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Student learns to value patients, care in rural setting by David Forsh COM student, fourth year As a third-year medical student in a large institution like MUSC it seems like I am always busy studying, following other doctors around to see patients, trying to manage money, or the lack thereof, or trying to catch up on sleep. Oftentimes the monotony is more than one can bear.   In the midst of this busy daily regimen that follows each rotation that I am required to do as a medical student, it is quite easy to forget about the most important reason that I am here—the patient. Having the opportunity to do my family medicine/rural rotation in Newberry at Emmanuel Family Clinic rekindled the passion to pursue a career dedicated to serving and making a difference in people’s lives in a more holistic sense; particularly regarding the cultural differences that exist within the community of Newberry.     When I first decided to come to the Emmanuel Family Practice, I was told that it was a very diverse clinic with approximately 70-75 percent of the patient population being Hispanic. I had no idea that there would be so many people of Latin-American origin in Newberry. Very excited and anxious about working with this population for the next two months, I didn’t know what to expect.   Several questions ran through my mind as I made the trip up Interstate 26 for the first time: How will I interact with the Hispanic patients there? What is the standard/quality of care in a small rural town like Newberry?  What is the cultural sensitivity like in a community that seems to be diversifying more and more every year? As I arrived on my first day, I couldn’t have been more pleased; many of my questions and more were answered after my first day of clinic.   The diversity of patients that I saw during my first day was equal, if not superior, to the patient population that I worked with in Charleston at MUSC. Everything was electronic. The facilities and equipment, at the clinic as well as the hospital, were all up date, and the quality of care was superb. The daily pace was definitely a lot more laid back than what I was used to, and I was able to spend a significant amount of time with each patient and work with the individual as a person—a person with feelings, cultural beliefs, a family and loved ones, not just a person with a medical problem—I was able to deal with the patient from a more holistic point of view. One of the biggest things that I learned is that through interacting with the patient not just as another medical problem, but as a dynamic individual with his or her own concerns and issues, and being sensitive to these concerns and various issues, I was able to be more effective in helping and meeting the needs of the patient; more so than any medicine I could prescribe.   Probably the biggest thing that I noticed from traveling out within the community and working with patients, particularly Hispanics, is that there is a need for more health care providers and professionals who are culturally sensitive and able to communicate with this growing patient population. I had the opportunity to give a series of talks to Hispanic middle school students at one of the local middle schools on sexually transmitted disease (STD) awareness and prevention, and the majority of them had never even heard of STD’s before. When I asked the teacher afterwards, she told me that many of the students and their parents are uneducated about certain health issues because there are limited resources available to them due to the cultural and language barriers that exist within the community.   I also had the opportunity to work at Emmanuel Family Clinic in Saluda where the patient population is greater than 95 percent Hispanic. We had a patient there who was pregnant and went into labor, but instead of going by EMS to Newberry Hospital, where she was trying to tell the ambulance to take her, she was taken to Greenwood where there was no record of her pregnancy history or any other health information. It strikes me as odd that health care professionals that serve in a community predominated by Hispanics would not know how to ask ¿Qué hospital? I remember when I first met Dr. Garcia and he asked me how I would feel if I was in a foreign country and had a medical emergency, but could not tell the doctor what was wrong—imagine that! As health care providers we must be more than medically competent, we must be culturally competent as well. Speaking with some of the patients, I heard of stories when they were referred from the clinic to other specialists and had difficult times being seen by a physician because of language barriers. At MUSC, yearly Spanish classes for health care professionals are offered, which allow individuals to communicate more effectively with this ever-growing population; I think that this is something that would definitely serve this community well.        From my experiences here I learned to practice medicine by treating the whole patient, not just the medical problem. To acknowledge cultural differences and help to bridge the gap between health disparities that exist within our communities. Rural medicine is definitely not something that is behind the times. If anything, it is one of the best environments to learn to be not just a doctor, but also a good physician. Overall, I couldn’t have asked for a greater experience in Newberry or a greater group of individuals to work with. From my daily breakfast with the friendly people in the hospital cafeteria, to the meet and greet opportunities in the neighborhood Wal-Mart, I have learned to appreciate the little things that make all of us tick—the laughter, the sorrow, the good times and the bad times, the cultural differences, yet the same spirit—and all of the things that make us sick—the allergies and the upper respiratory infections. And all of the things that make us click—the God in each and every one of us. All of these are the things that make up the physician-patient relationship, something that I hold in a totally new regard; Things that will help me become the physician I aspire to be. I would like to thank the town of Newberry for welcoming me with such warm and friendly esteem, and most importantly, my new family at Emmanuel Family Clinic—I will never forget you all! Editor's note: Reprinted from The Newberry Observer     Friday, June 3, 2005 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.