Sleeveless T-shirt in 35*F

So yesterday, Thursday 3/12 was a nice day. It started off with a standardized patient encounter at 9:30a. Even though it was scheduled to start at 9:15a, no big deal.
What's standardized patient (SP) encounter?- some of you migt wonder
It is when someone is acting as a patient. That is they present with a complain and have a script which they follow. This is used as a teaching tool so that medical students can act as doctors and attend to the SP's complaints, do physical exam then come up with an assessment and plan on how to treat the patient (SP). My first SP presented with a neurological complain and the second one presented with some generalized complain (realize that I'm trying not to be specific here b/c we're not allow to talk about specifics of the encounter) so I apologize if I'm not being clear enough or at all. Then I returned home which is about 10 minutes walk from the hospital. Ate some lunch then drove to the Family Medicince clinic.

I saw this 39y/o African American (AA) . Upon entering the exam room, I saw a gentleman, unkempt wearing a sleeveless t-shirt, sitting down while shaking both legs which were crossed at the ankle. During part of our conversation, he told me that he had a chronic flank pain (pain around the R mid back region) due to kidney stones and was on Percocet (a narcotic). He wanted a refill of his narcotic. I wanted to assess how well the Narcotic is working and how to adjust (if necessary). He proceeded to tel me that he used to take Oxycontin (a Narcotic) and was changed a couple of months ago to Percocet. "Dem Percs sure work like magic doc. They must hae some enzyme or something. Ever since I been taking dem, my stones are coming out in tiny pieces and not as big as they used to be when I was on Oxy's).

It's also amazing how many people will come to the doctor with diagnosis already and just wanting to get some Antibiotics for their self made diagnosis. I'm all about empowering the patient but I think the patient should have an open mind and let the doctor explain his thought process ... at least a doctor has spent a lot of years in school learning about all these things.

Later.