Connecting and forming relationships with patient’s and their families in an outpatient setting is much different from connecting to them in the inpatient setting. Inpatient medicine comes with the benefit of having almost unlimited amounts of time with the patient and their families; the only real limiter is the amount of time and effort I want to put in – and of course, the patient’s cooperation. At first, in inpatient peds, it seemed like all my time was spent writing notes and practicing my presentation; I didn’t get much time with the patient directly. However, within a few days I started to understand the flow and structure, which sped up the paperwork and left me with much more time in the patient room. In the hospital, you see the same patients day in and day out. You’ve read through every single note written about them and analyzed every last lab value they’ve had. You wake them up, you give them updates, you answer their questions, you elicit their concerns – it is almost inevitable that a connection is made.
Outpatient on the other hand is a constant battle against the clock. It seems like there is never enough time to fit in all the questions, and there is always 15 other patients waiting impatiently. The parents and patients are already tired and angry about waiting for hours, and then to top it all off a perpetually confused medical student they’ve never seen walks in, asks all sorts of random questions, and tells them they have to wait even longer for the real doctor to come. It is almost perfectly set up for sure failure. But this is also the setting in which connecting with people matters most. The point of a well-child-check is to see how the child is doing across all aspects of life – physical, emotional, mental, social, etc. It is almost impossible to do a full and effective well-child-check-up without establishing some level of trust. And this is where I’ve had to learn, change, and adapt the most. Along the way I’ve slowly picked up some tricks and techniques, and I’ve slowly gotten more used to the pace. I’ve found that in such time constraints, it is really the smallest things, like a well-placed joke or a comforting smile, which makes all the difference.