Specialties and departments

The clinical model mirrors the real Bingham service catalog: 57 specialty groups and 16 hospital-department groups, wired so access scales by nesting rather than per-share lists. Built by make specialties (on top of make clinics).

Specialties (57 groups, nested under Clinicians)

Every clinical service line is a security group, and all of them are members of the Clinicians meta-group. That single nesting means any specialty member reaches the phi share transitively, with no per-share edit. Specialties are groups only (no per-specialty share); team file shares exist for the original clinics and the departments.

Addiction-Medicine, Anesthesiology, Arthroscopic-Surgery, Athletic-Trainers, Autoimmune-Medicine, Bariatric-Surgery, Behavioral-Health, Cardiology, Dentistry, Dermatology, Diabetes, Emergency-Medicine, ENT, Endocrinology, Family-Medicine, Functional-Medicine, Gastroenterology, General-Surgery, Gynecology, Headache-Migraine, Hormone-Sexual-Health, Integrated-Medicine, Internal-Medicine, Interventional-Radiology, Laboratory, Mens-Health, Midwifery, Nephrology, Neurology, Neurosurgery, Obstetrics, Oncology, Ophthalmology, Orthopedics, Osteoporosis, Pain-Management, Pathology, Pediatrics, Pharmacy, Physical-Medicine, Plastic-Surgery, Podiatry, Primary-Care, Psychiatry, Psychology, Pulmonology, Radiology, Rheumatology, Senior-Life-Solutions, Sleep-Medicine, Sports-Medicine, Thyroid, Urgent-Care, Urology, Vascular-Care, Weight-Loss, Womens-Health, Wound-Care.

Departments (16 groups, nested under Hospital-Operations)

The hospital’s operational units are distinct from outpatient specialties. They nest under a Hospital-Operations meta-group (which is itself under GH-Staff, so department staff read the all-staff share). Each gets a gated team share.

Admissions, Business-Benefits, Case-Management, Community-Health, Nutrition-Services, Education, Emergency-Department, Hospitalist, ICU, Infusion-Therapy, Laboratory-Services, Professional-Training, Pulmonary-Rehab, Radiology-Services, Same-Day-Surgery, Therapy-Services.

The nesting, and where the PHI line falls

Generated from the live group memberships by make diagrams (counts and the GH-Staff members reflect the actual directory):

flowchart TB
  spec["61 specialty + clinical-dept groups"] --> Clinicians
  Clinicians ==>|gates| phi(["[phi]"])
  dept["16 hospital departments"] --> HO["Hospital-Operations"]
  nAdministration["Administration"] --> GH["GH-Staff"]
  nBilling["Billing"] --> GH["GH-Staff"]
  Clinicians["Clinicians"] --> GH["GH-Staff"]
  HO["Hospital-Operations"] --> GH["GH-Staff"]
  nIT["IT"] --> GH["GH-Staff"]
  nMedicalRecords["Medical-Records"] --> GH["GH-Staff"]
  GH ==>|gates| allstaff(["[all-staff]"])

The patient-facing departments (Emergency-Department, ICU, Hospitalist) are nested under Clinicians too, so they get PHI. The back-office departments (Admissions, Education, Nutrition-Services, and so on) are only under Hospital-Operations, so they read the all-staff share but not patient records. That mirrors the real-world line: an ICU nurse sees PHI, an admitting clerk does not.

Why groups but not 57 shares

Adding a specialty is one group plus one nesting edge. Membership is what gates PHI, so a new specialty inherits the correct access with zero new ACLs and zero new shares. Shares are reserved for teams that actually share files (the original clinics and the departments). This is the same lesson as the HIPAA boundary, now proven at 57x scale: when gregory.house was added to the brand-new Nephrology group, he could reach phi immediately, because Nephrology is under Clinicians.