Family medicine is a six week rotation, and for the first two weeks I am in New Orleans at the Tulane clinic. For the last four weeks I am headed to Eglin Air Force base outside of Destin Florida to do the military thing.
I quickly learned in the first couple of days that having an Internal medicine rotation under my belt is a huge advantage in Family. If you know how to deal with a sick diabetic patient in the hospital, then it is only a matter of readjusting your guidelines and mannerisms to manage the ambulatory patient in a clinic.
The Doc I am with at the Tulane clinic is a rock star, one of these guys that remind me of the kung fu professor I had in college, seems that no matter what you ask him there is a sense that the answer will be awe inspiring. The best part is that he loves to teach. The way it works is a patient comes in, the nurse sees them first, puts the chart next to the door. I then read the chart, go into the room by myself, talk to and examine the patient, then I leave and present the patient to the doctor. I tell him what I think is wrong and why, I also tell him what I think isn’t wrong and why and how I think we should treat it. Then he gives me feedback, mostly on my treatment plans, after that we both go into the room and see the patient. Follow the above steps and repeat 20-30 times and you have my average day.
I have to say it’s a lot of fun getting to interview, diagnose and treat a different patient every fifteen minutes. It's kind of like Christmas, you get to keep opening new presents with new surprises and challenges. Unlike Medicine where you only get one present, you play with it for a while and eventually get bored and throw it in the corner, but because you only got one you’re forced to keep playing with it. What is also really cool about family medicine that I didn’t really realize is that you get to do everything. From delivering babies, to performing colonoscopies, if you’re comfortable with it then go ahead and do it. The best moment I had in the first couple of weeks was when we had to go to the hospital during lunch one day to check on a woman that just had a baby the other day. It took me a while to understand and appreciate that this doctor took care of the mom, delivered the baby, and now will be the baby’s doctor for maybe the next 20 years. The best part is the fact that he is the only doctor following the mom and the baby in the hospital, OB/Gyn docs have no part in it, and he does this on his lunch breaks.
If there is one rotation I have been on that is the most like the show “House” its family. But of course no where as cool as House, I’m waiting for the rotation where I get to break into houses and do brain surgery all before lunch. I have to say though that the Peds and OB part is throwing me off a bit, I get a little nervous doing a well baby exam, and making two year olds cry by sticking a scope in their ears. I wont even mention my Pap smear skills.
It is pretty awesome having an 8-5 job, no call, and getting the weekends off, maybe the opposite of medicine and surgery. No wonder they all seem so happy. However on the flip side, I do think it helps to have a strong apperception for family values to be a good family doctor. Not one doctor in that entire clinic is single, or without kids. Although the money is not bad, it’s not great, and I think there may be some other fields that I could see my being just as happy in, not to mention an additional 300,000 reasons a year. At least I am starting to get a sense that living day in night in a hospital for the rest of my life is not something I’m too fond of. An intern that I worked with on Medicine that was going into anesthesiology after his intern year put it best when I asked him why anesthesia? He said “because I like doing things outside of the hospital”. So simple, but so true!