It’s 3:45 p.m. and the health center at Hudson Headwaters Health Network is almost closed. Our next patient is a pleasant man who has recently retired, coming in for an annual physical. He has over 10 documented “problems” in his record and presumably, a medication corresponding to each problem. After reviewing the chart, I knock on the door and meet the face behind the record. He greets me with a smile. After taking a brief history, I learn he quit smoking after 25 years, and hopes to make more positive changes in his life. His motivation is a desire to keep up with his school-aged grandchildren. His newest challenge: losing the 30 pounds he has gained over the past few years after quitting tobacco.
Further examination reveals a beautifully well-rounded diet, but a look of guilt when asked about exercise. He admits he has been slacking, and is having trouble finding the enthusiasm to get going. After utilizing some motivational interviewing, we come up with ideas for how he could be more active. We settle on a plan to purchase a pedometer and work towards 3,000 steps per day. Before leaving, we talk about where to get a pedometer, and different ways he could get those last 300 steps at the end of the day. Instead of looking for another problem to add to his list, we find a solution. Thinking back to this visit, I realize this is why I am becoming a doctor, to help people empower themselves to be who they strive to be.
As one of the first participants in the University of Vermont Larner College of Medicine’s Longitudinal Integrated Clerkship (LIC) I have the luxury of connecting with my patients beyond a single encounter. The focus of this program, completed during the third year of medical school, is to gain the perspective of the patient, and see medicine from their point of view. Instead of the traditional block format, where students complete rotations in seven different medical specialties, we choose a panel of patients that we follow to every doctor visit, to surgery, through labor and delivery, and even navigating through health-related social services. Their life becomes our life; their goals become our goals. On my patient’s next follow-up visit we can see if our plan was a success, or if we are one more attempt closer to success. We can come up with different strategies, recipes, and ways to approach a more active lifestyle until we find one that sticks. This is the side of medicine you don’t see in the textbooks. This is why I am here.
Note: Some details have been altered to protect the patient’s identity.