Category Archives: Family Medicine Stories

The Three Services I Want to Provide to My Patients

Lara Baatenburg

Lara Baatenburg

We all have those areas of life where we just feel incredibly out of place and like we are standing like deer in the headlights. For me, this is going to the mechanic. I’m always nervous to bring my car in; what if there is something wrong with my car and I can’t afford it, what if the mechanic tries to pull a fast one on me, what if, what if, what if? I recently had to go to my mechanic, and he proceeded to list all the things wrong with my car. As I stood there nodding my understanding I was really thinking that I had no idea what he was talking about. He was using words I didn’t know, explaining about parts of the car I had never heard of, and the list of my ignorance goes on. Obviously I know nothing about vehicles, but I don’t want him to know that!  When he finished and asked if I had any questions I responded confidently, “Nope, you did a great job of explaining that, thank you,” when really I had no idea what to ask because since I only understood maybe 10% of what I was told, forming any question was difficult.

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Risks, Benefits, and the “Invisible Bag”

mitchell-f-richard

Richard F. Mitchell, MD, MS

“Did you discuss prostate cancer screening with your patient?”

“I did, but…”

“But what?”

“Well, it was strange, but as I was discussing the risks and benefits, the patient just looked at me and said, ‘This is confusing, can’t you just tell me what I should do? What would you do if it was you?’”

Has something like this happened to you while you were precepting residents? Has it happened to you when you were talking to your own patients? In this age of patient-centered care, we teach our residents to involve patients in shared decision making. How do you counsel a resident working with a patient who doesn’t want to buy into that program? How do you teach your residents to respond to the question, “If it was you, what would you do?”

You might find the answer in an invisible bag.

“There is an invisible bag right in front of you. Think ‘Santa Claus sack.’ Would you like to reach in and take something out?”

“Why would I do that?”

“It’s full of $100,000 bills.”

“Yes! Can I take two?”

“No. But there’s something else you should know. The bag also has blank pieces of paper that feel exactly like $100,000 bills.”

“That’s OK—can I put my hand in now?”

“One last bit of information before you do—it’s also full of razor blades.”

“…Ah.”

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Rising Stars

robinder

Robinder Bahniwal, MD, MA

This is a finalist in the 2015 STFM Blog Competition

This article was inspired by a personal encounter I had after a 16-hour work day on labor and delivery. As I was leaving the hospital and making me way out of the College of Medicine, one of the hematology oncology attendings joined me on my way to the parking lot. He asked me what program I was in, and I proudly said family and community medicine. He responded with how impressed he is by the field of family medicine. I smiled back and asked why. He responded that being a specialist for more than 30 years he is extremely well versed in the literature regarding the diagnosis, prognosis, and latest treatments available within his field. He recalled that he spent many years reading material specific to his specialty, that at times he becomes uncertain of himself when a patient comes in for a follow up, and they ask him for advice regarding their groin pain, erectile dysfunction, or is incidentally found to have a low vitamin D level. He is the expert on peripheral smears, new and innovative treatments of leukemias and lymphomas, but he still has moments of uncertainty, and this was very enlightening and reassuring.

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