Hola Chicos!
As you know by now, Meghan and I are here to do clinical work for the 6 and a half weeks that we are here. Our school has partnered with FIMRC, and Meghan and I are at the very first clinic FIMRC established. We are located in Alajuelita, Costa Rica and serve the local neighborhoods. Let's go through a normal day in the clinic!
Everyone stays in beautiful homestays in the neighborhood of Santa Ana, Costa Rica. Each morning around 8:00am, we get picked up by a bus and head out to the clinic. After about a 30 minute drive through the hills, we reach our clinic.
If it's a Monday, and we have a new batch of volunteers, we usually all sit around the table and take time to introduce ourselves by saying our name, area of study, year in school, and if we have graduate plans. I've met so many pre-med, pre-PA, pre-OT, pre-PT...the list goes on and on! Once everyone has learned each others names, we get divided into groups for our duties.
Reception
At reception, you are responsible for manning the front desk. This is my personal favorite, because this is where we get to use the most Spanish. We sign into the computer and look through the google doc at the list of appointments. We sign into the EMR and wait for the first patient to arrive. Once the patient arrives, we look them up in the EMR and create a new visit consultation file. We take their weight, height, and blood pressure. We then notify the doctor the patient is here and wait for the next patient. Sometimes we get to create a new EMR encounter for patients who have never been to the clinic. Other times, we get to create appointments for patients. Many of our patients don't have access to a telephone, so instead of calling to make an appointment, they walk in and ask if there are any spaces for either today or tomorrow. Usually our clinic schedule is very packed, which makes it hard to accommodate same-day appointments, but we try our best to get each patient an appointment as soon as possible.
Exam Room
The patient is then called back by our volunteers to meet with the Doctor. We are very lucky because at the moment we have 3 amazing physicians working at our clinic. The first is Dra. Karen. She is from Costa Rica, and has been out of medical school for the past 4 years, and working with our clinic for 3 and a half. She is a great asset to have because she not only understands the culture, but also knows how the health care system works which comes in handy. Our other two physicians are Dr. Benjamin and Dra. Sloan. They are two Family Medicine physicians from Washington State who are volunteering for a total of 8 months! They love to teach so it has been great observing and helping them in the exam room. We see patients for general health maintenance as well as for acute needs. I have seen a huge variety of cases and I've only been here for 2 weeks so far.
Pharmacy
After the patient has been seen by the doctor, they may be prescribed medication. In pharmacy we have volunteers count out pills, measure out syrups for kids, and keep a close record of how many meds are distributed. Everything we have in our pharmacy is from donation. Everything we give is within moderation, unless it's an antibiotic. We wish we could give everyone bottles of Acetaminophen or Ibuprofen but we have to be cognizant of how much we have and how many people we can help. Most of our patients are given multivitamins, especially our pediatric patients. They love their vita-gummies!
Psychology
Our clinic has a fourth part that is unique to our FIMRC site. We have been blessed with a psychologist on site! Her name is Tatiana and she sees everyone from adults to kids for therapy appointments. We have had our share of volunteers interested in psychology so this has been a great opportunity to see therapy in action. Tatiana does a great job with giving a synopsis before the patient enters, doing the visit in Spanish, then explaining what happened and what her assessment was after the visit is over and the patient has left. I have not had the chance to sit in on a session with Tatiana but I am excited for the day I am able to!
All of these groups operate for the morning, then we break for an hour lunch at 12:15. During that time we relax and eat our packed lunches provided by our homestays. After lunch, we open the clinic back up for our afternoon appointments and continue on again until we end at 4:00pm. As you can see it is a very simple set up but can end up being a very busy day, especially if we get complicated cases early in the morning! On average, we see about 20 people a day, sometimes less, sometimes more. Our docs do a great job keeping up the pace and flow of our little clinic.