After finishing the first 4 weeks of my Family Medicine rotations for 3rd year, I have taken home an extremely important lesson. Your patients will reflect to you the respect and responsibility you give them. I had the pleasure of shadowing Dr. Mahoney all day Friday, and I could see that his patients were extremely respectful to the MA's and to him. They were happy to be there, they brought their medications, their blood sugar charts, and had honest life-style changes to report to him. Every time Dr. Mahoney entered the room, he immediately sat down to see eye-to-eye with the patients, asked about their personal lives, checked in about their families, etc. He also took time to teach them and explain his thought process regarding their health and care. He ran 10-15 min late with every patient so he had to catch up during lunch, but people were understanding and never angry at him for this. Most of his patients are doing very well and making such amazing progress.
I'll contrast this to another physician at Brookside, who spends more time at his desk than with the patient, and as a result never runs late, but also has patients that don't seem to care about their health, have an attitude of entitlement and get angry very quickly if they don't get what they want. After working with this physician, I went home and literally cried. I felt like my whole world had been turned upside-down- I was supposed to love Family Medicine but I felt like completely eliminating it from my list after spending time on that side of the clinic. Yet after a couple of days with Dr. Mahoney, and after talking to him about this phenomenon, I realize that patient behavior is largely physician-dependent. No matter what field I decide to enter, this rule will apply.
Brookside is a community clinic next to Doctor's Medical Center, San Pablo. The patients are mainly insured by Contra Costa County/ Medi-Cal, although the clinic does have protocol for seeing uninsured patients and immigrants. This week they began the extremely difficult task of switching from paper records to electronic medical records, which will be necessary for almost all clinics in the future. My last day was Friday and they had not yet started using the EMR in the rooms with patients, but I am sure they are in for a bit of a rocky transition. There was a lot of stress and frustration regarding the training sessions from the MA's and Physicians. For this reason, I don't think it would be very helpful for me to talk about what my daily schedule was like for any 2nd year or 1st year readers- it will most definitely be different by the time you rotate through.
One thing that will remain the same is the primarily Spanish-speaking population, so if you have a good grasp on your Spanish skills, you'll thrive! If you are still working on it, like me, people are happy to help you learn. I have been working through Rosetta Stone, but its helping only a fraction as much as actually spending time with Spanish-speaking patients. I really hope I have time to do a traveling rotation at the end of my 4th year so I can immerse myself in a new culture and be forced to use my Spanish 24/7.
In other news, I am still on the fence about Family Medicine v. PM&R, although in recent weeks I have leaned more in the direction of Family Medicine. On the personality assessments, PM&R keeps coming up for me ahead of Family Medicine, but not by much. When I take time to deliberate over the pros and cons, I usually end up thinking I should do Family Medicine. I think its hard for me to decide because I could probably end up loving what I do no matter which path I take. There are a few things I know for sure:
1) I love OMT, and must be able to use it in residency and subsequently in my practice.
2) Similar to #1, I have a special interest in Neuro and Musculoskeletal systems. This interest is apparent to my preceptors and I notice that they tend to call me in with them to evaluate complaints related to these systems.
3) I want to be the kind of physician who can give my patients the time they need, and I also want to eventually have time to be a good wife, mom, relative, friend, and to take care of myself. To me this is the definition of living a meaningful life.
I picked TUCOM-CA for medical school because it was a direct and solid fit for me, and I am sincerely hoping I can find a way to do that for residency. There is so much anxiety for me about this right now because I am in the middle of trying to schedule my audition rotations. Hopefully the remaining ones will be scheduled with ease and at the right programs for me.
In other news, my parents are coming to visit this weekend! And I don't think I posted about this yet, but we found a wedding venue we like! Unfortunately we pass the # of guests we can afford with just family alone, so I don't know how we're going to handle the guest list. Lets just think about that one later, shall we? haha.
