Monthly Archives: October 2015

An Insider’s Perspective: What really happens when you go to the Dr.

We’ve all been there. We make an appointment to go see the doctor and it seems like a quarter of the day is gone by the time we leave. The majority of the time is spent waiting in that little room, sometimes clothed, sometimes wearing just an itchy paper gown with nothing to do but flip through old magazines or listen in to the sounds of the hallway just hoping the next footsteps are someone coming to see you. What you may not know is what really happens. Here is what your Dr.’s day looks like:

You check in downstairs with your insurance card: The moment you check in our fancy computer systems tell us you are here. Your name turns green. Sometimes we are still finishing up our notes from the last patient so we have just a few minutes to review why you are here and any past visit information and what we talked about last. If you are lucky and the system works like it should, everyone came for their appointment at the exact time they were supposed to (no one missed their bus, ran late because of their babysitter or couldn’t find what street the clinic was on), they stayed for exactly 15 minutes and there was nothing additional that needed to happen–this is the first time you’ve seen a doctor in a year, but we know you only have one thing to talk about so of course we won’t need to discuss additional issues that came up or health screening tests that you missed. Who are we kidding? This is life. Patients are late. Medical issues can become complex. And we are the type of doctors who want to help. The reality is, 3 or 4 patients turn green at the same time. We do our best.

You are sitting in your little room and a stranger with a white coat knocks on the door: If you are being seen at a clinic associated with a teaching hospital there is a high chance the first person to see you is a medical student. Before you roll your eyes or look annoyed that you’ve been waiting in this room for 15 minutes and now you are forced to speak with just a medical student I ask you to consider a few things.

You came to a teaching hospital because you likely know we practice cutting edge medicine, you have access to world renowned care and we accept all patients (those with excellent insurance and those with none). Yes, a medical student is in the early stages of their training and they can’t write you a prescription today. But what you’ll get by speaking with a medical student is their undivided attention, a propensity to seek out every detail of your health concerns, meticulous attention to every possible “red flag” and the strongest desire to really listen to you. If the medical student wasn’t here you’d probably be sitting in the room alone for another 15 minutes and the next person to come in may not have the time to probe as deeply into what you’ve been feeling. Medical students know more than you think, often times there is only one year that separates them for the title of MD. So when we walk in the room and introduce ourselves as “student doctors” give us a chance. It’s actually your lucky day! After we leave you, we’ll condense what we just talked about into the key things that are truely “worrying” and help the doctor focus when they come to see you. You are getting two visits in one! When the Dr. enters the room they will already know everything about you and can spend time explaining the plan to you or ask additional pertinent questions to help us arrive at a diagnosis.

Someone has completed their exam on you and states please get dressed and we’ll be back to talk:  It’s always great when we can tell you not to worry and that what is happening is likely benign or the medication is doing its job. Those days we jump for joy! The hardest thing we ever have to tell a patient is that there is something wrong with them. That part, I imagine, will never get easier.

As a medical student on my Ob clinic rotation I recently experienced that moment of dread. Standing in the room performing our routine exam, the resident and I exchanged a knowing glance. We both knew what had happened–there was an intrauterine fetal demise. Our pregnant patient’s baby was dead. This information was hanging in the room, dark and suffocating. For seconds it wasn’t real. It wouldn’t be real until we said it. Those moments of disparity of information–when you know something that will change a person’s life forever is a heavy burden. We want to ease you into it. To help you through it. It is hard for us, please remember that. There are dark moments in medicine and our job turns simply to easing your suffering. These are the toughest things we do all day.

The next time you are waiting, annoyed, please forgive our inefficiency. Sometimes your 15 minute visit becomes more complex. Sometimes we notice red flags that need our attention and we end up catching something before it’s too late. Sometimes patients need our undivided attention and care. You are important to us. When it is your turn to need more than 15 minutes, we will be there for you too.

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Filed under Rotations

Ob/Gyn Life

To my neglected blog and readers, let’s catch up!

I successfully finished my psychiatry rotation with a clear understanding that psychiatry is not for me. It was the first rotation I’ve been on, where I wasn’t excited to go to the hospital. Work actually felt like work. The hours were wonderfully short in comparison to hospital life yet the days dragged on. I can’t put my finger on exactly what it was that didn’t appeal to me–in theory, psychiatry is fascinating– but it just didn’t grab me. Feeling ambivalent about your day is the surest way to cross a specialty off your consideration list. Done and done forever.

In comparison, this past week has been invigorating. I started my obstetrics and gynecology rotation and I am loving life. Driving in when it’s still dark out, seeing the sun rise above the hospital and knowing that I’ll be scrubbing in on gyn surgery, while the rest of the world is just waking up makes me feel alive. I love when things are happening–the busier the better. I like the fact my patient progress note is due by 6:20 am because we have a full day of surgery ahead and who has time for rounding. I love how hands-on everything is. It’s true, my back is killing me from standing and I arrive home too exhausted to cook dinner. Somedays, the thought of going upstairs is too much to bear and I end up falling asleep on the couch. The physicality of it is tough. It’s also tough to imagine going through life being this tired. But despite how draining the day is, I feel so incredibly fulfilled by what I am doing. I think that in a nut-shell is the dichotomy of medicine.

This past week, I’ve had time for exactly one thing–surgery. Unfortunately, that means my singular interest consumes my life. For two weeks, my marriage can easily handle that but much longer and I can see why doctors have such high divorce rates. I have a great husband who’s picked up dinner, vacuumed the house and even woke me up with Starbucks this week. But eventually, he’ll want a wife again. But this is the point of 3rd year of medical school– you get to put yourself in the life of various specialties and try on that life. Spend a few weeks walking in their proverbial shoes and see if you can handle it. We’re all looking for that perfect pair that fits just right. So far, I’ve felt most comfortable in my Emergency Room sneakers 🙂

In any case, I digress, I have 5 more weeks of ob/gyn which will include two weeks of clinic and two weeks of nights/days on Labor and Delivery service. What makes the rotation manageable are 4/6 weekends off and a dedicated lecture/study day on Fridays. This is the first rotation where I’ll be graded not only on my medical knowledge and interaction with patients but my (limited) technical surgical skills. Perfecting various suturing and knot tying techniques is certainly a new challenge for me–but it’s also really fun!

That’s it for now. I am quite literally too tired to write more. Until next time!

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Filed under Medical School Experience, Rotations