Video and Direct Observation Precepting: Time to Remove Our Head From the Sand

Keith Foster, PhD

Keith Foster, PhD

Advances in technology have made direct observation by video recording or live-feed easy and affordable, allowing the most financially limited programs to conduct direct observation this way. It is not surprising, then, that a large number of family medicine residency programs use some form of video recording or live-feed direct observation.

What is surprising is the absence of or only passing reference to the issues of informed consent, patient authorization, and procedural guidelines related to video recording and live-feed precepting in the examining room, particularly in the age of HIPAA.

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Family Medicine and Family

Bridgid Wilson Medical Student

Bridgid Wilson
Medical Student

This is a finalist in the 2015 STFM Blog Competition

Our first indication that my pregnancy may not be quite as smooth as we originally thought came around 6 weeks when I experienced some spotting. It was days before Christmas, and knowing that our ability to get care may be limited in the coming days, my husband, a family medicine doctor, reached out to his colleague, Dr Justin Edwards, in hopes we might get a quantitative hCG before the holiday. Not only did Dr Edwards order the tests and let us know the results as soon as they were available, but he also offered the kindest support during a time that would have been otherwise unbearably nerve-wracking. We had a good Christmas because of Dr Edwards.

A few weeks later, just when I started to feel less anxious about my pregnancy following our first little scare, I began experiencing episodes of tachycardia. The episodes increased in length and frequency over time and quickly became refractory to vagal maneuvers. Not only did Dr Edwards identify the diagnosis following a Holter monitor study, but he also presented me with the appropriate medical management options. Furthermore, he listened patiently as I routinely—and I’m talking at each visit “routinely”— agonized over taking pregnancy category C medications, and would gently remind me of the current literature suggesting that my medication would not harm the baby at this point in the pregnancy.

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The Path You’re Meant to Take in Life

Farrah Fong Medical Student

Farrah Fong
Medical Student

This is a finalist in the 2015 STFM Blog Competition

Sometimes, it’s difficult to recall that single defining moment or person that sends you on the path you’re meant to take in life. I was fortunate in that I found that experience halfway through my undergraduate career at University of California, Davis. I had recently lost my grandmother—although I’d wanted to help, all I’d been able to do at the hospital was translate for her. That overwhelming sense of helplessness I felt due to my lack of medical knowledge fueled my desire to help and serve others as a physician. Since I needed to find someplace to start, I applied to become a patient advocate and medical interpreter for Paul Hom Asian Clinic, a student-run clinic that provides free health care to a predominantly uninsured, Cantonese-speaking population.

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