Patient Follow Up

My days in family clinic are coming to an end soon. I only have two sessions left and then I'll have to move on to other things - that makes me really sad. I really like my preceptor and the patients I've seen and next week I'll be seeing my first patient for follow-up. It makes everything we learn in medical school feel both real and oversimplified at the same time. My preceptor and I have been talking a lot about evidence based medicine and intuition and how practice takes a bit of both. There just aren't evidence based guidelines for everything, and there are different motivations for doing things that aren't necessarily based on evidence. For example, patient reassurance. I took someone's temperature the other day to reassure her that she didn't have a fever. There really wasn't any indication for it, but it didn't cause any harm - I think that's ok. We sent a patient who was clearly a vasculopath for a stress test. There aren't any specific guidelines for his situation, but we thought it would be prudent from a preventative health perspective - so we did it and I think that's ok.

I used to think that I would love family medicine except for the boring office part. Now I'm realizing that the office part isn't really boring at all. It's one of the things I've come to like the most about family med.

Yesterday I had my first patient express regret that I wasn't going to be able to follow her as her family doctor. Now, if you're cynical, you could think that she was just trying to play me for drugs or buttering me up for a sick note, but I really think she was sincere and it made me feel really good. I like being able to have a good chat with people about their health and where they're at. I like being able to find a solution to a problem that makes everyone happy. I like family medicine.