Final Thoughts: Family Medicine

My eighth (and FINAL) clerkship of third year (Family Medicine) has come to an end...

• 5 weeks, 21 days, 161 hours of work in areas ranging from Family Practice clinic to Inpatient Family Medicine in the hospital.
• Working at the clinic and hospital, I worked 16 days for 141hours (average of 8.8hours/day; about 35.3 hours/week)
• I was in lecture for 5 days, totaling 19.5hours (average of about 4 hours per lecture day).
• I enjoyed 12 days off in the last 33 (that's ~2.5 days/week).
• I completed 0 nights on call.
• I studied family medicine outside of work a total of 50 hours.
• My total work in Family Medicine over the past 5 weeks is: 211 hours in 5weeks (42.2 hrs/week...about 6 hrs/day).

What I LOVED about Family Medicine:

• The lifestyle is amazing. The days when you work are long (9-12 hours), but the days off are pretty much full days off. 
• You get to see different things with each patient, and each day is different. You never know what's going to happen in the office, so it can be somewhat exciting.
• It's the first line of diagnoses for most diseases. Think about it...who diagnosed your asthma? or broncitis? or sinus infection? or your ankle sprain? And they do most of their diagnosing based upon a thorough history and physical alone, and order labs/tests as necessary based upon their clinical inclinations. That is pretty fun.
• I actually enjoyed seeing kids! I couldn't do it all day, but interspersed between adult visits was actually kind of enjoyable. I know, I'm just as shocked as you are. I like the kids! 
• You have a long-term relationship with your patients.
• Patients trust you, and rely on you for your second opinions for more specialized conditions. And they are always asking for advice from their family doctors. Strangely, although some medical professionals seem to lack large amounts of respect for family doctors, the patients seem to respect their family doctor most.
• If anything gets too complicated --> refer to specialist.
• There are procedures that you can do! ...even if it is just removing a wart, it's still a procedure!! 
• I delivered a few babies, without going through OB-Gyn residency. That's pretty awesome. And both the mom and the new baby will be members of the family doctor's practice for many years to come. I love that.
• I love working in a clinic. We also got to do some rounding on the patients who were in the hospital, which I also enjoy doing. 
• It's just a little bit of everything. And if there's something you don't like to do, you don't have to do it - just refer to a colleague. The freedom is unbelievable.
• I really love preventative medicine. I enjoy having conversations with patients regarding their nutrition, exercise, lifestyle, habits. I also like to talk to them about what they can expect in regards to their health. I also like the idea of stopping a disease before a patient even notices its presence (like with hypertension or hyperlipidemia or diabetes).

What I DIDN'T love about Family Medicine:

• Some days get super long.
• Some patients come in with the strangest complaints...like weird complaints. Like "my belly button itches, what's my diagnosis?" kind of complaints. I know it's probably just anxiety, but it still feels strange to hear such bizarre reasons for coming in to the doctor.
• Each visit is so short. 10-15minute visits just aren't enough for some of the more complicated patients or diagnoses. 
• I would like to know more about the specific diseases. I think deep down inside, I'm meant to specialize. I just want to know everything about something rather than something about everything.
• Often times, other doctors don't give family physicians the respect they deserve. 
• Patients will do as they wish...all of our best interventions are useless if the patient decides not to comply with our recommendations. This is such a huge source of frustration for me, but can sometimes be avoided with proper patient education - which requires more time spent with the patient in each visit, which is simply not very feasible.
• The compensation is nothing to write home about...not that money matters, but it is certainly a factor in the decision making process.

Since I didn't actually get the chance to work in the Ambulatory Clinic with an Internist, I'm not sure if this is kind of how their days are arranged (minus the kids). If so, even life as a General Internist wouldn't be a bad choice for me...but at this point in time I really would love to specialize (likely in Medical Oncology).