Family medicine philosophy is active listening and patient education. Therefore, even in a setting of high patient volume I did my best to make sure my patients leave room having an idea of how to take a proactive approach to their health.
Having implemented a structure to a student patient care I have learned from my ER preceptors, I took on a full responsibility for every patient I took on from the moment I greet them to the moment I set up their follow up appointment. At Dr.Dairo’s clinic, once she approved of how I conducted the visits, I had a full autonomy and acted as a full on provider which was very empowering.
An interpersonal challenge I’ve encountered was some communication issues with my preceptor as she never really clearly laid out her expectations of me, so I had to adjust and learn by observing. After some time, I was able to document my own treatment plan in the clinical records which was a step up from every other rotation I had before and a great learning experience.
A memorable patient experience I will carry from this rotation was with an older lady that had a pan positive review of systems. She was very demanding and anxious and talked a lot. I listened and tweezed out every complaint, interrupting when needed and redirecting with leading questions that gave me answers I needed (thanks Dr.Davidson and the Interviewing and Counselling course), then did a thorough complete physical exam on her. I pulled up visuals on the computer to educate her about HDL and LDL and a physiology of gallstones so she can understand why her pain can be right sided or left sided. At the end of her visit she grabbed my hand, looked me in the eyes and said “You will make a great doctor. You know, you have a talent for it. This job is not for everyone”. I told her that actually I am a Physician Assistant, and the mere existence of this profession allows us to have this experience together since, because doctors often take on a a role of the final decision makers, they are very busy and may physically not have time for such an extensive patient education session like we just did. That moment made me realize once again that I chose a right profession and I enjoy doing what I do so much.
My approach to patient care was a bit different from my preceptors. I liked explaining patient’s conditions to them and emphasized on things they can do to improve rather than the things they should stop doing since that’s something most of them already know. For example, I recommended implementation of more whole foods plant-based meals into their diet, shared accessible information resources and did my best to make them feel inspired for a change.
I learned about myself that I was lacking patience before – having practiced in Urgent Care and ER I got accustomed to high pace critical thinking environment, so Family Medicine took a bit of adjustment at first. However, I later realized I have been practicing Family Medicine without knowing it for quite some time now with my loved ones as I’m always excited to share health promoting strategies with my friends and family so, in a way, my patient encounters felt like talking to old friends.
Improvement needs to be made in the time efficiency. Prioritizing thoroughness turned me into a pretty time-consuming provider. On average I got to see 7-9 patients a day, which, in a setting of learning was relatively fine, but I do understand that once I become a practitioner, my patient volume will have to be double if not triple that so I need to learn how to save time. However, I believe that in a family medicine setting, once the initial connection is established, the subsequent visits should not take as long.
