Primary care can often get a bad rep – people will often say that the “duds” end up here, because you weren’t smart enough to specialize. I couldn’t disagree more! A primary care provider needs to have a wealth of knowledge across different specialities to be able to take care of their patients. And yes, primary care providers often refer their patients out, but these illness wouldn’t be caught without a PCP. So for me, it was really important that I was on top of my game during this rotation. I wanted to share some of the “pocket” resources that I found most helpful.
Primary Care Pocket Guide: I thought that this was one of the best resources I could have used, and I used it multiple times a day, every day. The book has 16 sections in it: General Medicine, Cardiology, Dermatology, Endocrine, Gastroenterology, Hematology/Oncology, Infectious Disease, Musculoskeletal, Neurology, EENT, Psychiatry, Pulmonary, Urology, Women’s Health, Men’s Health, and Geriatrics. All of these coincide really well with the areas on the PAEA end of rotation exam topics. Within each section, the book’s break down important diseases. And then for the disease, the book presents you with the background, clinical manifestations and diagnosis, treatment, and complications of that disease.
How I used it: After every patient (at least at the beginning), I would read through their diagnosis after seeing them. This would help me cement what I had learned during didactic year, and connect that learning with the patient I had just seen in clinic. Later in the rotation, I started using it just for patients with diagnoses I had yet to see, or ones that I struggled with.
The Sanford Guide to Antimicrobial Therapy 2017: This is a godsend. Confused about what medication to give for a fungal infection or for an ear infection in a pregnant woman or someone with an allergy – its all in there. The book can be kind of confusing to use at first (there’s a LOT of information in it), so I suggest definitely familiarizing yourself with how to use it before you go on rotation. There’s a couple of ways to look things up in the index: by drug, infectious agent, or disease. Or you can use the tables to look things up. I like using the tables initially, and if I’m still struggling look up specifics in the index. Some of the tables I like are “Clinical Approach to Initial Choice” (which goes through each body part and the diseases you can find there), “Antibiotic Activity Spectrum” (which indicates what the drug is effective against), “Pregnancy Risk”, and “Antibiotic Dosing and Side Effect”. I find these the tables that I am using the most. You can also get an app version of it, which charges you a yearly fee but updates content regularly.
How I used it: whenever I saw a case that was going to be prescribed an drug, or if I was on the fence about if the symptoms warranted a drug, I looked it up in this book. I think so many people want to follow an algorithm of “If this is the problem, treat with this drug” and there is so much more to prescribing than that. Looking up possibilities helps to prevent any complications.
Case Files Family Medicine: Technically this wasn’t in my pocket at clinic (its kind of big and heavy) but I did bring it with me and use it every day! It presents you with a clinical scenario and asks you some initial brainstorming questions. Then it discusses the answers to those initial questions and goes into an analysis. Here it talks about considerations, definitions of the disease or condition, clinical approach, assessment, and differentiating between differential diagnoses. Finally it gives you some comprehension, multiple choice questions with detailed reasons why the answer is what it is.
How I used it: During down time at clinic, I would read through a case in this book. I would read a random case (I went in order), but the book does also list the diagnosis of the case in an index in the back of the book. So if you wanted to focus on cardiology, you could look up and do all of the cardiology cases. I didn’t do this because I didn’t want to know the diagnosis of the case before I read and thought about it.
Perfect H&P Notebook: I found this amazingly helpful. There are a couple different options out there on History and Physical books to use, but I like this one the best. It gives you one full page (front and back) for each encounter. On the front, you have a space to take the History of Present Illness, Past Medical History, Family Medical History, Surgical History, Social History, Medications, Allergies, and Review of Systems. For each section, it gives you some key words to make sure you hit all of the major points. The Review of Systems is a check off area. On the back is an area for Physical Exam with Lab fishbones. Then you have an area to go more into detail on lab findings, come up with differential diagnoses, summarize your findings, create a problem list, and then blank space for additional notes. The entire page is basically everything you need to do to create a good, full note.
How I used it: Any time I saw a patient (who wasn’t there for a medication follow-up visit) I used this book to guide my questions and take notes on. I thought it was super helpful to ensure I hit all the major points, and the organization of the book really helped with my organization in my questions asking. I especially found this helpful for sick visits and physicals.
Maxwell Quick Medical Reference: My school recommended my class get this resource when we first started. It has a ton of different information in it, including ACLS Algorithms, Lab values, how-tos for different notes (progress, discharge, pre-op/post-op, etc), History and Physical Exam, Neuro/Mini Mental Status exam, ect). They told us that we would be able to use it through out the entire clinical year, and that it wasn’t as “limited” as some of the resources we would find (i.e. They could just be used during one rotation)
How I used it: I mainly used it for the ECG information in the front, the ruler on the back of the book, and the normal lab values. I know people who have normal lab values memorized, but I don’t have the brain power for this. Also, I definitely feel like I will be getting more use out of this resource in some of my hospital setting rotations
History and Physical Exam Pocketcard Set: My mom gave this to me when I got into PA school, and it was also another recommendation from my program when we started doing Integration (fake patients read outloud by ur advisors and we had to ask history questions and indicate what physical exams we would want to preform). It has a ton of information on it and is great for when you’re just starting out doing physical exams or when you just want a quick reminder while on rotations
How I used it: I glanced over it before I started my rotation to remind myself what was included in the full physical exam (since I had been on dermatology before this). I kept it in my pocket for a quick reminder during the rotation when I saw new patients – to make sure I did everything I was supposed to.
Moleskin Classic Notebooks: I like the blank notebooks because I enjoy drawing diagrams and figures, and it allowed me to write bigger or smaller depending on the importance. So this was literally just a blank notebook that could fit in my pocket. The last 16 pages are perforated so you can tear them out.
How I used it: This is what I wrote down my patient encounters in. So in the front of the book, I would date a page and then write down all of the HIPPAA compliant information (Male or Female, broad diagnosis, and how we treated them – Aka what I have to log for school) I needed on the patients of that day. In the back of the book (I would flip it over) I would take notes on important things I learned, and I had a running list of things I should look up. I didn’t want to bring two separate notebooks for this.
Other things in my pocket:
- My stethoscope (duh)!
- Pens: my favorite is is the Paper Mate Ink Joy Quatro because having four colors in one pen is wonderful, and I really like the ink and colors of this pen. I feel like they are very bold, smooth, and don’t smear.
- Small Sticky Notes: I love to make a little note on these pads to stick in a book or on my study charts. They allow me to add in additional information where there isn’t a lot of room, or where I don’t want to write on the actual book.
- Tic-Tacs: I hate gum and having a mint that quickly disappears is a lifesaver for me.
- Lip balm: I really like Burt’s Bee or those Eos eggs (but these are kind of annoying to have in my pocket).
- Crystal Light Pink Lemonade packets: I’m currently (and always) in the process of trying to give Coke up, and I find this lemonade to be pretty tasty. Always having a few of these packs in my pockets gives me more reasons to drink water over Coke.
- My phone: I’ll talk about some great apps later
- Granola bars or other small snacks.