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Certified PAs are changing the face of healthcare today. They practice medicine, manage acute and chronic patients, perform complex procedures, prescribe medications and assist in surgery.

The PAs on this page have maintained certification by completing a substantial amount of continuing medical education and passing a rigorous national exam. Some of them have additional credentials as well. They are all skilled providers who share a common goal: to deliver the highest quality care possible to optimize each patient’s outcome and satisfaction.

If you are a patient or an employer, you will enjoy meeting each of them and reading their story.

Click here to read about more PAs and the exciting work they are doing!

If you are a PA and would like to share your information for this site, submit your profile here.

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PAs Support Hurricane Victims

National Guard

Certified Physician Assistants (PA-C)
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National Guard PAs Support Hurricane Maria Victims

By Chelsea Smith

“For only a small group of people, we made quite an impact.”

That’s how Vermont National Guardsman Maj. Michael Korczykowski, PA-C summed up his recent deployment as commander of Charlie Company, 186th Brigade Support Battalion. He served as the officer-in-charge of a 21-person detachment dispatched Sept. 16 to the U.S. Virgin Islands. Arriving just days before Hurricane Maria hit, the medical cadre sheltered in place during the storm and was ready to provide medical care to disaster-affected civilians and military personnel in her immediate aftermath.

Korczykowski’s team consisted of a trauma surgeon, five nurses, three PAs and 12 Army medics who staffed the Schneider Regional Medical Center on St. Thomas (a sorely understaffed hospital) and performed sick hall operations aboard the SS Wright, a navy vessel housing first responders. For nearly 30 days, the team treated wounds, administered medication, wrote prescriptions, and performed surgical procedures in emergency and operating rooms. Capt. Beth Carriere, PA-C and her team of medics even aided in the reconstruction of a shelter on St. Johns Island.

The team worked with local, state and federal partners to provide care in areas faced with a sudden surge of medical needs.

“My teams, in conjunction with the Department of Health and Human Services, were going door-to-door to check on locals and provide the medical care that they needed,” said Korczykowski. “Many of the locals are living in poor conditions and lack access to medical care. Our mission was to take care of people and do our part in ensuring they’re healthy enough to rebuild and recover from the storms.”

Personnel across FEMA, the American Red Cross, local EMS and other relief organizations all collaborated to assist in the humanitarian effort. Medical support also came from area support medical companies from the Army and medical evacuation teams from the Vermont and Kentucky National Guards.

On Oct. 13, Korczykowski and his team redeployed to Burlington, Vermont, but a medical team from the Pennsylvania National Guard will continue what they started in the islands.

“We’ve been working with them to assure good continuity of care so that they can continue to provide quality medical care and staffing support,” said Korczykowski.

National Guard units have a minimum requirement to train 39 days each year, where they practice and hone skills in preparation for natural and man-made disasters. Through planned exercises, which often include local, state and federal partners, units network various skill sets to complete unified missions and prepare for a range of events.

“In uniform, we learn to ‘train as you fight,’” said Maj. Kathleen Parris, who served as the Virgin Islands National Guard's medical planner during hurricane recovery efforts. “This means all training should be seen as ‘the real thing.’ Therefore, when it happens, we are prepared to act and know how to respond.”

Relief efforts continue in the aftermath of Maria, which indiscriminately damaged communities and disrupted services across the chain of islands. Though medical needs persist, Korczykowski said he is proud to have led a team that brought critical care to communities in need, and he was inspired by the resiliency of people resolved to regain their sense of normalcy.

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Korczykowski has worked full-time for the Vermont National Guard for eight years, following a 10-year active duty tour in the Army. He also works per diem in the emergency room at Porter Medical Center in Middlebury, Vermont and at Northwestern Medical Center urgent care facilities in St. Albans, Vermont.

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Certified PAs: A Family Affair

The Rittles

Certified Physician Assistants (PA-C) and PA Student
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Matt, Nick and Beth Rittle give credit for their interest in healthcare to their mom Colleen, a nurse who encouraged them to volunteer at the hospital in high school and college. One by one over the course of several years, they each chose the PA profession.

