What has healthcare become?

This musing comes after a relatively benign day at the clinic. However, something interesting happened that made me question the entire healthcare system. That is because, unfortunately, what happened is similar to what goes on in "Doctor's offices" around the nation.

I went to see a patient this morning whom I was informed was "self pay" prior to me going in. That is to say that the patient doesn't have insurance, so he will probably not want any blood work or much done. Or does it? This was a 60 year old truckdriver who had a full page worth of medical issues including chronic pain from an accident. He had never had any routine screenings or even a rudimentary prostate and hernia check. This would be unacceptable for any other post-50 year old man WITH insurance or medicare. So what did I do? I listened to all his ailments and decided it was pertinent to check him for a hernia and to check his prostate since he had never had it done and had symptoms relevant to the exam. For the first time ever, my preceptor comes knocking on the door wandering what is taking so long. I finished up and left the room. The first thing I hear from my Doc is "What took you so long?" "He is self pay, you can't be spending time asking him a bunch of questions and checking his prostate." So after I was a bit blown away, I rebutted with "I was doing him a service since he has never had a full physical or been checked out very well since he is self pay." A bit of a slap in the face to my preceptor since he has been seeing this guy for years. But his only response was, "True."

My lesson is that I shall decide now, as a student to always treat my future patients the same, whether insurance or not.

Stick a fork in me..

I'm a little overdo for an update...but it will have to wait a bit longer. I'm swamped, sleepy and should be doing other things instead of interneting it. The DuToit's are on their way to Missouri for the first time and I'm way behind on studying, sleep, exercising, spending time with Lydia and anything else that may be enjoyable. However, things are about to change. I'm going to try and relax for a few days while our friends are here and I'm thinking the Johnson's will have a new addition before the end of next week. We shall see. But I hope everything with the delivery goes as smooth as that little baby bottom is going to be. Anyhow, I will update later about life at the clinic. Adios.

Dual Roles

I have, as a matter of fact, learned something on my rotation. My preceptor informed me what the term "props" is short for. As in "I gotta give you props for that." In case you didn't know, it means "proper respect." Intriguing. I also have become far too familiar with the male prostate exam. This is a right of passage for all men turning 50 and then yearly thereafter. If most men only knew the poor sensitivity of this exam, they would probably be much less cooperative to "bend over and rest your elbows on the table." Unfortunately, the sensitivity of the exam is highly dependent upon the body habitus(build/shape) of the patient, the length of the clinicians examining tool(finger), and how well the Dr/PA know's what he/she is feeling for. Until we come up with something better, the dreaded finger wave continues.

As a side note, it is amazing how many people struggle with depression and anxiety. I have to keep up with all of the patients I see and their ailments. So far, I have logged 4 times as many depression or anxiety diagnosis than any other! I was given a bit of an open door today to encourage a struggling patient who mentioned that he had been a Christian for 12 years but just doesn't feel happy overall. I'm really not sure about my boundaries as a student and medical professional talking about Christ, but God gave me the opening and I couldn't ignore the opportunity. I told him that even as Christians we still struggle with stressors of this life, maybe even more so because of conviction. But that Christ took on our ultimate sin burden so that we can trust in Him fully to provide for us in every aspect of life. We went on and on and talked for about 45 minutes about his life and struggles. I just pray that something I said could be an encouragement for this man. God has blessed me in my life and I pray that he gives me a great ability to counsel those patients in need.

Studying is always on the back of my mind. Therefore I will close this session so that I can review some medical literature. I do believe I will first check to see if the snow has begun. We are supposed to get 2-4 inches tonight and tomorrow. We shall see.

Christmas and PA School Part Deux

A lot has happened since my last update 3 weeks ago. The Skinner trio had a successful and enjoyable trip to Texas. We thoroughly enjoyed spending some time with our family and friends. We chose to drive at night during Lydia's sleep time. This went off without a hitch on the trip down. Although Lydia slept well on the return trip, it felt like torture for mommy and daddy between the hours of 2 am and 415 am. I think the running around for 2 weeks finally caught up with us on Interstate 44. Thank the Lord, he must have drove us home because I think we slept.

Upon our return to Missouri, I began my first 6-week clinical rotation on Tuesday morning in family practice. I see most all the patients myself and then check out to the physician. Now, on Thursday, it has become enjoyable for me to see my own patients. I think it just took a couple of days to get comfortable with everything. The patients seem to find favor with me, even as a student. So that is comforting. So far I have frozen some warts off a guys foot and given someone a flu shot. I was going to do an excisional biopsy on a suspicious mole on a female patient, but she declined because it was very near her genitalia. Oh well, there is always next time. This experience has been a bit frustrating for me because I am a slight perfectionist and have always been good at answering on-the-spot questions. So far I feel like I have failed miserably at answering several easy "pimp" questions from my preceptor. Hopefully it is only temporary because I know the answers, but I haven't been able to regurgitate some of the info immediately. Maybe it is God's way of humbling me before myself and others. Point taken.

I am trying to balance life better now since I have a pretty consistent schedule. Trying to workout 3-4 times a week, do more things with the family, even cooking and watching movies. Not things that we were able to do much the past 6-12 months. God has blessed our family tremendously and I am still amazed at how he has made a way for all of this to happen so easily. I pray for boldness in Christ so that I may leave His mark on this Missouri community before I leave. Adios y vaya con Dios.