Urban Tales

No, I've not made a return to the tundra (though I do plan to go back for a week in January - stay tuned for chilly blog entries then). Instead, I've tried on the "urban family doc" hat for the past few weeks in my post as a family doc in a community health center in Seattle. It is surely a new kind of challenge. The perks: being able to sleep in my bed and see Ben and Linus daily, having a random day (Wednesday - hence the time for blogging) off in the middle of the week, getting work with some amazing docs (that's right Drs Copp and Weitensteiner!) and interesting patients. The not so perks: having to figure out a new hospital for labor and delivery, not speaking the language of 85% of my patients, budgetary limitations on health center offerings, a medical record system that was created by people on crack who hate doctors... to name a few.

For the most part I'm enjoying the challenge of being a real doctor. I do miss the preceptor safety net (my current safety next is Dynamed. It's sad that being a real doctor means you have to break up with uptodate unless you want to shell out $$$). But I'm finding that the only way you can truly learn how to take care of patients is to just make a decision, go with it, do some research, and modify the plan as you go. This does cause me heart palpitations at times.

I've also noticed that things come in multiples, making for theme-type days. I try to think of a catchy name as if the day were some sort of mini series. For example:

Stamping out disease one runny nose at a time (very popular during the fall/winter months)

Why cough syrup should not be given to small children (very hard to convince people)

Those are more running themes. This week so far it's been some harder ones:

An accidental pregnancy at 44: an overbearing husband and the pressure to keep it

or

An obese 6 year old: how society has failed children

or

Sex at 13: Don't do it. Oops, you already did.

It can be overwhelming to say the least. But I'm taking it one day at a time, or rather one (15 min!) visit at a time. Because 15 minutes is really enough time to counsel parents on why feeding a 91 lb 6 year old MacDonald's, soda, candy, and ice cream throughout the day ("well, she cries if we tell her she can't eat those things") isn't a good idea.

Maybe my blog will land in the hands of someone in charge of health care reform. Yea for health care reform! Oh. Oops, none of those initiatives passed in this election. Oh well, maybe we don't really NEED maternity and child services. Or interpreters. Or health care for immigrant children.

But I digress. Stay tuned to see if this idealistic family doc gets beaten down by the system...