Today was slightly less busy than the first few days of the week, but we still saw a good number of patients. I learned even more about the wide scope of a pediatrician’s job: not only do they have to handle and diagnose uncooperative children, but they also have to deal with their parents — almost another set of patients in and of themselves. In fact, even before we started the day, I was warned about a couple parents we would be seeing on the schedule. One that stood out to me was a mother who had to be absolutely certain that her daughter’s father would not be able to find out certain information in case he were to call the office asking for details of her appointment (because he would “punish” her). Dr. Villareal had to explain that he did have legal parental rights to his daughter but that she could put certain comments in a “confidential” section that he would not be able to see. Another mom asked the doctor about her son’s rash, when he wasn’t even present at the appointment (it was his sister’s checkup). There was also a boy coming in for medication management who had already been prescribed three different medicines, none of which were working. Dr. Villareal explained to me that he suspected that the patient hadn’t actually been taking them as directed and that he might have been faking his side effects, but that there was no way to be sure. Out of options, he had to refer the patient to a psychiatrist instead. (Complete referrals were rare; the doctor had only had about three in the six years he had been working at the office.) In yet another case, Dr. Villareal recounted something that had happened to the patient’s sister weeks ago — showing his incredible memory and attention to detail. In all, I learned that the job requires many social and communication skills in addition to just medicinal knowledge.
I also got to see a bit more of what the nurses do around the office. Two additional tasks that I observed today were the weighing and measuring of a four-month-old baby and a strep test. The nurses always call the patient in from the waiting room and take their measurements, but it’s a little harder for children who are too young to stand up. They have to use a scale to lay them down and weigh them, and they do their best to lay the baby flat and make marks using a pen on a large sheet of paper to measure their length. The strep test included two samples from cotton swabs that the doctor took from a patient’s throat. One was tested immediately and if it was negative, the other would be plated and cultured overnight for a reading 24 hours later. The nurses are also responsible for running and reading other tests such as urine and blood. I had a fantastic first week at Cary Pediatrics, and I can’t wait for next week!
