Sunday, May 21, 2006

Oh come on

Family practice so far has been like Internal Medicine-lite. Less sick patients, and fewer of them. And though I know I'm supposed to be sympathetic to all, sometimes that's a bit tough. Some of the residents seen this situation as it is. I was in clinic, having a pretty slow day, when a walk-in patient came up on the schedule. His sign in sheet said "trauma to left hand," so the resident and I were getting ready to actually do some good.

I should take this aside opportunity to say that this resident, Dr. Sard, is my kind of doctor: a bit sarcastic, though not about sick people, with a good sense of humor. The radio had been on in his office, and interposed with the typical pimp questions I'm getting, e.g. "what's the first choice antibiotic for community acquired pneumonia?" he's tossing in things relating to the songs we're hearing like "Cher is possessed by Satan. True or false?" So we're getting along fabulously. (The right answer is yes, by the way)

And this patient walks in, having hit his thumb with a hammer while doing some light construction. Yes. He hit his thumb with hammer. We looked at it, and saw nothing broken, nothing seriously injured at all. So Dr. Sard pulls me outside, and we have this conference in his office:

"So, Nathan, have you hever hit your thumb with a hammer?"

"Yes sir, I have."

"So have I. Did you go the doctor for it?"

"Um, no."

"Neither did I. Let's give him a bandaid and some encouragement.

I can't wait to retire."

So that's what we did. Unfortunately, that's a lot of what I've seen. Sniffles, headaches, minor injuries. The sort of thing anyone with a mother should know how to handle. You definitely don't need an MD to tell someone they have a bruise on their thumb, or that Tylenol does actually do what the label claims. Lest you worry, we also got an x-ray of his hand, which was completely unnecessary. Perfectly healthy hand.

I don't think primary care is going to be my strong point.

2 comments:

Thainamu said...

This reminds me of one of the gripes I have with the way medicine is practiced in the USA. My background is living in a third-world country and seeing barely-trained medical workders doing a lot, followed by returning to the States and waiting around doctors' offices for hours and spending a fortune for some pretty basic care. There should be more places where nurse practitioners or physician's assistants can provide things that you don't need a "real" doctor for at half the price and in half the time. Patients could be sent on to a real doctor in the next room if the PA thought it was necessary. It seems to me that lots of little things mothers take their kids to the doctor for could be handled at this level.

LSI said...

Nathan said:
I should take this aside opportunity to say that this resident, Dr. Sard, is my kind of doctor: a bit sarcastic, though not about sick people, with a good sense of humor.

Oh c'mon Nate. A good sense of humor, eh? ;)