Here is my schedule:
Monday: 8:00am - 7:00pm
Tuesday: 8:00am - 7:00pm
Wednesday: 12:00 - 7:00pm
Thursday: 8:00am - 7:00pm
Friday: 8:00am - 7:00pm
Saturday: 9:00am - 2:00pm
Sunday: off
What kind of patients does a family practice doctor see? The group I am working with will see mostly kids on Mondays. These will be school physicals, well baby check ups, vaccinations, sick kids. The sick kids mostly have mild things that the parents are worried about, so far I have seen a handful of allergic reactions presenting with urticaria (hives), pink eye, sinusitis, pneumonia, pharyngitis, pulled muscles, constipation, diarrhea, asthma, headache, menstrual cramps. When I was growing up these were all things that you did not even bring up as "illness" so it is interesting to see these things from the doctors point of view. On one hand the doctors do not want to discourage this, because this is what pays their mortgage but on the other hand they almost feel guilty because in 80% of the cases all they are really doing is reassuring the parent and explaining that most likely the illness is due to a virus. However many of the parents will not shut up until they get an antibiotic and even the ones who don't beg for antibiotics do not feel like the doctor did anything unless they get some kind of medicine. Unfortunately, there is a lot of inappropriate antibiotics being thrown around. The doctor I was working with today told me that when she does not give an antibiotic she can plan on a ton of calls over the next few days and often the parent will come back in claiming the child is sick but when she gives an antibiotic she will not get the worried phone calls at all hours of the night and the parents are very grateful and refer their friends. They feel their child was healed by the doctor even though 9 out of 10 times the illness was viral in nature and had to run its course. It is a tricky juggling act.
Then on tuesdays the doctors see adults. These are travel vaccinations, annual physicals, blood draws to check labs for management of chronic conditions like hyperlipidemia, diabetes, hypothyroidism. Today I saw adults suffering from, diabetes, diarrhea, constipation, hyperlipidemia, genital warts, annual paps, breast exams, asthma management, depression / anxiety, congestive heart failure. In the afternoon we went to a nearby nursing home to see 12+ nursing home patients of the doctors. This was an assisted living center so most of the patients were ambulatory and fairly healthy. We followed up on previous medications, renewed prescriptions, check labs and adjusted meds accordingly, and did some basic check ups.
At the nursing home we had this couple; she was 93 and he was 95. She was plagued with many of the illnesses we see in the elderly like diabetes, congestive heart failure, neuropathy, arthritis etc. She was on about 12 different medications to keep her alive. He was a hilarious old man with nothing wrong. He said "doctor can you tell my wife that she needs to quit acting all sick and broken and just toughen up like me!" Then he explained that he has never been on any medication and has never really been sick except for one case on pneumonia that he caught while in the doctors office for a physical. I asked him what his secret was and he said in all seriousness that since the age of 10 he has been drinking a glass of red wine at 4:00 in the afternoon and a drink of brandy with vermouth at 7:00 pm. He said that is all the medicine he needs. Now he calls his 72 year old son and his 70 year old son everyday at 4:00 and 7:00 and they all drink their "medicine" together over the phone. I told him that it was obviously working and to keep up the good work. His wife rolled her eyes at her husband and said to him "don't you think you can over do it sometimes?" and he laughed and said he was too old to change, she smiled and said "you have been saying that for 75 damn years!". It was a great exchange. I hope I am that healthy at 95!
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