Tuesday, March 20, 2007

Rhetorical Questions on Family Practice

1. What do you say to a woman who offers the information that she was sexually abused by her father as a child? In the middle of a conversation about her constipation problems?

2. Why is depression so prevalent? I mean, I suffer from it myself, so I shouldn't be so surprised, but I would say that up to 50% of the patients I've seen at this clinic have been depressed, anxious, or a combo thereof. Maybe this population of patients is just particularly stressed?

3. How many times in one week can my preceptor offer a handout on back stretching exercises to patients presenting for allergic rhinitis, depression, diabetes, pap smear, or carpal tunnel syndrome?

4. How does a person keep a straight face and not cringe when the answer to the question "Why are you here today?" is "I have this burning, stinky vaginal discharge"?

5. Why is it that last week on pap smear day, the attending told me "you're doing a great job, the only ones [cervix] you missed I had a hard time finding" and this week on pap smear day, the same attending rated me as "average" on my technical skills because "you had a hard time finding the cervix"?

6. For that matter, why is it that for most family docs at my clinic, "Procedure Day" = "Pap Smear Day"?

7. Why do I feel the need to apologize to my attending for spending 30 minutes interviewing, examining, and writing a note on a patient with depression, hypothyroidism, other psych issues, chronic pain issues, chronic vomiting, constipation, dizziness, arthritis, urge incontinence, and vaginal discharge, who feels the need to yell at me and cry about the inanities of the county medical system preventing her from seeing a doctor and receiving her medication?

8. Why are Hispanic patients so surprised that a white girl speaks Spanish?

9. Why do Hispanic patients get past their surprise that a white girl speaks Spanish and proceed to speak so rapidly that I am then forced to call a translator anyway?

10. If you were a young woman who weighed 350+ lbs, with a BMI of 62, diabetes, high cholesterol, and high blood pressure, and your husband weighed around 400 lbs, would you be so utterly shocked when told that you were having problems conceiving a baby because of your weight? I mean, I'm all about women having healthy curves, but seriously, at some point you have to realize that GIRL, YOU ARE HEAVY AND IT'S UNHEALTHY.

11. Why is it that some patients will ignore a health problem until their leg is falling off, their inflammatory breast cancer is visibly rotting, etc., but other patients come in for the least little thing (eg, "I have this tiny white spot on my arm that doesn't hurt and it looks the same for years--is it cancer?" or "I get these headaches when I'm working and I haven't eaten for hours, they go away with 1 Tylenol--is this okay?" or "I'm 35, with no family history of prostate problems or symptoms--can you check me for prostate cancer?" (bonus if this is a female!))???

Tomorrow is my last day on FP/FM!!!


frectis said...

Awesome. The obvious answer to all of the questions is this: people are strange so we can blog about them. :)

The Peanut Gallery said...

Run away from family practice and don't look back. I might kill myself next week when I make up the days I missed.
I think the docs who can deal with that crap every day must have special powers or really good therapists.

Maggie said...

Hi there, I think No 1 shows you must have a good bedside manner for her to be able to say that to you. So YAY for you! :-)

Best wishes from Liverpool(UK) and good luck with your last day on FP (though I suppose it's half over by now - I can never get the time difference sorted out!)