Coming into this rotation I was eager to see what being in an out patient office would be like. I was excited to see how the relationship with the patients and other staff members would be. What I learned in my first week was that family medicine could be super overwhelming. The amount of patients seen in one day is more than you could expect, and you need to manage all aspects of the patient. Although I was coming from the emergency room, the volume and fast pace of family medicine was entirely different and was something that I had to get used to. Family medicine is much more broad and has less of a teamwork approach. There were two medical assistants who were very helpful and friendly, but when it came to physical exams and treatment plans it was me and the doctor alone. I missed the team based practice of the emergency room, but what I did appreciate was the relationships I formed with the other staff members, the doctor and even some of the patients who I saw a few times over my five week rotation.
As I continue in rotations I continue to gain confidence in my abilities and with my interactions with the patients. This time, one of the important skills I gained was interpreting routine lab work and giving results to the patients. This included A1C, cholesterol levels, CBC and urinalysis. I got better at providing educational information regarding maintaining healthy diets, exercise and medication compliance. Many of the patients were not compliant with their treatment plans and learning how to impress the importance of taking care of their health while maintaining a level professionalism was something I picked up very quickly. I went in the room with the doctor a few times and adapted what she said to the patients to how I wanted to speak with them.
I also got to practice drawing blood, which I did on a daily basis and am grateful that I now feel much more comfortable with that skill. When I first started I was always nervous to do it but over time I got better and more confident. I remember there was once a patient who requested to have the medical assisstant draw her blood and not me. I completely understood where she was coming from and was not insulted. The medical assisstant that she requested has been working at the office for over 20 years and had way more experience than me. This is something that I will take with me to all my rotations. Sometimes people will request someone else. It doesn’t mean that I am incapable or say anything bad about me. At the end of the day, the most important thing is to maintain patient comfort in all possible ways. This is just the surface of the skills I gained, which also includes preforming EKGs, spirometry tests and of course conducting a physical exam. One skill I did not get to practice was pelvic exams and pap smears which I hope to experience in a later rotation.
As I remember my didactic year I recall learning the importance of professionalism, bedside manners and making your patients feel comfortable. That was something I tried very hard to focus on and always tried to be friendly and calming to the patients. Multiple patients mentioned that I was gentle when taking blood, very calm and made them feel comfortable. They mentioned that I was very professional. I was proud to see that what I was doing was making an impact on the patients who I encountered and this is something I hope my preceptor noticed.
As I mentioned, many of the patients were not compliant. It was easy to lose sight of the fact that some patients lack the education that medical professionals have and sometimes they cannot make better choices for themselves. Sometimes I wondered why they cared so little about their health instead of spending the extra time to educate them. This is something I wish to work on in my future rotations. I would like to remind myself that patients typically do the best that they can for themselves based on their situations and knowledge base and that is where I can come in to help and educate them.