8:00 AM- 5:00 PM
I was very eager to arrive at Dr. Handy’s office for the first time. Having been his patient for most of my life, we had discussed me having this rotation many times. When I arrived on the first morning, I learned that Dr. Handy can see upwards of 30 patients a day. This is a very heavy load compared to what I am used to seeing. I had the opportunity to see around 23 patients. The first few that I saw were chronic pain patients that were on multiple medications with many being treated for comorbidities such as depression and anxiety. After seeing these patients, he notified me that he does not have many patients who are on pain medication currently. He believes in an approach to pain in which people try things such as physical therapy, pain therapy, relaxation, yoga, and many other holistic approaches. He is practicing in this way in an attempt to fight the opioid dependence problem that we face in the region. He also notified me that I was going to see many of these patients as it was the beginning of the month, a time when most of his patients on pain medications come in. He explained that if a patient has been on these medications for many years that he will continue to prescribe, but if a new patient comes in he tries other approaches first. One of the very interesting patients that I was able to see on this day had a mitral valve prolapse, so Dr. Handy was eager to let me auscultate the area and hear the common “wooshing” sound. Dr. Handy also just purchased a dermascope and completed a class on its utilization, so we were able to use it quite a few times on patients with dermatological conditions. It allowed us to see certain skin abnormalities such as nevi, melanomas, and many more. One thing that was very interesting was Dr. Handy removing a mole using a punch biopsy and allowing me to cauterize the wound with a silver nitrate strip. I was curious about the mechanism by which this works, and he explained to me that the nitric acid in the compound causes the cauterizing action when it comes into contact with blood. I enjoyed this day very much as I was able to see many cases of general medical conditions and learn about the medications that go with them.
8:00 AM- 6:00PM
My second day got off to a very similar start as yesterday seeing some patients suffering from chronic pain. Just as the first day, Dr. Handy let me perform tasks such as auscultation, using the ophthalmoscope, and utilizing the dermascope. This was a very fun day as he let me take on more responsibility such as issuing a pediatric patient a physical examination questionnaire and freezing a skin tag from a man’s axillary area with liquid nitrogen. He also allowed me to perform an evaluation on a woman’s wrist that I determined to be a possible scaphoid fracture, an injury that I have not had the opportunity to see in my other clinical rotations. One patient came in who was suffering from shoulder pain and Dr. Handy allowed me to instruct the man in some exercises and treatments that would benefit him from a rehabilitation standpoint as well as explain what movements could make it worse. Getting this exposure in a setting outside of physical therapy and athletic training is very interesting as it allows me to see that other medical providers trust our skills and even understand that we have skills that allow us to do many things in a better fashion. At the end of the day a very interesting case came in that took us around an our and a half to complete. A young lady, who has been a long-time patient of Dr. Handy, came in with some family members to discuss her progress with her alcoholism. She told us a story about her passing out in a random place during the past week and how she had been sliding back down a slippery slope since her first trip to rehab. Dr. Handy provided her with a psychological evaluation and explained to her the consequences of her actions. He took a very personal approach and discussed setting her up with rehab again. At the end of the day I asked him how he is able to play so many different roles and he said “We went from packing wounds to an intervention without batting an eye and in the span of 30 minutes. It is just what we do in general medicine”. I stayed in his office for about 30 minutes just discussing what I had learned as he was eager to hear of my experience that day. It definitely was put of my comfort zone being in that meeting, but I gained a lot of perspective and understanding.
9:00 AM-10:00 AM
I was not able to see much on this last day due to it being my last hour. I saw three patients before leaving that involved one lady with a palpable deformity in her breast determined to be a cist, one man coming in for a yearly checkup, and one man coming in to discuss his depression with Dr. Handy. Overall this was a very enjoyable experience. I learned a lot in terms of comorbidities and pharmacotherapy that will benefit me in physical therapy and athletic training and I also got a glimpse into the respect that physicians carry for these fields and the trust they have in their capabilities.
Total: 20:00 Hours