The Rotation for Ambulatory Medicine in Dr. Difranco’s office was a great experience because I had the opportunity to see a lot of patients with a wide range of complaints. The best part about this rotation was that I was able to practice as an independent provider. Interacting with the patient alone was an empowering experience because the patient viewed me as the provider. The rotation gave me a glimpse of what it will feel like to be a practicing PA in the future. I really liked the interaction with my patients because I developed a rapport and provided ways patients could improve their health conditions. I learned that if I explain my steps to patients then they are more willing to follow my direction. The NP and Dr. Difranco was really helpful and supportive in making the treatment plan and treating the patient as I would as a PA. Also, Dr. Difranco taught me about the most common drugs prescribed for patients and the mechanism of actions. He also shares his experience from the past 34 years of practice and ways I could improve my differential diagnosis. Dr. Difranco suggested always looking back at the last two visits of the patient in order to make sure the patient is following up with all the recommended lab and radiology tests. 

 

I did not agree with some of the practices in the clinician such as ordering a PSA on most male patients over 50, performing EKG on every patient, and performing a chest x-ray on the initial patient. While working, I was thinking about the ethics class because we were discussing a situation whereas a PA we might not agree with the doctor. As a future PA, I might face a similar situation again, which was a good learning moment on how to handle these situations. Also, initially, the clinical platform was difficult to grasp as the office required multiple routine questionnaires (COVID, general, depression, anxiety, alcohol, substance abuse, and pain scale). This routine questionnaire was time-consuming, but it helped to create conversations with the patient where they felt comfortable sharing their medical problems.