Sunday, November 9, 2008

One Hundred and Eighty-six, Patient Continuity

So this daily blogging isn't going to work as is apparent to all who read my last one and then glanced at the date on this one.  Ohwell, ONWARDS!  
Continuity of Care is important in medicine for particular doctors.  Mainly Family medicine, Ob/Gyns, Psychiatry, and Pediatrics.  You see the same patients regularly either for checkups or for sick visits.  Hopefully the former, but the world isn't perfect.  Friday closed a chain of events in which I had interacted with a particular patient through three separate events, as opposed to following a patient stuck in a hospital during my rotation.  The first encounter was during my Ob/Gyn month during clinic where she came in for a 28 week checkup.  I can recall the exacts of her circumstances, older mom, excited that she quit smoking during the pregnancy, and with a particular medical condition which required some vigilance on our part when delivery-time came but was not a major worry.After her checkup that day, I placed her out of mind and figured, like the rest of the patients I had seen during those months, that I would let her melt into the pool of faces and names and diagnoses that collects all the patients I see.
Ten days ago during Newborn nursery my fellow classmate was examining a baby who had just come from the OR where mom had just had an emergency Caesarian section.  I didn' think much of it as I was writing my note on another baby while listening to them talk about a medical condition plaguing some mothers when I happened to hear the baby's last name.  I glanced up and without thinking uttered a first name.  The attending glanced down and read the mother's name.  Perfect match.  Mom was not exactly with it since she was recovering from her operation so I didn't get a chance to congratulate her then.  I felt a little warm inside with this patient continuity but again I figured that this was it, the end of the line.  I was prepared to let her and her child melt into the pool of patients although I figured it would take a little longer due to this second interaction, however remote it was.
Two days ago in my pediatric outpatient clinic, again I found myself sitting writing up a note on a patient I had seen while listening to the residents and attendings interacting and teaching/learning.  This time I heard about how this newborn's mother had a particular medical condition but it had been handled properly and there was no sign of damage to the baby due to it.  This time I glanced over at the folder the resident was working on.  There was the last name again.  This time I did go in to say hi.  
I don't know what I want to do yet, but I do want continuity.

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