Matt (27): Four Years as a Certified PA

Matt knew he would go into the medical field in high school. While volunteering, he shadowed a PA and decided to enter the PA program at St. Francis University in Loretto, Penn. where he could get both his undergraduate degree and Masters in Physician Assistant Science in five years.

As soon as he graduated he took a job in emergency medicine at the Heritage Valley Health System in Beaver, Penn., a working middle class suburb of Pittsburgh.

“I love the unpredictability of the emergency department and the schedule where I work four nights a week with three days and weekends off,” says Matt. “The ED can be tough, and about 70% of what we do is family practice. However, I cannot imagine doing anything else.”

Nick (24): Graduated 2017, Newly Certified

Nick’s high school volunteering made him realize he wanted to work in a medical atmosphere that puts patients first. He also wanted a job with flexibility, and — observing his brother’s great experience — he felt that the PA role would suit him.

He applied to several colleges after high school and chose St. Francis University as well. There he was granted full admission, meaning he had a guaranteed spot in the PA program as long as he kept his grades up.

Having graduated in May, Nick has just started his first job at UPMC Mercy in Pittsburgh where he will care for inpatients after trauma, vascular, thoracic and general surgery. His shift is three nights one week and four nights the next, with every weekend free. The schedule definitely appealed to him.

Nick’s graduating class had a 100% pass rate on the PANCE, and all his close friends had multiple job offers. Nick himself interviewed for his current and job and accepted it immediately. “I like the flexibility and the diversity of patient problems,” he says. “It is also very satisfying to see patients improve after surgery.”

Beth (32): PA Student at Slippery Rock University

When Beth went to college, her mom “tried to push me into nursing but I wanted nothing to do with it back then!”

Instead, she chose to major in communications. For most of her career, she has worked in hospital marketing and public relations departments doing writing and web design.

“About five years ago, I realized I was not passionate about what I was doing,” she says. “I was surrounded by nurses and administrators and got interested in how hospitals are run and the legislative issues that affect them. Then, I worked on a website for advanced practice providers and interviewed NPs and PAs and learned about them. I realized that what I wanted to do was direct patient care.”

This decision had big implications for her life. Beth did not have the science prerequisites necessary, so she spent several years going to night classes while working two part-time jobs to save money for PA school. She also sold her home so that she did not have a mortgage and could focus on her studies.

Beth says her PA class includes about 15 other students who have chosen the PA profession as a second career. When she graduates, she is interested in either working in a hospital or an urgent care setting.

Beth says the sacrifices she made to get admitted to a PA program were worth it. “Work life balance is important to me. When I graduate, I will be 35, and being a PA will give me the flexibility I am looking for. Most importantly, I will feel good every day because I know I will be making a difference.”

The siblings are very close and share stories about PA school and their work. In typical sibling banter, Matt quips: “I laid the groundwork for them, although they might not admit that.”

The three have a fourth sibling, Ali, who volunteered in the hospital during high school for one day and realized medicine was not for her. She, however, gives back in other ways — as a special education teacher.

It is no surprise that Colleen Rittle says, "I am extremely happy and proud of the choices and accomplishments that all of my children have made in their careers!"

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Credentials Confer Confidence

Christopher Edelstein

Eastern Long Island Hospital
Certified Physician Assistant (PA-C)
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In the emergency department at Eastern Long Island Hospital in Greenport, New York, Lawrence R. Schiff, MD, Director, Emergency Department, and Christopher Edelstein, MPAS, PA-C, work as a seamless team to care for the wide variety of patients and health conditions they see every day.

Year-round they deal with patients with chronic disease, managing often complex comorbidities and medications. During the summer, they see an increase in boating injuries, Lyme disease, heat exhaustion, and car accidents.

“Our patients expect the best treatment possible from the best medical staff,” says Edelstein. “More and more of them are looking up their providers on the internet, to ensure they have the certification, credentials and qualifications that make them comfortable.

