Dick’s greatest achievements were his role in the creation of the General Medical Clinic at San Francisco General Hospital, now named the Richard Fine People’s Clinic (RFPC), and in establishing the Primary Care Residency Program.
Before the Clinic, patients who were in the Hospital were discharged with no follow-up.
As one of his colleagues says in Biker With A Moral Compass, “There weren’t clinics so you’d hospitalize a patient with diabetic ketoacidosis then you’d wave goodbye. See them again in the emergency room or see them in the morgue. That’s no way to practice; the Clinic was essential for us.”
The revamping of primary care according to the vision of Dick Fine was what made this clinic amazing. Also remarkable was his ability to see the effectiveness of outpatient care for management of chronic conditions like hypertension, diabetes, and coronary artery disease.
Dick had a major role in creating general medicine and ambulatory care, with continuity of care for patients and ongoing relationships with their providers. He started teams before there were team teaching, team rounds incorporating the nurses, the residents and the physicians for each patient. He helped change how people view American medicine and care. He wanted others at San Francisco General to realize the need to improve the availability of care. Dick committed his life to inspiring support for the concept of healthcare as a right.
