Well 4 weeks of vacation (and a US tour later) I am back to rotations but not back home. After going to Nebraska, Chicago, making a road trip from LA to Portland and going to Little rock arkansas, I am back in Portland for 4 weeks doing my elective in family practice and today was my first day....
I flew in last night at 11:45pm then by the time i picked up my car and got settled into my new place I got to bed around 1:15am. Then i woke up at 5:45am so i could be at the clinic for 7am only to find that the receptionist told me wrong and i didn't have to be there until 8. I sat and got familiar with the office and then had some coffee. The doctor came in at about 8, we chatted for a bit and then I shadowed her for the day to see how the clinic runs [and mostly learn how to fill out the electric medical recorded computer system...paperwork, charting, insurance, etc etc]. Dr. X [not real name...obviously] is an awesome doctor and a great lady. She went to Western and was an OMM fellow and is now working in a group practice. She did a residency in family practice and she also incorporates OMM into her practice.
We started off the day with a women wellness exam [a pap smear....like i haven't seen enough of those] and then had a couple older ladies come in to check on their blood work. they both had diabetes and high blood pressure...i think this might be a trend for this rotation.
Then the most important part of my day came... I saw my first adult male patient. Since I have only done OB/GYN, peds and then vacation...after 17 weeks of my 3rd year i finally was a student doctor to an older male. And when we asked what we could do for him today, the first thing that comes out of his mouth...he needs a refill on his viagra. and that was my introduction to males. haha
I was told for lunch a drug rep was coming and got excited cause that means free food...and its usually damn good food. Then, i was even more excited when the drug rep came and i discovered it was a very good looking, talk, dark haired, very handsome man in a suit. He was around my age and wasn't wearing a wedding ring....he taught us about a new diabetes drug and we ate panera. i can see why drug companies only hire good looking people and i dont think its a coincidence that this GUY came into be the rep for this clinic that has all female employees [except for one doctor]. they know how to play their cards right...
by the end of the day i was becoming more comfortable with the doctor and i think she was starting to relax a little more around me because we started to joke around with the staff. a couple patients cancelled so we had a lot of down time in the afternoon and got to chat a lot more. Overall we saw 7 patients from 8:30 to 1pm and then only 3 in the afternoon.
What i noticed today was most of the patients smoked, heavily smoked. It was interesting to see them truly struggling with their addiction. One lady was 14 days into quitting while another 68yo lady who was well aware that she needed to quit and sounded very logically about wanting to, just couldnt. it has such a grasp on people and even though they smoke over a pack a day and their health is drastically deteriorating over it, they just cant find the motivation or drive to quit. i am struggling with how i can counsel these patients in the future knowing it is such a powerful mental obstacle to have to overcome.
overall i really liked my first day and have yet to completely rule out family medicine. im wondering if as time goes by i start to really enjoy it. dr. x really knew each of her patients and couldnt stop telling me reasons why she loved her job.
i dont have to be there until 8:30 tomorrow but i think i will go to bed now so i can get a solid 10 hours of sleep :)
good quote from the day:
"Mr. X, Have you been short of breath at all?" -doctor
"no. Well... I was the other day, but that was after climbing a mountain" -patient
where's my shout out????????
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