Shadow Me Next!

6 - Building Community and Education in Medicine, an interview with a Primary Care Physician Assistant | Jessica Murray, PA-C

• Ashley Love • Season 1 • Episode 5

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Transitioning from PA school to a thriving family medicine practice isn't just a career shift; it's a journey filled with both hurdles and triumphs. In our latest episode, we bring you the inspiring story of Jessica Murray, a dedicated family medicine Physician Assistant making her mark in a small Florida town. Jessica opens up about the challenges she faced during the tumultuous COVID-19 pandemic and how she found empowerment by emphasizing the importance of community support and self-reflection. Her story is a testament to the power of resilience and relationships in building a fulfilling medical career.

We also explore the multifaceted experiences that come with gap years and their critical role in shaping personal and professional identity in healthcare. Jessica shares her insights on maintaining a healthy balance between personal life and career demands, offering thoughtful advice for aspiring PAs. Her anecdotes about the pressures of clinical rotations and the strength found in community support provide a candid look at the realities of medical training. Mentorship emerges as a pivotal theme, with supportive preceptors playing a key role in guiding her journey and shaping her approach to patient care and teamwork.

In her current role, Jessica is excited about the potential of group medicine visits to enhance patient education and empowerment, demonstrating her commitment to patient-centered care. Her unique path to a collaborative healthcare setting highlights the benefits of a supportive and diverse medical team. Through her experiences, she underscores the significance of aligning career choices with personal values and fostering a supportive work environment, offering invaluable insights for anyone pursuing a meaningful path in medicine.

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.

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Ashley:

Hello and welcome to Shadow Me Next, 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 incredible members of the healthcare field and 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. 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, where I'll give you sneak previews of our upcoming guests.

Ashley:

This is episode six of Shadow Me Next. Today we are joined by Jessica Murray, a family medicine PA who is making a big difference in a small town Florida private practice. Jessica shares her journey through PA school and how she found her place in medicine, reflecting on the challenges and rewards along the way. She opens up about struggles she faced, including navigating tough ICU rotations during COVID, and the successes she has celebrated, like learning how to prioritize the relationships that make a specialty feel like home. Jessica also offers heartfelt advice on managing the demands of this profession, why taking a gap year was the right choice for her and how she keeps her life balanced while pursuing her passion. This is a conversation full of honest insights and encouragement. I'm glad you have chosen to shadow me next, hi, jessica. Thank you so much for joining me on shadow me next. I am so excited to have you today.

Ashley:

I'm so happy to be here, ashley, thanks for inviting me. So tell me a little bit about where you're working currently.

Jessica:

Yeah, so I am currently working as a family medicine PA. I'm in a private practice in a pretty small town here in Florida. I found my job while I was on PA rotations actually, so my current boss had reached out to my program and said he was interested in having PA students rotate. So yeah, I started there as a student and have been there for about two and a half years now.

Ashley:

That's very cool. Pa school is hard enough and then I think people forget that during PA school a lot of times we're also trying to find our job. You know, at the end of.

Ashley:

PA school. You're wrapping things up and you're studying for your boards and on top of all of that, you're also trying to find employment and find out where you're going to fit best. So I'm really interested to hear about that. But let's take a step back and tell me what interested you in medicine in the first place. Did you always know you wanted to go to PA school? Oh, I in the first place?

Jessica:

Did you always know you wanted to go to PA school? I think I began being interested in medicine at the very beginning of my college career. I took an anatomy and physiology class and I just fell in love with it. It was the best class I had in college. I had an incredible professor who was just really engaging. He was really invested in medicine and so that's kind of where I started having an interest and I wasn't sure where I would fit in the medical field. But that kind of got my brain going. I was talking to my mom about it and she had a friend whose daughter went to PA school. She connected me and we had a phone call and I got off that phone call and I was like 100% sure that PA school was my track. So before that I explored a few other options. You know medical school, like sonography, things like that but PA school is kind of where I landed.

Ashley:

Did you find that there were certain qualities about PAs that you thought really resonated with you and when you had those conversations with that friend that you thought, you know, this sounds like something that I want to do, this sounds like someone I want to be.

