For my seventh rotation, I had the pleasure of rotating at All Care Family Medicine for Family Medicine. I really enjoyed my time at this rotation because it was the first instance in which I had follow up with patients; in other words, I was able to see them at multiple points in time. It was also pretty fast paced, and I saw a ton of patients, which was great in terms of getting experience working with patients. I really learned a lot while on this rotation. 

Rotating in Family Medicine really allowed me the time to connect with patients. As a provider in primary care, your job is to get to know your patients to understand what they value and need in order to provide the best possible care. You learn about events in their lives that may also be affecting their overall health. While you should always take a holistic approach to managing patients, my experience in family medicine made that even more apparent. There are so many things you learn about individual patients that guide your management. For instance, there was one patient I had who was following up on her blood pressure and it happened to be high that day. The question was whether or not to increase or add medications to her regimen for better control, but before doing so I asked the patient if she was going through any stressful events in her life at the moment. At first, she had mentioned something about her mother back in her homeland, but it was difficult to understand what she was saying; however, after clarifying I found out her mother had just passed away and her funeral was being streamed online during the office visit. With this new information, it was decided to hold off on making changes to her medication regimen and have the patient keep a log of her blood pressure measurements at home to bring to the next follow up visit. Moving forward in my career, I hope to keep this experience with me to always remind myself to look at the patient as more than just their disease or condition.

Another thing I had to learn on the job was dealing with patients who don’t speak English as a first language or at all. I usually don’t have an issue with this as I am bilingual in English and Spanish, and most patients I have come across in Queens speak either or, but not being able to communicate with patients was a new experience for me this year. At times it was frustrating because it is difficult to know whether the patient is understanding what you are trying to explain. Language barriers are one of the most common reasons for patients not receiving the care they need; it can lead to misunderstandings of diagnosis or medication non-compliance, etc. It helped that someone else in the office spoke the most common native language I came across in the office, but I tried my best to learn common phrases to say to patients to at least make them comfortable enough to let me perform a physical exam. What I took from this experience is to look into other resources to ensure my patients are getting all the correct information.

Another obstacle I had to overcome while on this rotation was dealing with patients who refused preventative screening tests. A lot of my patients were from the West Indies or from India, so I am not sure if it was a cultural issue or if patients lacked health literacy; it was a combination of things really. My preceptor was great about notifying me that the next patient I was seeing was due for screening tests but that the patient has refused them in the past. I made it a point to try and change the patient’s mind but educating the patient on the importance of the screening, and I think that really made a difference sometimes. I was able to convince most patients to schedule testing, but not everyone took the patient education into consideration. I learned that some individuals will not change their minds whatsoever and it’s something I’ll just have to accept as the patient has a right to make their own decisions. However, it is important to provide alternative options and to document that the screening test were offered, and that the patient declined. As a future provider, I will continue to educate my patients on the importance of preventative screening measures, testing or treatment that may be needed, and always respect my patients wishes. 

All in all, my time in family medicine was great. I loved working with my preceptor Fenny. She was so good at talking to patients and I enjoyed learning from her. Working at this practice showed me the importance of finding an environment that works me and a job that I enjoy doing. I love working with patients and I’m excited to become a PA, but I realized that, while I had a good experience with this rotation, Family Medicine isn’t my first choice when looking for a job.