“That is one of the reasons I earned Certificates of Added Qualifications (CAQ) in Emergency Medicine and Hospital Medicine. Credentials give patients confidence, and physicians respect you if you know the latest studies and nomenclature and present it in a concise way. Preparing for the CAQ keeps you on top of your game.”

Edelstein--who has been a PA for 16 years and has experience in a Level 1 trauma hospital, surgery, toxicology, and orthopaedic surgery—has worked for six years at this small community hospital.

Given that PAs work with a collaborating physician, it is important that their relationship be strong. Dr. Schiff says, “Certified PAs help the physician by being able do most things a doctor does. We discuss each case, and they provide another set of eyes and hands. Chris knows medicine. We have an open dialogue, he knows when to involve me, and we back each other up.”

Edelstein, who serves as the team’s chief PA, also has a key role in the hiring process. Says Schiff, “I trust his judgment.”

The CAQ recognizes PAs who have completed rigorous requirements in their specialty, including substantial continuing medical education, specialty-related procedures and patient case management, and passing a specialty exam. Edelstein earned the CAQ in Emergency Medicine in 2011 and a CAQ in Hospital Medicine in 2014.

“I am always working to improve my skills and keep up with research on drug interactions and disease management to provide for critically ill patients,” he says.

Edelstein loves the community he serves. “I feel like I have an impact, taking care of patients and reassuring them they will be okay,” he says. “It brings me great satisfaction to see patients in the ER and then see them back at work and caring for their families.”

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Certified PA and Dentist

Brandon Churchman

Dental Clinic and ER
Certified Physician Assistant (PA-C)
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Brandon Churchman is both a dentist and a Certified PA and plans to keep working in both fields at least for the foreseeable future.

After graduating from PA school in 2008, Churchman worked in emergency medicine for five years. During that time, he saw many patients with oral disease —in patients who visited for a dental problem and also those who were there with non-dental related emergencies.

“Particularly in rural areas where access to dental care is limited, I saw a lot of dental abscesses and overall dental neglect. It was in the ER that I first got interested in oral surgery and oral health.”

Churchman just graduated from dental school in May 2017 and has begun working three days a week in a dental clinic that works with many uninsured and underinsured patients. “I will be doing bread and butter dentistry,” he says, referring to the basics of exams, fillings and pulling teeth versus cosmetic procedures. The other two days Churchman will continue to work as a PA in the emergency department.

“The PA knowledge base is too valuable to give up,” says Churchman. “It allows me to treat dental patients holistically. Even in dental school, I was able to help avoid medical errors due to my PA background.”

For example:

  • In dental school, Motrin is often prescribed but Churchman knew to ask patients about chronic conditions such as heart failure where Motrin is contraindicated.
  • He identified a patient with AFIB during a routine dental exam and that patient went to the emergency department and had to be put on blood thinners.
  • A dental student colleague had a patient with a very high heart rate and Churchman diagnosed her with thyrotoxicosis, also known as hyperthyroidism. The patient just thought she was anxious.

So Churchman says the PA-C is too valuable to let it lapse. “The PA education and certification is generalist based. I have always felt the broader based your education, the more likely you are to diagnose a medical or dental problem that could go unnoticed. This is consistent with many professions looking to increase interprofessional education. I believe that collaboration versus islands of care improves patient outcomes.”

Will it be hard in the long term to do both? “An internal medicine physician told me you can’t do everything. I have thought about this but at this early point in my dental career, I see that it is possible to do both and that is the plan I am following.”

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First PA to co-author a textbook for physicians

Lyle Larson

University of Washington Medical Center in Seattle, Wash.
Certified Physician Assistant (PA-C)
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Lyle Larson is a Certified PA who has worked in cardiology and cardiothoracic surgery in a busy academic medical center for 30 years. He works with medical residents and fellows in surgical settings and recently co-authored the textbook Surgical Implantation of Cardiac Rhythm Devices 1st ed. Elsevier with his collaborating physician Dr. Jeanne Poole, MD. He is the first PA to co-author a surgical textbook directed for physicians and other practitioners in the cardiology subspecialty of electrophysiology.

