During your first few months as a PA, you really are trying to take it all in: sponge away as much knowledge as you can, form good habits (like never getting sloppy on the physical exam) and develop a style that will carry you through forty years down the road. It's daunting. Primary care is a crunch and though the PAs are programmed to ‘spend more time' with the patients and handle the acute visits, patients can still seem like careening trains that only the primary care clinician can really slow down.
At least every other day I have a conversation like this:
"So what brings you in today?" I say.
"Well, I was just at the neurologist (or rheumatologist or orthopedist-you name it) and I am confused and just wanted to talk to my doctor because I know you guys are the ones managing everything."
I cringe a little on the inside. I recall in my training my patients would ask the most bizarre, irrelevant questions and our rote answer was, "Ask your primary."
I am gleaning the fruit of that seed each and every day. These usually aren't the most go-getter patients, so often they won't remember the medication changes. Of course, the consult notes are rarely faxed over, but we forge ahead in the coordinating of care.
Some of the time, these patients insist on laying eyes on their doctor. After all, I'm still the new PA. Sometimes we just parse out what they remember and I give a pat, "Follow-up in two weeks and make sure neuro faxes your charts."
We make some headway. I tell them their vitals look good. I check a metabolic panel. I refill a med. Everyone is happy.
And I step away hoping we made progress in the chaos of the patient's medical problems and realizing there is something to be said for familiarity, for trust, and the importance of someone who will listen.