Jessica:

Yeah, absolutely, and I would say I've felt that with most of the PAs that I've met since then, which has been really cool. Some of those qualities I think was wanting a balanced lifestyle and having a lot of passion outside of medicine and wanting to be able to give a lot of energy to your career but also have, you know, space and energy for things outside of that, being really excited about people and connecting with relationships. That was a huge thing that I felt like was a common thread. And then being willing to go to school for a while and spend some time, you know, preparing for your career, but also being able to start it relatively quickly after undergrad.

Ashley:

Have you found that all of those things are? Have you experienced that? I mean, have you found that they're real?

Jessica:

I think so. I think that there are some bumps in the road and it doesn't always happen immediately. For instance, my transition from PA school into family medicine. You hit the ground running and I was definitely not experiencing a complete, balanced lifestyle right out the gate. But I think if it's something that's important to you, you can find that along the way.

Ashley:

Yeah, I agree, and I think that the way that you described having energy for your career and also having energy for just your daily life too I think that's so important, because energy is precious and it's hard to find and it's hard to repair and it's hard to replace when you're feeling really worn down, and and I think that I think life can do that, but I also think your job can do that too, and that's kind of where this phrase burnout comes from, which is a really important thing, and I do like talking a little bit about burnout here, but I think one of the things that fights that burnout is exactly what you talked about is about having both the energy for your career and also, at the same time, having energy for your own life and the things that make you happy and satisfy you.

Ashley:

You'll get those in both your career and in your life too, but it's important to be able to share in both, I think, and it does help with burnout. I think PAs do that very, very well. So tell me about your PA schooling. Was it a two-year program that you attended and, generally speaking, did you have a good time? Was it miserable? Tell us about it.

Jessica:

Yeah. So I did attend a two-year program. I was 24 months at the University of Florida and I really loved my program. I loved so much about it. I had great professors, great support system. There were definitely parts that were miserable and parts that were really wonderful. I tell people all the time I would never regret going to PA school, but I also don't ever want to do it again. I'm happy to be on the other side of it.

Jessica:

I think people thrive in different seasons, and so the didactic year, our first year, was a lot of classroom work and I had been out of school for two years preparing for my application, and so that was a challenge to get back into studying and preparing for exams and being in your books a lot, and so, as much as I was really enjoying what I was learning, it does get heavy and it does get old. I think that things that helped me during that season were finding a really small group of core people that we could study with and, you know, build study guides together, find resources together, things like that. That made that load a little bit lighter. And then the second year being my clinical year. That was where I thrived. I loved my clinicals. It was such a breath of fresh air to start using the knowledge that we had been learning in practice and really getting to have that connection with people patients, as well, as, you know, attendings and other PAs that I was working with.

Jessica:

So, yeah, I think PA school it has its bumps, for sure, it has its challenges, but overall I had a really great experience. It's a fast two years it does. It flies by. By the end of it You're like how have I accomplished all of these things?

Ashley:

But the day to day is slow. When you were out of school for two years, would you consider that your gap year or were you working? What did those two years look like for you?

Jessica:

So I did take a gap year. My undergrad degree was in athletic training, and so during that degree I was required to have an internship for athletic training each semester, and some PA programs would count those hours as clinical hours. However, not all PA programs did, or they counted as half credit, and so I wasn't able to get my full amount of hours to apply to my top school. So I did graduate and then I got a job as a medical assistant and took that year. I didn't have to take any classes, luckily, so I was just able to work and travel. I went on several mission trips and volunteered around town, things like that, and that was a really great year for me. It was a breath of fresh air and I made a lot of great connections with other people who are going B and PA school. We were all doing applications together, interviewing together, so it was a good season. And then I continued working during my application year as well.

Ashley:

If you didn't need the patient contact hours which is a fancy way of saying you know working directly with patients to gain hours in order to apply to PA school. It's one of the requirements. If you didn't need that, do you think you would have taken a gap year? Looking back on things, that's a great question.

Jessica:

I think that it felt like there was a lot of pressure from outside towards saying that, my gosh, if you take a gap year, will you for sure go back? Or how old will you be when you graduate and you know, is this going to delay you getting a job and the start of your life? And it feels like this may be a big deal and I think it's really a very personal question and it takes a lot of self-reflection. I mean, if you've had a great undergrad experience and you feel so ready for PA school and you don't need that gap year, then I think a lot of people do really well going right into school and you don't need that gap year, then I think a lot of people do really well going right into school.

