As I wrap up my 5th year of #primarycare practice, I can't help but reflect on the TEN "sparks" trainees may miss out on during residency that make this work so rewarding.
1) Spending the majority of time in an office visit talking about kids, grandkids, sports, golf league, and fears for the future.
Very few people get to be a sounding board in the lives of others.
2) Knowing your patients without having to look anything up. What would take another provider 45 minutes to orient to, you can address in 2 minutes or less.
9) Setting mutual limits to avoid frustration or harm at the end of life.
Supporting the family and securing closure when “tune ups” or “additional evaluation” in the hospital no longer align with your patient's goals of care.
10) Calling the family after the arc of life is complete to offer condolences and validate the tough choice they made in transitioning care to focus on comfort after your patient passes away.
If you're brave enough to follow the highs and lows of someone's life as a trusted source for "good" in all circumstances, then primary care may be for you!
It's only the hardest and most rewarding thing you could do.
11/11
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Most people talk about Aaron Judge’s power & distance b/c he’s a 6’7’’ powerhouse who "causes the most damage” any time he connects at bat - a real stat in ⚾️!
Few, though, talk about a key ingredient to his success – #AdaptiveExpertise.
3/
All 3 of the above scenarios encourage interns to leave their comfort zone to do more than simply “explain the data” or “propose a plan.”
This opportunity adds the DESIRABLE difficulty of letting them “say what they think is going on” & most importantly, explain “why?”
2/8
I find interns who inherit a pt & present in an inverted manner have ⬆️latitude to think out loud, particularly if not "performing" in front of med studs.
Best of all, when previous notes were organized by organ system, interns are also free from documentation inertia.
3/8