Moderator ventana Posted October 17, 2012 Moderator Share Posted October 17, 2012 Tough day today but also great..... figured I would share the list of Dx so people can see how amazing being in primary care can be - not easy but oh so rewarding to be on the front lines 30 patients seen today - 8:30-5:30 clinic hours - left office at 8:00pm URI Pneumonia Active Trigger point of left Trap Viral Cold Sore Throat/Thrush Cold Hyperglycemia/Diabetic/Cold/Thrush Fever - Viral Impetigo URI Mastitis vs Cellulits Head trauma in 85 yr old on plavix - to ER - uroseptic with negative head CT Calf Cramps - hypomag on labs Abdominal Pain - R/O pregnancy Right Calcific Deltoid Bursitis Pre-op - ST depression seen on lateral leads as a new finding Recurrent pneumonia Lung Cancer - new Dx Male UTI / Diabetic Recurrent Lymphadenopathy Acute Low Back pain/strain Left side leg pain - likely OA but DVT R/O Lumbago Allergic Dermatitis Left Knee Pain, +DVT Reactive Airway /Asthma UTI/ early pyleonephritis Ear Wax and a simple Acute Otitis 30 patients Likely Lung CA Dx Likely cardiac ischemia diabetic... DVT likely in one patient - + D-dimer - US pending no where else can you effect so many people and have such interactions across so many specialities!! for all you new grads out there - don't forget primary care as it is truly a great field! Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 17, 2012 Moderator Share Posted October 17, 2012 I also enjoy primary care activities and working in settings of true need. Working in small emergency departments in inner city and rural environments I end up serving as a de facto primary care provider to many people. The wait for a new pcp for someone without insurance in my community is 5-6 weeks. I have diagnosed and treated many pts over the years through the er for htn, dm, hypothyroidism, etc and provided counseling on a variety of health issues. much of my work overseas centers on providing primary care services. typically when I go to Haiti we see 1000 pts in a week. 900 of those are fairly benign primary care issues, 90 are primary care issues of some urgency requiring intervention, and 10 are true emergencies. as I get older I have come to understand that although em is fun, as far as "bang for the buck " goes you can't beat primary care for influencing the health of large populations, especially with regards to prevention of pathology before it presents to the er. Link to comment Share on other sites More sharing options...
Joelseff Posted October 17, 2012 Share Posted October 17, 2012 Tough day today but also great..... figured I would share the list of Dx so people can see how amazing being in primary care can be - not easy but oh so rewarding to be on the front lines 30 patients seen today - 8:30-5:30 clinic hours - left office at 8:00pm URI Pneumonia Active Trigger point of left Trap Viral Cold Sore Throat/Thrush Cold Hyperglycemia/Diabetic/Cold/Thrush Fever - Viral Impetigo URI Mastitis vs Cellulits Head trauma in 85 yr old on plavix - to ER - uroseptic with negative head CT Calf Cramps - hypomag on labs Abdominal Pain - R/O pregnancy Right Calcific Deltoid Bursitis Pre-op - ST depression seen on lateral leads as a new finding Recurrent pneumonia Lung Cancer - new Dx Male UTI / Diabetic Recurrent Lymphadenopathy Acute Low Back pain/strain Left side leg pain - likely OA but DVT R/O Lumbago Allergic Dermatitis Left Knee Pain, +DVT Reactive Airway /Asthma UTI/ early pyleonephritis Ear Wax and a simple Acute Otitis 30 patients Likely Lung CA Dx Likely cardiac ischemia diabetic... DVT likely in one patient - + D-dimer - US pending no where else can you effect so many people and have such interactions across so many specialities!! for all you new grads out there - don't forget primary care as it is truly a great field! Looks like my pt pop...I LOVE Primary Care Too! You get to do SO much! Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
physasst Posted October 17, 2012 Share Posted October 17, 2012 HA, I saw 6 patients today... 1. Cervical myelopathy that I am simply watching as it is mild.... 2. Lumbar stenosis, severe at 3-4 with neurogenic claudication 3. Thoracic cord injury secondary to kyphoplasty at T6 with radicular and myelopathic features. 4. Lumbar radiculopathy, 5-1, acute on the left. 5. Complicated patient who presents with mechanical back pain on anticoagulation after an MVA several months ago. Mixed presentation. Primary pain complaint was secondary to degenerative facet arthritis, but noted altered AMRs, diffuse right sided weakness, absent and diminished reflexes (diminished L4, L5, and almost absent S1 on right).....all consistent with upper motor neuron findings. 6. Ultrasound guided SI joint injection.... Then a 30 minute research meeting over a late lunch.... Then 2.5 hours of time to work on a new statistical model for CDS evaluation, finish up 2 systematic reviews, and work on this other grant proposal....... I love my current job....perfect day for me.... Link to comment Share on other sites More sharing options...
primadonna22274 Posted October 17, 2012 Share Posted October 17, 2012 Many say it won't make sense for a FM PA to become a FM physician, but first love is irrational. Primary care is definitely my first love. Money will work itself out right? ;) Link to comment Share on other sites More sharing options...