Jessica:

I think on the other side, some people are already experiencing burnout by the time that they're graduating from undergrad and it feels like such a heavy thing to start PA school right away. And so I think that takes some self-reflection of where am I at in my relationships? Am I going to be moving for PA school and how is that transition going to affect me? What does my support system look like outside of school and then, how are my habits? Even after undergrad, do I have healthy habits so that I can sustain myself through PA school in a healthy and happy way?

Jessica:

That's kind of the things that I would have had to consider in that season and I think, looking back, it did end up being a really healthy thing for me to take that time.

Ashley:

That's amazing, jess. I love the way you described all of those. It was almost like an algorithm to determining if you wanted to do a gap year. Right, and I think a lot of people would appreciate an algorithm for determining a gap year. And when you mentioned the fact that you know people were worried well, would you go back to school? Well, how much time is this gap you're going to take, et cetera.

Ashley:

You know, I think a lot of people use the gap year in medical school, npa school and I think some nursing schools do. Students do gap years too, and I think people use the gap year kind of as a means to an end right. I mean my gap year in order to get my patient contact hours end right, I need my gap year in order to get my patient contact hours. And what I have found speaking to so many people was you know, yes, during your gap year, we do talk about the fact that you got patient care hours. But you mentioned hobbies and you mentioned developing personal relationships and I think, looking back on my gap years, it's those things that I was really really able to develop and hone in and mature and that's what really supported me a lot in PA school and beyond as well, in my career too and I think that our gap years don't have to be a means to an end.

Ashley:

They can just be another season of our life. It's a short season, but it is a season. How many times, you know? Looking back on it now you're in your career, you know how many times could you just go and work your quote unquote nine to five and then go out with your friends or you know, just randomly say I'm not going to come in to work for two weeks and take a mission trip. You know it's, it's a season and it doesn't necessarily need a full purpose. I think you can find your purpose in that gap year while you're doing it. So thanks for answering that question. I have very fond memories of my gap year, so I love talking to people about theirs.

Jessica:

Yeah, I enjoyed it as well and I think I would really encourage people sometimes it's internal pressure and sometimes it's external pressure that your life starts when your career starts and I think it's so important to realize that you have an identity already. That's separate from being a PA or an MD or a nurse or whatever field you're going into, and you also have that identity afterwards and you can mold it and change it. But, yeah, kind of getting away from that mindset of things start when I graduate, like your life is already going, you can enjoy it day by day and peaceful happening. It's great for you.

Ashley:

I love that. That is so great. So your identity, you know it is important and I think that if we have time to develop it it's fantastic, and then we can use that while we're in school but, more importantly, during our rotations, right, Because that's when who we are as people and who we are as providers is really going to shine. Just think back to clinical year. Didactic year is hard just because it's studying and tests are hard and people, you know, challenging your knowledge is where you ran into a challenge, any type of challenge, and you really relied on that identity that you had to kind of get you through.

Jessica:

Yeah, absolutely so. I began my PA school journey at the beginning of COVID and so COVID, you know, really influenced everything about my education and also the people that I was working around had, you know, worked through a lot of COVID by the time that I was rotating with them. I think the first time that I came against a real challenge that rocked me a little bit was my third rotation. I was in the ICU cardiovascular ICU on night shift for the first time and it was just rocked my world in every way.

Jessica:

I was completely thrown off by the schedule, by the advanced medical things that I was seeing, and then, unfortunately, I felt like I was working with people who had just really kind of had to emotionally shut down to be able to offer care to the patients after seeing so much COVID, and so that was a time that was really discouraging, I would say I would show up to work and just realize that none of my patients were on the brink of being healthy. It felt like we kept people alive overnight instead of being able to really make a lot of progress anywhere. Most of my patients were on ventilators and I wasn't able to connect with them. Their families weren't allowed in the hospital, so I couldn't connect with their families. A lot of what I loved about medicine just wasn't available at that point.

Jessica:

I think that was a really challenging time where I was like, oh my gosh, this is not what I want my career to look like, this isn't what I want for these patients, and it felt kind of helpless. I think that was a time that one my community was very grounding for me to just have things outside of work that made me happy and, like, felt purposeful and could kind of fill up my joy thing a little bit outside of that, and then just realizing that you know, medicine is hard in a lot of ways and, you know, kind of having grace for the providers that I was with and recognizing that they had some really hard times and I think at first I was kind of like how can you be so unemotional? And it's just realizing what they had been through and learning from that and then also having some self-reflection afterwards of how can I protect myself from emotionally shutting down when I'm dealing with a tough situation. So that was probably the hardest time that I had during my clinicals.

