Dr. G was the doctor I followed, and he was not at all what I expected. In the first five minutes of talking to him, he decided that I should know how much he made, and that was the first shock of the experience. He made nearly double the median income for a primary care doctor. He also takes a ten-day vacation every month, has weekends off, and never takes call. I think he got that all out up front to counter everything that I've heard about primary care: that you're overworked and underpaid. I did quickly see, however, how he managed to do that. Dr. G saw about 40 patients in eight hours! He was a whirlwind that whole time, bouncing from room to room, glancing at charts for a few seconds and dashing off in another direction. This was the second shock for me. I've always heard that it is bad medicine to hurry through, that the patients become very dissatisfied. He got me to work immediately interviewing patients and reporting back to him. They had taught us to do a medical history in our class, but this was completely different. I realized that if I was to take a full medical history, I would be there forever! I just tried to get the history of present illness (HPI) portion down. After getting this part of the interview down, one patient remarked to me that I was very lucky to shadow Dr. G and that they loved how Dr. G always took his time with them and they never felt rushed. My jaw dropped. This doctor was seeing patients at more than double the speed of the other family doc I had shadowed, and still somehow the patients weren't feeling short-changed. I soon saw how this could be managed.
Dr. G had some killer people skills. He always came in with a huge smile and a joke on his lips. He often wrapped his arm around the patient and then immediately started with the person's complain that he had gotten off the chart previous to coming in. He sat close to them, listened intently for thirty seconds or so, and even started examining them while they were talking. He would throw in a comment here and there and carefully, yet effortlessly, guided the conversation to the end point of discussing treatment. He would always throw in a couple of compliments. The patients somehow felt comfortable enough to interrupt him with a concern, and he would interrupt them if they got too far off track. He would talk about his treatment plan for them with utmost confidence, joke around for a bit more with them, and walk out with them, and direct them to the desk to pick up their prescription that he would send over electronically. Then, he'd jump into the next room and repeat the same thing. He'd take breathers to chat with the staff and me, or run into the back room to dictate a stack of charts, but that's what he did the entire time. It was exhausting for me to try to keep up with him. He always kept at least 4 examining rooms filled with patients for the entire day.
I saw how crucial the nursing staff was to keeping up the pace. Dr. G's nurse always saw the patient first to get the stats and the chief complaint and kept up a steady stream of papers for Dr. G to sign. The nurse was extremely friendly with the patients and kept the steady stream of patients filing into the newly vacated exam rooms.
Overall, the experience was very enlightening. I feel like I got a small glimpse into the 'real world' of medicine, for better or for worse. I really doubt I could ever get Dr. G's speed or people skills, but I certainly began to see the truth of being able to practice as you see fit. There are different ways to doing this job, and each doctor brings his/her own unique style into the picture.
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