As of last Friday, I finished my Family Medicine rotation.  In my opening thoughts about it posted previously, I mentioned how I loved exploring the therapeutic relationship, forming bonds of trust with patients, and having to know a little bit of everything.  Throughout the 6 weeks, I would say that these were definitely the core concepts I encountered.  As said before, I definitely did enjoy them.

However, I encountered much more than these core concepts as well.  An interesting part of family medicine is that you can ‘specialize’ within it, even though it is so broad.  As examples of this, I spent a few shifts working within Emergency, I spent an evening working with a doctor at a Transhealth Clinic, and I spent a day shadowing at a Methadone Clinic.

So, at a tertiary care centre (a big ass hospital), most of the doctors you will encounter in an ER are Emergency Medicine doctors, which is another type of specialty.  In a smaller centre, you may have some ER doctors, but you will also have family doctors who either have extra training in Emergency, or have spent enough time working in the ER that they are considered qualified for it.

Long story short, I loved my shifts on ER.  It is an entirely different experience compared to clinic.  In general, the problems are much more acute, they require fast-ish follow-up and treatment, and you often get to send people home within a few hours.  I loved the adrenaline rush of this.  Also, strangely, I found that the fact that the patients were around for hours actually gave me more of a sense of connection to them then I sometimes got from clinic, in which 20 minutes was my average.  I am definitely looking forward to my Emergency Medicine rotation after these encounters.

Another exposure I had was to Addictions Medicine.  Now, it is important to note for both this one and the Transhealth clinic that within the scope of the clinic, the physician is not serving as the client’s family doctor.  This is due to the funding model of both of these clinics.  Never-the-less, it is a family doctor who is serving these roles.

To put it simply, for both the Addiction Clinic clients, and the Transhealth Clinic clients, there is a lot that I could say.  And a lot I will say in future blog posts.  Although very very different in nature, both of these populations are generally down-trodden, judged, and forced to live on the outskirts of society.  As you can guess, being treated this way is not good for your health.  If we truly wish to progress as a society, then it is those who we force down that we must focus on helping.  But that is a story for another time.

One of my initial complaints about the rotation had been the simple fact that it wasn’t quite accurate in terms of how actual family medicine feels.  When I watched a patient come in and talk to my preceptor, the doctor already knew that patient’s medical history, social history, etc etc.  This was something that was impossible to emulate, as it only comes with time and familiarity.

Well, because of the 6-week nature of the rotation, I did get to follow-up with a few patients throughout.  To put it simply, it feels rewarding to actually remember a patient from before, and to continue talking to them about their ongoing medical problems, and life in general.  This part of family medicine is definitely something that appeals to me.

So, scattered thoughts need to be summarize.  My final thoughts on Family Medicine:

1) Family Medicine is awesome.

2) I absolutely love the long-term thereapeutic relationship that comes with family medicine.

3) The ability to sub-specialize into different aspects of family medicine allows you to practice medicine as you want, and really seems to breath new life into your practice as well.

4) Family Medicine is definitely not crossed off of my list.  If anything, it is now ranked very high up there.

 

And now, onto my psychiatry rotation.

 

TWS