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In my head

April 5, 2012 in In My Head

You instruct your patient to open their mouth and say “AHH” during the exam. Patient opens mouth, but no “AHH”. They just hold their mouth open.
“Ok, I need you to make the noise. Say “AHHH”. Good, I just need to see that hangy downy thing move around a bit.”
(Are the instructions confusing? Two parts. Part one open mouth, part two say “AHH”.)

You walk into the exam room and the patient is sitting on the stool not the exam table.
“I need you to hop up on the table so we can do a proper examination.”
(I know it’s challenging to climb your fat a@@ all the way up to the table, but do try. Pretty please, with sugar on top!)

(Check out what happened with a stool in the OB/GYN room!)

Patient presents with no symptoms, but they know some type of upper respiratory infection is coming and they want to catch it before it turns into something.
“Well, it looks like you really don’t have much going on at this time. I can write an antibiotic for you to take if fever develops or you symptoms worsen in some way.”
(Does this lady just want to be sick? What is her deal? Using this logic we need to just go and put all the citizens in the country in prison just in case one of them might “turn” into a necrophiliac.)

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Family is fun

March 23, 2012 in Pet Peeves and Polls

Totally lying about the one million dollars, but since you’re here continue on and take the poll.

Dealing with the family members of your patients can be extremely taxing. As much as you might try it is difficult at times to be understanding with unruly family members. Put on a smile, be polite, answer their concerns then go talk smack about them in the break room.

Do you answer a patient’s family member when they start asking questions about their own personal health?

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Does your clinic limit the number of family members permitted to be in the exam room?

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Have you ever asked family members to leave the exam room because it was too crowded?

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“I’m not a doctor, but I play one on TV” Part Deux

February 24, 2012 in General interest

If you have landed on this page and are not sure what the hell I am talking about, go to “I’m not a doctor, but I play one on TV.” Part Un. Read that blog then return here and you should be all up to speed. Also, don’t forget to take the “I’m not a doctor, but I play one on TV.” poll after this.

So, this is the second portion of “I’m not a doctor, but I play one on TV.” I never imagined this blog would become so large. I got started on this with one simple word scribbled down in a notepad, “DR”. I wrote it down on a day when I had seen a good number of new patients and had to correct most of them when they said “thanks doctor”. It reminded me of when I was a very green Physician Assistant and it felt like I was correcting people all the time about my title. I started questioning exactly what was I doing? Am I just pretending to be a doctor or am I serving some unique function in the health care system? This phrase “I’m not a doctor, but I play one on TV” kept popping into my head. Literally making me laugh out loud. Of course I have matured in my role as a health care provider and no longer question what I do or who I am as a clinician, but that phrase has been stuck in my head since then. I want those who are looking into becoming a Physician Assistant (I call them wannabes) and those new Physician Assistants (pups) to really understand what they are getting into. Who knows maybe one of them, or one of you have said to yourself “I’m not a doctor, but I play one on TV.”

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Ferverish Debate

February 21, 2012 in Pet Peeves and Polls

Tell me I’m not the only one that hears this; “I never run fever, my normal body temperature is (insert any number that is less than 98.6°F).” Man, this really gets me heated up. As a student some professor or preceptor told me that a fever in an adult is 100.5°F. Being a good scut monkey, I believed them. To this day I tell my patients this very thing, and it burns me when they say some crap like “I never run fever.” This got me wondering if anyone else hears this and how do you react to it when you do? Also, it really got me re-thinking what is a fever? Do we need to reassess our definitions of normal temps? Do some people actually never run fever?

The Mayo Clinic Says a fever is “when your temperature rises above its normal range. What’s normal for you may be a little higher or lower than the average normal temperature of 98.6 F (37 C).” This definition actually makes sense to me, but in order to determine if a person is running fever you have to have some baseline numbers to know what their normal range is. Not very helpful in an urgent/emergent situation.

MedicineNet says “Fever is considered a temperature above 100.4 degrees F (38 degrees C).” This is very close to what I was taught in school. But does it hold true for all Homo sapiens?

So, I bring the poll to the people. I’d like your input on this.

Do you hear this in your practice?

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How do you react when you hear this?

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So what is a Physician Assistant anyway?

February 14, 2012 in General interest

One of the most frustrating aspects of being a PA is having to explain, to just about everybody, what you actually do. When I was in school the program directors and faculty brushed over the fact that a PA will need to be able to articulate their function in the clinic to patients. I naively thought this would be a random occurrence that was isolated to a few patients here and there.

I COULD NOT HAVE BEEN MORE WRONG.

I find that I have to explain what a PA does to patients at least 3-4 times a week. Add to that the 3-6 times a month that I break down what we do to non-patients (friends, family, acquaintances). I have even had to repeat the same explanation to the same patient twice, on two separate visits (He counts twice). As you can see, it starts to feel like nobody knows what a PA is or what we do. The scenario I see the most is when I walk into the exam room, introduce myself and in response I get the proverbial deer in the headlights look.
I stare at them; they stare at me.
On cue….3….2….1.
They ask, “What’s a PA?”

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