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Family Medicine Shadowing

Discussion in 'Nontraditional Students' started by Holderlin, Aug 17, 2011.

  1. Holderlin

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    My God what boredom

    I would say that 75% of these patients need psychologists/life coaches and physical trainers.

    The only people that really needed to be seen were:

    a) elderly
    b) diabetic
    c) needed antibiotics which was signaled by a clear pain symptom

    The Doc I shadowed was the nicest guy in the world, and he'd been doing this for like 22 years, since he was 28. I couldn't believe his judgement reservation skills. I was there for ten minutes and I wanted to bring in Tony Robbins to slap these people and tell them to go workout and do something with there life. "Why does your back hurt!? Why are you depressed? Because you don't do anything, and you're fat!"

    Don't get me wrong. I wanted to help these people, but a Family Medicine Physician was not what they needed. Maybe I would have been referring more of them out or something. I mean he was doing things things like, "Are you still having depression? Maybe we should put you back on Paxil hun?" And I was thinking, "really? Just like that? 'depression?' This lady needs to talk to someone."

    Anyone else get a similar impression? Should I still be a doctor?
     
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  3. FTFY

    5+ Year Member

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    :laugh:
    So, I take it you gained a valuable lesson from this experience in that you do not want to be a family medicine doctor... or a psychologist.

    I actually really like family medicine. I enjoy the variety of problems and the challenge of dealing with all of the body systems, but I find I most enjoy the conversations. I notice that most people visiting the doctor may not have an acute issue that needs to be addressed, but for some the doctor is the only place they can voice issues that would otherwise go unaddressed. Of course there are those who make seemingly unnecessary visits to the doctor, but they are being proactive in their own way by making an effort. While one may not be able solve a lot in the span of an office visit, it is through repeated and followed up efforts in combination with referrals to a strong network of specialists that one can hopefully make a difference.

    It is a tough field though and is not for everyone. It is especially trying due to long hours, on call, and significantly less reimbursment as compared to the specialists. But, one takes the good with the bad. Maybe it's the doctors I've shadowed, or my time working in clinic, but it's a field where I've found that if one appreciates the small things, then one will find fulfillment.
     
  4. FutureDrB

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    I'll admit, I have the same reservations about working with adults and that's why I'm planning on going into pediatrics. Kids can't help their ailments. Sorry, but most adults are just morons.

    I have a problem helping people who come in for treatment and don't understand why they are sick... come to find out they smoke 2 packs a day, drink like a fish, and/or live on McDonalds.

    I don't think you're alone in your feelings. In fact, I would bet the majority of physicians want to knock some sense into their patients...at least under these circumstances.
     
  5. theseeker4

    theseeker4 PGY 3
    Physician 7+ Year Member

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    Unfortunately, that is what a doctor sees the most of. The people who don't take stupid risks, don't abuse illegal drugs/alcohol/food/their bodies/etc. are the ones who don't need to go to a doctor most of the time. The stupid decisions made by people keeps physician salaries high because there would be much lower demand for medical care if they didn't make these stupid decisions.

    Unfortunately, you will run into a lot of the same with pediatrics. Sure, the stupid choices are often on the part of the parents, not the child, but they are stupid decisions you cannot just directly confront all the same. More so than with adult patients, since if you confront the decisions of the parent and they walk out, they are removing their innocent child from your care, not just themselves.

    The biggest challenge for me will be to redirect my frustration. I am sure I would love to say "Look you moron, if you eat >5,000 calories a day you will continue weigh >500lbs, and until you loose the weight your knees will continue to hurt because you are crushing them!" at certain points, but I will need to learn to address my patients in the way most likely to convince them to change their behavior. Getting them pissed at me and walking out won't help me do my job and won't help their health. You have to go into medicine knowing that many of your patients will simply not follow your advice, will not take medication and will not take care of themselves. And some will blame you for their failing health after refusing to follow your advice for years.

    I believe the patients I actually can help will make up for those I can't, either due to inadequate technology or non-compliance. If not, I will probably be miserable, but it is a chance I am more than willing to take, and I can't imagine it will make me less happy than not being a doctor makes me already :D.
     
  6. Holderlin

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    Good way to look at it, and I think half the time I was thinking like this. But the other half I was thinking "Wow, no wonder America/The West seems to be in decline. These are grown-ass people and they are absolutely incapable of actualizing their will. Pathetic."
     
  7. MT Headed

    MT Headed snow, PBR, and bears
    Lifetime Donor Classifieds Approved 2+ Year Member

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    I had the opposite experience. I shadowed FM in a rural clinic and in an urban under-served center (well, at least what qualifies for "urban" in a state where our biggest metropolis has 100,000 people). It was a blast.

    The patients from all walks of life generally had an acute reason for being at the clinic. Splint my leg, sew my arm, test my blood, plan my pregnancy, renew my prescription, etc. Even the chronic alcoholics knew how and why they were there; one of them introduced his chief complaint as "well, doc, what I really need to do is go back in time 30 years and stop drinking". At least the doctor and the patient are on the same page!

    I see an underlying theme of obesity in the other posts. I wonder if that is the biggest issue (no pun intended). We get a lot of hard smokers and hard drinkers up here, but everybody is still thin and active.

    There is another half to my statement "I had the opposite experience" - I don't like hospitals. As a patient, as an EMT, and as a visitor I've never once been in any hospital and thought to myself "yeah, this is where it's at". I imagine this could cause some problems in third and fourth year. I am applying to a lot of medical schools with rural tracks.
     
  8. Dayzie

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    You should probably avoid geriatrics too..... grandma sometimes just wants somebody to talk to, after all, and that nice doctor always listens to her. ;)

    In all seriousness, though, I sort of feel that same way about the ER.
     
  9. Holderlin

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    It's good to see some more perspectives.

    I just don't think I could work for 8 years to ride my bike to the clinic to hold some girls hand, and give her tissues, while she cries after I tell her that I can't give her any more oxycodone.

    And that's kind of ironic given my epic youth. I'm VERY familiar with the sadness that comes when a doctor tells you to that Advil will have to do.;)
     
  10. Holderlin

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    Yeah I've heard the ER can be even worse. I mean those people wont even make an appointment.

    And you know, I'm not a misanthropic, tee-totalling, lame dork who sits at home in a padded room with a helmet drinking tea, judging everyone. I'm down with people having fun and making bad decisions. I'll be there to patch you up, and send you where you need to go. It's the people who've seemingly given up on life that drive me crazy.
     
  11. Catburr

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    I completely feel you on this. However, on the rare occasions when someone in that kind of rut pulls themselves out and changes up their whole routine, it's extremely rewarding.

    Still up in the air myself about whether the occasionally would be enough to keep me sane...
     

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