Geriatrics: Last day of GAP clinic

For our last day of GAP clinic, we saw that there were three annual exams scheduled for today. Annuals take longer b/c you have to do a MMSE, a geriatrics depression scale, and various other questionaires about nutrition and other important things in life. None of us have had much experience with annual exams since Meng usually does them (though Justin and I did one on our first day of GAP clinic), but Justin and I, being future internists, had a pretty good idea of what to do. Corey, future radiologist, was still trying to find things on EMR, and he seemed determined not to see a patient requiring an annual for that reason. I took one of the physicals and met a very nice woman in her 80s along with her son. She seemed very alert with very little cognitive decline; she only had trouble naming animals and got the hands of a clock confused during the clock test. I probably spent an hour with her, and but it was well worth it, and afterwards her son thanked me and told me I would make a great internist someday =) When I left the room I found that Justin and Corey were gone; because there were so many no-shows, Dr. JK sent my "partners-in-crime" to Westover Hills to start seeing patients (we had 11 for the afternoon). That was fine with me; I just saw one other patient who needed and ER F/U for abdominal pain that Dr. JK and I think is attributed to anxiety more than anything else (but we're giving her Ensure with fiber and Benefiber to keep her bowels healthy, anyway).

I left the PCC at 12:30 and drove to Chick Fil-A for lunch. I left just as Corey came toward the restaurant; he said there were only three patients left to see. Back at Westover Hills, I meant to see two patients (I was taking too long pre-writing notes so Corey offered to see another pt to speed things along), but one of them was away at work and the other was perfectly fine (just needed labs). We went to some interesting rooms today; one lady had a room full of antique vases and other things from her grandmother and great-grandmother's time. We also saw my bipolar patient who'd taken St. John's wort; she was still having some abd pain so to be safe, we removed the bottle of St John's wort. With all the notes that needed signing and orders that needed writing (I spent about 5-10 minutes just trying to find a chart with patients' weights in it), even when starting rounds at 2:30, we didn't get out until after 5:00 pm. Imagine if the guys hadn't prerounded on the patients starting at 10:00...I'd hate to think how long we'd be there.