When I first started meeting “real” patients, I felt really intrusive: I’m supposed to ask them what? And they are going to answer? I ask them questions about bowel movements to how many times they wake up at night to urinate to “men, women, or both.” I feel especially awkward asking patients these questions when they are close to me in age. I feel like they can better sense how little I know.
The more times I ask these questions, however, the more comfortable I start becoming. At first, I struggled to maintain eye contact with patients during these uncomfortable questions. Now I think that I am treating these questions as my job and present them with an indifferent non-judgmental tone that helps me seem more professional, at least in my mind.
My experiences in CPCP at the internal medicine clinic at Metro have really helped me advance my ability to ask these questions as well as start to really learn review of systems, physical examination, and differential diagnosis. One of the other key things that my weekly experience has taught me is the unpredictability of patient care. I may have arranged to have dinner with a friend at 7:30pm, but if a few of the patients come in with complicated cases (i.e. three borderline patients in one day!), my other plans don’t matter. I’ve learned that there really is no way for you to predict how the day will go and you really have no chance in planning what time you get out. A few weeks ago we had a “light” schedule and the last patient was scheduled for 3:40pm for a 20 minute appointment. I got out past 6:30pm. This was early for me. I think that I really struggle to learn that you can’t plan your day as well as I would like. The physician that I shadow is usually running late and although I’m sure it’s because of her other commitments, I struggle to understand why she checks her emails between patients if she is already an hour late for some appointments. I guess that I still have a lot more to learn about becoming a doctor! :)
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