Going from QHC’s psychiatry rotation to family medicine was a bit of a whirlwind on the first day. I learned that my preceptor was out for the week prior to when I started, so I went from learning how to triage patients with the medical assistant to seeing my own patients on the first day. In psychiatry, I rarely performed any physical exams on the patients, let alone any procedures such as venipuncture or giving injections. I did not even carry a stethoscope to prevent patients from hurting themselves or other people. On the first day of family medicine, I remember being slightly overwhelmed because I had to remember what to do for a physical exam and perform many blood draws by myself.
Throughout the rotation, I was able to practice many skills that I previously was not able to in psychiatry, including doing physical exams, venipuncture, administering injections, measuring PFTs, and more. I would watch the doctor or medical assistant perform one or two, then try myself. I was able to pick up the skills relatively fast, which surprised both the people I was working with and myself. In addition, they used eClinicalWorks, an EMR that I did not have any prior experience with. I found that navigating the EMR was the most challenging during the first week. However, with more practice, I was comfortable with the EMR by the start of the second week.
I found that I was able to speak comfortably with my patients of all ages. I had some difficulty with pediatric patients, especially during well visits because I did not know specific questions to ask, such as milestones. In addition, the physical exam for pediatrics is slightly different than adults so it took some time getting used to knowing what to do and what not to do. I would look up things I found difficult or did not know the answer to the same night to help solidify my understanding of the topic and relate it back to the patient. This is something I hope to continue doing moving forward since it is part of the learning experience to further increase my baseline knowledge of medicine. Another challenging skill was eliciting all the pertinent information from patients who had many comorbid diseases. These patients have been through a lot and have seen many things so they enjoy talking, thus I had to learn how to redirect the conversation without losing rapport and without being less meticulous to detail.
In family medicine, I saw more patients come in for anxiety and depression than I had expected. Since I rotated in psychiatry prior, I was able to build rapport with these patients and more easily encourage them to see mental health specialists, seek help, or start medication, if warranted. I was thankful for my experience because you never know when you would need the skills that you have previously learned. All of our rotations are connected in ways that we may not be aware of at first. In addition, I am very thankful to the team in the office and my patients for providing me with the opportunity to learn. The doctor, medical assistant, and clerk were all willing to teach me and the patients were more amazing than I could have imagined. Most of my patients were interested in the PA profession, would ask me questions about it, and congratulate me or wish me luck for the rest of my career.
Ultimately, I learned that in family medicine, each disease state is somewhat connected to another. For example, you have to manage both hypertension and hyperlipidemia as they relate to better goal management of diabetes. Establishing rapport is especially important as we, as primary care providers, serve as the extra push to help encourage patients to better manage their overall health.
This entry is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International license.
