Monday, January 10, 2011

My GP Posting

Such a direct post title.

Last week, 3rd to 7th Jan 2011 was the week I had to tail a GP working in a private GP clinic. And I'm fortunate enough to be able to do the posting in a clinic only 3km away from my house, and I get to go back home for lunch and Zuhur, saved me a lot of money!

The doctor was a middle-aged chinese man whose eldest child is going into a kindergarten this year. And while surveying for the suitable kindergarten, he found that the rate is RM200-RM300 per month for only 3 hours a day! Ishh... Is that kindergarten that good?

Anyway, I am glad that he likes to ask me a lot of questions. Too bad, I didn't get to do any hands-on except for using the auroscope to view someone's infected ear.

There was one boy who came in for abdominal cramp and I noticed his arms and forearms had rashes on it. And when the doctor asked the boy to pull his shirt up for him to palpate his abdomen, I was even more shocked to see an abdomen full of rashes, red large islands of rashes.

The doctor asked the patient things like where do you go for the treatment of this skin disease and so on.
Then, he turned to me, "So, do you know what this is?"
And I was dumbstrucked.
"Is it impetigo? Eh, vertigo? Or is it .... vitiligo?"

And the doctor almost shrieked!
"Impetigo??! Vertigo?? Vitiligo??"
"Which one are u talking about?"

"Sorry doctor, but I do not know. I am confused with all the names now."

"This is a spot diagnosis. You should know what it is once you see it. Take the history from this patient after this. He knows his own condition."

"Okay, doctor..."

So, after interviewing the patient, I got to know it's neither of the -go -go. It was a psoriasis case. Hurm... How am I supposed to differentiate psoriasis from usual dermatitis? I can't even spot diagnose a chicken pox, yet.

And a few days later, another psoriasis patient came in. This time, the patient mentioned the name "psoriasis", so I know it is one. If not, there is no way I would know about it.

Of course, later that day the doctor asked me what exactly is "impetigo", "vertigo" and "vitiligo". And I was smart enough to have peeked into my book and read about them before he had the chance to ask me.

There was another day, he was talking about infectious diseases. And he asked me what was that latest infectious disease that almost turned our country outside down, and made the headlines. Spread through the wastes of rodents, and involves the lakes, I remembered it started with "L" or something like that. I even discussed that with Farahin the week before! After some thinking suddenly I got excited, and answered, "Leprosy!". And he burst into laughter.

"Leprosy is leprosy laaaa... This is leptospirosis!"

Ooppsss. I got confused again.

On my last day, the pharmacist next door told us that drugs containing pseudoephedrine can no longer be sold freely since some people are making amphetamines from it. And he asked me, "Do you know what is amphetamin?"

I said, "Panadol isn't it?"

And he FROWNED....

"Oh sorry! Panadol is ACETAMINOPHEN, not AMPHETAMINE. I got them confused. Sorry sorry, amphetamine is a drug that can stimulate our central nervous system", I quickly corrected myself.

And he gave out a BIG relieved sigh. I am not that ignorant after all.

So, that's pretty much my experience being in a GP clinic, observing a GP's field of work.
One thing I can say for sure, I am glad it is only a week.
I had fun though.

Going back to what I think of GPs, in my last post I mentioned that GPs love to go to the easiest diagnosis and tell the patients to come back to them after a few days if the symptoms remain. But at that point of time, I forgot one most important fact. The commonest reason of a doctor visit is indeed, these easiest diagnoses; cough, flu, fever and abdominal pain. And these diseases are, I would say self-limited but some people preferred to consult a doctor than drinking a lot of water and eat more nutritious food.

And I am proud to say too that, this doctor actually palpated the abdomen of all the patients who came complaining of vomiting, abdominal cramp, or diarrhoea. He tried to exclude all other causes of those symptoms and not directly jump to the diagnosis of food-poisoining. I can't remember seeing many GPs who are willing to get up from their seats, walk to the couch and palpate tens of patients' abdomens a day.


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