Med-Peds Shadowing

Yesterday, I shadowed a med-peds physician for most of the afternoon. Med-peds means they did a combined residency in internal medicine and pediatrics and are board certified in both. A lot of subspecialties are open to med-peds physicians, but about half of them stick with primary care. The physician I shadowed does primary care, which is what I would most likely do if I chose med-peds.

Most of the visits I saw were fairly routine primary care (colds, well child checks, etc). Because of the double certification, the patient population a med-peds physician sees is quite varied. While I was there, we saw some elderly patients as well as some infants. The physician did a routine physical, some check-ups, some diabetes mainenance, and some basic prescriptions.

The last patient we saw was the most complex and the most troubling. She was actually there because her two sons were sick with the flu and they needed checked out - but she had a big list of issues herself. There were so many things going on with this family, that I can't even begin to type them all out. It was borderline whether we should have called children's services or not. This woman had good intentions and wasn't actively putting any of her kids in danger, she was just extremely overwhelmed and had no support. If there were more support set up for her, it would make a world of difference for her kids. It was frustrating standing by while nothing could be done.

If I end up working in primary care and working in an office I really think I would want to have a social worker on staff. It's so important to me that the whole patient be addressed. This family needed support systems set up and needed to be educated on what kinds of services are available for help, but physicians just aren't trained to do that. It should be a team effort utilizing the strengths of different fields.

Perhaps this strong desire to address a wide range of issues in patients is naive and is driven by an unawareness of how being a physician will be. Maybe I'm just not jaded yet and have a naive optimism. I had a hard time going home last night knowing that we really didn't do anything to help that family. I hope I don't ever get to the point that I'm so jaded or just going through the motions that situations like that don't bother me. Seeing a family in that much distress should bother me. I hope that continues and I can figure out ways to provide more support than just acute medical care.