Tuesday, February 8, 2011

not my clinic

clinic is interesting. the patients typically do what you say and listen pretty intently, unlike a lot of places in the U.S. of course, the private practice clinic I followed a couple months ago had some excellent patients (follow advice, good payer source). in the tertiary care hospital, there are a lot of specialists and even more patients. 60-80 in a day is typical. I think I saw more diarrhea and constipation in a day than I have all year. they all come home with some form of prescription. sometimes it's an antibiotic, well, a lot of times. some WHO approved oral rehydration source (apparently you can make your own in a pinch 1/2 tsp salt, 1/2 sodium bicarb, and 4 tsp of sugar in a 1liter of water), and sometimes some racecadotril (a seldom used drug available in the U.S too), and some Chinese medicine. I'm not sure if the antibiotic resistance patterns are much worse here than the U.S. It would like the case since antibiotics here seem worse than th ER docs giving vitamin R shots (rocephin).

the manners here are different than the U.S. you have patients barging in to check on their status to be seen and no sort of specific order. the nurse is no where as helpful in triaging patients in. they are really good at lab draw and getting the ultrasound done super fast. they don't even takevitals. some of this may stem from the fact that Western medicine is still relatively new here and their med school still emphasizes a lot of Chinese medicine. I know I would get burn out seeing 60+ cases a day though. There is still a big hierarchy system and the older attendings do not see much clinic and never take any sort of call. They do a lot of admin stuff. Some of the same stuff still occurs here though - parents bringing their kids in for basic common sense stuff (diaper rash, diarrhea when it's not really diarrhea, etc), over utilizers of the systems, and people using the ER during holidays as their clinic. I haven't been able to figure out how many people have a primary care doctor.

next is maybe inpt

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