Certified PA first to co-author book in electrophysiology

This year, Lyle Larson, MS, PhD, PA-C, adds pioneer to his list of many accolades. As the first physician assistant to co-author a textbook for physicians, Larson documented over 30 years of experience working in electrophysiology in Surgical Implantation of Cardiac Rhythm Devices with co-author and collaborating physician Jeanne Poole, MD. Electrophysiology deals with the diagnosis and treatment of heart rhythm disorders.

The genesis of the book began eight years ago when Larson and Poole saw a need for a comprehensive textbook on electrophysiology device implantation and envisioned a resource that addressed safe, effective surgical implantation of pacemakers, ICDs (implantable cardioverter defibrillators) and other devices. In its first edition, Surgical thoroughly covers surgical techniques and procedures ranging from sutures to special circumstances and complications. Medical providers training or requiring additional guidance to perform these complex procedures can refer to the book’s detailed illustrations and accompanying online video clips. The book debuted at the American College of Cardiology meeting in March 2017 and became the second highest selling textbook at the Heart Rhythm Society meeting in May 2017.

Off the heels of the book’s recent release, Poole and Larson are starting to gather data for a second edition. In the interim, Larson has a busy schedule fulfilling duties as clinically-practicing PA, teaching associate, preceptor and president of the Washington Academy of PAs, a role he’s held since 2016.

But rewind 30 years ago. and the blueprint for his career would look vastly different. After graduating from the University of Texas at Southwestern’s PA program, he initially planned to practice in rural health. Those ambitions were diverted after a job offer fell through due to the death of his hiring physician. Soon after, Larson accepted a position as a PA in the cardiology division at the University of Washington Medical Center. It was there that he met cardiac electrophysiologist, Poole, and they would go on to form a decades-long partnership as colleagues in medicine.

“I happened to be in the right place at the right time with the right people,” he said.

Since 1986 he’s practiced clinically and taught medical students and fellows on electrophysiology surgical procedures. A typical day begins at 7 a.m. conducting clinical rounds on pre-operative patients. He then heads to an electrophysiology laboratory where he instructs fellows through surgical procedures while an attending physician either participates or observes. In the afternoon, he conducts another set of clinical rounds and allots time for administrative and academic responsibilities. Larson also precepts about 15 students per year from the MEDEX program in Seattle; the Heritage PA program in Toppenish, Wash.; and Marquette University’s PA program in Milwaukee.

“I like watching the light come on when students finally grasp a concept and understand what they’re doing,” he said about what he enjoys most about instructing. “It’s always been my goal to make complex things simple and simple things obvious.”

As Larson makes an indelible impact on the profession, his commitment to advancing his own skills is apparent in the way he “operates” too. He says, “From a surgical aspect, my attending physicians refer to me as MacGyver because I’m always trying to improve upon a surgical technique. I am also deeply influenced by the concepts illustrated in Anders Ericcson’s book Peak: Secrets from the New Science of Expertise.”

As a Certified PA in a surgical role at a hospital, Larson has watched the profession expand into new areas of growth, such as administration and medical research, and influence healthcare delivery across a variety of clinical settings.

“I like that it is continuing to evolve,” he said. “It’s not the same profession as when I started. It’s an honorable profession, and I think it will stand the test of time.”

PA-C…Educator…Preceptor and now Co-author…Because he’s opened new lanes for the profession, Larson’s accomplishment is one for the history books.

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Caring for Women's Health

Hema Majeno

Adventist Health Community Care
Certified Physician Assistant (PA-C)
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As a PA in a rural area, Hema works with many undocumented immigrants and especially women to build relationships so they trust her to provide necessary healthcare and wellness counseling.

EMPLOYER:

Adventist Health Community Care in Parlier, California

NCCPA CERTIFICATION:

Certified physician assistant (PA-C)

Hema’s blog (below) was previously published in Physicians Practice.

