Monday, December 9, 2019

Life as an Urgent Care Physician

Managing more than just colds and coughs!


Since I've started practicing, a lot of you have reached out to me wondering what it's like working as an urgent care physician, and what a typical day entails. This post will hopefully give you a glimpse into my current role and answer a lot of your commonly asked questions.

How would you describe urgent care?

The best way to describe urgent care would be something along the lines of "Emergency Medicine meets Family Medicine (with a sprinkle of Surgery)." I manage patients from 3 months old to 100+ years old, and I get to do a little bit of everything. Whether I'm treating an asthma exacerbation, performing vaginal exams, managing fractures, suturing lacerations, doing incision and drainage procedures, or treating something as simple as a UTI (just to name a few), urgent care pretty much does it all. We don't treat super complex things like heart attacks or other life-threatening issues, but oftentimes these patients will come to the urgent care instead of going to the emergency room, and it is my job to stabilize them until EMS transport arrives to take them to the emergency room. We perform x-rays, EKGs, place splints and boots, and can even provide IV hydration if needed. We then refer to specialists for ongoing management if a patient requires continued care. Urgent care offers a great deal of variety and I think it's a really great way to keep clinical skills current while avoiding burn out.

What are the hours like?

Urgent care offers a very flexible lifestyle and the hours are pretty nice. The practice where I currently work has two locations, one that is open 9am - 1030pm seven days a week and the other that is typically open 9am - 8pm (with slightly earlier closing times on Fridays and on the weekend). At the location with longer hours, shifts are 9am - 4pm and 4pm - close. The other location usually just has one shift that lasts the entire day until closing time. I usually work until about an hour or so after closing time since we have a rule that as long as a patient walks in the door before the official closing time, they will be seen. Usually someone will walk in around 10:28pm with something more complex to deal with, which means I'm working until at least midnight or whenever that patient is fully managed. Despite this, the hours are still insanely better than any day in residency since I never worked less than a 12 hour shift on any given day during my training. 

What is the patient load?

I typically see an average of 20 patients per shift, but this number can vary by more or less depending on the day. It is a job that requires quick thinking and efficient management, but I have never felt super overwhelmed. Sometimes a ton of patients will all come into the waiting room at once, and other times it is a more steady flow of about 3 patients per hour.

Is there help?

When I work, I am the only physician on staff, so I am responsible for seeing and managing all the patients. There is a front desk person that checks everyone in, a medical assistant who does triage and any procedures I may need done (such as x-rays, injections, strep tests, giving IVs, etc.), and at the busier location, I also have a scribe who follows me into the room and types up the majority of my notes so that I can focus on patient care. During my training, I often split my work with at least one other individual and I usually had more senior residents and attending physicians to step in if I needed help. Urgent care differs in that I do not have anyone to split the load with, but I never truly feel alone as I can always call up one of the other physicians in the group for advice, to provide a second set of eyes on an x-ray image, or to even come in if I feel swamped and need help (thankfully I have not had to do this yet *knocks on wood*). Our medical malpractice insurance company also provides helpful resources such as UptoDate for free, so I always have access to the most current medical information and treatment guidelines for my patients.

How is your work-life balance?

My work-life balance now is spectacular compared to how it was during my training. Before I worked no less than twelve hour shifts per day at least six days a week with every third day consisting of a full 24 (which almost always turned into a twenty-eight) hour shift. Right now, I work an average of three days a week with shifts that range from seven hours to eleven hours. The most hours I have worked in one day since starting urgent care was 14.5 and that is only because I picked up another physician's shift and worked a double. I work less than half of what I did during my training, am more than fairly and doubly compensated, and I have time to explore my passions and do some of the things I love outside of medicine. Even better, we are asked for our desired work schedules in advance of each month's schedule being made, so I am able to plan trips and spend more time with my daughter. The work-life balance is without a doubt one of the best things I've got going for me right now, and it will surely be missed if I end up going back to residency.

What new insights have you gained from working at an urgent care?

