For my first site evaluation I presented 1 H&P. My first H&P was about a female complaining of right eyelid swelling for 2 days. Due to this being a clinical diagnosis, there was not much of a workup besides testing visual acuity. In my plan I included through hygiene instructions that the patient can follow in order to prevent future episodes of conjunctivitis. I also included ER precautions that encompassed red flag symptoms. After my presentation we discussed the differences in presentations of allergic vs. viral vs. bacterial conjunctivitis and also hordeolum vs. chalazion. It was helpful to review how to differentiate some of the different types of eye disorders. We also discussed other treatment options for conjunctivitis and clinical reasonings for deciding between eye drops vs. ointment as treatment.

For my final site evaluation I presented another H&P and a journal article relating to it. For this H&P I presented on a female with ear pain for 4 days. The patient was diagnosed with otitis media. During this time we discussed some “wouldn’t want to miss” diagnoses such as mastoiditis and how it would present. We also discussed common causes of otitis media. This led to a discussion about my journal article which showed that many cases of otitis media will resolve without antibiotics.

I think this site evaluation was very helpful in aiding me to develop a strong differential and being able to support/provide reasons for each. It also helped to allow me to better understand and explain the differences between some diagnoses that can present similarly. I think my plan for this second round of H&Ps was a lot more detailed and I provided additional patient education since that is something that is very emphasized in family medicine. I will continue to apply what I learned this rotation to my future ones.