so this is the outpatient side...!

Having done very little outpatient work during 3rd year so far (except for like 3 days on OB/GYN), it has come to my attention that as a student, you are much busier in the outpatient than inpatient setting. This is because:

1) Patients in the hospital are not going anywhere, nor do you need to wait for them, so you really can see them whenever you are able. Basically, you can manage your time. If you really wanted, you could spend an hour on one patient. On the contrary, in clinic, you have a set schedule, so once you're done with one patient, another one is waiting for you, and your time is limited. I had more time on the floors to use the bathroom than I had in clinic today.

2) On the floors, you were assigned certain patients out of a whole list of patients. In the office, you see EVERYONE (or at least, every other o_O).

3) If each patient's visit goes a bit longer than is scheduled, you are no ddoubt going to be 'late'. There is no real concept of 'late' on the floors. I had enough time to think and formulate a plan on the wards...that definitely did not happen today.

However, my school's family medicine department is PHENOMENAL. Sometimes I feel like the physicians there know loads more than the hospitalists, because their knowledge is 1) broader in scope and 2) more applicable and realistic. Most people are healthy but need checkups. Also, it is usually a PCP that sees a patient's first presenting signs of any illness. I know this might not hold true for all family medicine departments, but props! :)

The Medscape report I posted about in the previous entry comments on how PCP's are the physicians who most complain about underpayment. After today, I couldn't agree more. Specialists have their job almost handed to them--usually the HPI is already taken, you order some tests that only you can order but don't compensate you back THAT much...you have one area where only so many things can go wrong...on the contrary, the PCP does a lot of the heavy lifting. Honestly, I feel like specialists who get paid the big bucks like cards and GI do so because of their procedures. But family medicine doctors do procedures too! In big academic centers and cities, primary care doctors are grossly underrated. They are THE doctors, THE lifeline, in low resource/rural settings.

 I dunno...this is only my first day on family medicine and already I am both overwhelmed and in awe. It doesn't help that my preceptor has high expectations. Did I mention I'm working directly with an attending?? (but who happens to only be like...in his early 30s?!)

With this year off, if I choose to do onc, I'll be...25 when I graduate medical school. 28 when I finish IM. 31 when I finish my onc fellowship. I keep forgetting that fellows are pretty much attendings. But for those who only have like 3-4 years of residency training, and them WHAM you're an attending--i.e. EM, peds, family med, hospitalists or IM generalists, PM&R, OB/Gyn, neuro, ophtho...basically most things if you don't specialize...some of my medical school CLASSMATES are older than some of the newer attendings. That blows my mind. Especially since 30 is like the new 20s.

That, and I feel like I have friends who range from 23-31. So technically I could be peers with an attending o__O