© Physicians Practice 2016

Physician's Quote

“I have worked with Hema for almost three years at Adventist Health Community Care in Parlier, California. She is a very bright, knowledgeable and experienced physician assistant who has a great deal of responsibility in managing a wide diversity of patients from newborns to geriatric patients with multiple medical problems. I am very impressed by her compassion for our patients, her integrity and professionalism. She is a highly committed individual with a good sense of clinical judgment and priorities.” --Rogelio Fernandez, M.D.

PAs Providing Women's Health: More than OB/GYN

By Hema Majeno, PA-C

Having emigrated from India in 2003, I have always been interested in the healthcare of women in rural areas. Today, I am fortunate to work as a certified PA in a family medicine practice, which provides care to many women in the San Joaquin Valley of California.

Women PAs can help to meet the needs of women in rural areas by providing access to needed health programs and services, and offering the opportunity to be seen by a female provider. I think this also increases patient satisfaction as women may be more candid with another woman.

Many of my patients are undocumented farm workers, who are dealing with language and cultural barriers as well as raising their children and trying to keep them in school. While the demographic base of my practice may be different than yours, by and large women's health needs are universal. It is important to treat the whole woman, not just today's problem. This includes not only preventative physical exams, but also screening for mental health.

Most of my patients come to me through word-of-mouth referrals and I usually see 20 patients a day. Typically, a woman will come in because of symptoms, like a cough or cold. While I handle the acute problem, I also use the opportunity to ask if they have had a Pap smear or a mammogram and try to schedule a physical. I want to have more time to do a total assessment: check for cholesterol, diabetes, hypertension, and more. Many of my patients put their families first and have neglected their own health for years. Of the 45 minutes I schedule for an exam, I spend at least 20 of those minutes on preventative education.

However, my goal isn't to just to provide acute care, I want to build relationships so these women will continue to come back for preventative and wellness services. I've found there are four primary reasons patients will schedule follow-up visits:

1. Family planning. Family planning is a big part of my practice. Teenagers and young women tend to be timid, and my priority is to be sensitive and find a personal connection. I smile, make eye contact, and sometimes hold their hand when I speak to them, so that I can gain their confidence. I explain birth control options and discuss STD prevention.

2. Depression and/or anxiety. During routine physicals, I frequently uncover symptoms of depression and anxiety. If patients are mildly depressed, I explain meditation techniques and may prescribe antidepressants and therapy. I have found that, often, even a short course of treatment can bring them back to feeling normal. For more serious issues, I refer to a psychiatrist or a psychologist. I also check to see if they may be in an abusive relationship, and if so, we look for community resources that can assist.

3. Weight loss. Female patients often ask about weight loss. The diet in this rural area seems to be high in fat and carbs. I provide basic nutrition counseling and explain carb and calorie counting. I also prescribe medication in the case of morbid obesity, but then I also refer to a nutritional or diabetes educator. Again, I stress prevention and educate patients about how they can take control of their weight and their health.

4. Menopause. For middle age and older women, I perform breast examinations and Pap smears and order mammograms. I ask about menopausal symptoms such as hot flashes and mood changes. I also educate them about natural alternatives to hormones, which have fewer or no side effects. At this point in their lives, they may have comorbidities that contribute to their symptoms. I help them understand menopause changes and manage any medications they are taking.

My goal is to treat patients the way I want to be treated — as if they were a family member. I'm fortunate to love what I do, and every day I thank my patients for the privilege of providing their care.

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Stabilizing Trauma Patients

Sarah Cawley

Team Health at Southwest Hospital Emergency Roon
Certified Physician Assistant (PA-C)
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Sarah Cawley practices clinically in emergency medicine. She volunteers at a pregnancy center, is a family engagement adviser, a member of several patient advocacy committees, and speaks regularly on patient experience and family engagement.

