Cowman, of Yankton, spends rural family medicine rotation in Redfield
By Shiloh Appel
Brice Cowman, a USD student originally from Yankton, South Dakota, spent his time in Redfield from February 10th to February 28th on a rural family medicine rotation. According to Cowman, he chose to come to Redfield because it was one of the bigger rural communities on his list of choices.
“I knew it would have things like a grocery store and stuff that would make life a little easier while I was trying to learn clinical medicine,” said Cowman. “Then, in addition to that, my fiancé has relatives from Redfield. So I had heard that it was just a nice place.”
Cowman, who just finished his first year and a half of medical school in the classroom at USD before coming to Redfield, said he found Redfield to be a slower pace.
“The traditional medical school model is two years in the classroom and we cram that into one and a half,” said Cowman. “It is kind of wake up, study, repeat for awhile and that can be frustrating after awhile. You get burned out on that….So to put all of that knowledge that you’ve been working on for a year and a half to use in the clinic and seeing something that you studied and all of a sudden it just clicks for you because you see the patient presenting exactly like you studied that they would — it’s really cool.”
Just starting out, Cowman said he had to get used to the routine of Redfield’s Community Memorial Hospital and Clinic. He said the slower pace gave him “room to breathe.”
“That was really a blessing,” said Cowman. “Other than that, though, I was surprised with how quickly I was able to integrate into the community. For example, there were a couple patients that I saw in the clinic and then I would see them again out somewhere else in town, either working at their jobs, or at at the grocery store or something like that.”
Cowman spent his time in the clinic and hospital and took calls whenever Dr.Owens was on call (one night a week and on weekends). He also went to Redfield nursing homes on Wednesday and Thursday mornings and spoke to the Redfield High School anatomy class.
“I think every night I was on call we got called in at least once. Then sometimes you get called in, and just when you are wrapping up the case, someone else walks in the door and you realize that you are going to be there for awhile,” said Cowman. “The big one that everyone worries about is when you hear that someone comes in with chest pain, because the first thing you think of is a heart attack and that is obviously the most urgent one that a lot of people think of. When you get the call ‘someone came in with chest pain,’ you gotta throw your coat on really quick and get out the door so you can get there because that is such a time-sensitive issue. I guess I didn’t really know how prevalent that was, but we had more than a few of those cases come through the doors in just a matter of a few weeks in a small town. So, that was kind of surprising for me to realize just how prevalent heart disease and heart attacks are.”
Cowman said he was not the first line of defense, however, when treating a patient.
“When someone is having chest pain, I walk into the emergency room and they will already be in the bed. The nursing staff at the hospital I can’t praise enough for how responsive they are to those situations. At those times they will already have started an IV line so that we can get drugs in really quick if we need to. They will already have an EKG, which tells us a lot about how the heart is pumping. It would show us if there is some irregular pattern going on,” said Cowman. “ That stuff is really helpful. My job during those situations would be to stand behind whoever the provider on call was, look at those EKG’s with them, ask about their clinical decision making, ask about why they chose to give this drug or hold on it, or why they ordered an X-ray versus a CT or maybe they chose to send them up to Aberdeen in an ambulance. So there is a lot of thought that goes into it. So I guess my goal during those situations was to understand their thought process and replicate that for myself.”
Cowman said he most enjoyed getting to know the people of Redfield during his rotation.
“All of the doctors and all of the providers at the Redfield Clinic are just great. The nurses, too. They made me feel really welcome from day one. A lot of times you can run into situations where the medical student ends up holding the group back from working as efficiently as they could. I’ve heard stories in other places where the staff at the hospital or clinic will get upset or frustrated with medical students for being slow and not knowing what is going on, but I definitely did not feel any of that animosity in Redfield,” said Cowman. “So that was really nice. I really enjoyed that. The sense of community that you get when you see a patient in the grocery store the next day that you had just seen in the clinic or the hospital or whatever, they are excited to see you and you are asking them how they are doing and they feel a lot better. That is a really rewarding feeling.”
Going forward, Cowman will be doing a rotation in the hospital and clinic in Yankton. Throughout this year, he will follow many different specialties, including internal medicine, obstetrics, gynecology, pediatrics and surgery.
“Your experience with those specialties is the basis that a lot of people use in forming their choices as far as what they want to go into. So I am hesitant to commit to anything just yet, but I’m leaning towards primary care, internal medicine, something in that department. I like the continuity of care that you get with holding on to your patients for a long time and really developing those relationships,” said Cowman.
Meanwhile, Cowman said he hopes to come back to Redfield at a later time.
“I am grateful for the opportunity to have spent time in Redfield and I want to thank the community for taking me in. Everyone was warm and kind. I hope to be back in a couple of years. In my fourth year of school I will have some more time to do some elective rotations and Dr.Owens has been talking up his hunting skills, so I need to take him up on that and see if he’s ‘for real’,” said Cowman.