Shadow Me Next!

1 - You're Invited to Shadow Me Next: How Virtual Shadowing can Impact your view of Medicine | Ashley Love, PA-C

• Ashley Love • Season 1 • Episode 1

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Ever wondered what it takes to thrive in the demanding yet rewarding world of dermatology? Join us on Shadow Me Next as we reveal the daily ins and outs of a dermatology clinic, where a Physician Assistant like me navigates patient care from acne treatments to the intricate Mohs surgery. Through personal anecdotes and real clinic experiences, we unravel the complexities of patient assessments and the pivotal role of education in enabling informed healthcare decisions. Drawing from my own journey as a PA and insights from my time in OBGYN, this episode offers a unique look at the parallels in patient care across different medical fields.

Meet Abby, a college senior on the brink of choosing a medical career path. Her story brings home the crucial role of mentorship and personal guidance, which are cornerstones of our mission here at Shadow Me Next. Through candid conversations with seasoned healthcare professionals, we aim to empower aspiring medical professionals with the knowledge and confidence needed to embark on their own journeys. Delve into the human side of medicine with us, where personal stories and expert advice combine to inspire and inform the next generation of healthcare providers.

Virtual shadowing is an important tool to use when planning your medical career. At Shadow Me Next! we want to provide you with the resources you need to find your role in healthcare and secure your place in medicine.

Check out our pre-health resources. Great for pre-med, pre-PA, pre-nursing, pre-therapy students or anyone else with an upcoming interview!
Mock Interviews: shadowmenext.com/mock-interviews
Personal Statement Review: shadowmenext.com/personal-statement
Free Downloads: shadowmenext.com/free-downloads

Want to request a guest? Shoot me an email: ashley@shadowmenext.com

Ashley:

Hello and welcome to Shadow Me Next. This is a podcast where I take you into and behind the scenes of the medical world to provide you with a deeper understanding of the human side of medicine. I'm Ashley, a physician assistant and the creator of Shadow Me Next. It's my goal to introduce you to the incredible members of the healthcare field and to uncover their unique stories, the joys and challenges they face and what drives them in their careers. It's access you want and stories you need, whether you're a pre-med student or simply curious about the healthcare field. I invite you to join me as we take a conversational and personal look into the lives and minds of leaders in medicine. Welcome to the inaugural episode. You're invited to shadow me. Next to the inaugural episode You're invited to shadow me next. In this episode, I'd like to introduce you to the whole concept of how shadow me next was born, tell you a little bit about myself and my journey as a PA, and then get you excited for the episodes to come. We have some incredible healthcare providers that have amazing stories to share about their own journey in medicine, but who also have a heart for teaching and a sincere interest in sharing their personal stories with you. I don't want you to miss a single one of these conversations, so make sure that you subscribe to this podcast, which will automatically notify you when new episodes are dropped, and follow us on Instagram and Facebook at Shadow Me Next, which is where I'll give you sneak previews of our upcoming guests.

Ashley:

In this first episode, I'd like to tell you a little bit about me, how I became a PA and how I arrived at the position where I'm speaking directly to students and encouraging them on their own journey. I always knew I wanted to be in medicine. I'm a problem solver and a people person, and I admired how healthcare providers are able to discuss some of the most intimate parts of a person's life their health and are able to partner with them to make changes that will increase their overall well-being. Initially, I was unsure if I wanted to become a physician or a physician assistant. Both offered the ability to diagnose and treat patients, both gave me the ability to provide for my family financially and both offered a lifetime of learning and continuous education and self-development, which is so important to me. But what ultimately helped me make my decision was understanding that I was ready to enter the workforce as soon as possible and that I enjoyed the idea of lateral mobility as a PA and that I appreciated the camaraderie that comes with working alongside a supervising physician. I have been practicing as a PA for 10 years now and I can safely say that I made the right decision for me. However, after mentoring students throughout that entire 10-year time, I understand that what works for me might not work for you, and that is the beautiful thing about medicine, because if you desire this, there is a spot for you, regardless of what your goals are and regardless of whether your goals are the same or different from mine. I have to say, one of my favorite parts about hosting Shadows is getting to discuss some of the ways in which we differ in our views of medicine or ways we differ in the roles that we wish to pursue. It's a beautiful thing, and I think medicine does it very, very well.

