Family Medicine

Hi everyone! I’m excited to start a new section of the blog under PA-C that interviews Physician Assistants working in different specialties! I wanted to include this in my blog because first I am curious to really know the reason why PAs choose certain specialties, second, I am able to investigate before I one day chose a specialty, and third, because I think it will be helpful to pre-pa and PA students to see what PAs actually do in each specialty so they can narrow down their interests.

On to the first specialty: Family Medicine with @thepolishedpa

How did you hear about the PA profession/What got you interested in the PA profession?

Like many pre-PA/PA students I started off with intentions of going to medical school. My goal was to work in dermatology because I was always fascinated by skin. I was struggling in some math and science classes, and I became discouraged. I did not feel motivated to complete all the difficult pre-requisite courses only to move on to 4 intense years of medical school, plus an additional 4 years of residency with my only interest being dermatology. I also learned that to get into dermatology, you must be in the top of your medical school class. This was all very discouraging for me! Regardless I pushed on, and I completed a summer medical and dental education program at Duke University. I had the opportunity to meet with other students like myself who were just trying to figure out whether medicine was right for them or not. I shadowed at Duke Medical Center. I became more and more interested in medicine in general. I met the PA school director who told me all about the profession. The profession actually originated at Duke University, and he was one of the very first PAs! He explained the fact that you can get into any specialty you want and you can even change specialties. I was fascinated and from then on, I knew PA was my dream job. This gave me so much motivation that I needed.

What specialty are you in right now, how long have you been in it, what do you like about it, what don’t you like about it?

Ironically I am not in dermatology! I have been working in family medicine for almost 3 years. After learning so much in such a short time during didactic year and during clinicals I really wanted to broaden my knowledge of general medicine before specializing. You can start PA school very one-track minded, and you are exposed to so much throughout school, that it’s only natural that some may gravitate toward a field unexpected of them. The way I see it, you can start in family medicine (or emergency medicine, internal medicine, urgent care etc.) and then specialize more easily then you can do the reverse.

I like the variety that I get in family medicine. I see ages 3 through 103. I do well child exams, adult physicals, chronic care management, acute care visits, and even pap smears. I get to suture lacerations, perform I&Ds, and perform cryotherapy of lesions or mole removals. I like the Monday through Friday 8 to 5 schedule. I love developing relationships with my patients, and getting to see them progress in their health. When those cholesterol numbers come down, or diabetes is reversed because they are losing the weight like we discussed, I am so proud! And when someone says that you saved his or her life, well that’s extremely gratifying!

What I like and dislike all at once is that I never know what to expect for the day. Somebody might come in complaining of indigestion and have an acute myocardial infarction. So you really have to be on your toes more than one might expect in family medicine. I sometimes need to redirect patients to the emergency room.

Another thing I’m not too fond of is the idea of having to “know it all”. It can certainly be overwhelming. Entire families look to you as the decision maker for their health issues. Sometimes the idea of specializing and being extremely good at what you do is a more desirable idea. I also dislike the pressure of seeing so many patients in such a short amount of time.

What does a normal day look like?

I typically arrive to work around 7:50 am and I review the patients on my schedule. I will review pertinent labs or imaging for each patient I will see that day. Then I will see my first patient at 8:00. The time slots are usually every 15 minutes up until 11:30, with 30 minute time slots for physicals. Then I have a pretty long lunch hour because I don’t see patients again until 1:30. I will eat lunch and spend time finishing up my progress notes for the morning. I sign off on all my labs and imaging and address patient phone calls/tasks in my inbox. I usually have time to spare, which I understand is pretty rare in family medicine, so I am definitely blessed! Then I will see patients from 1:30 to about 4:30, finish up my afternoon progress notes, and leave work by 5 or a little bit after. I see anywhere from 12-27 patients per day. There is a lot of variation depending on the time of the year, and how many doctors or PAs are in the office on any given day. Also of note, I may start off the morning with 8 patients on my schedule, but by the end of the day I will have seen 27! So I really never know what to expect for the day.

Are you interested in changing your specialty at some point?

I do plan to do dermatology in the future. It’s still what I am passionate about.

If you were to renegotiate your contract with your supervising physician right now, what would you change?

I would want more vacation time!

Advice to PA students for entering the workforce.

Be confident, but never be afraid to ask your supervising physician. If you may lose sleep over it, ask! It can help to start in general medicine (e.g. family medicine, emergency medicine, internal medicine, urgent care). I don’t think the experience would ever be something you would regret. And if you’re not sure what you want to specialize in, this can help you narrow it down to what you enjoy the most in medicine. Make sure you are working for a good doctor/group of doctors. This can make all the difference in your happiness at work. You can usually tell by reading patient reviews on the practice and at the time of your interview. Never get comfortable and always continue learning. Always put the patient first!

Thank you to @thepolishedpa for your open answers and time! Check her Instagram page out by clicking her handle above!

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