Today I got to shadow the OBGYN clinic. I can tell that everyone working there was a super fun person. They all also got along very well and this made my experience very enjoyable. In total we saw four patients in the morning. The first patient was a woman who wanted to exchange her Nexplanon since it has been in her arm for over 3 years. Dr. Lordo explained everything as he was extracting the older device and placing the new one. He even let me help him with the procedure. The second patient was there for an annual. The third patient was one whose story moved me. She was a non-English speaking mother of two. This was her second time seeing Dr. Lordo for the concern of passing blood clots in her urine. After getting ultrasounds, Dr. Lordo, along with the attending, found a big cluster of blood in her uterus leftover from her birth. They suspect that since there was difficulty removing the placenta during the most recent delivery, that it might be growing into the muscle lining of the uterus. In this case, the patient would have to get a hysterectomy done. We were in the patient’s room for 45 minutes because the patient and her father, who was with her, were expressing their concern that they felt neglected during the patient’s two deliveries. Dr. Lordo did a great job by attempting to not escalate the situation, however, I feel that the patient and her father really needed to be heard. After Dr. Lordo said “I understand. I am so sorry you are going through this. We will do our best to take care of you,” the patient felt relieved while tearing up. The last patient was a woman with a fibroid in her uterus that was not causing her any pain but was causing her to pass blood in her urine as well. Dr. Lordo and the attending attempted a biopsy of the cervix to test for cancer cells, however the fibroid was blocking the cervix. This led to Dr. Lordo to suggest booking surgery to the patient since the biopsy was not doable in the office setting.
Critical thinking and Social skills are two clear AAMC Core Competencies I observed in the OB GYN clinic today.
Throughout the entirety of the morning, Dr. Lordo and Dr. Blake, two intern residents, worked hard to critically think through each of their patients’s cases. While presenting the cases to the present attending, I was able to see how the attending walks the residents through each case. For example, when explaining the last patient’s case to the attending, Dr. Lordo thought through the different diagnosis the fibroid can be. The attending gave guiding questions like, “how big is the fibroid?” “Is it painful?” and “where is it?” This ultimately led Dr. Lordo on deciding for the biopsy to check for cervical cancer. Another instance that I saw clear critical thinking was in the third patient’s room. When explaining to the patient what her option was, he was clear that between a hysteroscopy and a hysterectomy, a hysterectomy would be best. He did not just state his opinion, but he gave reasoning. He explained that although a hysteroscopy is less invasive and if the patient chooses to have that done, then she would still have to sign consent for a hysterectomy while going in to do a hysteroscopy. This is in case a hysteroscopy may not be successful in stopping the bleeding, the surgeon would need to begin extracting the uterus. Dr. Lordo was able to thoroughly explain both options very well and give detailed pros and cons of each. I have recently had to make a hard decision using my crucial thinking. As a Health Sciences major who is also pre-med, there are many requirements to fulfill in my undergraduate. I have the option to study abroad for a semester next year, however, I know that if I choose to do that then that means I would have to double or even triple on taking rigorous classes next semester. Since this could impact my GPA, I have decided that I can not go away for an entire semester, but can take a class abroad during the month of May with MayX.
A physician can be able to critically think all day, but if they are not able to interact with their patients, nothing is going to get across well. Especially as a male OBGYN physician, Dr. Lordo made it his priority to make his patients feel comfortable. He never passed judgment and was always very conversational with the patients. A technique I noticed him do was during mammary or any vaginal examination, he made conversation with the patient. This draws attention from the actual exam and makes the atmosphere a lot more casual and less nerve wracking. As a Pathways mentor, which is a first year student class at Furman, I find that many students feel intimidated when having to meet them one-on-one. When I do have meetings with my students, I always start by mentioning to them that this is a very informal meeting to simply make sure they are adjusting to college life. Starting at surface level, sharing my own experience, and paying attention to my body language, are three things I focus on during those meetings that always tend to help the students feel comfortable.
As a future healthcare professional, being able to make my patients feel comfortable while being able to effectively communicate their diagnosis and options to them will be vital. Observing Dr. Lordo today taught me the perfect combination of utilizing both skills simultaneously.
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