodeficiencies, also known as inborn errors of immunity (IEI), present with features involving a disruption of the body’s immune system. The alteration of the immune system can lead to various clinical manifestations, including recurrent infection, autoimmunity, hematopoietic malignancy, lung disease, and enteropathy. These conditions are caused by monogenetic and polygenetic defects or epigenetic changes. We focus on the evaluation, diagnosis, and management of patients with primary immunodeficiency through in-depth genetic and immunological laboratory tests. In addition to patient care, our group works through research to help advance our understanding of immunodeficiency.

Our uncompromising faculty and staff are dedicated to the welfare of children and adolescents. One of two major pediatric centers in Connecticut, Yale offers an extensive range of services for patients through our 14 specialties. In addition, we have several interdisciplinary centers and programs that involve collaborations with multiple departments throughout Yale Medicine and Yale New Haven Children’s Hospital. Thanks to our reputation for comprehensive pediatric care, we serve as a regional and national center for referral and consultation. Many of our physicians are internationally recognized for their innovative approaches to the diagnosis and treatment of conditions including arrhythmias, diabetes, cystic fibrosis, childhood cancers, juvenile diabetes, dyslexia, blood disorders, infectious diseases, and complications of premature birth, as well as many other disorders. We are leaders in the global pediatric community, advocates for childhood health and development, and innovators in research. We rank among the top pediatric centers in the country with respect to National Institutes of Health support for research. Neonatal and pediatric ICUs that serve our most vulnerable patients with the highest level of care 24/7 subspecialty telephone consultation service for primary care clinicians with expected response time of three minutes More than 20 years of experience with neonatal and pediatric Extracorporeal Membrane Oxygenation, a sophisticated machine that acts as an artificial heart and lungs, crucial for some seriously ill infants One-call center that provides centralized appointment scheduling for all pediatric specialties Close collaboration with other Yale departments to provide such services as molecular and genetic diagnostic services, state-of-the art management of high-risk fetuses and newborns, bone marrow transplantation, and management of complex malignancies