Friday, March 14, 2014

At a lost for words!

* Image from UA med school

And that pretty much sums up my half-day rounding in IM at the local county hospital. Absolutely AMAZING, clinical care here I come!!!

Man, where do I begin? I'll start with the obvious; the serious patient risks of not having culturally competent Doctors costs lives, absolutely NO doubt about it! Not only were half of the patients I saw Spanish speaking, they were mostly minority, which probably doesn't come as a surprise considering that most of their funding is from Medicaid/Medicare. So I got a chance to brush off my Spanish speaking skills and my ebonics skills too, LOL!! Honestly, if the Doctor can't communicate with the patient because the translator can't be everywhere at the same time, how in the hell can they effectively provide care?

Anyhoo, during rounds I suggested ordering a Psych eval, thyroid panel, hormone status ie menopause, and a couple other things. And what became glaringly obvious not just to the team that I rounded with but the Attending as well, is that my life, educational, and professional experiences puts me FAR ahead of the average med school applicant in terms of just knowing what to do when what to do isn't obvious. I also think my ability to relate culturally helped too. Sure, my group had me "beat" in many of the clinically obvious things because this is what they've been doing full-time for the last 3 to 5 years. But those basic or gut instinct skills that typically come with age/wisdom, they just didn't have because they haven’t been around long enough or had enough life experience to know anything different. And this is the point older premeds need to emphasize in interviews. All that said, Dr. B my Attending, who's also the professor for my healthcare course, not only speaks fluent Spanish, he's got compassion "on lock". There wasn't ONE patient he didn't easily communicate with and I think that speaks to the kind of person/Doctor he really is.

I almost forgot to mention the computer cart AKA point of care cart, Dr. B used to both review and immediately enter patient data into the EPIC EHR, an image of which is shown below:

Again, I was TOTALLY AMAZED, I had finally seen the EPIC EHR in action in a real life medical setting and it's honectly not as bad as MANY Docs say it is. So the way our rounds worked, is that Dr. B gathered us all around it to discuss the patient, look at labs, xrays, ect. The monitor appeared ot be about 27'. Then we would go see that patient, ask them how they were doing, any complaints, ect, then we returned immediately to the cart to enter the pertinent data. Again, VERY cool!

So after giving me kudos for thinking of differentials on patients that neither he nor the team had thought of, I told Dr. B that I was taking the MCAT in the fall and applying to med school. At almost 50 years old. His response was "what does your age have to do with anything, I think that's a fantastic idea". And with that, I really did continue to enjoy rounding with the team. And they must have enjoyed me too since they asked my professor if I would be coming back. :) And that made me feel real good because I had hoped that I didn't come off as a "know it all", and clearly they didn't think that way. So in the next few days, I'll be setting up a regular schedule to round with Dr.B!!


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