Vacation time...

Ahh, I finally made it to my next vacation. I get a week off starting today, and its been a rough 4 months having had 2 of 4 be ICU months. But, all is good as Nicole, Sofie and I are heading through Atlanta and to Tampa! We wanted to do a vacation, but Sofie is too young for a kennel and not even spayed, so we decided to go home to Tampa so she could come with us. We definitely plan on relaxing, and spending time with the family, and seeing some of our friends while in the area (hi Danielle and Kristen!)

As a med student you are idealistic, thinking of all the ways you can help a patient overcome whatever problem it is. You have the opportunity to spend long amounts of time with a patient, really listen to them and get to know their story. Unfortunately, as an intern, you don't. On cardiology we worry about chest pain, and if the chest pain is caused by a cardiac problem, or not. If we find out its not the heart, or anything else serious, we discharge them. Thats great, except that they still have chest pain, and we don't know what its from. If they have other complaints that aren't serious, but are bothering them, doesn't matter...their regular doctor can see them. It's a bit unsatisfying for me, and for the patient, and for some folks they keep coming back to the hospital with the same pain...it hurts too much that they don't want to wait for their appointment with their doctor, but we never find a major cause for it. Half the time these people get admitted with the diagnosis of "rule out MI" (which means make sure its not a heart attack), rather than an actual condition. I'd love to be the med student again, sitting down with the patient and exploring other reasons that could be causing this patient their pain...how is their personal life at home? Their work? Stressors? What activities have they done lately that might have caused this? Rather, I have to work quick, and move on as 10 other patients will be needing my attention too. I sure hope its not like this when I "graduate" and become my own doctor.

Which is another sad part, that any "general doctor" often sees too many patients in one day in their clinic...often its 20-25 patients a day, but I've heard of even 35-40 patients! 40 patients divided by 8 hours, or 5 patients an hour, 12 minutes a patient, not including your lunch break, paperwork, phone calls, arguing with insurance to get them to pay for their patient's procedure. Maybe its down to 7-8 minutes a patient. Cann I really help that patient who is depressed and needs to talk about whats going on in their life in 8 minutes? Or just give them the script for an antidepresant...

Specialists, on the other hand, are the cardiologists, or GI docs, or the kidney docs. Their experts in their field, and they usually see patients when their general doc refers them. Their load may be 10-15 patients a day, and they can spend more time with their patients, work less hours, and often are paid more than generalists. Seems like a great gig. But a really good generalist is invaluable...they know the patient the best, and have a sense of perspective. Not sure which I want to do...