Clinics

It's nice having your own clinic. Something not all my colleagues agree with. The ACGME requires all trainees to have their own continuity clinics. For us, one half day a week of my 'Dr. Vagus' Clinic. I see only MY patients (we still see patients the rest of the time, but this is my own time). They know me as their endocrinologist. I have my business cards, and 2 secretaries to help me with the paperwork and scheduling.

I like it because unlike other clinics, these are my very own patients. Some I have known since residency who also had diabetes, and opted to 'follow' me from my internal medicine practice to endocrine. People I know well enough to enjoy their company, or to share even some personal stories.

I saw Ms. HN again yesterday. A high-performing CEO, somewhat of a Southern Belle, who was also overweight and has diabetes. As recalcitrant and stubborn as they get. I remember our first meeting, with her almost seething, arms folded and pouting, when her family doc finally made her see an endocrinologist for her diabetes.

"No injections. Over my dead fat body." A direct quote.

Now, 2 years later, it was a totally different scenario. She gave me a bearhug. I told her about our engagement, and showed her pictures (she was my last patient for the day and I was in no hurry). She told me of some legal/work problems she was having. She wanted even to come for the wedding (I'll take my private jet, she says).

Her diabetes is controlled. Controlled, not great, as she's still stubborn about not wanting insulin. But, she's on twice daily injections of exenatide (Byetta) and her hemoglobin A1c's way lower than they've ever been. And she doesn't mind the shots, "As long as it's not insulin!"

Some of my colleagues hate their clinics. Always a lot of paperwork. And though I'm not too excited about all that stuff myself, I do like my continuity clinic.

It's nice to see how your patients evolve, and grow. And, in a weird way, patients see how you grow as well. They know that you're a fellow; a trainee. At first meeting, they know this field may be new to you, and yet accept that (knowing you're supervised by a consultant). And they see, I'm sure, how one learns from them, and grows into a confident endocrinologist. Yup, I like my Thursday afternoons. Despite usually finishing up late from the chatting we do in clinic, seeing old friends again.