New Grads in Family Medicine

This post is for those who are considering a job in family medicine straight out of PA school. I started my first job 3 years ago in family medicine. I spent one year at the first practice, and I have been at my current practice in family medicine for 2 years.

I truly believe that family medicine is an excellent job for a new graduate. It’s the bread and butter of medicine. We learn so much in PA school in such a short period of time, so I am a huge advocate of solidifying that wonderful knowledge that we received by starting off in a field that is broad. I consider my experience to be invaluable. On the other hand, I see nothing wrong with specializing right away if you know that it’s truly what you want to do; there is absolutely nothing wrong with that and it may be more beneficial for some.

In school, we learn how to get a proper history, perform physical examinations, order and interpret labs and imaging, and write H&P’s and SOAP notes. What we don’t necessarily learn, even during clinical year, is how to follow up on patients, how to write 25-30 SOAP notes in 8 hours, and how to truly utilize your supervising physicians (SP’s) along with a plethora of other things that only come with experience.

Here are my tips for new grad family medicine PAs:

·      Most importantly: Don’t be afraid to ask your SP. Remember, you have a patient’s life on the line. You may feel like you should know the answer, but don’t forget, this is not a midterm exam!

·      Listen to the patient. Let your patient talk for a couple of minutes before interjecting with questions. He or she will appreciate it.

·      Have a good resource. One of my primary care preceptors emphasized this to me as his final piece of advice. I like Up-To-Date because it’s very current and detailed. I frequently use AAFP as well.

·      Don’t forget how to dose for pediatrics. I used to dread the sick kid coming in because then I would have to use my not-so-good math skills. Remember not to exceed the adult maximum dose for those kids who might be a little bit overweight. I like Epocrates as a reference.

·      Sometimes you will get an acute patient who needs to go to the ER for immediate attention. When in doubt, grab your SP.

·      Don’t forget to have your patient schedule his or her follow up appointment. This is important not only for continuity of care, but also for your business. Remember, you have to build up your practice. For hypertension, diabetes, and cholesterol patients I typically have them come in every 3-4 months with labs prior so that we can review in office. I refill their medications accordingly.

·      Utilize your medical assistants! As a new grad, it’s tough to feel out when you are asking too much (i.e. when you feel you could do things for yourself) and when your medical assistant should really be handling it. Train your MA to do what you want him or her to do and exactly the way you like it. It will make things flow much better. Look to other providers in the practice as an example if you’re not sure.

·      Stay on top of your patients. Make a list on those you want to follow up on right away. Check your labs and imaging every single day.

·      Something I like to do before going in the room is look back on a previous visit with that patient. I’m guilty of having walked in the room introducing myself, only to be reminded he or she saw me a week ago!

·      I have learned that patients appreciate when you explain the differential to them and why you are ordering certain tests. Keep the communication open.

These are just a few things that I have come to learn over the years. There is truly so much more that you will learn for yourself and it just comes with experience. I hope this helps. Leave any questions in the comments section.