EDUCATION:

BS, Liberal Studies, Excelsior College

MPAS, Physician Assistant Studies, University of Nebraska

NCCPA CERTIFICATIONS & CREDENTIALS:

Certified physician assistant (PA-C)

Sarah’s blog (below) was previously published in Physicians Practice. © Physicians Practice 2016

Being a Patient Makes Us Better Providers

It is not enough to simply practice medicine. As providers, the way we care for our patients is as important as the knowledge we possess.

Each of us has our own method of engaging with and managing patients; an approach that is individualized yet influenced by training and experience. However, it was only after a life-changing diagnosis for myself and my youngest daughter that I came to realize both the power of the diagnosis and the importance of the empathy we provide to our patients.

When my daughter was born in 2012, she was diagnosed with hydrocephalus, along with several other serious medical conditions that required countless medical appointments, tests and treatments. Then, in 2014, I was diagnosed with breast cancer and required multiple surgeries, chemotherapy and radiation. Those events changed our lives dramatically. Just as important they changed my perspective as a health care provider.

Some experiences with doctors over the last few years have been incredible, providing the emotional support, education and treatment quality we needed. Other interactions fell short. These experiences allowed me an opportunity to re-evaluate the way I practice medicine. Was I giving my patients the information, treatment, and emotional support they needed to overcome their situation?

As a certified PA in emergency medicine, my interaction with patients is critical, and I have the opportunity to make an immediate impact on their lives. My patients in the emergency room need someone who looks out for them and ensures they receive the best care possible. All healthcare providers are called to be patient advocates, not just medical practitioners. The challenge is, with our many other responsibilities, how can we step up and fill this role?

These are the takeaways from my own experience as a patient that have changed the way I practice:

1. Remember what it’s like to be the patient. Even though we have the knowledge and skills to treat medical conditions, being a patient is different. You may be overwhelmed with fear of the unknown or can’t collect your thoughts long enough to ask questions. It’s helpful to have the provider in your corner trying to anticipate those questions for you.

2. The patients need to matter to us. They’re more than a medical case; they’re real people with their own lives, families and struggles. Until we humanize them, we won’t be able to treat them to our fullest potential.

3. How care is provided is as important as what care is provided. Treating all patients with respect is key. When examining and treating my patients, I ask questions to get to know them, not just what has brought them into the emergency room. I explain any testing that needs to be done, discuss the results and carefully review treatment plans. I try to remember to talk with my patients and not to them. It’s my job to educate them so they comprehend their situation and can get better.

4. Understand that different patients may have the exact same diagnosis, but how they experience it is influenced by their life situation. We need to meet patients where they are and customize the manner of treatment to those needs. This requires us to listen.

5. A strong support system for patients can make a tremendous difference in their health. Get the families engaged and involved in your patients’ healthcare. 6. Join – or start – a committee aimed at improving quality, patient safety, patient interaction and patient experience. Whether you practice in a large hospital system or in a private practice, meeting with fellow practitioners, colleagues, and families to discuss how the delivery of healthcare can be improved for your patients can only benefit your practice. 7. It’s OK to get to know your patients. In fact, it’s critical. Listen to their story. Share your story. They can learn from you; and you can learn from them. This will change the way you practice. Be brave enough to connect! Ultimately, patient advocacy grows out of empathy. We all have a story and hardships. Allow that experience to connect you with your patients. When you can build that bridge, it will result in effortless empathy and better care for your patients. At that point, you stop just doing your job and start really caring for people.

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Caring for the Mentally ill

Kristi Kincheloe

Shannon Clinic
Certified Physician Assistant (PA-C)
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Kristi Kincheloe has been a PA for four years and took a job in psychiatry immediately after graduating her PA program. Before becoming a PA, she was a school psychologist for 10 years.

