Constantly looking for ways to improve the traditional delivery of health care, the Mount Sinai Division of General Internal Medicine has developed several innovative models that provide for highly coordinated and multidisciplinary care to patient populations that often find themselves outside the mainstream.

A case in point is the creation of a comprehensive obesity management program directed at individuals from disadvantaged groups that disproportionately struggle with weight issues, who often find it difficult to access appropriate clinical services. Aware of that void, the Division of General Internal Medicine at Mount Sinai Morningside and Mount Sinai West opened a clinic in the fall of 2023 under the direction of Rebecca Shafer, MD, a certified obesity management physician. Known as the Center for Healthy Weight Management, it is believed to be the first of its kind in the New York metropolitan region and is being run in partnership with Ryan Health, which has been providing a wide range of medical services for the past 50 years to underserved communities in Manhattan.

“We’ve developed a unique way to integrate an obesity management program into the primary care setting in order to give patients access to a specialized program they wouldn’t normally find at the community level,” said Fernando Carnavali, MD, Associate Professor of Medicine (General Internal Medicine) at the Icahn School of Medicine at Mount Sinai, and Chief of General Internal Medicine at Mount Sinai Morningside and Mount Sinai West. “We’re focused on medication management, nutrition support, education, and mental health, all of which are closely aligned with the broad-based model of care the Ryan network has so successfully brought to the community.”

The framework for this newest program began taking shape more than a year ago when Mount Sinai hired a physician with fellowship training in obesity management. The Division of Internal Medicine is now grooming a number of residents pursuing primary care tracks to also become certified in that field. At the same time, points out Dr. Carnavali, these clinical trainees are gaining valuable exposure to underserved populations and public health services by working alongside specialists at the Ryan sites, which include clinics and community outreach centers offering adult medicine, women’s health, mental health, pediatrics, and other specialized forms of care.

The concept of a seamless health care environment for the community also figures heavily in the key role General Internal Medicine is playing in the recently opened Mount Sinai-Behavioral Health Center in Lower Manhattan. Specifically, the $140 million facility co-locates on its second-floor outpatient psychiatry services with a primary care practice equipped to manage a full range of patient morbidities—an unusual and novel partnership by traditional health care standards.

“Our goal was to bring primary care to a community on the Lower East Side of Manhattan where access to such quality services is sparse,” notes Leonard Amoruso, DO, Assistant Professor of Medicine (General Internal Medicine) at Icahn Mount Sinai, and Chief of General Internal Medicine at Mount Sinai Beth Israel. “Now, while patients are visiting the psychiatry clinic, they could walk down the hallway and have a same-day appointment with a primary care doctor for health care screening, routine labs, or many other services they wouldn’t normally get, given the fact that mental illness often stands as a barrier to general medical care.”

In addition to creating innovative new approaches to health care delivery, the Division of General Internal Medicine takes pride in its ability to recruit in a post-pandemic world a rich crop of professional talent for its faculty and trainee ranks. “Amid all the competition, we’ve been capturing people from all over the country, as well as from our own hospitals,” says Juan Wisnivesky, MD, DrPH, Drs. Richard and Mortimer Bader Professor of Medicine and System Chief of the Division of Internal Medicine. “We’re securing the future of our entire department by drawing people with fresh ideas and strategies on how to make health care work for growing populations of patients.”