Believe it or not, I have learned a lot working in urgent care and not all of it is medical. The main thing I have learned is the power of collaborative relationships. I don't think I truly appreciated the power of collaboration during my training (probably due to fatigue and the type of environment I was in), but now it is more evident than ever and a daily necessity. Whether I'm speaking to a radiologist about a patient I sent for an outpatient CT scan, getting advice from a specialist, or working with my staff to make sure a patient is fully taken care of, I am so appreciative of the collaboration that urgent care involves. It has also enhanced my teaching skills as I am frequently educating patients on things like why I will not prescribe antibiotics for their colds or the importance of seeing their primary care physicians for follow up care. Medicine truly is a team sport, and it sometimes takes many individuals working together to ensure a patient gets the most appropriate care. Additionally, working at an urgent care has strengthened my critical thinking and self-directed learning skills, and the beauty of having work-life balance has taught me a lot about self-worth and recognizing the signs of burn out. Lastly, I've gained more insight into my self as an individual. Whether it's been learning to trust my own inner knowledge base or recognizing my limits as a physician, I continue to work on myself daily and being in the urgent care setting has truly allowed me to continue to learn and grow as a physician.

I hope this sums it up and answers most of your questions, but if not, feel free to ask away in the comments below!


Sunday, December 1, 2019

Thankful Vibes


I originally planned to type this post on Thanksgiving Day, but decided to truly bask in the day and relax. Then I had the bright idea that since I was working a double shift on Black Friday, and it would likely be quiet due to everyone being out shopping (wishful thinking), I would just type this up while I was at work. But after a crazy busy day filled with managing things like what a patient thought was a hemorrhoid that actually turned out to be a huge abscess (and the most satisfying incision & drainage procedure I've ever performed!), a hand versus chainsaw accident (put my suturing skills to work!), and even a feather stuck in the ear (who knew down feather pillows could be so dangerous?!?!), I learned my lesson about planning for any leisurely activities while at work during a time when most people are not working. Moving onto yesterday, I found some time to start the typing process, but ended up putting it on hold to attend an event, and then I decided to go to the movies afterwards (I saw Queen & Slim and thought it was really good). With that being said, I finally found a moment to write about a few things I've been thankful for this year :)

I guess the most obvious thing I am thankful for this year is having a job! I can't tell you how many nights (and days) I spent worrying last year about what this year would bring. Would I have a job? Would I be homeless? Would I be working somewhere completely unrelated to my medical degree? Would I be living in another new state, away from all family and friends, and working yet again another 24 hour call shift during the holiday? There was so much anxiety! But here I am a year later, a working physician, with an incredible job, living in an area that makes me happy, and able to spend time with those people who mean the most to me whenever I want. It's honestly really hard to put into words all the feelings that surround my current state of mind, but one thing I can say for sure is that God's plan is the best plan, and everything always works out perfectly and at the right time.

Another thing I am thankful for is my family and the friends who have become like family (or I guess "Framily" as they call it). My family always comes through for me, provides me with so much help with my daughter, and they're always super supportive even if they don't completely understand my path. I'm even more thankful to have a child who doesn't mind being away from me and who tells me on a daily basis how proud she is of me. And even though I am absolutely horrible at keeping in touch with people, I am thankful for those who still check on me and don't trip when I don't reach out often, and for those who can deal with me and all of my craziness. Over the past year, I have been amazed by the amount of friends who text me to make sure I'm okay, take time out of their busy schedules to travel to hang out with me, and even those who are quick to send me the latest postings on open surgery residency positions so that I can continue to pursue my goals. I might not be the best at expressing it, but I am thankful for each and every individual I interact with, and your love and friendship mean a lot to me. 

Lastly, I am thankful for YOU. Next month will make six years of blogging, and some of you have been around from the very beginning. You've followed my journey from newly accepted medical student to navigating life as Dr. Ward, encouraged me through various struggles, and continued to cheer for me when things are going right. I am beyond grateful for the support you give just by reading my posts, and there have been numerous times where I wanted to give up or quit, but then I receive an email sharing your success story or inspiration that you gained from reading one of my posts. This has really kept me going.

