Pediatrics Day 2 Outpatient Clinic 28-June-2011

I was not sure what to expect as this was the first full day at the outpatient clinic. In the morning we followed Dr. Wu, Yu-Nien (Dr. 吳俞哖), who is a pediatric cardiologist. The whole experience was very different from all the other outpatient clinics that I have been at in Taipei Hospital, the most contrasting difference was that the pace was much slower. It almost seemed to run at the pace most clinics do in the United States. A lot of the time was spent conversing with the parents of the peds patient, building a relationship, reassuring them that everything is going to be okay and patient education. Another interesting difference is the speed that lab results are done, often Dr. Wu would order CBCs, WBCs, X-rays, EKGs and have the patient return in about 20-30 minutes to discuss about the results. Dr. Wu being the only pediatric cardiologist on staff (actually she just retired and works once a week part-time now) get all of the suspected cardiac cases in addition to all the regular general clinic patients. Dr. Wu commented that she gets a lot of the chest pain cases, 60% of which are osteochondritis cases opposed to something more serous involving the heart or lungs. Other than a few cases of sinus arrhythmia Dr. Wu did not have any out of the regular cases. On the other hand Dr. Tsai, Ya-Hui (Dr. 蔡雅慧) next door walked over at one point to tell us about an interesting case of suspected Marfan’s syndrome and also get Dr. Wu’s opinion on the case. It turns out that the patient did not have enough of the criteria for Marfan’s he only had the wrist sign (the thumb and index finger overlap excessively pass the distal phalanx when the wrist is gripped with the opposite hand). His X-rays did show that he had a pneumothorax which was interesting in that Dr. Wu had just mentioned that for patients that are tall and thin we should look out for spontaneous pneumothorax if the patient complains of chest pain. Any case I seem to be having trouble sleeping tonight so I thought I catch up with some of the blog.