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First Year PA

Are your patients “pain points” or people?

Published June 9, 2014 10:13 AM by Caroline Pilgrim

Going to work full time for the first time in my life felt surprisingly just like the first day of a rotation, except this time I walk into the office and notice my name on the front door at the bottom of the list of providers in the sort of transparent, white print they write those things in on glass. I’ve noticed the past couple of weeks that all my outpatient rotations really prepared me well for interacting with patients and looking at them as whole people. What is different is that I know that I may see these patients again, that I won’t just move on the next month. Amazon.com, a company that has become infamous for its poor treatment of their employees, calls interactions with people “pain points.” In their machine of efficiency, it is vital for them to streamline production so that “pain points” don’t slow down shipments and development especially in their web development sector. I would love to tell an Amazon CEO that my entire life is enriched by “pain points” and I would quit this field if people were ever de-prioritized.

Being a provider forces you to closely examine the medical record: past notes, labs, and procedures. I have found in the middle of very busy day a phrase or a brief encounter with a patient will stop me and strike me with the utter humanness that makes life sad and sweet.

“This patient is a 78 year old Caucasian who is presently living in a motel…”

Or during a patient encounter, “My wife of 28 years wants a divorce because she said she wants to ‘find herself.’  What does it mean to find yourself?”

While doing a physical exam for abdominal pain, “My sister died from an abdominal aneurysm. I have to make sure I don’t have one.”

Just yesterday, “I missed my follow-up in February because my daughter-in-law died… complications of anorexia.”

The appointments are so short yet there is so much in every brief, directed conversation I have each day.

I know it’s not just those who work in medicine who see raw human nature, but I have noticed that in primary care amidst the ‘boredom’ of another upper respiratory infection, another pain seeker, or another general checkup, you can find beauty and pain without even trying. It is there in 15-minute slots in the middle of the best health care system of the world.  It begs the question, “What are we living for?” And we often don’t need to look any further than the next patient to realize living for others is a worthwhile pursuit. Don’t be jaded this week by all the “pain points” but actually realize that in a small way you can alleviate another’s pain. All these patients probably have completely forgotten about the very young brunette in the white coat, but I don’t want to ever forget them.


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