For my long term care rotation I was at Metropolitan Hospital at a geriatric outpatient clinic. I really got to enjoy this experience as I was able to work with the geriatric population and really get a better understanding of disease processes that affect this specific population. As geriatric itself is a whole speciality on its own and the problems that patients came here were usually associated with polypharmacy and trying to establish the best care.

The first new thing I would say I was able to learn in my geriatric rotation was the difference in physical exams and what the focus for the geriatric population is. Along with this there was the geriatric assessment that I had to do for every patient that came in. Physical exam wise, my attending instructed us to always look at the patient’s feet. As this was a good indicator of if the person is able to take care of themselves. This was indeed true as many patients would have overgrown nails, ulcerations, venous insufficiency that they wouldn’t bother to address. Another part of my physical exam I was able to improve on was identifying murmurs while auscultating. As murmurs are more common in the geriatric population I was able to hear murmurs almost every day and was able to distinguish between systolic and diastolic murmurs. 

During this rotation I did find certain patients very challenging and was sometimes overwhelmed as patients at times came with multiple complaints and multiple comorbidities. One thing I was able to learn from my attending was that, there are times we can’t address all the complaints the patient has and even change medications as other subspecialties for which a patient has gotten the medication may have a better understanding why the patient should be on such doses. The goal of a geriatrician is to help build a common ground for the patient and help them understand what and how to deal with everything that is going on in their life. This would lead to interviews with patients that lasted 60 minutes, which I have not seen on my previous rotations but is necessary for the geriatric population.

I definitely have had a change in perspective after finishing my geriatric rotation. This would not only be towards the geriatric populations but in terms of interviewing and how much time is actually needed to address patients’ concerns in all ages. In my last rotation we would not have enough time to go through every patient complaint in such depth but in geriatrics,we were given enough time to. This can also be because the geriatric population is dealing with a lot of more problems, but at the same time this is no excuse to not provide good quality healthcare to other populations. So at the end of this rotation, I definitely have tried to slow down my encounters with my patients and have also tried to translate my thought process to what the patient may understand. 

Building on that I would definitely say that this is something I can definitely improve on. Patients in the geriatric population were very curious and would always ask for me to explain what is going on with them in more simple terms. At times, I think healthcare providers forget that the patients may not have the medical knowledge that we do and they need help in understanding what is going on. Saying that, I would say I definitely need to refresh my memory on pathophysiology as that will help me understand disease process more, to help translate it to my patients.