During my weeks at St. Clare Hospital in Baraboo, Wisconsin, everyone I met, whether resident, attending or staff, was patient with my learning curve and eager to help me learn. Residents and preceptors were friendly and engaging, and all are people I would love to learn from and work with in years to come.
I was fortunate to spend time in the family practice clinic with both residents and attendings, and rounding on patients in the hospital. I visited at a local nursing home, admitted patients through the ER and observed a cesarean section delivery on the OB floor. Additionally, I spent afternoons in the physical therapy clinic, and worked with a local home health nurse doing wound care in the greater Sauk County community.
Working together, taking time
During my time, I was impressed by how well faculty, staff and students worked together. They were willing to help each other whenever possible, showing respect and positive communication with other providers in the community. I believe this exists more commonly in rural communities as co-workers, patients and neighbors are often one and the same. I appreciated other distinctly rural aspects of the Baraboo program as well, such as family practice physicians who admit and round on their own patients.
I was also impressed by the time each provider I worked with spent with patients. Almost unanimously, they made every patient a priority, spending as much time as needed in their rooms. In fact, when quick patient encounters presented themselves, residents often used the time to update patient information, education and screen labs, rather than requiring the patient to schedule a separate visit. A great use of time and very considerate when taking into account the socio-economic difficulties many rural patients face.
It was clear, however, encouraging patients to return for screening visits could be as hard as it is in any primary care office. Patients in all geographic locations can feel serious constraints on their time, money and transportation options, often questioning the need to see a doctor until they feel quite ill.
A higher level of service
At St. Clare, I noted the extent of services offered in this small rural community. I experienced an urgent C-section, the aftermath of an appendectomy and a lumbar spine compression fracture. All of these remained in-house for treatment. I also heard of transfers of more critically ill patients, including an elderly gentleman with a large subdural hematoma.
As a child, my home community of 800 was only 20 miles from the nearest large city, so we did not even have our own hospital. I was glad to know that most necessary specialists made it to St. Clare a few times each month and services like PT and rehabilitation, and all imaging could be done on-site.
A journey ahead
On a personal level, thanks to the variety of primary care experiences I’ve been fortunate to have, I believe I’ve developed a strong grasp on the typical patient problems family practice offices face. Health issues I saw ranged from ear and sinus infections to chronic aches and pains, OB visits, well-child checks, allergic reactions, skin lesions, and, of course, hypertension and diabetes management visits. Sometimes, these issues were sprinkled with an array of potential psychosocial concerns.
Overall, I feel I’ve encountered and become familiar with what I feel will be the bulk of a rural practice. As I have worked with many different providers, I‘ve experienced a number of different philosophies of management, especially regarding possible infections and chronic pain.
What my own personal management practices will be, what new studies emerge influencing those practices, and how l interpret recommendations will be part of my coming journey. My time at Baraboo certainly helped me on this path and I’m thankful for the opportunity to better know the program and its people!