Ashley:

I don't blame you. Icu medicine is. God bless the people that work on the ICU. I had a very similar experience and my patient was a young woman who had just delivered a baby and had an ecllamptic seizure and was non-responsive. And my job as a PA student was to go in and, you know, do our physical exam and I would talk to her. There's nobody else in the room and obviously, you know, I host a podcast. I like talking, like I couldn't, I couldn't fathom touching this patient and not talking to this patient. So, jess, did you ever question the fact that perhaps this career wasn't right for you, or perhaps being a PA wasn't right, or did you just kind of put your head down and get through it and realize that this just isn't the location for me?

Jessica:

Yeah, I wish I could say that I didn't question it, but I definitely did. I think that many people would run into times when you just falter a little bit and it could be after a bad exam or a bad review or just a tough patient experience and it's to sit with that and be uncomfortable and still decide this is where I'm going to stay. And so I definitely did have those times. I think, going back to my community, there were people who had been around me during that gap year who said, no, like you've worked so hard and this is like all the things that you've done or said or experienced that have confirmed that this is where you're supposed to be, and so it was helpful to hear that from other people when in my head I wasn't being able to tell myself those positive things, but there was definitely some doubt to work through.

Ashley:

It's like you've created this positive echo that just gets to echo all of these things back to you, the reasons you're passionate about this, what your aspirations were, what they are. I think having that positive echo is so important and we can create negative echoes too, and I think wording off those negative echoes is really important too. Jess, tell me, when you were on rotation and I think there's 12 at your program on any of those rotations, or even possibly during didactic year, which is first year, did you run into any surprise mentors, anybody that kind of affected the way that you perceive or view medicine or the way you practice?

Jessica:

That's a great question.

Jessica:

I think that there was a very clear distinction from people who just had a lot of joy in their job and who came to work really excited and motivated and even ready to teach and ready to answer so many of my questions, versus some who were maybe just a little bit, you know, had been really comfortable in their careers, kind of going through the motions, not really having that you know excitement and energy that they brought to.

Jessica:

I do remember I worked with an attending who was in internal medicine at the VA and she was just amazing. She was so helpful because she didn't just do the bare minimum and let me kind of follow along on rounds and assign me a patient to kind of work up here and there. She just would help me put presentations together. She would give me feedback on those presentations. If I wrote a note out for her on a patient, she would come back with you know little marker marks all over it saying, oh, change this here, I would do this here. She would kind of walk through her process and verbalize what she was thinking while she was doing it. And that was one of my really early rotations and so that was so refreshing and really helpful as a student and now as a PA. It really encourages me to kind of have that same response when students are shadowing at our clinic.

Ashley:

It's amazing when you have preceptors that are also really good teachers. Shout out to the VA internal medicine, because the VA internal medicine rotation that I had, the preceptor was also phenomenal. It was a male and he just I still talk to him from time to time they just they take a vested interest in you as a person, not just in the fact that you're sharing a patient right, and it is. That is incredible. I'm so happy to hear that. So we'll transition a little bit to your roles as a primary care PA, but before we do that, we have a segment called quality questions, and this is where I ask you if you have ever either asked a question or been asked a question that was very memorable for one reason or the other. Do you have one of these?

Jessica:

I don't know if I asked the question or if it came up in conversation, but it was really helpful for me and really changed the course of my career a little bit. And then I've passed on to other people as well. So the conversation kind of started talking about PAs have this auamazing ability to work in any field and you can change pretty much at any time you want to. How do you kind of hone in on where you're supposed to be, when do you start right after school and how do you know if you're supposed to change? My background was in athletic training. I really thought that I would end up in an ortho profession. I thought I would really enjoy surgery. I liked being hands-on and so going into PA school that's where my mindset was at. And then during PA school there was a lot of talk about you know, start in internal medicine or go to the ICU, somewhere where you can use a lot of your skills and work there for a year or two and then take the freedom to go to a different specialty. So somebody gave me really good advice and they said you came into medicine because you love medicine. So you're probably going to have an affinity to more than one thing and you might like you know something about surgery, and then you might like something else about GI, and then you know you might find something interesting in dermatology. It's going to be hard for you to kind of narrow down where you're meant to be, and they said, instead of just looking at the medicine, look at the people who are working in that field and get around them and see what are their personalities like, what is their language like, how do they act at work, how do they interact with their coworkers?