EDUCATION:

Masters in Physician Assistant Studies, Texas Tech University Health Science Center

Masters of Science, Abilene Christian University

NCCPA CERTIFICATIONS & CREDENTIALS:

Certified physician assistant (PA-C)

Kristi’s blog (below) was previously published in Physicians Practice. © Physicians Practice 2016

Bridging the Gap: How Certified PAs Serve Mental Health Patients

States across the country are dealing with the challenge of a shortage of psychiatrists and the impact it has on caring for patients with mental illness. In my home state where “everything is bigger in Texas,” it’s certainly a problem. With 200 of the state’s 254 counties designated as lacking enough psychiatrists, Texas stands out as one of the most severely affected.

To help solve the problem, Certified Physician Assistants (PA-Cs) are being tapped to fulfill an important role in caring for mentally ill patients.

As a Certified PA working with psychiatrists, I enable additional patients to be seen, diagnosed and managed. I see patients as young as 5 and as old as 100 for a range of mental disorders including ADHD, depression, anxiety, bipolar disorder and schizophrenia. Most referrals come from primary care, neurology or infectious disease specialists, and many of my patients also have chronic conditions such as obesity, diabetes or AIDS.

Currently, 1.3% of the nation’s 108,500 Certified PAs practice in the field of psychiatry, and we are well prepared to step up and specialize in this growing field. PAs are educated at the master’s degree level to practice in medical and surgical specialties. Plus, all PAs are certified by passing a national exam, and we maintain certification through substantive Continuing Medical Education and by passing rigorous exams at regular intervals throughout our career.

Certified PAs provide mental health care by:

1) Performing initial psychiatric evaluations. I see new patients, usually referrals, formulate a diagnosis and develop a treatment plan. It can be challenging, as some patients are forthcoming and eager for treatment, while others omit information they are uncomfortable sharing.

2) Educating patients about mental illness. I usually begin with a family history, trying to understand how that may influence current dynamics and the patient’s and family’s perception of the illness. We discuss the journey ahead, and I connect them with community resources. Unfortunately, we have a high suicide rate in this area, so I often refer them to counselors on suicide prevention. Educating the families on what they can expect and how to support the patient is also part of my mandate.

3) Managing patient medications. Of course, many of these patients are on long-term medications. I want to treat each patient with the same high standards and compassion I would treat a family member, so I try not to prescribe medication unless it is absolutely warranted. For example, I try not to automatically prescribe ADHD medication without considering early interventions first, such as cognitive behavioral therapy or behavior modification therapy. However, when I do prescribe medication for any mental illness, I explain the importance of compliance and also monitor the patient’s prognosis. I review labs to make sure they are not elevated, monitor thyroid and liver function and manage patient treatment plans.

4) Teaching a healthy lifestyle. I talk to my patients at length about lifestyle, and modifications they can make to feel better both mentally and physically. This may include a discussion about moderation and substance abuse, including abstaining from smoking and alcohol. This is particularly important if they are abusing a controlled substance, for which we regularly do drug screens and refer to support groups. I discuss stress management as well as the importance of exercise and encourage them to start a simple routine like walking or joining an exercise group. Patients tell me this does make them feel better.

5) Collaborating with other providers. Many PAs choose this profession because we like working on a team. Daily, I collaborate with physicians in many specialties. For example, I consult with a rheumatologist if the patient is asking for early refills of pain medication for arthritis or fibromyalgia. I have a great deal of crossover communication with primary care physicians. Together we stabilize and improve patient health.

Certified PAs can make a big difference to any practice, particularly in the area of mental health—where there is a significant and growing need.

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Treating Diabetes

Ji Chun

Optum Medical Partners
Certified Physician Assistant (PA-C)
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Ji Hyun (CJ) Chun, PA-C, BC-ADM, has been practicing endocrinology in southern California at Optum Medical Partners for 6 years. He works closely with patients who are resistant to certain therapies due to fear or misconceptions and tries to get them to modify their lifestyle to improve their overall health.

