Family Medicine at Amazing Medical Service was a very different rotation, the previous two rotations were in hospitals with many nurses, doctors, staff. At Amazing medical, there is only one Dr. Dario, four staff Ricci, Tola, Sandy, and Joan, and one working for billing, Booky. There was no place for me to hide, even if I wanted. I had to take patients. On the 2nd week, once I learned how to use their EMR (eClinicWorks), I was enjoying seeing patients, and I felt part of their team. I really love how Dr. Dario taught me during every patient encounter. 

• How could the knowledge I’ve gained here be applicable in other rotations/disciplines?

For this rotation, I had to review my old didactic notes from the first semester: I had to review interview and counselling because to almost all the patients I was seeing, I had to provide a preventative counseling to encourage them to lose weight, exercise, smoking cessation, recommend them to visit the gynecologist, colonoscopy screening. I needed to be prepared for any questions they may bring up. I also used a lot Week 10 Coding, Billing, & Reimbursement slides from PA profession because in rotation, I would write the whole H&P with ICD10 and CPT codes and they needed to be acquired to be able to bill them. At the end of the day, this is a business.

• Types of patients you found challenging in this rotation and what you learned about dealing with them

The most challenging patients I had in this rotation were the non-adherence ones. I remember one patient with significant past medical history of HTN, DM2, and hyperlipidemia, who came to the office to check on her blood pressure. Her blood pressure was sky high, I asked her if she took her medication, she would say do not remember. I ended up doing detective work by calling her pharmacist. The pharmacist confirmed that she did not pick up her medication since November of last year. I had to confirm one more time with the patient which pharmacy does she go, maybe she changed it without notifying us. We had to give her a clonidine and document very well what is going one. We talked to the patient and tried to find out what are the wishes of the patient and how we can help her.

• What did you learn about yourself during this 5-week rotation?

During my rotation for family medicine, I got my share of patients who refused to see me, however, my preceptor instructed me to persuade the patients and ultimately interview them. My preceptor taught me how to talk to the patients, and at the end I was able to speak to them as they opened up. I learned that I would not feel sad or angry for whatever attitude or words they told me, rather I was understanding of their illness can bring frustration and seeing a student is the least thing they want. At the end most of them apologized to me for being rude, and I would only tell them to feel better and I can only imagine what they are going though. Another aspect of myself I learned in this rotation was that I would not take any silliness from patients: I was seeing a patient whose phone rang, and instead of hanging up, she continued talking on the phone. After repeated attempts to tell her to hang up, I walked away from the room.

• What do you want to improve on for the following rotations? What is your action plan to accomplish that?

For the next rotation, I want to be able to take history faster, do the mental status exam from memory. I also want to be able to present the HPI to my preceptor in a more organized pattern. For Psych I should learned the medications because it is important to know their interactions, therapeutic ranges. I would need to know their mechanism of action, and side effects. I also want to continue preparing for PACKRAT and focus again in cardiology, I read my weak points on the EOR family medicine exam.

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