My day started at 10am with my first patient. He was concerned about loss of muscle mass and pain located in his arm as well as upper back pain. He was diagnosed with a probable new cervical disc herniation with a trigger point. He received a Cortisone shot to his trigger point and a cervical spine MRI was ordered. Thankfully, the MRI did not show a new herniated disc and the trigger point injection alleviated his back discomfort.
Our second patient came in for an emergency department follow up for chest pain with multiple risk factors for coronary artery disease. We arranged a stress test and discussed diet and lifestyle modifications. We will be following this patient and encouraging him along his journey.
The third patient of the day came in for an ongoing issue of abdominal pain and dizziness. The recent development of nausea and vomiting was cause for concern. A CAT scan of her abdomen had been ordered but not performed due to scheduling issues. Her physical examination revealed a mobile upper abdominal mass that could represent stool. We rescheduled her CAT scan, finding the most cost effective facility for her insurance, and gave her medications for symptomatic relief.
The fourth patient was an old patient that decided to come back to our practice because of being unhappy with her current PCP. She expressed frustration with lack of communication and accessibility. She saw our facility and signed up for the year, scheduling a physical exam.
The fifth patient has history of obstructive sleep apnea and post concussive syndrome with diminished taste. As a result he had some ongoing anxiety and depression. His medication was reviewed and changes were made to help alleviate his symptoms. We also made an appointment for counseling.
Our sixth patient was seen as an urgent visit for COPD and asthma. Unfortunately, as we see time and time again due to health care costs, the patient had stopped his inhaler a week prior due to medication cost. We did an in office nebulizer treatment and set him up with home nebulizer treatments. Thankfully, while he was in the office, we were able to get him on a less expensive inhaler and he was able to go home.
Seventh patient of the day was seen urgently after his father called and stated that he was having difficulty swallowing with a sore throat and fever for two days. The father carried his six-year-old son into the office. His throat was quite swollen and he did have a positive strep test with a temperature of 102.5. He was able to drink water and we gave him a shot of an antibiotic and put him on oral antibiotics. We called dad the next day and he was almost back to normal . He was glad he did not have to go to the emergency room and thanked us for being their doctor.
The eighth patient was a scheduled annual complete physical for a vibrant 74-year-old and doing quite well.
The ninth patient was a new patient looking for a primary care doctor, so we had a “get to know” you visit.
Interestingly, this was the first time I saw more than five patients in one day since beginning our direct primary care journey in October of 2017. Before that we would routinely see around 25 to 30 patients a day.
Not exactly A busy day.