Ashley:

Something else I frequently discuss with my shadows is the value of a good mentor. Mentorship is a gift, especially in medicine. It's a way for students that are interested in healthcare to find guidance and support and encouragement while navigating their careers. This podcast serves as a form of mentorship by providing accessible insights, advice and inspiration through candid conversations with medical professionals. It's designed to encourage and empower you and give you a sense of direction and connection. However, it does not replace the value of a personal relationship with a mentor. True mentorship involves a deeper, one-on-one connection where advice is tailored to your specific needs, goals and challenges. This podcast complements that relationship, acting as a resource to spark ideas and build confidence as you take steps towards your goals. Throughout this podcast and on our website, shadowmenextcom, I offer you tangible tools to help you develop these relationships that are so important in your current and future careers. I encourage you to find mentors in every facet of your life faith, marriage, parenthood and your hobbies, too.

Ashley:

My goal for Shadow Me Next is to provide a transparent and engaging platform that bridges the gap between aspiring medical professionals and the healthcare community. By sharing real stories from clinicians across a wide range of medical disciplines, I hope to give you the exposure and insight you need to make informed decisions about your future careers, while also helping the general public gain a deeper understanding of the human side of healthcare. I am committed to demystifying the world of medicine, showcasing both the challenges and rewards of a career in healthcare and providing valuable resources for you to excel on your journey. Ultimately, I strive to shape a future where both students and patients are empowered with knowledge, feel seen and heard, and gain a stronger sense of trust in the medical profession. One of the primary questions you'll hear me ask our healthcare professionals in the coming episodes is to describe the challenges they face in their field.

Ashley:

Challenges are a given in any profession, but the challenges in medicine oftentimes involve the health and well-being of another person. So often our challenges become our pain points for burnout, and understanding this before you enter the medical arena will set you up for a successful and satisfying career. I love a challenge, but the challenge has to have an end goal of helping someone else For me. That's what makes me tick. Medicine offers these challenges every day and, as with all things in life, I believe that if you approach challenges with a positive attitude, they will move away from being what caused burnout, which is a huge issue these days, and will instead be the fuel to your fire, pushing you towards greater success in life and in your career.

Ashley:

As a PA, some of the challenges that I focus on are regarding partnering with patients to help them improve their health. This looks like different things for different specialties. For derm, it could look like encouraging more sun protection or for primary care, it could look like improving their diet or encouraging exercise, but generally speaking, there are 10 points of challenge that I see routinely and that cause friction in my job as a PA. I think the biggest thing to remember here is that your patients are people, not problems, and this should be pretty easy to do. Because I am a patient too, I know how hard it is to exercise frequently. I know how hard it is to eat a balanced diet or to sun protect while I'm chasing my children all over the pool. If you remember your patients as people and not problems, finding common ground with them to help solve some of these health issues will be so much easier. As we meet with healthcare providers over the next several weeks, you will hear these themes presented consistently, because they are a greater challenge for more than just one practice or even one specialty. It's a common theme across medicine and I am excited to see how current and future advocates for healthcare improve these challenges.

Ashley:

So digest these 10 things. Consider how they may affect you, your patients and how they could impact your role as a healthcare provider. The first challenge I see so often are insurance challenges and financial barriers. Patients may not have insurance or may have high deductible plans which limit their ability to afford necessary tests, medications or treatments. Also, a lot of times we have to navigate prior authorizations for medicines or for procedures and this can delay care. Delay care. The second are geographic challenges. In rural or underserved areas, patients may have to face long travel distances to reach a specialist or healthcare facility. I talk about this a little bit more later and I think you're really going to enjoy what we have to say about rural medicine. Number three specialist shortages Finding specialists in your area. Even in a town like mine where physicians and PAs and NPs are in abundance, it's very challenging for your patient to have to wait on a specialist visit for months just to get more answers, sometimes when it's something that you diagnosed initially but you just don't have the resources or the expertise to manage it in your practice.

Ashley:

Number four health literacy. Patients may not fully understand their condition or their treatment plans and sometimes this leads to non-compliance and poor outcomes. Also, miscommunication about the importance of follow-up care can result in delayed diagnoses. Five access to medications. Patients may not be able to afford what you've written, particularly brand name drugs or newer therapies.

Ashley:

Number six transportation issues. Lack of reliable transportation can prevent patients from attending appointments or picking up medications. I see this so often and I speak to our surgical patients about this frequently. Perhaps they were able to arrive at their first appointment and we've done a biopsy and unfortunately it's bad news and they have to return. Well, sometimes scheduling that return visit is hard and it causes a lot of anxiety knowing that they have a diagnosis that needs further treatment but they cannot get to your office.

