As a third year medical student, I dreaded my family medicine rotation. My belief about family doctors was that patients came to see them with vague complaints. The doctor would order a bunch of tests and then send the patient to a specialist, unless the patient had hypertension or diabetes. I wanted to be that specialist. I wanted to solve those complex problems.
Challenging assumptions
My family medicine rotation in a rural area challenged that belief. What do you do when the patient doesn’t have the time to find a cure but simply wants to tolerate a medical problem so they can keep their job, which is inevitably heavy on manual labor? What do you do when you know the patient or their family and care deeply about titrating the perfect insulin regimen? What do you do if there is no specialist?
I can’t count the number of times I saw a rural family medicine doctor doing something I had been told I would only see on my orthopedics rotation, or dermatology rotation, or internal medicine rotation in the ICU, or in psychiatry…the list goes on.
In rural areas, family practitioners are also the hospitalists who see their own congestive heart failure patients in the ICU. They remove questionable moles. They take care of post-partum depression. They diagnose meniscal tears. They are like superheroes!
Making connections
In my month at a rural practice, I saw a lot of the same patients or families more than once. One couple was struggling financially and emotionally when the husband lost his job after suffering several small strokes. Our conversation in gathering their social history ran the gamut from talking excitedly about a daughter’s upcoming wedding, to the wife’s distress about her husband’s failing memory and coordination. My own emotions during this deeply personal conversation made me understand what compassionate care in medicine means.
I came to know and understand my patients’ points of view, and I saw patients with a wide variety of complex medical issues. I helped make decisions about treatment plans, learning so much more than I could have in an urban setting.
We had a developmentally delayed female come into the office several times for evaluation and follow-up of a superficial abscess on her abdomen. I saw her, drained the abscess and explained how to care for it at home. I was pleased to see she understood my instructions and with the help of antibiotics, it cleared up over the next 4-5 days.
One of the residents at the practice was the woman’s primary physician, and was explaining that she would be leaving to start practicing on her own and that the patient needed to pick a new doctor in the practice. The most touching experience I have had yet in medicine is when the patient turned to me and said, “Can Samantha be my doctor?”
Yes, I will. You can bet on it.
Samantha Simpson is a third year medical student at The Ohio State University College of Medicine. She is a recipient of the United States Air Force Health Professions Scholarship and hopes to put her rural medicine training to work.