I thoroughly enjoyed my rotation at Southshore Family Practice for family medicine. This was my seventh rotation, and my third one in an outpatient setting. Prior to this rotation, I did not think that I wanted to go into Family Medicine. After seeing my preceptor interact with patients who came in frequently and seeing how much of family medicine is about education, therapeutic communication, and being there for the patient, I recognized how valuable a good family medicine provider could be to patients who need and crave that support. It is definitely something I am considering more strongly after this rotation.

Some patients I found challenging during this rotation were patients who were rude and disrespectful. Although this was the minority of patients I dealt with, there were a few patients I encountered who were not interested in speaking to me, did not want to listen to anything I had to say, and were unpleasant to deal with. Occasionally, patients would yell at me as well. I learned that in dealing with these types of patients, it is very important to not take it personally, remain calm, and remember why I am here. I am here to help people and treat them in the best way possible to ensure that they are healthy and safe. I made sure to keep the smile on my face no matter how they interacted with me, speak to them calmly and pleasantly, and try to help them as much as possible. Though this was not always the case, many times patients would come in agitated and acting rudely, but once I spoke to them calmly and pleasantly, they actually calmed down and began to speak to me more pleasantly as well. I also learned that it is important to not let these difficult interactions get to me and make me feel down, because when there are more patients to treat, they deserve my best mood and happiest self, and I need to deliver that. As providers, we are still human, and getting yelled at or treated unfairly will affect us emotionally. But, we cannot let that affect our overall mood, because that may go in to how we interact with other patients, and that is not fair to us or them.

My perspective changes on patients with HIV, or other “stigmatized” diseases, as a result of this rotation. I encountered a patient who came in for a physical exam and bloodwork as he needed everything done before starting a new job. As I spoke to him and asked him some questions about his medical history, he seemed very hesitant in answering some of my questions. I encouraged him to open up, explaining that this is for his health and in order for us to treat him in the best way possible, and he admitted to me that he was diagnosed with HIV. He then ensured multiple times that we would not share this information with his future employer, since he was concerned they would not want to employ him knowing this information. I reassured him that we would not share any medical information that he did not want to share, but it really changed my perspective. It hit me then how there are certain diseases that are so stigmatized that patients living with them have to deal with these extra consequences, in addition to all the physical issues that come along with this disease. I did not think any less of this patient when he told me this information- to me, he was another patient with a health issue. But, when I saw how uneasy sharing this information made him, and how private he was about it, I recognized that this diagnosis is one that is emotionally very difficult for him to deal with, and that it carries into every part of his life. For example, he was worried he would not get a job if people knew about this diagnosis. It taught me that as a provider, not only should we be non-judgmental and not view these people any differently than someone with any other medical disease that we want to treat properly, but moreover, we should be sensitive to the fact that this diagnosis may be difficult for them emotionally, and make every effort to reassure them and make them as comfortable as possible.

A memorable patient I encountered was a new patient who came in for a regular physical exam and bloodwork. When going through her history, I asked about alcohol use, to which she responded, in an embarrassed way, “I drink more than I should be,” and went on to say that recently she has felt very stressed and has been drinking a few beers a night. When going through the CAGE questionnaire with her, she admitted yes to ¾ of the questions. When asking her if she wants to quit, she said not completely, but she definitely wants to cut down. I then proceeded to educate her about the harms of alcohol use, and help her make a realistic plan on how to cut back. This patient was memorable because I saw in her a struggle and a deep desire to overcome it. She opened up to me about this struggle because she really wanted help and did not feel like she could do it alone. I felt that with my practical advice and education, as well as my empathy and emotional support, I was really able to help this patient on her path to cutting down on alcohol and improving her overall health. I felt that in the short visit, I was able to build a relationship with her, and she thanked me profusely as she left. Sometimes we do not get to see the positive difference we can help make in patients’ lives, but it is really special and memorable when we do. 🙂

During this 5 week rotation, I learned about myself that confidence is key and I am capable of stepping up when put to the challenge. During this rotation, I performed a lot of venipuncture, and was able to become very comfortable at it. During my first few rotations, I was not very comfortable with this procedure, and only got to do a few. In addition, there was always someone else that was better than me, so when I encountered a patient with difficult veins, I would hand the job over to a superior and would not push myself to try. Now, I am almost finished with rotations, and I am with 2 PA students who have just begun their rotations. We are the designated people to perform venipunctures, and, as I am the “most experienced” of the group, I am the designated one to perform the “hard sticks.” This was something that made me  very nervous just a few weeks ago, but when I was put in the position, I stepped up to the challenge, and was successful! I am now much more comfortable and confident in performing venipunctures, all because I got over my fears and tried at something that seemed challenging. I hope to carry this into other roles I will have as a PA, and remember that I can do a lot more than I think, as long as I approach it with confidence and step up to the challenge.