Ashley:

Number seven systemic inequalities. Patients from marginalized groups may face discrimination or biases in the healthcare system. This limits their access to equitable care. Number eight preventive care gaps. Many patients delay seeking care until their conditions become severe, either due to costs or lack of awareness about preventative care, or sometimes just fear or concern over having to visit a doctor or a PA or an NP in a medical office. Number nine cultural and language barriers. Language differences can make it harder to effectively communicate diagnoses and treatments, and cultural beliefs and practices may impact a patient's willingness to pursue or adhere to treatment plans. And number 10, technological barriers. This is a rather new challenge, but patients without access to technology may struggle to schedule appointments, access telehealth services or use online portals for results and communication. Nowadays it's hard to pick up the phone and speak to your doctor, and this can cause a big challenge for our patients who are not as technologically savvy. That's 10 challenges that I face at my practice pretty consistently, and I wish I had the answers for you as to how to overcome them consistently every single time, and I don't you know. My biggest recommendation is to view your patients as people, because if you start viewing them as their technological challenges or if you start viewing them as their financial difficulties or as their language barriers, they have lost you as a valuable member of their care team. Being my patient's advocate as their PA involves standing alongside them, even during these challenges, and that is one of the reasons why I am so proud to be a PA.

Ashley:

It's funny anytime you ask a medical provider for one of their most memorable patient encounters, they might laugh and say I know exactly one to tell you, and it's typically because that patient encounter began with a challenge and it's usually because we were able to work through that challenge with that patient and come to a harmonious, beautiful, healthy conclusion. And come to a harmonious, beautiful, healthy conclusion. This happened to me when I had a young mother come into the office with her husband and it was for her skin exam. I was proud of her for taking her health into her own hands and stepping in, even though she was so incredibly busy. And, by all accounts, she had absolutely beautiful skin, not a single spot on her. She had sun protected well, she used good moisturizer, she was the perfect patient and her husband was with her. And at the end of the visit I'm already running a little bit behind for that day and I was so grateful to have a patient who was just so healthy sitting in my chair so that I could maybe get caught up.

Ashley:

At the end of the appointment the husband said excuse me, but do you have just one second to talk about something that I have that I'm concerned about? And oh, it's so hard in those moments because, as a medical provider who's trying to see the rest of her 24 patients and stay on schedule, these impromptu visits sometimes can throw a big wrench into things. But I felt drawn to say yes and of course he was very kind with this presentation and explained briefly about what he had going on. And it turns out that just by speaking with him I was able to deduce that he likely had a condition called hydradenitis suprativa. I'll link it below.

Ashley:

But hydradenitis suprativa is a chronic genetic skin condition where you have recurrent abscesses or cysts that form in the most uncomfortable areas under your arms, in your groin, under your breasts for women behind your neck for men underneath your chin and these abscesses become inflamed and they drain and then they scar and the scars will then scar. And it's this chronic cyclic condition that becomes worse and worse over time. And he was middle-aged and he had been struggling with this for a long time. And just speaking with him I mentioned HS and it's a word that he had never heard of. Then I began to talk about the fact that it can be genetic and it can run in families, and he opened his eyes very big and said you know, I think my mother and my grandmother probably struggled with the same thing. And I asked about his children and he said that he had two young children and they probably also were struggling with the same thing and they probably also were struggling with the same thing. And so what did we do? We went ahead and booked an entire family visit. He and his wife and his two children returned to the office the following week and we openly had a conversation about this type of skin condition and I am so happy to say that they are all currently symptom-free. They're living their best life without HS and we were able to address it early so that the treatment options for them were very mild and doable and not an impact on their regular daily life. Sometimes, just taking a couple of minutes with one patient can change the outlook of an entire family, and that is the kind of stories that I'm here for. That is the kind of thing that I want to encourage you about.

Ashley:

Medicine is yes, even if the challenge presents itself sometimes. If you push into that challenge, you are met with the most wonderful stories and successes that come from it. Stories and successes that come from it. If you were to come and shadow me for a day, you would see a PA who worked, amongst other PAs and physicians, to provide the best medical and surgical dermatologic care to our patients. Our office is open Monday through Thursday. During those days, I see anywhere between 20 and 24 patients with medical dermatologic conditions. This includes things like acne and rashes, shingles, etc. But it also includes regular skin exams and this is a part of preventive medicine.

