Issue 3 - Fall - Providence Washington - Providence Health & Services

:30:15:30:00:15:45For the medical residents, every day is filledwith the experience of a lifetime. Although nosingle day is ever typical in the life of a doctor,here’s a sample day in the life of two residents:6:30 a.m.Jonathon Anderson, MD, arrivesat the Intensive Care Unit (ICU) atSacred Heart to meet with the overnightmedical team. The doctors andstaff review patients’ conditions andtreatment plans. Dr. Anderson willbe caring for four patients today.7:00 a.m.Dr. Anderson begins rounds, personallyassessing each patient’s condition,checking diagnostic reportsand making adjustments in thetreatment plan. His first patient is a74-year-old man admitted initiallyfor myocardial infarction (heartattack) with acute heart failure, pulmonaryedema (excess fluid in thelungs) and acute kidney injury.“My goal is to reduce the excessfluid, manage his myocardial infarctionwith medication since he is apoor candidate for surgery at thistime, and wean down his ventilatorsupport enough to see if he’s able tobreathe on his own,” says the doctor.7:15 a.m.Faculty members arrive early at theFamily Medicine Residency clinic.So does second-year resident LilyWittich, MD. In her role as chiefmedical resident, she acts as a liaisonbetween the residents and faculty,attending faculty meetings, managingthe schedule for resident doctors andhandling other administrative duties.8:30 a.m.Dr. Wittich’s day shifts to her clinicalresponsibilities. She’ll be seeingpatients within the hour, and beginsreviewing patient charts.9:00 a.m.In the ICU, Dr. Anderson meetswith a pulmonologist, who is aspecialist focused on the respiratorysystem. It’s what Dr. Andersoncalls a teaching moment—the entiremedical team discusses diagnosticsand recommended treatments fortheir critically ill patients.9:05 a.m.At the primary care clinic, Dr.Wittich sees her first patient, a34-year-old developmentally disabledman from a group home.He fears a toe may be infected.Dr. Wittich uses the visit to evaluatehis overall health. “Many of mypatients have complicated medicalproblems,” she explains. “This is animportant opportunity to check ontheir well-being, evaluate medicationsand determine if there areother health concerns.”9:45 a.m.Dr. Anderson is doing rounds on hispatients again, this time accompaniedby an intensivist, which is theattending physician who specializesin the care of critically ill patients.A 65-year-old male with an extensivehistory of heart disease is in theICU with a very serious case of congestiveheart failure. The patient’smedication was changed earlier inthe day, and Dr. Anderson is monitoringhis progress.10:30 a.m.Dr. Wittich has treated threepatients in the clinic so far thismorning and now follows up onanother matter: calling a homehealth agency to arrange for heartmedicine management for one ofher patients. “She is a 75-year-oldwoman with serious blood clottingin her legs, which has traveled toher lung,” explains Dr. Wittich.“She needs to be on warfarin,which is a blood thinner, for sixmonths to treat the thrombosisand pulmonary embolism.” Butwarfarin can be dangerous if notmonitored closely, and the doctorwants to ensure her patient getsthe help she needs.MedicalEducationby theNumbers71Number of medical residentscurrently in ProvidenceGraduate MedicalEducation programs.245Number of family medicinegraduates since the programbegan in 1972.65Percent of family medicinegraduates who remainedin the Spokane referral areato practice medicine.80Percent of family medicine“rural track” graduates whopractice in rural Northwestcommunities.22,500Number of patient visits toProvidence Family MedicineResidency-Spokane.71Percent of Internal MedicineResidency graduates whoremained in the Spokane referralarea to practice medicine.16 ● Fall 2012 Heart Beat