Over the past two weeks, the shadowing experience with Dr. Sher and his PA’s (Maggie and Jonathan) have been very enlightening in regards to the differences in patient interaction and procedure undertakings between the two fields. Physician assistants typically approach the patients first in the clinical office, taking down holistic patient histories (i.e. asking relevant questions in regards to the patient’s visitation, symptoms, previous medical visits, etc.), assisting in the associated medical paperwork (i.e prescriptions, past files), and aiding in medical procedures such as anastomosis and sphincterotomies. Doctors, on the other hand, have a much more intensive hands-on approach during the operations, pre-op, and post-op. On average, the doctor spends approximately double the time that a PA does with a patient. Certain procedures, such as colonoscopies, do not require a PA and are completed with the aid of a nurse and an anesthesiologist.
Viewing a colonoscopy firsthand has been very educational from both a technical and anatomical perspective. During the procedure, I was able to view how the doctor operates a scope. The flexibility of the scope, along with the four directional motion control dials, CO2 pump (blows up the colon), water pump, and suction all aid the process of navigating through a patient’s colon to reach the cecum. It was noted that the doctor spends a minimum of six minutes navigating back out of the colon after reaching the cecum to check for polyps and other potential anomalies such as diverticulosis (common formation of pouches in older people) and hemorrhoids.
Typical medical information and procedures outside his specialty as a colorectal surgeon have come up well in regards to genetic relationships to diseases (i.e Lynch syndrome) and cardiovascular conditions (i.e. valve replacement). I was able to witness an EKG, learn technical terms (A-Fib, V-Fib, heart echoes), and how the team of medical professionals act and react depending on the patient’s reaction and vitals. It was surprising to see how hyperaware everyone was of their surroundings and their quick
decision-making skills. This is a life lesson to hold onto since I am usually quite an indecisive person, which is something I may need to change as I continue down this path. I also found that I was more excited to dive into discussions regarding genetics and things relating to the heart, which may be quite helpful in narrowing down my specific interests in this diverse field.