Jessica:

And, although it's a little bit different based on your facility, I think there is something where a lot of surgeons and surgery PAs they kind of have the same vibe A lot of family medicine. People have a lot in common, and so that was something that was really helpful for me to realize. You want to be around people that are easy to be around. You want to be around people who get you and kind of think like you, and so that is actually what made me interested in family medicine during my rotations was realizing that when I was in the family medicine clinic I really got along with the people who were there. I loved having conversations and sitting at lunch with them and that really kind of changed my direction and what I was open to looking for in a job. So that's my recommendation when PA students ask me, how did you pick family medicine is look for the people in the fields, look at their personalities, get to know them and see where you fewualityualityel comfortable.

Ashley:

That's great advice. That is such great advice because those are the people that are going to be supporting you in your career right, Absolutely, and and while I think that that makes our career a lot easier and it it helps reduce that awful burnout that we've talked about a little bit. Jess, you're so amazing. I give you one question and you answer two, and then you segue into the next segment.

Ashley:

It's perfect, well done. I think that's fabulous. So tell me a little bit. You know you mentioned earlier that your current supervising physician reached out to your program, said that they were interested in hosting students and that's kind of where you ended up and how you ended up working there. That seems like a unique situation. Is this typical for PA school?

Jessica:

I think it was somewhat unique in that, you know, this office had never had a PA student there before, and so the backstory that I didn't know at the time was they were hiring an additional provider and they had done, I think, 12 to 14 interviews and they had eventually just shut down. They said we're not finding anybody that's finding anybody that feels like the right fit for us, and so we're just going to kind of close out our interview process. And in doing so they started thinking about PA students and said you know, we might as well give it a shot. Let's reach out to the PA program and just see if we can get some students rotating here. One of the professors reached out and just sent an email to the class hey, if anybody wants to drive out to this clinic, they're interested in PA students. There might be a job opportunity, but who knows. So I was already scheduled for a family medicine rotation at a different clinic and I figured, why not? I say I want to try a PA student and it's a new experience, like at 50-50 shot. So I sent an email back saying, hey, I'd be interested in going, and so, yeah, I showed up and it was a great experience. They were so open to having students.

Jessica:

They had had medical students rotate through, so they were familiar with the process a little bit different with a PA student and I was all hands on deck the first day. They gave me a patient chart to go see and I just kind of jumped in. And I was all hands on deck the first day. They gave me a patient chart to go see and I just kind of jumped in and I had so much fun.

Jessica:

So I have a supervising physician and two nurse practitioners that work there and what I loved about my rotation was they all sit in one office together and just bounce questions off of each other all day long, and so it's. You know this is going on with my patient. Is this what you would do? Or, you know, do you see an alternative to this plan? So it felt like I was just getting infused with knowledge all day long in a really positive, really upbeat environment. I didn't really know when I started there that I was kind of starting an interview process and we just casually, you know, asked questions, kind of got to know each other, and at the end of my rotation I had a job contract, which was crazy.

Ashley:

Jess, that's amazing. Now, what rotation? Do you remember what rotation that was on your list?

Jessica:

Yeah, so I'm thinking it had been a while. I think I started my rotations in August, so they were, you know, a month each, and this rotation was February. I had a few rotations left for maybe three years, so March, april, may, I'm guessing. Before I was kind of like wrapping up school, I had already had a primary care rotation, actually, yeah, one primary care rotation before this. So I had a little experience in primary care but a very different clinic setting. I had a little experience in primary care but a very different clinic setting. And so, yeah, a lot of it was just talking about what motivates you. What would you want primary care practice to look like? There was just a lot of freedom and autonomy and just a really open relationship with the people I would be working with which was really great.

Jessica:

And also just a great client base and I loved the patients that I was meeting and I just felt very much at home there and also, and I loved the patients that I was meeting and I just felt very much at home there. And also, I think as a new student, the concern can be am I going to be given a foundation where I can learn, where I'm given time to learn slowly and not get crazy behind? Am I going to have people to ask questions to? What does my support going to look like at work? And so it was really incredible to work there for a month and kind of get a taste of that. I felt like it was like a little mini trial of working there and it's been great.

Ashley:

That's great. It's like on the job training, but for free for them. Yeah, exactly, exactly. Again, you've answered two of my questions in one fast loop.

