Today, I shadowed Dr. Scott Luria, a physician who specializes in general medicine. I felt prepared for the day because of the research I had completed last night, but I was a little nervous anyway. I had been to the University of Vermont Medical Center in the past, but had never met Dr. Luria. I wasn’t exactly sure what to expect: I knew generally what a general physician’s day looks like, but not how many patients we would see or what my role would be. My goals for the day were to be open-minded, to ask questions when possible, and to better understand the speciality of general medicine.
I arrived at UVMC a little before 8 a.m.; Dr. Luria introduced himself to me and showed me to his office, where he asked me a little about the independent study process and why I had chosen to explore the medical field. He then drew up a window on his computer filled with notes and numbers--the first patient’s chart. Dr. Luria usually sees about 14 patients a day, but today he saw only 6 (partially because of the bad weather, and partially because he had allotted some time for us to discuss each patient). The patient’s chart contains the patient’s personal history (how old they are, where they work, etc.), the patient’s medical history (any problems they have had, and how these problems have been treated), recent lab results, and Dr. Luria’s notes from previous appointments. While Dr. Luria reviewed the first patient’s chart, a nurse showed the patient in and took his or her vitals. She then gave Dr. Luria the green light to begin the visit, and I followed Dr. Luria into the patient’s room. Dr. Luria essentially used the chart as a guideline for the appointment, discussing first the patient’s concerns and then his or her medical history and past problems. He would tend to speak at great length with patients with many concerns or a long list of problems; those patients who were doing well had shorter visits. After about twenty minutes of discussion, Dr. Luria would conduct a physical exam. This exam was made up of multiple parts: Dr. Luria listened to the patient’s heart and lungs before checking the sinuses, looking at the eyes, mouth, nose, and ears, and testing reflexes. The visit was pretty much finished after the physical exam. Dr. Luria would make a couple of concluding remarks, wish the patient well, and then lead the patient out of the exam room. After the visit, Dr. Luria and I would speak a little about the patient’s condition and any questions I had. I asked some specific questions about the difference between diseases or the harmful effects of a certain disease, as well as some general questions about Dr. Luria’s daily work and his career path (why he chose general medicine, how long his residency took, etc.). Each patient visit ran similarly to the first patient visit, and I finished my day at around 5 p.m. Today was a long but interesting day. Through observing Dr. Luria, I learned quite a bit about some of the cut-and-dry medical procedures (such as checking the reflexes and listening to the heart and lungs) as well as about common problems like diabetes and high blood pressure. However, I also learned a lot about how physicians interact with patients. Medicine is perhaps as much about science as it is about people, especially for general physicians, who see patients regularly over the course of their lives. I learned the importance of trust between patient and physician, a kind of trust that is formed only when a physician connects personally with his or her patients. This connection is often formed or maintained through conversation--asking about the patient’s family, job, and emotions. I also learned about the effectiveness of preventative care, or stopping problems before they occur or become too serious. Preventative care can take many forms, such as a flu shot or a cancer screening. Finally, I learned a little about the speed of the medical profession. In essence, everything moves really quickly. Dr. Luria usually sees a patient about every half hour; today, he saw a patient only every hour, and the schedule still felt hectic to me. Overall, I really enjoyed shadowing Dr. Luria today. I’m not sure that general medicine is what I’d like to go into, because I think I might like to do something more specialized. However, I do like the idea of connecting so closely with patients and getting to know them over many years. This unique trust and connection is difficult to achieve for non-primary care physicians who do not usually see patients over extended periods of time. Tomorrow I am shadowing Dr. Sharon Mount, who works in Pathology. My day will be much different because it won’t involve interacting with patients at all, but I’m still looking forward to it!
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As the entirety of my independent study project will take place at the University of Vermont Medical Center, I spent the majority of my day traveling to Vermont, arriving later than I had expected due to a delayed flight. Fortunately, I had nothing scheduled for the afternoon, so my late arrival wasn’t problematic in any way. Once I had settled in to my grandparents’ house in Vermont, I set about preparing for my first day of shadowing. I knew that I had planned to spend the following day (January 4) with Dr. Scott Luria, a physician who specializes in general medicine, but I wanted to learn a little more about the daily work of a general medicine physician. I decided to do a little research; my goals were merely to get a sense of Dr. Luria’s profession and to come up with a couple of questions that would allow me to dig a little deeper into the experience.
I found out that general medicine is another name for internal medicine, and physicians who practice internal medicine have the job of assessing the general health of adults (usually over the age of 18). They tend to see each patient about once a year; during this annual check up, the physician will discuss any medications the patient is taking and any concerns that the patient has before completing a physical exam. The internist, or physician who practices internal medicine, doesn’t specialize in any particular area of the body (such as the heart or the brain), but has a general knowledge of disease and how each of the systems in the body function. Based on my research I drafted a couple of questions for Dr. Luria. First, I wanted to know why he chose to specialize in general medicine. What experiences did he have that led him to that particular speciality? Why general medicine and not family medicine, a similar speciality which deals with kids as well as adults? I also wanted to know if physicians who practiced general medicine ever had to refer patients to specialized doctors--after all, I had found that internists didn’t specialize in any particular area. In addition, what were the most common problems that Dr. Luria sees? Are most of his patients healthy, or do they usually come to him with significant concerns? Finally, I wanted to know what the best and worst parts of practicing general medicine were. Overall, my day was productive (although very tiring), and I feel more prepared for tomorrow because of my research. I am very much looking forward to meeting and shadowing Dr. Luria. |
AuthorKiran Dzur |