The past six weeks have absolutely flown by, though arguably not as quickly as my recent three day “golden weekend,” which included catching up on television, exchanging stories with classmates on other rotations, and apple picking with friends from college. Regardless, I am finished with family medicine, and for my sake (and yours), it’s time to summarize my thoughts on the rotation (even though I still have a few family med stories to blog about in days to come).
First things first: I loved this rotation. But I suppose there’s a caveat to that: I had the best preceptor I could possibly ask for, and she really felt like she could be me in twenty years. She graduated from the same med school, shares my love for ice hockey and trying new recipes, juggles ridiculous numbers of side projects that include medical advocacy (one of my passions), and even shares my lightning multiple choice test taking speed. We occasionally would stay later than we intended, just chatting about life. As a former educator, she was a fantastic teacher of medicine, but she also taught me lifestyle tips, both for my career and life in general (like putting your kids to sleep in their clothes to save the morning battles… brilliant!).
Add in the fact that I never had to work Fridays and I felt like I had won the family medicine lottery. So, of course I loved this rotation. How could I not?
The question becomes: “Could I do family medicine as a career?”
I always knew I liked working with kids. But this rotation, I realized I really enjoy working with the adult and geriatric populations as well. At this point, I can’t imagine not seeing one of those populations for the rest of my career, so FM is a logical choice to provide balance.
But realistically, the things that draw me to family medicine would be factors of primary care in general:
-I’m good at planning and coordinating; primary care physicians are often the quarterbacks of a patient’s medical team, making sure consults communicate appropriately and that all bases are covered.
-I enjoy the breadth of diagnoses that walk through the door; in one day of Family Med, you can see prenatal care, followed by hypertension follow-up, followed by a well child check, followed by new onset chest pain.
-Primary care docs are constantly being challenged by a new presentation, but if it’s really complicated, they can phone friends from any number of medical specialties.
-Primary care allows you to get to know your patients (and potentially their families) really well. (If my patients love me half as much as my preceptor’s love her, I’ll call that a success.) These relationships potentially will facilitate medical advocacy work, which I would really like to incorporate in my career.
-At this point in my short clinical career, acutely/severely ill patients make me REALLY nervous. I’m sure this will improve as time goes on, but for now, I feel much more at home in an outpatient setting.
But Family Med has its cons as well. One of the biggest for me is that it’s very limited in terms of specialties, and it’s really easy to burn out in primary care. It’s frustrating to see a patient with a BMI of 70 and know that they’re slowly killing themselves, but they won’t take their medications or change their diets. That fact pushes me away from family medicine and more towards Medicine/Pediatrics solely because you can subsequently specialize; I really would like to know I have an out if I need a change.
It also has the potential to get boring. One day, I saw about 10 follow-up appointments for hypertension. Sure, I enjoyed interacting with the patients, but by the end of the day, I didn’t care if I ever had to take another blood pressure again.
At the end of the day, this rotation has done one thing: taken a career pathway that was not even on my radar and placed it at the top of my mind.
And now I’m on to psych. Which is also not on my radar, but talk to me in a couple weeks and see where I stand. Most likely, I’ll be the one hovering outside the patient’s door, reminding myself that they’re “crazy”, not me.