Family medicine was an interesting rotation, primarily because of the location, the patient population, and the function of the clinic itself. While family medicine typically features a broad array of diagnoses and exams to perform, the clinic that I rotated at essentially functioned as an occupational health clinic that primarily saw patients that had experienced accidents or injuries as a result of their work conditions. Because of this, my rotation had a strong focus on orthopedic assessments and management for chronic pain for our patients.

One of the most valuable lessons I learned was the need for very precise documentation. Our clinic saw many patients that were involved in workers compensation cases, and the care provider could be liable to provide information and documentation of our visits with the patient in a deposition if the case went to court. This meant that everything needed to be written down with no ambiguity in terms of where and how the patient experiences pain, and what could be found on a physical exam. This greatly strengthened my attention to detail and ability to make sure I ask appropriate follow up questions for everything that the patient complains of. I struggled during my first week, as I had a vague idea as to how I should document physical findings, but I was corrected repeatedly until it became second-nature to write with more detail. I also was able to review the special tests we use in orthopedics, like the McMurray, Lachman, Drop Arm, and Cross Arm tests, in order to evaluate patients for possible joint injuries. This was beneficial to me, as I have a strong interest in orthopedics and would potentially like to pursue it as a career after graduation.

Another benefit that I gained from family medicine was the ability to do thorough physical exams and eliciting history in a short amount of time. Aside from patients, we were also responsible for performing physicals for the Department of Transportation. These DOTs required a head-to-toe exam and a patient’s medical history needed to be commented on in order for them to receive clearance to operate a vehicle. I became much more adept at reaching a “flow” in moving from one body system to another and asking about the surgical and medical history.

While I enjoyed this rotation, I feel it was somewhat hindered by the fact that it was very specialized, and I did not see a large breadth of patient complaints. I saw many patients with acute and chronic pain but we did not treat any other chronic conditions, such as diabetes or high blood pressure.

I would like for my preceptor to recognize that I became much better at evaluating patients physically and performing ortho-focused exams. I was glad that I got to be as hands-on as I was and that I did and I will carry my documentation improvements with me going forward to my next rotations.