#Family Medicine

[appalachiananarchist]

Actual letter I received after a patient's migraine rescue med got denied:

We have denied the request for Sumatriptan for the following reasons: patient has failed to try the preferred alternatives: 1. Sumatriptan 2. Rizatriptan

One of these days I am going to make headlines as a clearly documented case of spontaneous combustion when the anger boiling inside me explodes, exploding me with it. At least on that day I won't have to deal with insurance companies anymore.

Another gem from this week: I sent a lady with suspected acute ischemia of the limb to the hospital where she had a CTA done. Insurance wanted to deny it all because I "did not do an ABI" before sending her. Because, you know, when someone's leg is purple and cold with no palpable pulse, you should definitely delay hospitalization to do some ABI testing to confirm there's a problem.

#medblr #family medicine

[emgoesmed]

1/25/2023

Today’s my day off of clinic and I’m at a local cafe feeling cozy and ready to study. One of my favorite winter moments is a lovely snowy winter morning when I don’t have anywhere to be.

#emgoesmed #studyblr #studyspo #med student #med school #med studyblr #productivity #coffee #happy wednesday #cafe #cozy #winter #snow #hyggemoment #ms3 #clinical rotations #family medicine

[wayfaringmd]

“Shouldn’t my insurance pay for it if you ordered it?”- patient exasperated about the cost of a necessary but uncovered test. Welcome to America, where insurers without medical training determine what service is medically necessary.

#health insurance #insurance #medblr #family medicine

[eirianerisdar]

Nothing like breaking down sobbing in front of the associate consultant today telling her why I had to take two seperate sick days last month because the patient load is wearing me out

I told her I can't see patients the way I want to if we have to see a new patient for 2-3 complaints every five minutes, eight hours a day with a short lunch in the middle. Working 5.5 days a week

Her response was to tell me "Hey don't go into too much detail with some patients who don't want to listen to you."

Which, I mean, fair enough, but it doesn't change how the doctor-patient consultation model was modeled after a minimum 20-minute consultation and I get five

I mean she did say that I managed to address a lot of patients' concerns within those five minutes so patients are usually very grateful to me but it's a cold comfort when she essentially is saying if you don't want to burn out you have to care less about certain patients

If doctors seem in a hurry sometimes this is one of the reasons

#our district public health system was built to handle a quarter of its current population #bleh #medical happenings #family medicine #doctor #my post #personal

[justinesurvivesresidency]

I just started a patient on HRT for the first time ever in our residency clinic!!

After ~2.5 years of residency, 1.5 years of building a LGBTQIA+ curriculum, 4 months of advocacy seminars, and a whole lot of barriers, we have finally gotten the okay to start initiating hormone therapy for the purpose of gender affirming care.

This patient is one of two who I had already started the evaluation and informed consent process. We had actually already decided on a plan to start estrogen, but this week the administration approved our official informed consent form so she came in, signed it with my colleague, and got to start estrogen tonight!!

This is a huge milestone for our clinic, residency, and community but also for me, my colleague (who has been a huge champion for all of this change), and of course my patient. I'm honestly a little bummed that I wasn't the one in clinic today to have the visit after doing all the evaluation and informed consent, but the excitement and progress is definitely worth it and I'm thankful for that.

#osteoblr #residency #family medicine #clinic #lgbtqia #pgy-3 #medblr #gender affirming care #gender affirming healthcare #estrogen #testosterone #transgender #trans

[heardatmedschool]

“Whatever can fit in there, can, and will, get trapped in there.”

About foreign objects in the ear.

#medicine #med school #medblr #pediatrics #family medicine #foreign body #pinned

[trishmishtree]

The funniest part of doing my KSA modules (to keep my board certification) is getting to see a bunch of other random doctors complaining in the comments of each question about how dumb or unfair a question is

There was one question asking us to calculate a positive likelihood ratio and the comments were full of people complaining about how clinically irrelevant the question is

Every time I see a question with like 10+ comments under it, I know it's going to be a doozy that everybody got wrong and is salty about

One dude is so sick of this question set that he's just started leaving sad face emojis in the comments

Pretty much every question has comments under it that are either "the test writers are in the pocket of big pharma, always pushing to start drugs!!!" or "your question is bad and you should feel bad," with the occasional "your question is out of date, they updated the guidelines in 2022"

Every time I get one wrong after multiple tries, I can always count on the slew of angry doctors in the comments airing their grievances and know that the problem is the question, not me 😂

Oh boy, you know they're gonna tear this question a new one

#medblr #family medicine #life of a smol medical bean

[didanawisgi]

#covid-19 #sars-cov-2 #print this off later #fav #family medicine #covid-19 vaccine

[amarcare]

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#Family & Elderly Care Specialist #family medicine #geriatric medicine #doctor for senior citizens #best doctor in Bhopal #medicine #health #doctor

[appalachiananarchist]

Funny clinic story: I had a lady come in to establish care. She moved here from somewhere out west. She had COPD from smoking. She was distraught that "some doctors don't treat a lot of COPD and don't know how to do it well." She asked me over and over again if I was familiar with COPD management.