ToppDog Posted October 17, 2012 Share Posted October 17, 2012 Tough day today but also great..... figured I would share the list of Dx so people can see how amazing being in primary care can be - not easy but oh so rewarding to be on the front lines 30 patients seen today - 8:30-5:30 clinic hours - left office at 8:00pm URI Pneumonia Active Trigger point of left Trap Viral Cold Sore Throat/Thrush Cold Hyperglycemia/Diabetic/Cold/Thrush Fever - Viral Impetigo URI Mastitis vs Cellulits Head trauma in 85 yr old on plavix - to ER - uroseptic with negative head CT Calf Cramps - hypomag on labs Abdominal Pain - R/O pregnancy Right Calcific Deltoid Bursitis Pre-op - ST depression seen on lateral leads as a new finding Recurrent pneumonia Lung Cancer - new Dx Male UTI / Diabetic Recurrent Lymphadenopathy Acute Low Back pain/strain Left side leg pain - likely OA but DVT R/O Lumbago Allergic Dermatitis Left Knee Pain, +DVT Reactive Airway /Asthma UTI/ early pyleonephritis Ear Wax and a simple Acute Otitis 30 patients Likely Lung CA Dx Likely cardiac ischemia diabetic... DVT likely in one patient - + D-dimer - US pending no where else can you effect so many people and have such interactions across so many specialities!! for all you new grads out there - don't forget primary care as it is truly a great field! That's awesome. I loved family practice as an MA. My ideal job will combine primary care & urgent care in a rural setting. Link to comment Share on other sites More sharing options...
Moderator ventana Posted October 17, 2012 Author Moderator Share Posted October 17, 2012 follow up to the ?DVT with + D-dimer - neg US - not a DVT..... the idea of a doc in IM is really attractive to me - but only if the schooling and residency is reasonable - I see no need to kill myself with school and residency to get out and do the exact same thing I already do - hence WE NEED A REASONABLE BRIDGE PROGRAM See tag line below.... Link to comment Share on other sites More sharing options...
Guest JMPA Posted October 17, 2012 Share Posted October 17, 2012 Tough day today but also great..... figured I would share the list of Dx so people can see how amazing being in primary care can be - not easy but oh so rewarding to be on the front lines 30 patients seen today - 8:30-5:30 clinic hours - left office at 8:00pm URI Pneumonia Active Trigger point of left Trap Viral Cold Sore Throat/Thrush Cold Hyperglycemia/Diabetic/Cold/Thrush Fever - Viral Impetigo URI Mastitis vs Cellulits Head trauma in 85 yr old on plavix - to ER - uroseptic with negative head CT Calf Cramps - hypomag on labs Abdominal Pain - R/O pregnancy Right Calcific Deltoid Bursitis Pre-op - ST depression seen on lateral leads as a new finding Recurrent pneumonia Lung Cancer - new Dx Male UTI / Diabetic Recurrent Lymphadenopathy Acute Low Back pain/strain Left side leg pain - likely OA but DVT R/O Lumbago Allergic Dermatitis Left Knee Pain, +DVT Reactive Airway /Asthma UTI/ early pyleonephritis Ear Wax and a simple Acute Otitis 30 patients Likely Lung CA Dx Likely cardiac ischemia diabetic... DVT likely in one patient - + D-dimer - US pending no where else can you effect so many people and have such interactions across so many specialities!! for all you new grads out there - don't forget primary care as it is truly a great field! so boring, i would definitly be bored out of my skull Link to comment Share on other sites More sharing options...
Joelseff Posted October 17, 2012 Share Posted October 17, 2012 so boring, i would definitly be bored out of my skull To each his own....what floats your boat? (We should have a thread on why PAs love their specialties!) Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 18, 2012 Moderator Share Posted October 18, 2012 To each his own....what floats your boat? (We should have a thread on why PAs love their specialties!) "boat floating: ENT, surgery, primary care, or derm. why you do what you do" (sounds like an article in jaapa....) Link to comment Share on other sites More sharing options...
physasst Posted October 18, 2012 Share Posted October 18, 2012 "boat floating: ENT, surgery, primary care, or derm. why you do what you do"(sounds like an article in jaapa....) Hehehehehehehe....:) Link to comment Share on other sites More sharing options...
Just Steve Posted October 18, 2012 Share Posted October 18, 2012 First month of family practice rotations are wrapping up this month...not too many cases left me scratching my head but I'm having a blast. It's a steady flow of chatting with folks, learning the best fishing spots, how the hunting season is going, who's the father of the local woman's baby (she doesn't know either), seeing five generations of the same family within the same week. And we do some medicine while we're at it, figuring out how to try to improve their lives when there are no available health care dollars for anything much more than the $4 prescription list and patient education paperwork to illustrate physical therapy exercises that they need to do on their own. Sometimes it feels futile but at least I'm not dodging vomit and blood that's sloshing on the floor of an ambulance while being driven a million miles an hour by a hyperactive squirrel through rush hour traffic, hoping we don't get crushed. Good times :-) Link to comment Share on other sites More sharing options...
Joelseff Posted October 18, 2012 Share Posted October 18, 2012 "boat floating: ENT, surgery, primary care, or derm. why you do what you do"(sounds like an article in jaapa....) Lol, I think I read that! Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Joelseff Posted October 18, 2012 Share Posted October 18, 2012 First month of family practice rotations are wrapping up this month...not too many cases left me scratching my head but I'm having a blast. It's a steady flow of chatting with folks, learning the best fishing spots, how the hunting season is going, who's the father of the local woman's baby (she doesn't know either), seeing five generations of the same family within the same week. And we do some medicine while we're at it... Sauce for the goose... I also enjoy the sweet potato pies the little old ladies bring me for caring for them...I had one tell me "I only used one cup of sugar because I don't want you getting 'the sugar.'" Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.