Saturday, July 25, 2009



From the inpatient wards of the SF General hospital and the fourth floor operating rooms in SF, I have migrated to an entirely different world-- the outpatient world of family medicine.

Two weeks ago, I packed up my car and traveled 55 miles North to Santa Rosa, a city that prides itself for it's proximity to a diverse array of natural attractions, including vineyards, redwood forests, rivers and lakes, as well as a unique downtown that features a year round Farmer's Market. I left the fog behind and discovered a real summer filled with sunshine and heat.

In my two weeks of family medicine, I have learned about the broad scope encompassed by family medicine. So far, I have counseled several patients with metabolic syndrome (the triad of diabetes, hypertension and hyperlipidemia), examined pregnant women during their prenatal visits, listened to fetal hearts, performed well child visits for babies, evaluated numerous pediatric rashes, performed a PAP smear, participated in a wellness group therapy session, attended homeless clinic and learned about mental health issues in the homeless, interviewed patients in a community clinic as well as in a Kaiser clinic, burned warts off, counseled almost every other patient about lifestyle changes, and so much more.

I am lucky to be taking a hiatus from my beloved SF and learning about family medicine in a community-based program in a city that has few specialists and a large underserved patient population (mostly Spanish-speaking). I am starting to see how medicine is practiced outside an large academic institution (its pretty similar) that is equipped with specialists for every possible disease.I've had to draw on four-years of high school Spanish to communicate and in the process I have probably sounded absolute ridiculous. Oh well.

In such a community, patients rely heavily on their family medicine doctors for most every aspect of healthcare maintenance.

"One of the best things of family medicine is really the longitudinal care. For example, we take care of a pregnant woman, provide prenatal care, deliver her baby and take care of the baby and mom afterwards," said one of the family residents.

Family medicine is truly unique because of the focus on taking care of a patient through their entire life, requiring a comprehensive medical knowledge and solid patient-doctor relationships. At the same time, healthcare providers are limited by 15-minute appointment visits, healthcare cuts, a growing patient population and lingual barriers.

Despite the challenges, the process of interviewing patients, learning about their lives and developing meaningful relationships represents a incredible learning opportunity. We'll see what the remaining four weeks bring.

1 comment:

Anonymous said...

Sounds cool! I have two similar rotations coming up as a visiting 4th-year: one month on the inpatient family service at SF general and one in Santa Rosa. I'm excited to see the similarities/differences that you alluded to! My email is lrodelo@med.wayne.edu, from SF originally, going to med school in Detroit. (Sorry I don't have any of the ID options for posting a blog comment here)
Lisa