Finding a job I can do during my postbac

I am making progress with this. 1 offer and 3 interviews. woot!

Terms to remember

False positive
False negative
Positive data
Negative data
gestalt
interobserver reliability
intraobserver reliability

I know I kind of didn't pay attention in some of these MPH courses. However, seeing these physicians practice. It is showing me the importance of being able to interpret data and studies to decide what is best for my patients. I think remembering these terms will help me have stronger conversations with physicians.

Vertical Line Thinking

Is there more to be found beyond what is seen here? Keep searching until you are satisfied to find everything. I need to always ask myself this.

There is a need of creativity and imagination when clinical findings and data don't mesh well. A lot of physicians are afraid to think outside what is known.

Clarify expectations upfront.
Perfect can be the enemy of good.

Satisfaction of Search

This is another error that is often made. This is a tendency to stop searching for a diagnosis once you find one that suffices. A good doctor will search for everything and not one answer that suffices.

I think I am guilty far too often of this type of thinking. I need to work on decreasing this type of thinking in my everyday life. I think by looking at the different types of cognitive errors physicians make. I can see errors in my own thinking and start to remedy then before medical school.

Commission Bias

Commission bias is the tendency towards action rather than inaction. The likely happens with doctors whose egos are overinflated. In these cases, these doctors decide on a course of action even if they are not sure of the diagnosis.

Personally, I have seen this take place in my shadowing and personal experiences with physicians. Luckily, the people I have met shadowing did not do that as much as other physicians I have encountered.

I think the doctor I have liked the best so far clearly gave reasoning for a certain diagnosis with his patients. If they were low income or had a low health literacy, he really broke it down to their level of understanding. He did a great job of trying to relate with his patients. I really enjoyed his honesty when he did not know why a certain thing caused something he stated it. He also cited medical literature to his patients so they could know what he was basing is medical decision on. Loved it.

Post Bac Article in NYTIMES

I love patient care!

This is what I have been waiting for. This is the only job that my heart melts. It just feels so right that I am in the room with the patient. Chatting with them and providing patient care. I just love the patients. Even the non compliant ones. I think all these people have such interesting lives and are so fascinating. I need to keep hanging out with patients and the community until I am in med school. I love it! Research can not top the feeling it has of helping a patient.

Preparing for physcians shadowing

read about clinical reasoning!

Shadowing Day 1

Can I see myself doing what this doctor does on a daily basis?
Yes!! maybe with more female patients/old people/kids
Can I see myself as a colleague of this doctor?
yes i can ...he's a great and sociable guy
What are the joys and frustrations of this career?
none...
What are the pros and cons of this particular type of medical practice?
Consider: size of practice (solo or group), types of patients (age, sex, problems/diagnoses, insurance), size of community, salaried or self employed, paper charts or electronic medical records, hours and call schedule, family life, community service and/or influence, ability to practice in rural area or overseas
Am I drawn to diagnostic problem solving?
hmm need to explore this
Am I drawn to procedures?
maybe need to find out
Is the doctor involved in clinical research?
not much
Is the doctor involved in "bench" (lab) research?
nope
How does the doctor learn more about his/her patient's personal lives? How is it factored into the patient's care?
a lot of open ended questions ....
How does the doctor relate to his/her patients?
Consider: formal or friendly approach, standing up or sitting down, rushed or not rushed, listening or interrupting, speaking with words that the patient can understand or speaking medical jargon or speaking in patient's primary language if it isn't English
he had relaxed body language/like he was chatting with a friend but serious about his medical care
What factors seem to play into how the patients respond to the doctor?
demeanor/presentation
How do I feel when there is no "cure" or treatment options?
okay for now unless its life/death i might be sad
How do I feel about chronic problems compared with acute problems?
indifferent at this point
How do I feel when I see patients who don't listen to advice or who don't take good care of their health?
the physician is frustrated and upset
Did all patients with the same diagnosis seem the same? If not, how and why might they have been different from one another?
Need more data to do this ....
Do I like situations in which a decision has to be made quickly?
he didn't make any situations quickly
Do I like the pace of this type of practice?
yes i did ...slow get to speak with patients
What did the doctor do when s/he didn't know the answer to something?
he said he didn't

Common Family Medicine Problems

Why I am doing an informal postbac | Postbac Premed

The main reason is money and convenience. I am comfortable where I live now. I can pay in state tuition. This is probably the biggest perk. I am confident I can get things done here.