Ashley:

When a patient comes to our office. They usually see a medical assistant first who walks them through reviewing their chart, updating any information that needs to be updated and asks about any concerns that they have that day. At that point I'll come in and do a full skin exam or address the specific problem that they presented with that day. During the skin exam, if there's any suspicious findings, we'll talk about them. I'll provide a clinical diagnosis and I'll let the patient know what treatment options they have available. Occasionally, the patient wants to think about their options, and that's okay. That's part of teaming with them. It's part of my job to make sure that they have the education they need to make an informed decision about their own healthcare. Most of the time, however, our patients are ready to make that decision at our appointment. Whether the spot that's worrisome needs to be frozen off with liquid nitrogen or scraped off with an electro desiccation and curatage, or if it needs to be biopsied, we can perform that procedure in that exact moment and the patient will be on their way to knowing exactly what that lesion was.

Ashley:

While you're enjoying these podcasts, you may hear PAs or physicians or nurse practitioners or nurses describing certain procedures, or perhaps they'll just state the name of a certain procedure. What I like to do is make sure you know exactly what they're talking about. So at the end of every episode, down in the comments, you will see a link to a video of that procedure. These links are meant to serve as a visual education, if you will, so that you can better understand what these medical providers are talking about.

Ashley:

The procedures we do in dermatology are all on the skin, of course. We do biopsies, electrodessication and curatage and cryosurgeries, and we do bigger surgeries as well Excisions for cysts, lipomas and any type of abnormal mole, as well as a specialized surgery called Mohs surgery. Surgery called Mohs surgery. Mohs surgery is a specialized procedure used to treat squamous cell and basal cell skin cancers. It requires close work with a dermatologist who is also a board certified dermatopathologist, which is someone who can look at slides prepared of the skin. The patient who has already had a biopsy return as an abnormal skin lesion, basal cell or squamous cell, will come back to the office for further procedures. We anesthetize the area. The physician will remove a small portion of their skin with a very slim margin, process that into slides and then examine that underneath the microscope If the margins are positive at any point either around or underneath that sample. The surgeon can then re-enter the operation and remove more of the specimen. This allows for the smallest amount of tissue to be removed, which is really important on areas like the face or the scalp or the back of the hands, where there's not much loose skin to work with. Once the physician has completely cleared the margins at our office, the PA gets to enter the procedure and perform the repair. This is where we take this defect which has been left by the surgeon and close it in a way that is both functional but also cosmetically beneficial.

Ashley:

Being able to work as a medical and surgical PA is one of the most wonderful aspects of my career. Before I was in dermatology, I also worked in OBGYN, and in OBGYN it was a very similar experience. We saw patients in clinic where we performed routine pap smears, routine breast exams, any type of a problem visit. But I also was able to step into the surgical suite and, right next to the operating physician, perform these incredible surgeries and right next to the operating physician, perform these incredible surgeries robotic hysterectomies, open hysterectomies. It was incredible, and the opportunity to serve patients face-to-face and also serve them under big procedures is one of the highlights of my career, students will ask me well, do you prefer clinic medicine or do you prefer surgical medicine?

Ashley:

And it's an impossible question to answer because I prefer both, simultaneously working in harmony with each other. I love the ability to sit and talk to our patients, to share in that decision-making with them, and then I also really appreciate being the one to help them, being the one to fix their problems, to remove that skin cancer, to take out their uterus that is causing them years of abnormal bleeding. Ultimately, it goes back to the whole reason why I entered medicine I enjoy solving problems and I enjoy solving problems in order to benefit other people. In the middle of each podcast that you will hear on Shadow Me Next, I like to include a place where our interviewers can share their most memorable interview questions, and hopefully this will give you something to think about for your own interviews, and if it doesn't, then hopefully it will give you something to laugh at. And here is your quality question.

