Family Medicine – Day 1

Family medicine is probably the core rotation that I am most curious about. I’m curious about how I will feel working in it for a relatively extended period of time and I’m curious if what I’ve envisioned working in primary care could look like is the reality (I keep rereading that sentence to see if it makes sense). Primary care is kinda the whole reason I decided to go into medicine. I loved the idea of having loooong-term relationships with my patients, to really get to know them, to be the person they trust above all other doctors. I want to be the doctor that my patients come up to while I am with my family in Costco just to say hi. I want to be able to prevent my patient from getting disease, not just treat it when it happens. I want to be able to teach them about their bodies, and work with them depending on their individual situations, life experiences, world view, to figure out a plan that aligns with their goals and values. Today, I got a glimpse, and I’m excited to see more.

The morning was all just orientation. Getting my badge, doing paperwork, learning how to sign-in to the EMR, etc. Apparently I get free lunch at the primary medical center which I took advantage of after orientation especially since I won’t be going there often. I got a bit of a tummy ache with the pasta, but the lunch ladies were all so nice maybe I’ll go back just to say hi.

After lunch I had a little extra time and got some studying done at Starbucks and then made my way over the clinic to meet my preceptor for the day at 1 PM. When I go there I really had no idea what the plan was so I just checked in at the front desk and was told they would notify the administrator and they would come get me soon. I waited about 15 mins, at which point I went back to see what was up, concerned that the doc was expecting me. The MA at the desk said, “Oh they are in a provider meeting, someone will come out when they are done.” In my head, I was just like “??? you couldn’t have told me that earlier so I’d have some idea of a timelines.” I just went back to studying in the waiting room. Couple minutes later someone came out, one of the administration assistants and I guess the head EMR guy there, he said he would give me a tour of the facilities while the provider meeting was going on. The medical plaza was impressive for what it was. There was relatively high capacity for primary care (at least it seemed that way) as well as on-site availability for labs, specialty care, and some imaging.

We finished up the tour and I was introduced to my preceptor who apparently was only finding out in that literal moment that I would be working with her that afternoon (she was having difficulty moving due to some apparently extensive sun burns down her legs which was a repeat source of some [sympathetic] comic relief throughout the day). She was very nice and welcoming, and I was told during the tour she was one of the family med docs who also specializes in high risk OB which I thought was interesting. Turns out she’s a whole ass badass (a WABATM if you will). I mostly followed her through the afternoon, but in that short time we basically did everything. Pediatric well-child checks, hypertension follow-up, OB superimposed on a neuroendocrine disease, severe eating disorder, low back pain with narcotic addiction, she was even consulted by the other doc there for management of some lactational mastitis. I was a whirlwind and she handily dealt with it all, jumping from patient to patient, knowing their stories and their situations. For one of the well-child checks she gave birth to this patient and watched him grow up and works with both the parents. She still takes call to do deliveries and even performs C-sections.

Oh and did I mention half the patients were Spanish-speaking and to my untrained ear she sounds basically like a native speaker (which I don’t think she is but I could be wrong).

It was really impressive to watch her work and to work with her (she also really reminded me of my aunt who is also in family medicine and has a similar way with patients and is multilingual). I don’t think I’ve ever been this impressed with a provider. All the one’s I’ve worked with in the past have been good and knowledgeable, but just the sheer breadth of what she is able to do and manage with the competence was really remarkable. No only does she have to know a lot of medicine, but she has to actually apply all of it on a daily basis. What I saw today was why I came into medicine and why I envisioned myself in primary care. I came out of the clinic more motivated than ever. I guess we’ll see how it holds up over the next 5 weeks and working with a few different physicians.

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