Lessons from Clinical Experience 1: Week 3

Week three was only three days. I gave thanks for these three days by eating lasagna and honing my hand-eye coordination (playing COD).

Without further ado, lessons from my third week:

  1. As a healthcare provider and MSK specialist, be prepared to answer questions about ANY related conditions. Does essentially every condition have the potential to affect MSK maladies? Yes, that’s my point. I’ve had patients ask me about their cramps, diabetes, BP, arthritis and cholesterol. Of course I stay within my purview, but it hurts my credibility if I don’t even know a reasonable A1C value.
  2. Thoroughly read patient notes and screen when necessary. PTs have fought hard for and have gained increasingly higher levels of autonomy. This has come with increased amount of schooling and increased cost. I don’t have a license yet, but I am damn sure once I am a clinician I will be protecting my license the best I can. I am going to be more disciplined in taking a minute or two to ensure I appreciate the patient’s medical history. I had one patient leave with a systolic over 200. My documentation was clear about our activities (which weren’t strenuous) and she never reported any symptoms. It turns out there were several factors that played into her elevated BP. You better believe I’m taking her BP and asking about her pharma adherence every time she walks in now.
  3. Symptom magnification vs malingering. This is rather specific to worker’s comp. Apparently malingering implies that a patient is faking or magnifying AND I know their motive for trying to reap benefits. That’s a bold accusation with serious implications.
  4. Chitterlings a.k.a. chitlins are pretty vile to prepare. I’ll take my patients words for it and not try it myself.

Only two weeks to go. Hoping to be able to discharge more of my patients that have been hanging around a bit. We’ll see how it goes. The down time has been nice. I always feel refreshed when I get to put more work into my side projects.

Ramble on,


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