Around the clock, Dr. Eugene Somphone works to improve patient outcomes and increase access to health care in his role as a medical director of on demand medicine at Southwest Medical Associates. From traditional in-person care provided at the urgent care center to the new face-to-face on demand care of telemedicine, what does it take to accomplish this task? This is a brief glimpse at a typical day of a doctor dedicated to providing the right care for his patients while balancing his everyday life and family.
It is an early weekday morning at the home of Dr. Eugene Somphone. His wife and four children are asleep. Well, some of them are. Their 9-month-old is not yet sleeping through the night. Soon he and his wife are up and helping the children get ready for the day. After taking his elementary-school-age children to school, Somphone heads to work at Southwest Medical’s South Rancho Urgent Care (888 S. Rancho Drive) where he serves as a medical director of on demand medicine, overseeing both urgent care and telemedicine services.
He arrives at 8:35 a.m., and takes care of administrative tasks before he meets with Jimmy and Marie, medical students at Touro University who are shadowing him. Somphone explains that mentoring with Touro and other local medical schools is an important initiative. “Our practice has always worked closely with the medical programs of our local universities.”
Somphone spends time with the medical students reviewing electrocardiograms (ECG) and related topics — over 20 sample case studies. They discuss the symptoms presented by the patients and the ECG readouts, as well as the appropriate medical response. They continue until about 10:45 a.m., at which time he and the students review the medical charts of incoming patients.
From now into the late afternoon, Somphone meets with patients. “I see about three an hour, although the flow can change quickly,” he says. As he has the students shadowing him today, he has them go in first to speak with the patients and gather information on their symptoms and concerns. Somphone then enters the room to follow up. “They learn by obtaining the patient’s health history, taking readings and making determinations, and then they learn by observing our doctors. That’s how they learn to be providers.”
Mornings can be very busy at this urgent care. The midnight to noon timeframe experienced 70 people checking in, with a total count of about 200 for the day, which is a typical patient count for flu season.
“This is a fairly routine day for us,” said Somphone. “There is an onsite lab for ‘point of care’ testing as well as computed tomography (CT) ultrasound and x-ray. We can have a blood panel completed in 10 to 15 minutes. If we need an X-ray at 2 a.m., we just pick up the phone. I’m proud that we have a low number of patients — only 2 percent — that are referred to a hospital from this urgent care, because we have the resources on-site to evaluate them and provide follow-up.”
After reviewing the test results for his patient with intestinal bleeding, it was determined that the patient was safe and stable he referred to Southwest Medical’s gastroenterology department. Somphone’s other patient care for this day includes what is sometimes referred to as a “work-up” — a complete medical examination including a medical history, physical exam, lab tests, x-rays and analysis for an ectopic pregnancy.
“Amidst everything else, I had a NowClinic telemedicine patient in the early afternoon,” for which he diagnosed and prescribed treatment and medication for a patient’s urinary tract infection. NowClinic is a telemedicine service that allows patients to have a virtual appointment with a Southwest Medical provider via smartphone, tablet or computer, regardless of location or time of day.
While seeing patients the remainder of the day, Somphone continues with more medical student rotations — “preceptorship” is the technical term. Somphone adds that universities typically provide doctors with a stipend (a small sum of money) for providing preceptorships. He and the other doctors at the urgent care pool that money in a fund that they then use to donate to worthy causes in the community. In the past year they have donated at least $10,000 collected in this manner to local charities, including the Special Olympics and the March of Dimes.
Somphone’s patient visits begin to wrap up around 6 p.m. On most days, he is able to head home around 7 p.m. for dinner and time with family. Before heading to bed around 11 p.m., he finds himself left with at least one important question:
Will this be the evening when baby sleeps though the night?