Ashley:

When I was interviewing for PA school, near the end of one of my interviews, someone asked me if I was an animal, what animal would I be? And it just threw me off because I had prepared for every PA related question in the books and I had not thought about what kind of animal I would be. So, you know, knee jerk, I just I splurted out dog because I was hardworking and friendly and playful and, of course, in retrospect, driving home on the way back from the interview, I thought of a thousand other animals that I could have said. That would have been more thought provoking, I guess, or exciting, but what I've realized is, a lot of times, when they throw out these offhanded interview questions something that you know, not necessarily something you could prepare for they want to see you think, and they want to see you think on your feet, because that's a lot of what medicine is. So if you were an animal, what animal would you be? I am so excited about that break for quality questions and I think it's going to really be a huge highlight of this podcast for you. You can always review these quality questions on our Facebook and Instagram at shadow me next, and if you're looking for more interview resources, head over to our website at shadow me nextcom for mock interview opportunities. When it comes to working as a derm PA, we'll have plenty of opportunities for me to talk about certain things that I've been exposed to and certain experiences that I've had that might help to shape your decisions and might help to confirm, one way or the other, where you want to end up in the medical field. Getting into the specifics of it, however, I will leave to my colleague, who I plan to interview in the next few episodes, because I think she has some incredible insights into our field and I'm excited to share those with you. But now I want to talk to you about why this podcast matters, and I'm going to do that by telling you about Abby.

Ashley:

Abby is a college senior with a science major who's interested in a career in medicine but has limited experience in the field. Her mother is a teacher and her father works for the local sheriff's department. They are supportive of her goals and have had excellent relationships with their own medical providers, but they don't know anyone personally who Abby can shadow. Abby's hobbies include running, going to the gym and spending time with her friends. She has a full course load this semester, including two hours of organic chemistry lab. She TAs for her bio class and tutors high school students a few days a week. She is involved in many organizations on campus which require on-site participation in meetings, as well as promotional and volunteer activities. She enjoys these organizations but realizes they're a means to an end goal, which is to enroll in a postgraduate medical program. During one volunteer activity at a local health department, abby was able to play an active role in providing medical care to underserved people. Role in providing medical care to underserved people. This single experience solidified her desire to become a medical professional who is capable of improving the lives of others by providing excellent health care and sincere social support.

Ashley:

As the end of her final semester nears, abby has started to feel more anxious regarding her decision to enter medicine. She wishes she had time in her schedule to research medical professions and wishes that she could get time off work to shadow medical providers and ask them the personal questions that would help make this decision easier. As a result of her lifetime experience, she believes a career in medicine would best support her lifetime goals To teach like her mother, to serve like her father, to further her education and desire for learning, to become financially independent and to continue with the community service that means so much to her. She understands that a career in medicine is an ambitious goal and, as such, wants to be sure she's making the right decision about which direction in medicine to take. Abby would love to be able to passively listen to her most important questions being asked as she walked to class or exercised at the gym. She would love to discuss the things she learned with her parents and her friends so that they can help her make the best decision.

Ashley:

Abby needs more than just the steps for how to get into medicine. She wants access to medical providers to help her confirm why she wants to go into medicine. She wants tangible evidence that the immense effort she will be dedicating to becoming successful in a professional program will result in a life of learning, of service and of true career satisfaction. Abby wants to shadow me next. I talk to students like Abby all the time. Students who need more of why we do what we do. Students who need assurance that the efforts that they're going to put into getting into school and surviving school and then entering their career is all worth it. Students who want to know if I am satisfied with my decision, if I have achieved my dream in my career, if I have a good work-life balance and if I'm happy overall with where I'm at in my life. That is why I have created the Shadow Me Next podcast so that we can dive into those questions with not just me but many other members of the medical community. I think sometimes their responses will shock you. Sometimes you might hear yes, I'm working 100 hours a week, but it is the most wonderful work I have ever done in my whole life. Or other responses like I wish I had taken that gap year or those two gap years or three gap years to really spend time with my friends and my family and hone in on my hobbies before I entered my career. These questions are for you. These questions are for you. These conversations are for you.

Ashley:

By providing accessible on-demand content and offering more interactive opportunities for learning about medicine. Shadow Me Next stands out in a space that is otherwise limited to formal in-person shadowing or lecture-based resources. This allows you to explore healthcare careers in a flexible, less rigid and more personal way, which is a growing need in today's fast-paced, digitally connected world. My goal is to move beyond simply outlining how to get involved in healthcare and instead help you clarify why you're driven to pursue a career in this field. Thank you so very much for listening to this inaugural episode of Shadow Me Next. If you liked this episode or if you think it could be useful for a friend, please subscribe and invite them to join us next Monday, as always. If you have any questions, let me know on Facebook or Instagram Access. You want stories you need? You're always invited to shadow me next.

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Ashley Love

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