Ashley:

So you know, I just like to highlight how fantastic it is that you get to work in such a collaborative office and you get to experience, in my opinion, truly medicine at its finest when we are collaborating with people with different backgrounds and people with different training. You know one of the main differences between nurse practitioners and PAs, which you probably could speak on this a little bit more intelligently than I can, but they're trained under a nursing model, whereas PAs are trained under the medical model. And medical doctors are also trained under the medical model, but your medical doctor obviously has a little bit more experience than you do just because he's been practicing longer than you have and went to more training and residency, et cetera. So that collaboration, just first of all, as a PA, is fantastic. I love bouncing off ideas. You all sit in the same room. How amazing for our patients, right? I mean, it's not just your brain, it's your colleagues' brains as well that are popping into some of their issues and some of their diseases and concerns.

Ashley:

So anytime I am a patient and I visit an office that I do know is this collaborative environment, I just I feel better knowing that there are many people involved in my care. So that's great, and it sounds like one of my questions was I must've been kind of scary Number one being one of the first PA students to enter this office. But beyond that, being one of the first PA students to enter this office, but beyond that, being one of the first PAs to enter this office, and something that I talked to a lot of the shadows that I host in my office about is making sure that your supervising physician knows how to appropriately employ a PA, Because I've heard horror stories about people who have used their PAs as scribes in essence, and we were trained for so much more than that. So did you ever run into an issue where you had to step up and say, hey, this is what I can do, or was it pretty smooth sailing because of the nurse practitioners that were there, kind of helping you along too?

Jessica:

I think that I had a really great experience. To be honest, I have heard those stories as well where I had friends who graduated a couple of years before me and were the first PA in an office somewhere and it was rocky. I mean, they had some tough times and you're under a contract for a period of time, so you're kind of stuck there for a while trying to work it out and see how willing your supervisor is to make changes. For my experience, I think having the nurse practitioners in the office was helpful.

Jessica:

The way that they worked was very similar to how I wanted to be able to operate. I saw them having a lot of autonomy. They had their own patient panels, their own schedules. Of course they could see patients from the doctor if he wasn't available, but for the most part they were operating very much on their own. And I also was able to kind of see that my supervising physician was really wanting to make sure that he was equipped and had enough information. So, for instance, he called somebody who had PAs working for them and asked how is this going, how does this work at your practice? So I think before I started we were able to have a pretty open and candid conversation, which was helpful.

Ashley:

He sounds like a really good supervising physician.

Jessica:

He's great. Yeah, I'm really really blessed by that.

Ashley:

He sounds amazing. I'm so happy for you. So has your role. In the two and a half years that you've been there, has your role evolved, or have you found that you are just simply more comfortable in doing what you're doing on the day to day?

Jessica:

Yeah, I definitely think that I'm getting to that point where there's new opportunities opening up and just areas that I've kind of progressed in. So at the beginning I was really slow and I was given time to be slow, which was great. I had an hour per patient and I was establishing a new panel. So these were patients that weren't known to the practice. They were coming in and meeting me for the first time, and so I had a slow progression of just kind of getting my feet wet, learning how to work the EMR system, learning how to get to know my patients and address their concerns, and so I had kind of a slow ramp up and it took me some time to get comfortable with that.

Jessica:

I think at the beginning I would wake up and work for an hour before I went to work to prep all my charts, and then I would come home and I have to close all my charts.

Jessica:

It was a miracle if I could call a patient back about their labs in the midst of the day. I have to be getting no work-life balance. It was a lot of work but it has so paid off, and so now life doesn't look like that so much. I'm able to handle a lot more and work a lot quicker, and so with that and being a little bit more comfortable with my medical knowledge, I am excited to start eating in different ways. I've been able to step up in a few roles around the office. It is a small private practice, and so helping with billing, helping with training, medical assistance, things like that have kind of become part of my role. And then in the future I'm really excited about potentially starting some group medicine visits as part of what we can offer to patients. And so that's kind of what's on my horizon, what I'd like to start looking into.

Ashley:

Jess, I love that, and are there any specific health care issues or patient populations that you are particularly passionate about addressing, and it sounds like these group visits might perhaps be a solution to that.

Jessica:

Yeah, absolutely.

Jessica:

I think in primary care, so much of the hardship but also the joy is education and patients understanding their disease process, understanding what they're in control of and what is out of their control, and really just empowering patients to be good advocates for themselves.

