When patients think I’m too young

What often annoys me, is when patients think I’m too young, and therefore they perceive that I’m not experienced enough. It doesn’t help that I’ve only just started work as a GP, and every now and then I have to phone up my supervisor for advice. In fact, I probably still am quite inexperienced, but which starting GP registrar isn’t inexperienced? It comes with time, and right now, I’m doing the dam best that I can to improve my knowledge and experience, something which patients can’t appreciate in that 10-20 minute consult that I conduct. Never mind the weekends that I end up spending trying to study up on the cases that I didn’t know much about during the week.

I remember in the first few days of work at my practice, one of the patients said “oh, it seems that doctors are getting younger and younger”. In reality, I feel flattered that I look young for my age (I’m around 28 years old this year), but at the same time, I feel like that me being so young means that the patient won’t have as much confidence in my diagnoses, in my management plans.

Just yesterday, I had a 20 year old patient talk about “closing the gap” program, to which I advised that I wasn’t entirely familiar with it.

“Are you sure you’re a doctor?”. Fed up at this so called “joke” (what an utterly tasteless joke by the way), I shot back matter of fact “Yes, of course I’m a doctor”. From what I make of it, I don’t believe that she would have made such a “joke” if I perhaps looked much older. The fact that I was feeling a little stressed out at the time didn’t help, as the patient mentioned irregular vaginal bleeding. In my mind, I was trying to work out what the best approach was. Thoughts about ruling out pregnancy, ruling out STIs and ordering blood tests swirled through my head. But this patient’s a lesbian. Do I still do a pregnancy test? She seemed the patient that was easily offended, and very crass with her comments. I opted to do some blood tests, and stealthily added a “serum bhcg” to the form.

Being the youngest in the practice (every other doctor has greying hair), it would appear that if patients had a choice, they’d obviously go for the greying hair doctors. I mean, who would trust a young doctor who just started out over someone who’s had 20+ years experience as a doctor right? What they forget though, is that being young and still learning, I’m probably more up to date with the most recent guidelines, more technologically savy as well, and well um, less cynical as well.

But I don’t think all that matters in the 10-20 minute consult. It’s just first impressions. At the end of a consult, if I am able to convey a sense of confidence, an attitude and an approach that seems beyond my years, I hope that the patient won’t just think that I’m too young and inexperienced just based on how I look. That behind the young face is someone who has worked hard, studied hard, and knows what they’re doing to do a great job of treating the patient.

 

 

Experience Comes With Time

It’s always been said that experience comes with time. That’s something you can’t rush, as it takes exposure and learning from mistakes before things become ingrained into one’s repertoire of knowledge and skills.

And so, that’s what I’ve realized the beginning of this year. That I have definitely gained a year’s experience of being a doctor.

It’s strange in that going through my rotations, I always felt in a way that I wasn’t making much progress. I’d get familiar with a rotation, start to get comfortable, and then bam! It’s time to move onto the next rotation, where I am completely unfamiliar with the environment, and the jobs that I’m supposed to do. And it’s from the fact that I’m always moved to new units and wards that keeps making me feel like I have made no progress at all.

It hasn’t only been till the beginning of this year, where I am currently in Emergency rotation again that I can actually feel the progress I have made from last year. Taking a history is much smoother, as I am familiar with certain presentations and know what questions to ask, what differential diagnoses to consider and what relevant investigations to order.

What also surprises me, is how my just seems much more organized with things. Last year, I relied on a clip board and paper, scrawling almost everything the patient told me. This year, I still bring a clipboard and paper, but find that I spend more time listening to the patient, and only note things down that I will forget like a list of medications, or a list of their past medical history. I’ve always been in awe of the doctors that could take a history without a pen or paper, and recall nearly everything about the patient history. I thought they possessed some super human memory capabilities, something that I was lacking in. But I feel a step closer to that now 🙂

Another thing that happened last night, was when the consultant told me I did a “good job” at the end of my shift. I had never been told that last year, but being told that last night really made my day. It was something I never would have expected, not the least in the Emergency Department anyway.

Taking from all this, the past year has definitely given me some experience. I’ve learned from mistakes, I’ve become familiar with common presentations, I’ve gained some experience. And now I can see why most consultants have grey hair. It’s taken them a lot of time and experience to get to their position, and it isn’t something that can be had overnight.

Deja Vu

Wow, it has certainly been too long since I wrote in my blog. Christmas came and went, as did new years, yet I hadn’t written a thing in my blogs.

These past few weeks have been both relaxing and busy. On my medical rotation, the consultant was busy admitting a lot of patients, so I was kept busy. Ridiculous hours ensued, with me leaving on most days around 6-7 pm. It didn’t matter; I felt I learned a bit, and the work wasn’t very stressful, so I felt ok with it.

Today felt like I was coming back from a long break. I had a total of 6 days off work, before going back into ED. And what deja vu I got. I felt like I was repeating things from 4 months ago – same environment, same senior ED doctors. Except now I was writing JHO at the end of my name. Yeap, it’s officially the first day that I’m no longer an intern anymore. I’m a fully registered doctor. But I’m scared. Scared that I still don’t know enough about medicine. Scared of the night shifts that I will be doing in about a weeks time, where there will only be me, another resident and a PHO managing all the patients from 10pm until the next morning. I don’t feel ready. I don’t feel ready at all to be managing a large patient work load.

The other deja vu feeling, was walking into the kitchen area and toilets. Reminiscing the feeling of feeling extremely lost close to 6 months ago. Lost in the work I was doing (because I had no clue what I was doing) and feeling lost personally (due to breakup with girlfriend). Walking into the toilets gave me a momentary feeling of feeling lost again, and I realized how lost I felt half a year ago. Dread would fill me up at work, and I couldn’t help but feel despair on some days, and hopelessness. The only hope I held out, was that the pain of heart break would be temporary, and the suffering of the nature of my work would soon be ending as well. They were tough times I remember.

I still don’t know how tough round 2 of ED will be, but I feel more confident in myself. Perhaps it’s the experience in the past year?

My aim for this year, would be to write more regularly in this blog (at least twice per week). It will give me relief from the stresses of work, let me speak my mind, and let me see things from a new perspective.

I guess it helps that on ED, at least I get to go home on time 🙂