So in my attempt to keep this post relatively short, I'll just end by saying every year I grow more and more thankful for life and all it's ups and downs. I'm thankful for the dark times that allow me to enjoy the happy times, the people who make life worth living, and for being able to live my dream as a physician. I honestly couldn't feel more blessed at the moment, and for that I am truly thankful. I hope everyone reading this had a very happy Thanksgiving, and I wish you all a wonderful holiday season ahead.




Thursday, November 21, 2019

I'm Officially the Mother of a Teenager! (Paris, France recap)

Smiles outside the Louvre Museum in Paris

Life has a funny way of working itself out. Around this time last year, I was feeling overworked and extremely upset at the fact that despite putting in my request well in advance and getting approved, I was still scheduled to work a 24 hour call shift during my daughter's birthday weekend. This meant having to cancel an already scheduled flight and miss my only child's birthday for the first time ever since no one was willing to switch call with me (and who could blame them?).

Fast-forward to this year, and not only do I feel less stressed with the ultimate work-life balance, but I recently returned from a trip to France where I took my daughter to celebrate her 13th birthday. I seriously could not feel more blessed and thankful for life's current twists and turns :) This post will serve as a recap of our recent trip, but since I recently promised to get back to writing more frequently, more posts will be coming soon answering all your commonly asked questions and detailing my recent life experiences :)

Her first silk press!

I've never really understood why, but for the past few years, my daughter had been wanting to go to Paris. She has a picture of the Eiffel Tower on her bedroom wall and Paris trinkets throughout her room, so I figured I would surprise her with the real thing this year to ring in her officially becoming a teenager (yup, I'm now the mother of a 13 year old! *shock face*). But first, it was time for a trip to the hair salon for a new slightly more teenage look. She received her first silk press and judging by how many times she kept flipping her hair, I think she liked it.

Birthday welcome from the hotel

I don't think my daughter actually believed we were going to Paris until the plane started to take off, but the look of happiness on her face was priceless! It was the one picture I wish I would've captured. The flight was enjoyable, and when we arrived at the hotel there was a surprise gift, balloons, treats, and a welcome message waiting in our room for her. It was super sweet!

Sightseeing in Paris!

We arrived around 1pm and although we were tired and jetlagged, we knew we had to stay awake or we would risk being up all night. So we immediately ventured out for some exploring. We took pictures outside the Louvre, walked all the way down to near the Notre Dame so my daughter could check out a Manga shop that she swore had books in English (it didn't), took a little detour so that I could buy something nice for myself, and even went inside the Louvre and took silly pictures with some of the art. We ended the night with a nice dinner together, and then we were out like a light!

Day 2: More Paris sightseeing

We started off our second day in Paris with a trip to the Eiffel Tower where went all the way up to the summit and took in the gorgeous views of the city. Following this we used the hop on hop off river cruise (only $17 for 24 hour access!) to go to all the major stops in the city and take in the sights. We explored so much and the city was absolutely beautiful. In my Instagram highlight story reel of France, I have a video of a man playing the piano in the middle of the road. In my opinion, it captured the feel of the city so wonderfully, so feel free to check it out.

Eiffel Tower fun!

At the end of the day, we returned to the Eiffel Tower to see the light show. My daughter thought it would include various colors during the show and was not impressed with the 5 minutes of twinkling lights. I, on the other hand, was super enthralled! It was such a magical display and I was completely caught up in all its beauty.

Happy 13th Birthday to my little love!

The next day was my little one's 13th birthday and what better place to celebrate than Disneyland Paris?!?! After eating breakfast (during which the hotel surprised her with a cake and candle), we checked out, grabbed an Uber, and made our way to the happiest place in France. When we arrived at Disneyland, we went to the visitor center where she was greeted with a surprise birthday call from Mickey Mouse. I even got her to try escargot for the first time (she wasn't a fan LOL), we rode a few rides, had good laughs, and enjoyed both a parade and the evening fireworks show. I think it's safe to say she enjoyed her birthday :)

Birthday fun at Disneyland Paris

The next day it was time to return home, but we left France full of happy smiles and awesome memories. I'm so happy I had the opportunity to provide my daughter with such a memorable birthday experience this year, and I hope she'll cherish it for years to come. That pretty much wraps up our trip, but I thank you for reading and hope you enjoyed this recap. Until next time!




