Three days in Family Medicine. It’s been an interesting start. Being out in the polyclinic has been so vastly different from functioning at the hospital and I like it. The doctors are generally friendlier and all-round more pleasant. I guess it would be because the environment itself is much less stressful than the hospital’s environment. Sure, there are frustrations at either place and there’s always a problem with resources but the hours of work and patient load probably gives a more positive impact on the way these doctors are.
Practicing at the hospital and practicing at the polyclinic is also incredibly different. We spend most of the day with the residents in the Family Medicine programme with some teaching sessions with…I guess, the consultants. I’ve learnt quite a bit in 3 days and one of those things is patient-centred clinical medicine. And that’s also a large contributor to the behaviour of these doctors. It’s all about the patient.
It’s a little sad to say but the patient-doctor relationship isn’t nearly quite as explored as it should be at the hospital. Often it has to do with time constraints and the number of patients that need to be seen a day. There’s always that sense of urgency. As such, the biomedical problem of the patient is always thoroughly explored but, not always, is the psychosocial aspect. Often times the disease is treated, but not the whole person. And that’s always the main focus in Family Medicine: looking after the whole person and not just their disease – listening to the patients, managing their disease, managing their illness (there’s actually a difference there), acknowledging and addressing concerns, and being empathetic…to list a few.
I like Family Medicine quite a bit. Granted, it does get a little monotonous sometimes (I recall my 4th year Family Medicine clerkship being extensively so), but when you really talk to patients, every day brings something new and different. I’m at a different polyclinic this year though so maybe they function a little differently. It’s hard to say. So far, I can say I’m pretty satisfied with it and I’m quite happy to have started out my final year with this.
Oh, the difference between disease and illness? Basically, disease refers to the patient’s biomedical problem/complaint; illness refers to what the patient’s ideas/concerns/expectations about their symptoms/disease are.
I still take about 30 minutes (or sometimes more) to fully take a history and examine a patient. We’ve been told to do focussed histories and examinations. They don’t want all that fluff we pull out our noses at the hospital. Ha. Even then, I still take long…trying to practice some patient centred care.