How PAs help practices in rural areas, during holidays

Some of the best providers I saw growing up in McCook, Neb., were physician assistants (PAs). After working in a lab for a few years, I decided that I wanted to be a PA, too. I wanted to diagnose patients on the front lines instead of reporting the lab results to the clinical team.

Except for a short stint in Kansas City, Kan., I have chosen to work in rural areas, much like my hometown. Currently, I spend the bulk of my time in a family practice clinic but also work in the local emergency department (ED).

The town I work in has a population of 1,000 and a service area of 3,000. PAs have the opportunity—and the obligation—to treat acute illnesses in children, manage chronic conditions in adults, stabilize car accident patients, run medical codes, and round in nursing homes. The town has two physicians, two PAs, and one nurse practitioner plus a 16-bed hospital. If the hospital is full, patients must be transferred 30 to 60 miles, depending on need.

As a provider, I see it all, and I love the variety.

One of my most memorable patients was a 38-year-old trash collector who came to the ED with shoulder pain, assuming it was from carrying and throwing trash cans over his shoulder. After evaluation, electrocardiogram, and lab enzymes, I realized he was having a heart attack. I called a helicopter to transport him to a hospital an hour away. The paramedics told me I saved his life. He was well managed, completed his cardiac rehab, and is back to living his normal life.

Sometimes PAs, particularly in rural areas, have the chance to spend a bit more time with patients. I had a mom bring in her 6-year-old daughter who had previously seen other providers for abdominal pain. She had been told it was a virus, but the pain persisted. The child was eating well yet appeared malnourished. Because I had the time, I asked her questions about what she likes to eat and when it hurts. I also spoke with her mom and found her brother was having issues as well. I diagnosed gluten sensitivity and changed their diets. A simple nonclinical intervention like dietary changes can dramatically improve a life.

Whether you live in a big city or a small town, certified PAs not only increase access to quality care but are proven and prepared to handle almost any medical issue. Particularly in rural areas, this is important for holiday coverage.

Before you head out the door, it’s important you convey to patients that they can have confidence in the care PAs provide. Put photos and bios of PAs on your website and print a one-page flyer for your waiting room explaining to patients the PAs in your office are capable of providing of many services.

Here are three ways PAs can help physicians take a vacation:

PAs can manage a full patient schedule or cover call while you are taking some much-needed time off.

Their education and certification prepare them to work autonomously but in collaboration with physicians. They have a master’s level education and have completed a rigorous certification maintenance process, which includes earning 100 credits of continuing medical education every two years and passing a written assessment every 10 years.

PAs can develop specialized program for patients.

Some practices ask PAs to develop specialized programs that benefit patients, such as group appointments or educational sessions. Do your patients have diabetes or heart disease? Do your patients want to get healthier or have a plan for the holidays? Certified PAs can help.

PAs are one answer to the physician shortage and avoiding burnout.

If you cannot recruit another physician, you may be able to add a PA to your staff by working with a PA program in your state. You may also want to ask other providers if they know PAs from the area who, like me, might enjoy the chance to come home.