By Arielle Schultz
As a premed Biology major, my Haverford courses have given me ample exposure to the cellular processes at the root of human health. To learn more about the practice of medicine, I knew I wanted to spend this summer engaged in a patient-care centered environment. Thanks to funding from the Jaharis Primary Care Pre-Medical Internship, I spent my summer as an intern with a family medicine physician at the OptumCare clinic in Cypress, CA.
Family Medicine providers see patients of all ages, which lends to an interesting variety of cases. From children who had incurred sports injuries to senior citizens developing dementia, I observed the full breadth of health care management that falls under the umbrella of Family Medicine. Some patients come in once a year for an annual physical, while others with chronic conditions may need to schedule appointments every 3-4 months. Health care providers have to be able to both manage chronic conditions over several years and quickly diagnose and assess acute illnesses and injuries.
The physician I shadowed often said to patients, “Sometimes it’s my job to push you into the medical vortex, and sometimes it’s my job to pull you out.” An advantage of healthcare today is patients’ access to subspecialists who can provide expert care and innovative treatment. But diagnostics can be invasive, treatments have risks, and certain medications have negative interactions. Thus, it is part of the Primary Care provider’s job to distinguish red flags from common symptoms or signs of aging, and to advise the patient and their family on whether to consult further medical care or wait-and-see.
I have learned in my courses about social and environmental determinants of health, and seeing how this played out with real patients deepened my commitment to this component of medical practice. Social support, access to resources, and socioeconomic status drastically impact individuals’ prognoses. For example, a 90-year-old living with arthritis and cognitive impairment who lives alone will struggle more to complete activities of daily living, take her medications, and travel to appointments compared to a 90-year-old with the same conditions, but who has a healthy supportive spouse and multiple adult children living nearby. Then again, if our hypothetical patient lives alone but has the means to afford in-home care, this factor will significantly improve her quality of life. I knew that I was passionate about health inequity but seeing the effects of varying circumstances on real patients really resonated with me. I am determined to work to improve access to quality health care in underserved populations and to work with my future patients and their families to help them access the support they need.
The biggest takeaway from this experience is knowing that empathy and compassion are absolutely fundamental to the work of health care providers. This definitely isn’t new information, but spending time with so many different patients crystalized my understanding. In the world of 21st-century primary care, you have an average of 10 minutes with each patient. 10 minutes not only to collect the relevant information, synthesize it, and give a recommendation but also to gain your patient’s trust. When a person walks into a doctor’s office, they are potentially having to discuss the most painful and difficult elements of their lives. In order to provide them with care, doctors have to be able to show their patients that they are safe, that the healthcare team has their best interests in mind, and that they are going to receive help without judgment. If patient trust is compromised, then not only is it harder to gather information to make an accurate diagnosis, but the patient’s trust in the entire system is weakened, potentially undermining their future care. And of course, if a patient feels comfortable, seen, and heard, they typically have an all-around better experience.
I am so grateful to have had this opportunity. I learned so much about patient care, engagement, and compassion that will make me a better health care provider. I will be applying to medical school knowing that this is what my future looks like, and being wholeheartedly excited to work with my future patients. I am very thankful to the Jaharis Internship for making this experience possible.