When I started my clinical rotations as a third-year medical student, upperclassmen told me that I should do Primary Care if I found myself liking all of the rotations. Nine months into my rotations, I now also think Primary Care is a good option if you find yourself thinking about all of the “wrong diseases” on each rotation. Do you want to do something about a patient’s arthritis on Psychiatry? Is that patient’s high blood pressure really bothering you in Surgery clinic? Do you find yourself pushing Tdap vaccinations during Neurology? This is where I have found myself feeling frustrated, along with my patients, because their health concerns do not organize themselves in the order of their specialist clinic appointments.
A doctor once gave me the unsolicited advice that I should avoid Primary Care unless I was okay with being “the dumbest one in the room”–meaning that every specialist would be “smarter” than me in their field. Firstly, I think he was using a pretty narrow definition of intelligence. Secondly, and more importantly, what I aspire to is not to be the smartest or most acclaimed doctor, but to be the most useful doctor possible. As a Primary Care physician, you never know what is going to walk through the door, but you have to be prepared to do something about whatever you encounter in the exam room. I like the idea of that kind of challenge and variability. I spent a lot of time learning Cardiology, Gynecology, Psychiatry and Dermatology—I want to use all of it!
I remember being really excited on my Surgery rotation when we were told our patient, recovering from a hernia repair, might have scabies. My residents, understandably, wanted nothing to do with him, since he was getting discharged the next day. I was stoked. I decided to go look at his skin and talk about treatment. I sat with him for a bit and discovered that he was “in between homes” and couch surfing with relatives. As a result, neither delaying treatment nor covering himself in medicated cream before showering was really an option. So we tailored his treatment to fit what was reasonable in his life. A case of scabies may not be dangerous or “sexy” but it had big ramifications for this man’s ability to maintain access to shelter and get back on his feet.
This is what I love about Primary Care; you can look at a patient’s health in context and ask, “what is the most helpful thing I can do today?” You don’t have to refer out someone’s kidney issues because you are in the Neurology clinic, you can address diabetes even though you thought you were going to talk about arthritis, and you can do something for a patient’s mental health even if you planned to discuss colonoscopies. So here’s to (not) being the dumbest one the room!
About Sarah Dupont
Sarah Dupont is a 3rd year Medical student at the Emory University School of Medicine. She completed her undergraduate degree in International Relations at Gonzaga University. She plans to do a residency in Family Practice after completing her Masters of Public Health in Behavioral Science and Health Education.
Proud to be General Internal Medicine event
Come learn more about what there is to love about primary care at Emory’s first #ProudtobeGIM event on Tuesday, February 16th at 5:30 p.m. in Room 110 at the Emory University School of Medicine. Find out why many of our Emory faculty are proud to be internists, network with faculty in General Internal medicine and enjoy some delicious food and beverages.