Ambulating around with the geriatrics..

Posted by Elizabeth Kelly at Thursday, November 03, 2011

This month I have the pleasure of being on rotation with Dr. Tami Remington in ambulatory care practice. I don't know if people have heard but I am loving this rotation. It is a lot of work, but the amount of knowledge I am gaining from this rotation will help me a lot in the future.

Getting down to the basics with this rotation:

Mondays: Clinic day at West Ann Arbor. We see/phone new and returning patients for management of their chronic disease states: diabetes, hyperlipidemia, and hypertension. Some patients also get asthma action plans or get help managing their weight and diets.

Tuesdays and Fridays: Medication reconciliations and polypharmacy patients at East Ann Arbor. Patients are phoned after discharge to reconcile their medications with what they were taking when admitted to the hospital even before they have an appointment at the Turner Geriatrics Clinic.

Wednesdays and Thursdays: I review patients with Dr. Remington before we see the patients. We also do topic discussions, journal club, and a formal case presentation during that time.

Pros to this rotation:

1) I know a lot more about the three big disease states than I ever thought I would. I feel as is I have a much better understanding of how to monitor hypertension, hyperlipidemia, and diabetes therapy; when to make dosage changes; what starting doses should be; and when to discontinue therapy all together.

2) I know how to take one terrific manual blood pressure... that's for sure!

3) Dr. Remington is super smart and really pushes you to work your hardest, but she is also understanding and tries not to overwhelm you. She encourages you to focus in on your interests. She knows mine is about diet and exercise so she really encourages me to look more into those areas when it comes to patients. I was looking up the new myplate instead of the old food pyramid earlier today in order to help a patient with weight issues.

4) She has absolutely fun and pleasant patients to be around on Monday clinic.

5) You aren't hustling from one spot to another, 9-5. You are given plenty of free time to work up patients' therapeutic plans during your daily routinesa.

Cons:

1) You invest a lot of time and energy on your patients, but usually only on a couple nights a week, not every night.

2) Sometimes it can be disheartening to work so hard helping patients, and then they don't show up to clinic or answer their phones. It especially sucks when you have a bunch of good recommendations to offer.

3) I really can't even think of anything else.

I am really enjoying this rotation and looking forward to the next couple of weeks. I definitely recommend having your rotation at East Ann Arbor with Dr. Remington if you can!