Coming into this rotation, I was excited yet unsure of what the day-to-day dealings would be as my site, CitiMed was affiliated with JFK international airport. Besides myself, there were another three students that were divided between two providers, one nurse practitioner, and one physician assistant. Each day, you were assigned to a room, and after some training, you saw and cared for patients independently before presenting the case to the provider. At this office, cases were made up almost entirely of either workers’ compensation injury cases or no-fault MVCs, with the remaining being DOT, CDL, or other pre-employment physicals. When dealing with a workers’ compensation case, this rotation stressed the importance of being able to complete a thorough comprehensive physical exam. As many of these cases will at some point end up in a courtroom, it is our notes and plans that lawyers will request to verify that injuries obtained on duty were serious enough to keep these employees out of work. Adding in that this practice would sometimes see upwards of 60 patients per day, one of my biggest takeaways from this rotation was being able to complete a quick yet efficient exam with an emphasis on all documentation.
When helping complete employment physicals, I was also able to help with some tests that are not normally covered when working on inpatient services like our other rotations. While I have completed countless EKGs prior to and during school, getting to complete audiograms, vaccine injections, and drug testing are things that I have only had exposure to while on my ambulatory care rotation earlier this year. While these tasks are not normally done by the main providers at CitiMed, working with the medical assistants, techs, and front desk staff helped the entire process run smoother for patients and confirmed that healthcare requires a team approach.
The CitiMed system also employs specialists, with teams in Pain Management, Orthopedics, Hand Surgery, Podiatry, and Physical Therapy. Once patients were initially evaluated, we as the primary provider would be able to tailor their care to include services that would serve them best. Getting to spend some additional time with the physical therapy team, I was able to see some of the additional services offered, such as shockwave stimulation therapy, acupuncture, EMG to diagnose radiculopathies, and hyperbaric oxygen therapy.
While this rotation did show me many different aspects of family medicine, I believe this site would be great for students who aspire to go into orthopedics. Being able to accurately use a goniometer to document a patient’s range of motion and understand all conservative management measures such as home exercise programs, epidural spinal injections, and nerve branch blocks prior to stepping up to surgical management, is essential for seeing patients through their injuries from start to finish.