Tuesday, August 12, 2008

Outpatient Medicine and GI

The bronch I was supposed to see yesterday wound up getting cancelled, which was disappointing for me--I'm sure my patient was relieved though. This week, I still have general medicine clinics in the mornings and specialty clinics in the afternoons. General medicine clinic has been very slow so far. For some reason, a lot of the patients are no-showing. On the bright side, it gives me a lot of time to write my patient notes and get my logs done during clinic, and that means I have my lunch hours free (and sometimes even get to go to lunch early!).

I have GI clinic in the afternoons this week. So far that has not been the greatest experience. Yesterday, my preceptor showed up to clinic an hour and a half late. I only got to see one of his patients because after a while I got tired of waiting for him and just went to see the patient on my own. He showed up when I was done with the interview and about to start the exam, and he took over from there. After that I pretty much just shadowed him all afternoon. It's a good thing I went and saw the patient when I did, because otherwise I probably wouldn't have gotten to do anything on my own. I was also annoyed because he kept me until 6 PM for no good reason. One of his patients was late and showed up at 4:45 PM. It was only supposed to be a 15 minute appointment, so we should have been done on time or at most been 15 or 20 minutes late. Instead, he spent 45 minutes with that patient and then made me stay an extra half hour afterward so that he could tell me about how stressful his job was. I am supposed to work with him again on Thursday. Wow, can't wait.

My GI preceptor today was a little better, but I still had a kind of strange experience. He sent me in to see a patient with one of the fellows. The fellow was really nice and well-intentioned. He was demonstrating how he does the complete abdominal exam for me. Considering that I got no teaching yesterday, I was very appreciative that he was making this effort. But he was basically ignoring the patient. After some time, the patient made a kind of funny noise, and the fellow asked her if anything was wrong. The patient said, "I feel like I'm some kind of guinea pig." The fellow started stammering that I am a med student, and he was showing me how to do the exam so that I could learn, etc. etc. I turned to the patient, who was a graduate student, and introduced myself. Then I asked her what she was studying. After we chatted for a few minutes, she was fine, and the fellow and I continued with the exam. When we came out of the room, he kind of laughed and shrugged about what had just happened.

I was pretty surprised he still didn't seem to realize that the patient just wanted us to include her in the conversation. I guess his med school didn't make him take any classes to learn how to communicate with patients. Maybe all those communication classes that we had to take over the last two years weren't so stupid and pointless after all!


Anonymous said...

Communications classes are never stupid. You realize it later.

CCLCM Student said...

Yeah, a lot of things besides communication classes that seemed kind of pointless before make a lot more sense now. Last year, a lot of my classmates were complaining about how much clinic we had. Two afternoons per week seemed like a lot on top of everything else we had to do. But now that I'm on the wards, I'm really glad we did have all those clinic sessions and other training sessions. Not that third year still isn't a bit of a culture shock, but it could have been much, much worse. Sometimes you just have to have faith that the people in charge actually do have a method to their madness. ;-)