Saturday, September 28, 2019

The Training Wheels are Off and the Doctor is In: An Update

My glow is back!

So many changes have occurred since my last full post! Over the past three months alone, my life has made a complete 180 degree turn, and I couldn't be happier at the moment. It was only six months ago when I found out yet again that I didn't match into a categorical general surgery spot, and it was so stressful worrying about how I would be able to pay bills, take care of my child, and still continue to live my dream of being a physician. I never could have imagined how smoothly everything would come together for me, and I can't help but feel anything other than blessed and thankful. I've finally settled down enough to write about my recent experiences, so this post will serve as a quick recap for your viewing pleasure :)

Goodbye Philly!

A few days after I officially finished my intern year, I packed up my belongings, sold what wouldn't fit in my car, and I made the long drive back from Pennsylvania to Georgia. During that time, I had no real plan on what I would do for work as I didn't have any jobs lined up, and I was still waiting to hear back from a couple of residency programs I interviewed at for open PGY-2 positions. I only knew I wanted to be back in the south and that I would figure out everything later. During the last week in June, I took the time to relax, hang out with a few friends I made while living there, and enjoy some sight seeing in Philadelphia one last time before I was gone for good!

Badge Official!

During my final week in Philadelphia, I submitted the application to obtain an unrestricted medical license in the state of Georgia (I had to wait until my final day of training to officially have a complete application), and I received the approval email around three weeks later. This approval meant I could finally start working as a general practitioner, and I immediately applied for various jobs in my area. I also spoke with an old classmate who connected me with an awesome urgent care physician who told me his clinic was looking for a new physician. Just a few days after this conversation, I had a chance to check out the clinic and interview with the owner. I started training the following week working alongside other physicians as I couldn't fully work on my own until my DEA license was approved. Luckily the approval took less than two weeks, and my training was paid, so it was a super smooth transition. By the first week of September, I was working full shifts as the only physician on staff, and as we near the end of the month, I am starting to feel a lot more comfortable with my new role. I guess you can say the training wheels are officially off since, for the time being, I am no longer a resident physician, but a fresh urgent care physician.

Mommy-Daughter Time!

This new position is such a welcome change from the stress of residency life. I am no longer working insane hours, I have great work-life balance with much more free time, and I actually get to spend time with my daughter. I agreed to let her continue to stay with my parents another year to enjoy band, her friends, and her dwindling time in middle school, but being only six hours away from her by car (and one hour by plane) is way better than the two flights or twenty hour drive it took from the northeast. We pretty much get to see each other in person now whenever we want, and it's kinda fun making random trips in the middle of the week to help with homework or just relax with my little one.


Third time's a charm?

This new chapter in life doesn't mean my long-term goals have changed just yet. I am still one stubborn individual, and I submitted my ERAS application for yet another go-round of the residency match cycle. Having to re-apply sucks, but the bright side is I didn't have to struggle to pay for my applications this cycle, and no matter the outcome, I know I will have a job this time next year. In the past, I've been pretty quiet about the process, but this time around I will share more about it on the blog to help out my medical student readers. I'll also write a post detailing urgent care life since people close to me have asked a lot of questions about it. As for now, I'm going to use the next few days I have off to relax, and I hope everyone reading this has an amazing weekend!







Saturday, August 24, 2019

Buying / Gift Ideas for Medical Students and Residents

Click the picture to check out my Amazon Storefront!

Not too long ago I received an email from one of my readers who was about to start medical school and wasn't sure what to buy. Most schools are pretty good at providing lists of recommended items and providing PDF files of textbooks, but this is not always the case. This inspired me to create a few idea lists on Amazon to help out individuals starting medical school or residency. So far I only have a few idea lists, but will be adding more in the future.

Feel free to check out my Amazon storefront (www.amazon.com/shop/minoritydoctor) and let me know if there is anything you want added. I'm always open to sharing what worked for me and things that help make my life better. I also remember how lost I felt beginning both medical school and then again during the start of my intern year, so hopefully this will help you out a bit!


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