EDUCATION:

Masters of Physician Assistant Studies at A.T. Still University / Arizona School of Health Sciences B.S. in Kinesiology: Exercise Science, Arizona State University

NCCPA CERTIFICATIONS & CREDENTIALS:

Certified physician assistant (PA-C)

Board Certified-Advanced Diabetes Management (BC-ADM)

Physician’s Quote:

“Due to the epidemic of diabetes, there is an increasing number of patients needing access to the specialty of Endocrinology. Therefore, we've expanded our department to meet these needs. CJ is a valuable addition to our team. We consistently receive complimentary feedback from our patients regarding the excellent care he provides. They appreciate the time he takes to teach them and make them active participants in their care. In addition to his outstanding clinical and interpersonal skills, he is motivated to continually expanding his knowledge. He also dedicates his time to share this knowledge with the medical community by giving lectures across the country.”

--Amitpal Kohli, M.D.

Read CJ’s blog on managing diabetic patients below. His blog was previously published in Physicians Practice.

The Diabetes Crisis and How PAs Can Help Manage It

Diabetes is becoming epidemic. A 2014 Centers for Disease Control and Prevention report estimated that 29 million Americans have diabetes, 25% of whom don't yet know they have it. Another 86 million have pre-diabetes, with 90% of them unaware of their condition. An estimated 15-30% of those pre-diabetics will progress to full blown diabetics within five years without intervention.

There is also a critical shortage of endocrinologists, with three-month wait times for an appointment not at all unusual. That leaves primary care physicians to shoulder much of the burden of the increasing diabetic population. The good news is that certified PAs can help.

Certified PAs are well-suited to managing diabetic patients because they are highly educated, skilled in patient communications (critical to chronic disease management) and must pass a rigorous exam administered by the National Commission on Certification of Physician Assistants to be licensed in any state. They can provide vital assistance in this area in a number of ways.

Enable Additional Appointments

Certified PAs will increase access for the burgeoning number of patients. In addition, PAs can manage those uncontrolled diabetic patients who often require frequent visits and several days of follow-up, which is very difficult for already overscheduled physicians. Having PAs follow up on unstable diabetic patients is a big safety net for both the practice and patients.

Schedule Sufficient Time

Diabetes management is very time consuming, and most physicians struggle with lack of time. Each appointment requires a thorough review of the glucose log, adherence to lifestyle intervention and medication, and discussion of polypharmacy including cost and side effects. We need to do foot exam and manage lipids and blood pressure as well. Having a PA dedicated to diabetic management can ease the physician’s mind that this time consuming review is completed during each visit.

Focus on Disease Complexity

The field of diabetes is constantly changing. There were only two available drug classes (insulin and sulfonylureas) in the 1970s, and we now have 11 different classes of medications. As much as we are excited about the flexibility of different options, it is easy to get overwhelmed with "too many" and fall behind with the updates, especially with so many other things PCPs have to follow.

A PA designated for diabetes management can focus on staying up-to-date with evidence-based management by attending conferences and CME sessions, and then applying it to patient care. PAs can keep the physician current with the most clinically relevant updates.

Play to Their Strengths

We cultivate a team approach that includes the physician, PA and patient setting goals for outcomes. Everyone contributes to improve the patient’s care. As a PA in endocrinology, my strength is talking to patients who are resistant to certain therapies due to fear or misconceptions. Often the endocrinologist I work with specifically asks me to talk to a patient who has been refusing necessary treatments, whether it is insulin therapy, injectable therapy, statin therapy or something else. I take the time to explain the science, the rationale, and why changes need to be made now. I also try to add some humor to ease the tension.

For example if a patient shows worry or frustration with injectable therapy, I say: "I am actually relieved that you feel this way. I would be more concerned if you were excited to start injections." This usually makes them laugh and opens up the discussion.

Offer Perspective

There are now multiple options in treating diabetes, and each provider has preferences. A PA adds a different perspective in treatment approach. It's another benefit of working as a team — like having a second set of eyes on the same patient.

I became enamored with endocrinology during a clinical rotation during my PA education. I saw the joy in my preceptor who worked to motivate patients to change their lifestyle so they could reduce medications, come off insulin and improve their overall health. I realized then that drugs are only a part of medicine. Patient rapport, trust and relationships are medicine too.

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