"Family Practice is Certainly Never Dull"
(The following is an unsolicited letter from Catherine Martin, MD, a Family Physician and alumnus of Tulane Medical School currently practicing in Waupaca, Wisconsin.)
As I was sitting here finishing my dictation for the day, I found myself thinking about the people in medical school who told me that I would not do anything in Family Practice except see people with colds and flu and maybe do some annual exams (This was actually more often students than faculty, although some faculty were certainly guilty of it). Then I think about what I have done over the past week, especially today. What a variety we get to see in practice! Unfortunately, that doesn't often get communicated well to students. Well, here is my contribution to raising the awareness of the Tulane student body. If you are interested, you may share this info with students.
Family Practice is certainly never dull.
Catherine Martin, MD
Tulane Med Class of 1994
Things I have done or seen today (7/31/98)
(I really enjoy Family Practice and want to share that with students. I should tell you that the day I describe below was a call day, so not every day is quite so hectic. Actually, I was up until midnight that night transferring the baby I delivered to Appleton to the NICU with episodes of desaturation and bradycardia. However, she was discharged 3 days later and I saw her yesterday in the office. See, it never gets dull.)
1. Diagnosed and counseled a thirty year old man with a new diagnosis of diabetes (who also has hemochromatosis).
2. Plantar fasciitis
3. Mechanical low back pain
4. Greater trochanteric bursitis with injection of the bursa with lidocaine and depo-medrol
5. Normal spontaneous vaginal delivery of baby girl at estimated 41 weeks by poor dates (only 4 prenatal visits and not ultrasounds).
6. Newborn care of probable preterm baby (aforementioned baby was actually more like 35 or 36 weeks, not 41 weeks) with cyanosis on attempted breast-feeding.
7. Asteatotic eczema and brittle nails
8. Splinted a boxer's fracture in a 12 year old boy with planned follow-up with ortho on Monday.
9. Wound infection from skin lesion excision from under breast.
10. Tension headache and light-headedness in a diabetic
11. Acute bronchitis
12. Right lower lobe pneumonia in a 28 year old
13. Acute bronchitis and sinusitis in 40 year old woman with congenital adrenal
hyperplasia and hypertension.
14. Acute bronchitis and sinusitis in 15 year old
15. Pediculosis capitis
16. Prostatitis in a 57 year old who is status-post APR with ileostomy for severe colitis
17. Post-traumatic migraine
18. Otitis media in 15 year old
19. Contusion to quadriceps muscle from 4-wheeler accident
20. Chronic cough
21. Otitis media in 22 month old
22. Rhus dermatitis and impetigo in woman who is status post mastectomy and lymph node dissection
23. Nursing home patient with CHF and hemorrhagic bullae and petechiae of lower extremities
24. 6 week post-partum visit for woman who had NSVD then placenta accreta with transfer to tertiary care center (also has probable gallstones now)
25. 22 month old with fussy spells at night (no otitis media)
26. Elderly man with small bowel obstruction in hospital
Other interesting things from this week:
1. 35 year old woman with severe otitis externa (almost malignant) and poorly controlled hypertension from medication non-compliance.
2. Primigravida with PIH and decreased fetal movement.
3. G3P2 near term with PIH and right upper quadrant pain
4. 4 year old with bronchitis, but was born at 26 weeks and has bronchopulmonary dysplasia and weighs only 22 pounds, but is developmentally almost normal.
5. Shave excision of dermal nevus
6. Excisional biopsy of seborrheic keratosis (pedunculated)
7. Shave excision of dermatofibroma
8. Nursing home patient with increasing confusion and hypnatremia
9. Nursing home patient with weight loss, anemia, pathologic vertebral fracture.
10. 22 year old Type I diabetic who developed diabetes at age five from chickenpox virus (all the other kids got chickenpox, she got diabetes and is immune to chickenpox)
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