Sunday, November 17, 2013

"Rural" Family Medicine

One of my required rotations is to do a month in "rural" family medicine in Missouri. I am doing my rotation in my hometown which I can't really consider rural with 70,000 people, but none-the-less I am really enjoying it. I have moved in to my grandparent's guest room for the month and have actually been able to be part of my family.  I go watch the little ones dance 2 times a week, go to the gym with my mother, and take care of all of those things I keep putting off like the dentist. Several times a week (when I have the time) I turn my grandparent's living room into my craft room and have watched more night time TV in the last 2 weeks than I have in the last 5 years. (I really kind of like Elementary.) Surprisingly, I feel even busier now that I am home then I did when my hours at the hospital were twice what I am putting in now. I thought I would be swimming in time, but atlas that is never the case.
Not to say that I haven't been spoiled, because I definitely have. The physician I have worked with for the last couple weeks starts at 9 in the morning, takes an hour lunch, and then finishes no later than 5 in the evening. Not to mention his half day on Thursdays.  Even with the shorter days and later mornings, I still have learned a great deal in the last couple weeks. I see more patient and see more of a variety in a day than I would in my normal adult clinic in a month. I have found one of my week spots, orthopedics. He sees so many sports medicine type patients and not only have I learned how to decide on imaging but there is a whole different world of medicines out there for people who have insurance.
Everything about this clinic makes me enjoy it. I have never found family medicine very appealing, but he makes family medicine look very attractive. Let's start with the general atmosphere. His whole staff gets along so well, works together perfectly, and share laughs constantly. Everyone is so laid back and interactive with each other and they were all so welcoming when I joined the team. And when I say team, I mean they are truly an amazing team. Each person has a role in the patient's care and it makes it so efficient. Patients don't wait very long to be seen and then are quickly on their way. There is no waiting around for hours. One of the other things I have really enjoyed is that the doctor treats his nurses and his students like his equals. He talks about his life and listens to our stories. We spent a half hour of our down time this week just talking about the differences in how be got where we are. We talked about how he came to decide on family medicine and his complete honesty was so refreshing. Not to mention it was nice to meet someone who has more debt than I do and is doing just fine. He is a picture of what I hope to accomplish one day. A physician who is able to take care of their patients appropriately, work as a team and have a good relationship with their nurses and techs, and still be able to go home to a family they are dedicated to at night.
So onward with what I have actually seen in the last couple of weeks. I saw the first patient I knew this week. I was completely awkward because it was a first for me. She was so much more relaxed about it than I was. Silly me.  Both me and the doctor I worked with this week had a couple, "I have no idea" moments this week. I had one lady come in with tingling in her hands and feet, but no diabetes and had already been tested for vitamin deficiencies. We are sending her on, but keeping track of her to see what rheum has to say. I realized seeing several patients that I remember a lot from boards that I didn't realized I still remembered. I saw several really adorable little ones. I must say the pen light I bought from the camping section at Walmart is the best investment I have made when it comes to little ones. They will let you do anything while they are shining it on the wall. I met my first autistic child. Broken bones, concussions, broken bones, concussions. Yep I'm an expert. Okay maybe not an expert, but I am much better than I was before. And then I got a lot of experience with changing meds on the chronic conditions that are common. And if you add on acute illnesses, allergies, infections, well checks, depression, ADHD, pain, memory difficulties, and strange bumps you pretty much have my 2 weeks. Did I mention I got to see a lot?
Come Monday I switch to a different physician and have to start getting up at a normal time again. I am hopeful it is as useful as the last couple weeks.

On and just 37 days and a few hours to Christmas. I am very behind!

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