Family Medicine!

Next up was Family Medicine! I was excited to start this rotation, but I didn't know just how much I would like it. It was all outpatient clinics (meaning not in the hospital) and I would see a patient, listen to what was going on and do a physical exam, and then present my findings and plan to a faculty physician or resident. I realized that I love education and disease prevention, which is a big part of Family Medicine. I learned about Community Medicine which is sort of a branch of Family that is involved in community health, advocacy, social programs, and improving patient care among many other things. I got to see patients of all ages, from newborn babies to 98 year old ladies and that was really fun. I liked not having any patient population excluded. I got pretty excited about it so Family has definitely made the list of fields I may pursue! There are a variety of settings you can work in, and the training is really broad which excites me. I met doctors who chose their own hours and had a great family life which is really important to me. The more I learn about it, the more I get excited about it, so we will see if that's where I end up! Here is my essay from Family Medicine...

"In the first few months of my clinical training, I have spent most of my time learning about how to recognize signs and symptoms of diseases and how to treat them. I have also learned a lot during my Family Medicine rotation about disease prevention, patient education, and health maintenance. I get excited about figuring out a diagnosis, deciding what steps to take next, and counseling patients. It is exactly what I’ve been waiting for, the chance to practice medicine. However, over the past few weeks of Family Medicine, I’ve recognized that not everything is quite so black and white. Often there are financial, social, spiritual, and educational barriers to healthcare that require flexibility and sensitivity on the part of the physician. It is just as important to find out about those issues as any other part of the encounter. If a healthcare professional does not take the time to ask about different aspects of a patient’s background, then the rest of their plan of care may not matter because a patient may not follow it. Or, they may cause unnecessary emotional strife by being insensitive to a patient’s beliefs or level of understanding.

Many patients I saw this month had financial difficulties that prevented them from receiving the textbook treatments for their disease. It was often necessary to look at the Walmart $4 prescription list to choose medications that would be feasible for a patient to purchase. The five minutes it took to figure out which medications would fit a patient’s financial needs made treatment possible. Sometimes though, patients had multiple comorbidities, so even the $4 medications would add up and a patient was left deciding which medication was the “least important.” Before I jumped to labeling a patient as noncompliant, it was necessary to figure out WHY they hadn’t been taking their medication. After hearing that paying for prescriptions took a huge percentage of a patient’s monthly income, I suddenly became much more understanding and less judgmental of their “noncompliance.” Furthermore, some patients had difficulty finding transportation to their appointments or figuring out how to get childcare. It is easy to tell a patient to come back to do fasting labs or to follow up in two weeks without recognizing how big of a request that may be. Socioeconomic status also affects a patient’s ability to follow certain diets, especially when they have to provide for the needs of children. It is imperative to be aware of these issues and to be ready to counsel patients on less expensive ways of achieving their goals.

Education level also affects the way a patient responds to their disease or treatment plan. It is easy to take for granted that a patient would understand what kind of diet they should follow as a diabetic, when a patient may think they only need to avoid candy or coke. Also, certain conditions carry stigmas in different cultures, so the way information is presented to a patient with those beliefs is so important. I’ve learned that cultural competence, socioeconomic awareness, and being educated on social issues are going to always be a big part of my career. I need to work hard to learn as much as I can about the community I practice in and the resources available around me."