Sweet child. You are in central Appalachia now. Welcome. We have one functional communal lung between all of us, and it is damaged, too. I learned how to manage COPD before I learned how to take a medical history.

#medblr #family medicine

[emgoesmed]

1/10/2023

First day of family medicine rotation, enjoying it but still feeling tired from the holidays and struggling to get back into a routine. At least my friends’ cat is adorable 🥰

#emgoesmed #studyblr #med student #studyspo #med school #med studyblr #productivity #ms3 #clinical rotations #family medicine #primary care #cat

[wayfaringmd]

She’s fine, she’s just psychotic. Sometimes people are just psychotic and you have to deal with it.

- local psychiatrist

#residency #family medicine #medblr #psychiatry

[eirianerisdar]

New horror stories from the medical world

Went back to work as a fourth-year family medicine resident today after flying back from holiday 48 hours ago

Still horrendous jetlag last night didn't sleep a wink

Saw 32 patients in a 3 hours and 45 minutes AM session (think that over in minutes per patient)

Mentioned to my associate consultant at lunch hour seminar (that I had to stay awake for) that I hadn't slept at all last night and her reply was "Well you woke up properly when you saw patients didn't you? Here I want you to edit this powerpoint tonight for an hour-long presentation tomorrow."

Saw another 24 patients in 2 and a half hours in PM session. Came home. Finished editing the powerpoint at 9 PM.

Sometimes when your doctor looks like she's more tired than you are it's because she is.

#my good ol' workaholic insane associate consultant #have I mentioned I'm also currently doing a diploma in dermatology that needs timed replies for an e conference offset to UK time this week #medicine #family medicine #residency #doctor #junior doctor #my post #personal #medical happenings

[justinesurvivesresidency]

Which intervention level (individual, interpersonal, organizational, systemic) resonates most with you? Describe an action step you intend to take to advance sexual and gender minority (SGM) health equity at this intervention level.

I have always been most fulfilled by making changes at the interpersonal level. Individual changes are probably the easiest to complete but don't have that same sense of fulfillment and organizational/systemic changes are often a bit too daunting and I become easily overwhelmed with so many changes needed.

I have already made some significant interpersonal interventions since co-creating a LGBTQIA+ family medicine curriculum. The one intervention that really left an impact was just openly discussing the community and their needs with a co-resident who was very hesitant about caring for this community and listening to the bad experiences she had had with a member of the community in the past. She felt heard and was then open to taking in more information and learned that several of her colleagues also belong to the community. I watched her become more engaged through further lectures and start to relate the SGM health issues to issues she has faced as a racial minority. She then graduated and went on to provide care for minorities of all types in Missouri, somewhere that desperately needs open minded people like the amazing doctor that I watched her become.

My next interpersonal action step is to teach our new interns about LGBTQIA+ competent care. They are all so excited to learn how to best treat all of their patients. Unfortunately, it is up in the air as to whether our residency will allow me to continue giving regular formal lectures on this topic as there has been a lot of push back from a few opposing individuals. Regardless, me and my colleague who developed the curriculum are seen as experts in this field of medicine, especially gender affirming care, and the interns have already started bringing all of their questions about that to us. While I have quite a ways to go before I consider myself an expert, I do have a lot of knowledge and resources at my disposal and I look forward to teaching them how to best treat all of their patients regardless of my ability to have formal lectures.

#osteoblr #residency #family medicine #clinic #lgbtqia #pgy-3

[heardatmedschool]

“Pay attention, even if you want to be a pediatrician, because guess who brings children to the doctor when the parents are working.”

Geratrician.

#medicine #med school #medblr #pediatrics #geriatrics #family medicine #pinned

[the-pen-and-the-stethoscope]

AHHHH I FINISHED RESIDENCYYYYYYYY

#medblr #family medicine #residency #pgy3