Out of control...

• Well, it's been 2 months in residency already! Crazy how the time flies. I'm feeling, well, not that much different than 2 months ago. As usual, each experience I have tends to point out what I don't know vs what I DO. Or at least, maybe that's the part that I remember the most.
• My feedback from the last rotation was no great surprise - my communication and the vague but important "people" skills come naturally to me but I continue to need to work on my booksmarts. (That's what I'm saying, not exactly quoting my preceptor from my last rotation - they use more language like "Meets" and "Exceeds" expectations.) Whatever. I hear what they're saying and am in the process of figuring out a personal improvement or study plan. But today was a killer.
• Today was my first full day in family medicine clinic. Thursdays will be my only full day in clinic, otherwise it's chopped up into 1/2 days of mostly family medicine but a little of this & that thrown in. Anyway, a big learning is the computer system and the newly instituted electronic medical record. There's lots to learn with that alone. Then there's a set of new patients with established illnesses, etc that we have to familiarize ourselves with, plus actually learn about and treat their current medical problem, figure out what resources there are in the community available to them to use and how to access them, how to make referrals and to whom, the various people in the office that help you (nurse, receptionist, referral clerk, social worker, pharmacist, dietitian, psychiatrist, etc) and how to best use them. On top of all that, today I saw what my future could look like. I had a patient who fainted this morning get squeezed in unexpectedly for a 15 min time slot before my afternoon started. Her problem was not too easy since she has a heart condition and required a 45 min consult by the time all was said and done (with several more referrals for me to write after the fact). As a result, I started my first scheduled appointment 45 minutes late and then it was a domino effect, leaving me and my preceptor running late all afternoon. My day was supposed to be over by 4:30pm, instead I left at 6:45pm. Hmmm. I am confident that the whole EMR thing will totally speed things up though. We fax prescriptions directly to the pharmacy so they don't get lost en route. We send referrals electronically to a referral clerk who will print everything up for us and send it all off. And it's wonderful to have the other health professionals in the clinic handy to refer patients to. I can tell already that I'm going to be a fan of the "Family Health Team" approach to care that Ontario has bought into way before BC. I'll see what I can do to learn the best bits well and bring it back to BC.