Adam Lake, MD
Precepting is a sieve that catches all the most complex pieces of the clinic day. A man with liver failure, who is somehow still alive, is present for a hospital transition of care visit with our nurse practitioner. He is dying, and while no one has yet told him this, it could be surmised from a quick glance at his chart.
The resident presents a patient with a history of opiate addiction who has a severe ankle sprain, and only the most tenuous employment. The resident wants to know if the risk of relapse is higher if we prescribe an opioid or if the patient loses their job.
Another resident would like to order a patient’s sixth CT scan of the abdomen this year for their non-specific chronic abdominal pain. The treatment here is in first taking a history of the resident’s fears, and in assessing the therapeutic value of another CT.
I am fortunate to rarely precept alone. Our clinic is large enough that I get to eavesdrop on many of the preceptors who trained me. I look up to them as mentors. I see them as The Great Family Doctors, with whom I hope to someday be held in similar esteem. What makes for a Great Family Doctor?
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