Final Shadowing Hours

            Yesterday, April 21, 2017, I completed my 20 hours of shadowing at Finch Family Medical Care in Bristol, Va. for my Spring 2017 Colloquium project. A few things that I was able to learn more about during this shadowing session are the office’s on site lab phlebotomist, drug reps coming in to discuss new medications, and how the providers deal with the drug problem that plagues northeast Tennessee and Southwest Virginia.

            This week I was able to talk to the office’s onsite phlebotomist and watch as she drew the patient’s blood for testing. I was also able to see the order forms and the importance of drawing differing amounts for different purposes. I also talked with both the phlebotomist and the Nurse Practitioner about why certain tests were ordered if a patient was experiencing a specific set of symptoms. I was able to see the process all the way through, at least from the office side, of ordering the blood tests, drawing the blood, labeling the tubes, entering the samples in the computer, centrifuging/storing the samples, and billing for the tests performed. This again, was a completely different kind of shadowing experience than what I had seen before and it taught about yet another side to the medical field and all of the professionals that it involves.

            I was also able to talk to a few of the drug reps who come into the office to speak with the providers regarding new medications or treatments that they are promoting for their companies. I was able to listen to them describe the benefits and side effects of the medications they were discussing and why it would work better for certain patients more than it would for others. These interactions were interesting from all stand points, however I was saddened to see the differences in the levels of respect that these representatives gave to the different providers. It was obvious that they held more respect for the physician than they did for the nurse practitioner. Some of them would not even enter her part of the office to speak to her. This fact frustrated me highly because after speaking with and shadowing the nurse practitioner, I was able to see how much of herself she puts into her work and how smart she is. I also learned that she is going back to school to receive her DNP (Doctorate of Nurse Practice), at the end of this time she will have attended school for a longer time period than the physician at this office and the only thing that the physician can do that she cannot is sign a death certificate. Knowing this, it was upsetting to see them treat her as though she were lesser simply because the initials after her name are FNP and not MD.

            This leads me to something that I have seen ongoing, not only in this practice, but also in other practices that I have shadowed, and that is drug abuse/misuse. Northeast Tennessee and Southwest Virginia are number nine in the nation for this issue. I was able to see first-hand how adamant some patients are in requesting controlled substances such as pain medicine (Morphine, Norco, Lortab, and Percocet) and benzodiazepines such as Valium, Xanax, Ativan, etc. When shadowing the nurse practitioner I was able to witness some patients are extremely angered by the fact that she will not write them for long term pain medication but would rather send them to pain management or send them to a specialist to find out exactly what was going on and more effective ways to help. One aspect that I found slightly funny, as did the other professionals in the office, is when certain patients would come in and request a specific medication such as those listed above by exact name and dosage and give you a time limit for how quickly they needed it called in and how long they wanted it to last. It is funny to see the attitude change in the patients from when they come in at the beginning and are sweet, gentle, and quiet until they find out that they will not receive their medication and they become agitated, hateful, and in some instances belligerent. Seeing these reactions gave me an idea of how bad this situation really is in our area.

            This experience, as a whole, has been not only educational, but has also been so fulfilling. I was able to see multiple sides of the medical field throughout this experience and I feel that I am more aware of the road that lies ahead of me as I continue to strive for my dreams of becoming a doctor. I have gained a deeper appreciation for all whose jobs go into making an office work at its highest capabilities, and I have learned so much about the connections between the seemingly separate medical communities in our local area. I have enjoyed these 20 shadowing hours, and I hope to continue this learning experience both in this family care office and with other specialists in the area.