Day 1

So 1st day down. Even though it really was a half day. I had orientation this morning which was boring and I will spare you the details.

This afternoon was fun though. The doctor who is in charge of me didn't have too many patients this afternoon, but that gave us some time to chat and for him to show me around. The place I'm working at is quite a big outpatient center - with a number of family docs, a pediatric cardiac center, and a lab, etc.

I feel like there is so much to tell and it's only been the first day. It's partly because Dr. R and I talked about Family Medicine in general and where the practice and role of family physicians is going. We also discussed briefly his feelings about pharm reps, etc. The Pharm thing is hard - because it is ridiculous the amount of money people pay for drugs and how much the pharm reps spend feeding doctors, trying to get them to prescribe their brand. But....the free samples help patients. Docs can give out a months supply of meds at time to help a patient get the meds they need. Penn State is going Pharm free soon which means pharm reps won't be allowed to give presentations, etc. Dr. R (my advisor for the next 2 weeks) - says that he morally understands going pharm free, but there needs to be data backing it up. There are many docs out there - probably too many that prescribe based off of the pharm reps or just out of lack of knowledge or time to look into their patient's monetary situation and prescribe brand names at will. Dr. R says that his history shows him prescribing at a cost that is 43% less than his peers. He's not saying that he's never been influenced by a pharm rep, but that he's doing a pretty good job and in a way he and his patients are being hurt with this movement to pharm free.
It's a tough battle and no easy answer.

He loves his job and has been through some rough times with family medicine earlier in his career - not being able to survive on his own or with a group and that's why he's with the med center. But...he loves his job and can never see himself retiring. He works about 12 hours a day - by choice. He'd choose it again if given the chance.

This year is my year to find out what I will be so passionate about 15-20 years down the road. I feel family medicine is a good place to start. I have a lot to accomplish in the next four weeks. They give us a list of procedures and exams along with a few homework assignments that must be done by the end of the rotation. I'm excited - still a little nervous, but extremely happy to be with patients and people.


Picture: Vail