Jessica:

So I think that an issue I run into often is we've never had more access to information, and so, whether it be through Instagram or TikTok or what their friend posted on Facebook, people come and really guard it, I find, into primary care with a lot of fears about not being heard or something being done to them or a medication that they take harming them in some way, and so initially it takes a lot of time just to build trust with patients and give them time to just be heard and be seen and feel safe and feel like you're not going to force anything down their throat but instead realize that you're a teammate, you're there to kind of partner with them, and so the group visits do kind of segue out of that where I have patients with type 2 diabetes I think is a huge one where education goes a long way, and so that's probably where I would start with the group visits, and I think the benefit is having my own patient panel and working with nurse practitioners who have panels, you can easily identify patients who are really interested in something like that.

Jessica:

There are some patients who do not really want that education for themselves, and that's okay. But for the patients who do having space for them where they can have a longer period of time with you and also have a community of people around them working on the same goals I think that's my solution that I'm hoping will be beneficial to just kind of bring down some of those barriers, some of those walls, rid them of some of those fears and really empower them to feel like medicine isn't happening to them, their disease isn't happening to them. They're able to take a little bit more of a stand against it.

Ashley:

That's great, jess, and I just thank you so much for the care that you're providing these patients. It's inspiring the fact that you realize that patients are coming to see us. This is our job, this is what we do every day, we're used to it, this is where we're comfortable, this is what we do, it's what we love, yeah. And yet, a lot of times, patients do come in and I like to tell people, specifically students, when we have a let's call them a cranky patient. We have a cranky patient come in and you know, the medical assistant has identified that this is a cranky patient. I'll tell this, I'll tell the student. I'll say listen, this person is probably cranky for one of two reasons Either they are in pain, and it is our job to help them, or they are scared. Yeah, and it is also our job to help them.

Ashley:

And and you know most people. If you realize those two things, then the visit is just fantastic. So, like you said, these people they've heard horror stories because there are horror stories out there. People have been failed by health care time and time again and people have not been listened to and people have a misunderstanding about their disease process because of the information online. And then there's also people that come in with really great information online and we can have a fantastic conversation about their condition because they've done their research.

Ashley:

So online is not this terrible thing, but bad experiences exist and I think that the fact that you've identified that and that you keep that in the back of your mind is a huge service to your patients and I'm so grateful that you practice that way for every single person that walks in, whether they identify that upfront right away or perhaps they just show up in there a little cranky and you kind of have to deduce that and you have to sit and spend the time to kind of work through that with them. I think these group visits sound fantastic. I'm I'm so excited. Perhaps we can follow up with you on how these are going, and I think that camaraderie is important. As we talked about. Camaraderie is important for PAs and NPs and MDs, but camaraderie can be really important for patients too. Yeah, what advice would you give to current pre-health students who are just starting out in this career path?

Jessica:

It's a great question because there's so much that I could say. I think that it's really important to stay grounded in things that aren't school and aren't medicine, and so really spend some time on engaging with hobbies, engaging with friends outside of medicine, setting those things up, whether it's exercise, healthy eating habits, just things that make you feel good. I think those things are really, really important because they really do carry you through those tough times in school. And then really just stay curious. I think it can be really easy to set your mind on a goal and just really shoot for it. And I think that can be really easy to set your mind on a goal and just really shoot for it, and I think that can be a good thing.

Jessica:

But staying curious and being willing to change your course at any point, being willing to turn left or turn right and end up somewhere that maybe you didn't think you'd end up. And then the last thing is just be really comfortable, being uncomfortable. It's like starting up to that rotation where they'd never met a PA student before and I had no idea if it was a job interview or just a four-week rotation. That's a little uncomfortable, but PA school keeps you uncomfortable and it's a really beautiful thing.

Ashley:

That's great advice, Jess, and you know I'm laughing because I'm still uncomfortable and I've been doing this for 10 years. There are still conversations with patients and my supervising physician that are uncomfortable. It literally just happened this week for me and that's a never ending thing, but we're supported by our medical knowledge.

Jessica:

Yeah.

Ashley:

And what a great support system that is. We're supported by our colleagues and that's great. Thank you so much for joining us on the podcast today. We are so grateful for you and your time.

Jessica:

Well, thank you for having me. This has been such a fun conversation and I can't wait to listen to your other episodes.

Ashley:

Thank you so very much for listening to this 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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