Monday, November 24, 2008

Four Weeks of Leonard PA-C

It's time I wrote about how Leonard is doing at the clinic.

We work just down the hall from each other. It's nice because I can pull him into a room to consult about an abscess, and he can call my extension and double check the facts of when a blood test needs to be drawn after starting a new medication.

It's nice having someone around who I'm not ashamed to look stupid in front of. Leonard is as important a resource as my palm pilot or my stack of medical books.

Our first two weeks were crazy and frantic, but after a month we're getting more into the swing of things. Here are some highlights of Leonard's first month:

Leonard's stats:
# of patients seen per day: up to 16! Our patient load recently increased.
% of patients that only speak Spanish: 65-70%
Clinics Leonard works at: Nampa Clinic (with me) 3-4 days/week, Caldwell clinic 1-2 days/week
# of patients seen with real insurance (not including Medicaid or Medicare): ~7 total

Funniest presenting symptoms:

-abdominal pain starting in the belly button and spreading outward but only when the patient eats eggs x 3 years
-Bell's palsy (a transient paralysis of one side of the face) in a 17 year old female, which the mom was convinced was because she always held her cell phone on the affected side of her face.

Coolest procedure so far: Toenail removal (Leonard is really good at these)

Most frustrating experience: Trying to convince a gentleman that he needs to go on insulin for his very uncontrolled diabetes. Leonard has seen the man about three times now, and has spent a long time trying to educate the him about his disease and the possible complications, but the man won't budge. Leonard came up with a compromise: The patient is doing a two week trial of aloe vera juice which he is convinced will help. If it doesn't he agrees he'll start the insulin. Leonard can't help but wonder if the next time he'll be seen will be in the hospital after he's admitted for complications from his diabetes.

Proudest moment: Diagnosing a pyogenic granuloma (a benign but weird-looking growth, see below) on a patient's leg just from looking at it. The pathology report just came back, and sure enough, Leonard was right. Thank goodness for dermatology rotations during PA school.


Toughest transition - introducing himself multiple times as "Hi I'm Kyle a PA student...um, used to be a PA student, now I'm a PA, um...what brings you in today?"

Leonard has realized that some patients are not very self aware:
He had a pt come in and while going over her current medications she stated:
"Yes, I'm taking some natural supplements. The three "G's":
Ginseng, Green Tea, and, well there's a third one that they use for memory but I can't remember what it's called." (Leonard and I assume she meant Ginko Biloba). She had no idea how ironic that sounded.


7 comments:

Rebecca said...

Sounds like you are sure in the swing of things! So...what are your stats? I can't believe how few of them have insurance! Wow!

jrm said...

I love it! And so happy to hear you're working down the hall from each other. Now when are you coming back to Portland for a visit??

Jeff Hamm said...

huge congrats to leonard for the following:
-patient increase
-speaking medical terms in a foreign language (wow!)
-properly diagnosing all that stuff
-being put on the same plane as your wife's palm pilot (really impressive!)
Thanks for sharing!

helan said...

I recently came accross your blog and have been reading along. I thought I would leave my first comment. I dont know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.


Barbara

http://www.ipodepot.info

helan said...

I recently came accross your blog and have been reading along. I thought I would leave my first comment. I dont know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.


Barbara

http://www.ipodepot.info

Lindemans said...

What the...did your blog get spammed? Weird. Anyway, I love these updates! Keep them coming!!!

Adam said...

Really enjoy reading your blog. Your a great writer megs. and kyle it looks like your kicking butt. great call on the pyogenic granuloma!