I have being seeing patients at an orthopedic clinic for the past few weeks. The attending I am following specializes in knee and hip replacements. This means that the patient population we see in the clinic is highly specific – i.e. pretty much only patients with end stage arthritis of the knee or hip.
This patient population has shown me an interesting side to medicine. Almost every patient in this clinic is complaining of the same problem, and thus every visit is almost painfully similar. It is pretty rare that something unusual comes our way. At first, I thought this was a very boring and mundane way to practice medicine. Each visit could be almost scripted to the last sentence.
On the other hand, it is somewhat nice knowing exactly what to expect with each patient. I started orthopedics knowing literally nothing about the field. Now I continue to know almost nothing, except I have gotten weirdly good at pretending to know what I’m talking about. For example, at first when a patient would mention that they needed an injection I would instinctively run through the whole list of injections and be thoroughly confused as to what they are taking about. However, as I spent more time in clinic it became obvious that the only injection give at this particular clinic for this specific patient population is steroid injections. So it became much easier to muddle through the code of patient-speak.
This is similar to how much of medicine is. If you go through every possibility, you will end up confused and unable to make a diagnosis. Narrowing things down by probability is a much more important skill in 3rd year than being able to regurgitate extensive lists of information.