Not all Family Medicine clinics are the same
Depending on the location of the clinic, the types of patients you see and the conditions you treat can vary significantly. I say this because during this rotation I had the opportunity to work in two different clinics in the same city. One was located in a rural/underserved area, the other one was in a wealthy area by the beach. The patients were so different, the diagnosis were different, and even the way patient’s were treated were different. I realized as a provider, you are an advocate and its really up to you to make a difference. In the underserved clinic, patients had a ton of chronic conditions, they took numerous medications, and came to the provider with concerns and listened to advice and did what was required to better their health. However, in the other clinic, people would deny having high blood pressure, they wanted the “magic diet” pill, and when we would mention they needed to start medication they completely went against it. Having this mixture of experiences taught me a lot about dealing with patients and how to best approach them. It was interesting seeing the different dynamics and how these two Pas treated and diagnosed their patients.
You see it all
It’s true when they say family medicine Physician Assistants do it ALL, because they really do. You go from seeing a patient with hypertension, to ulcerative colitis, to a fracture, to a diabetic patient, then a hernia or even one with all of these! Yep, family medicine patients have 284384 complaints all at once! You never really know what your day looks like, because patients come to see their provider for basically everything. You are the one in charge of many of their chronic and acute medical conditions and this can sometimes be overwhelming, but its definitely such a great learning experience. You may encounter patients with a simple complaint, yet you have to educate them, ask about all of the general preventative tests for example a mammogram, pap, CT scan, Dexa scan, and many others depending on their age and what risk factors they may have. You may also have patients with so many chronic conditions and it can be overwhelming at first.
What I loved about family medicine
What I loved most about family medicine was what I mentioned above. You learn a little bit of everything and every day you learn something new. It’s without a doubt why so many people recommend PAs to start in family medicine as new graduates, you will get such a great foundation. I also enjoyed the schedule and the flexibility, most of the time I worked 8- 4:30 PM. I loved having the weekends off and the fact that neither I or my providers were ever on call. The most rewarding part of the rotation was seeing patients at the beginning of my six weeks and then seeing them again at the end while getting to see how I contributed to their health and wellbeing. I remember a particular patient who I prescribed blood pressure medication and she came back very happy with her new blood pressure. The continuity of care is something I enjoyed from this specialty.
Connecting patients
I think family medicine providers are true healthcare heroes. They are the ones taking care of so many chronic and acute conditions for their patients. They know their patients on a personal level, and they are their best advocate. However, you will realize family medicine providers are not experts in everything, there is a time where patients need to be referred and sent to the right provider to best assist them. You will get to experience the faulty system of referring patients, getting test results, and having their problems taken care of.
Bread and butter of Family Medicine
Hypertension, Diabetes, and Hyperlipidemia will be the bread and butter of family medicine. Make sure you review these conditions completely, know how they present, how to diagnose them, what labs to order, how to treat them, what medications to use, and how to counsel patients. You will see all these conditions everyday if not almost every day and you will really become a little expert on them throughout your six weeks. Review the adult immunization schedule and all the screening guidelines. You will screen every patient regardless of what they come to you for, you want to make sure they have their flu vaccine, mammograms, colonoscopy and all those other screenings up to date. Remember you will see a lot of conditions in family medicine and when it comes to having a differential diagnosis keep the most common things first, but also keep an open mind and try not to miss important information during your patient encounters.
Preparing for the EOR/ PANCE
This EOR exam is just as stressful as the one for Internal Medicine. If you have it at the end of rotations, you can also use this as a PANCE review like I did. Study all of the topics on the NCCPA website, know all of the common conditions, and focus on the bigger sections like cardiology and pulmonology. I didn’t see that many orthopedic topics in my rotation, so I knew I had do study these a little extra. The resources I used were PANCE pearls, Smarty Pance, Rosh review, and these below.
END OF ROTATION CELEBRATION, Marine Corps Ball 2019
