Adolescent Services

My 3rd week was spent at the adolescent services. It is a primary care clinic for 15 to 25 year olds. It ended up being a good review of obstretrics. 90% of the patients we saw were pregnant. It was really great primary care in the trenches. The Spanish was better for me than at the hospital because it was less technical and will likely be more useful in the future. By the 3rd day, I was largely doing the physical exam, vitals, doppler, etc. while the doctor wrote the notes and interviewed the patient. I didnt see any crazy diseases not in the US but quite enjoyed my time seeing a clinic in Spanish.

There were a few differences I saw from the US. They were much more quick to diagnose a disease and give medicine. Nearly all pregnant women with vomiting were diagnosed with hyperemesis gravidarum, a disease of vomiting too much during pregnancy. I rarely saw it diagnosed in the US and have not heard of much medication being given for pregnancy related nausea, but at this clinic anti-nausea medication was given to most people with nausea. Similarly, nearly every pregnant women with a headache (none of whom had any symptoms of a runny nose or cough) were diagnosed with sinusitus and given antibiotics. Vaginal discharge was given a slew of medications to cover yeast, bacteria, and STDs because they didnt have a microscope to diagnose if there were any disease at all.

I cant judge, especially since they have much lower rates of antibiotic resistance.

Next week I will do pulmonology.