An AM in the life…

…of a family practitioner.

I still practice 2 days a week. On the chance that some of you might be interested in a peek into the variety of pathology a family doc sees on a daily basis, I jotted down the chief complaints of the patients I saw this morning.   DNKAs are highest on Monday morning because we aren’t able to call to confirm the day before.  I’ve not gone into treatment ordered, and for privacy I’ve limited age to decade and mentioned sex only when relevant.

1) DNKA (did not keep appointment)

2) 8th decade non-insulin diabetic who is OC about his blood glucose readings. One of the rare diabetics who’s under too-tight control.  I go over dividing up his feedings into half meals. I think I’m getting through.

3) 4th decade Hypertensive-hyperlipidemic. Tricor + diet knocked his triglycerides from 739 to 100.

4) 4th decade “sinus infection, need antibiotic.” She doesn’t.  It’s allergies.

5) DNKA

6) 4th decade new patient, no insurance. Had flu sx a week ago, gone, better except developed persistent cough, green-yellow sputum. No sweats-chills-fever. Noisy chest. Non smoker.

7) DNKA

DNKA

9) 4th decade with ED. History of aniety/depression. On no meds. Probably psychogenic but will workup.

10) 6th decade male with lower left abdom pain. No other symptoms.

11) 8th decade with pain in right heel.  Pretty obvious plantar fasciitis.

12) 4th decade with anxiety/”panic”/insomnia.  Robbed earlier in the year. Given xanax by other doc. Helps but she can’t function on it.

13) 5th decade “sore throat” complicated by RA – on methotrexate and prednisone

14) 4th decade “sinus infection” – she really has one.

15) 8th decade with significant gout for 10 days (“why did you wait so long?’) (shrug)

16) 6th decade smoker with cough and purulent sputum

17) 6th decade bipolar with mild cererbral palsy concerned about having swine flu.  He doesn’t.

18) 6th decade smoker on meds for petite mal and RLS thinks he has bronchitis

19) 4th decade with persistent viral syndrome

20) 4th decade with urinary freq and urgency but negative urine.  If culture neg, will do ultrasound

21) 4th decade long-running worker’s comp case – ins company has finally authorized pain management

22) 5th decade with low back pain x3 days since bending.

Endocrinology, cardiology, otolaryngology, psychiatry, urology, infectious diseases, pulmonology, podiatry, orthopedics – all in one morning. And the afternoon will be different.

Family practice may occupy the bottom rung of the physician pay ladder, but it makes up for it with endless variety.