Future Physicians for Oklahoma Involvement ReportPayton Wright July 2nd, 2020In the spring of 2020, I applied for the opportunity to shadow a physician in rural western Oklahoma, with the hopes of gaining more exposure to and experience with rural medical practices within the family practice realm.While I have lived in rural western Oklahoma all my life and have seen some of the challenges of rural medical care from the patient’s side, I had not seen it from the side of the physician. As a first-year medical student, the ever-looming question is, “What area of medicine are you planning to go into?”. I consider this decision regularly, and as the time will soon arrive when I must commit to a decision, I find myself desiring as much exposure to different specialties as possible, believing they will greatly assist me with that career choice.My time with Dr. Michael Robinson, of Elk City, offered me the opportunity to observe the running of a medical office, to understand the various jobs of the staff, to work with an in-house lab technician and alongside the office nurses. I had the privilege of interacting with approximately 900 patients. I was also given the chance to actively use the clinical skills I was taught in school this past year. Additionally, I was allowed to be part of several surgical births and many natural ones. I moved beyond shadowing and had direct encounters and real-time discussions regarding each patient’s care. I saw a wide variety of cases and diseases, from pediatrics to geriatrics, and Dr. Robinson made a concentrated effort to constantly include me, as well as educate me.We removed skin cancer, drained wounds, removed staples, delivered end-of-life news, lost patients, birthed patients, referred patients, admitted patients, faced the ever-growing problem of language and cultural barriers, and so much more.Dr. Robinson’s office sees approximately fifty patients each day. He is committed to getting patients in quickly and getting them back to their lives quickly. This is a business, as well as a passion, for him, and good care results in recommendations. That results in more patients and that results in financial success and stability for him. This success has provided him the opportunity to set up a lab within his office, so that reports get back to him quickly and the patient can be treated more efficiently. It has also enabled him to help set up an extended office in a community not far from Elk City. This nearby area is in great need of doctors, and Dr. Robinson has established a partnership with another physician in an effort to bring more care options to those citizens. He has also expanded his practice to include an APRN, a weight-loss specialist, and a cosmetics specialist.While in his office, I learned of many of the challenges facing small private practices, specifically in our rural area. I was also able to meet pharmaceutical representatives, sit in meetings with hospice companies and home health companies, and gain insight into being the director for a home health agency. I was also part of a discussion regarding the doctor’s attorney and the legal obligations of physicians.In the office, we discussed the wide variety of patients we saw, their history, their health, and their treatments. Our conversations included the patient’s lack of health and science knowledge and their lack of self-care. We also discussed the travel distance required for many treatments that our patients need. This distance issue is a serious one for rural Oklahoma, especially for the elderly, the poor, and the underserved rural citizens of our state. I saw this doctor work tirelessly to arrange free transportation for a patient in a life and death situation, who had no means of getting to Oklahoma City, two hours away, for specialty treatment.With the community’s health in mind, I attended the city council meeting at the beginning of June, because part of the meeting was to be dedicated to a community health-related issue. The issue involved the local lake and the creeks and streams that run into it. The city officials, specifically the city manager, were accused of knowing for several years about the leaks in the city sewer system. The leaks had been reported many times, according to documentation, as well as the evidence that the sewage was flowing into the local creeks that run throughout the city proper. These creeks flow inside city neighborhoods and across main traffic areas, all eventually reaching the lake that is located south of town, and serves as a reservoir for the city, in a health emergency. I was highly impressed with the number of concerned citizens that were in attendance and with the medical representatives that were in attendance that night. The meeting showed me how valuable the knowledge and experience of our local doctors can be to our citizens even outside of the office.While interning at the Robinson Clinic, I also attended a local church where I met several of Dr. Robinson’s patients and further realized the impact a doctor can have on the citizens within their town, while being outside their office. Dr. Robinson stays involved in the community in several ways. He has worked extensively with the local hospital to educate the community regarding the Coronavirus Pandemic and the need for precautions. He also volunteers to conduct school physicals and works with the Community Health Education Initiative team.As my time with this family physician came to an end, I found myself appreciating his role in a way I never had before. He was kind, inclusive, hardworking, knowledgeable, approachable, encouraging, and forthcoming with me. I appreciated the respect he showed me and the many teachable moments he spent with me. He gave me topics to look up and asked questions that forced me to draw on my science, chemistry, and limited medical knowledge. He had me read labs and tell him what the levels indicated, and asked me my opinion regarding a patient’s possible diagnosis and treatment, always explaining how he came to his determination. I value the skills I learned and the many opportunities I had to use the skills I had gained in class.Experiencing family practice, from the doctor’s vantage point, was, of course, new to me. I found that I enjoyed the variety of cases that each day brought, the fairly predictable and stable work schedule the field allows, and the longevity of relationship that Dr. Robinson had with many of his patients. Under his tutelage, I was made much more aware of the work needed to bring real improvements to the rural healthcare situation. The glaring need for better health and self-care education, more localized mental health treatment options, and better parental education options related to childcare and wellbeing, have been impressed upon me by my time spent in this clinic.This field is a real possible career choice for me. I am intrigued by the many ways you can operate your clinic and the help you can bring to your community. This area of practice was not originally very high on my list of interests. I can honestly say that my thoughts have changed with this experience. After my time in this family practice clinic I believe I better understand the benefits of this specialty, both to the physician and to the community. I also see more opportunities within this specialty than I had previously, and I have a greater appreciation for what those working in this field do every day. I am grateful for the opportunity to spend a month alongside Dr. Robinson. When the time comes, making my career choice will not be easy, I’m sure, but the knowledge gained during this experience will help me make a well informed one.
