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Shadow Me Next!
Shadow Me Next! is a podcast where we take you behind the scenes of the medical world. I'm Ashley Love, a Physician Assistant, and I will be sharing my journey in medicine and exploring the lives of various healthcare professionals. Each episode, I'll interview doctors, NPs, PAs, nurses, and allied health workers, uncovering their unique stories, the joys and challenges they face, and what drives them in their careers. Whether you're a pre-med student or simply curious about the healthcare field, we invite you to join us as we take a conversational and personal look into the lives and minds of leaders in Medicine. Access you want, stories you need. You're always invited to Shadow Me Next!
Shadow Me Next!
10 - From Pilot to PA: One PA's Healthcare Journey in Acute, Urgent, and Emergent Care | Hector Bird, PA-C, CAQ-EM
Have you ever wondered how someone can transition from the skies of Alaska to the frontlines of healthcare? Meet Hector Bird, our fascinating guest who did just that. A former pilot turned physician assistant, Hector shares his journey from aviation to acute care, driven by a passion for patient interaction and making a difference. This episode promises insights into the versatility of the PA profession, emphasizing the remarkable career shifts possible within the realm of healthcare.
Listen as Hector reflects on his experiences at the University of Florida, where the camaraderie and support from both peers and faculty became a cornerstone of his professional development. His anecdotes reveal the vital role of mentorship and friendships formed during PA school, illustrating the journey from students to lifelong colleagues. We explore how these relationships foster resilience and competence, shaping not just knowledgeable practitioners but compassionate caregivers as well.
Whether it's providing urgent care at a patient's home or embracing non-traditional roles like working with disaster medical teams, Hector's career exemplifies the dynamic opportunities available to PAs. We delve into the nuances of the PA's role across various medical fields, highlighting the importance of understanding practice-specific responsibilities. Join us for this engaging episode that celebrates the collaborative essence of healthcare and the impact of personalized, compassionate care. Hector's story is a testament to the profound fulfillment found in helping others, whether you're in the air or on the ground.
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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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, medical editor, clinical preceptor and the creator of Shadow Me Next. It is my pleasure 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-health 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 we will review highlights from this conversation and where I'll give you sneak previews of our upcoming guests. And where I'll give you sneak previews of our upcoming guests.
Speaker 1:This is episode 10 of Shadow Me Next and we have the pleasure of speaking with Hector Bird, a physician assistant with a varied background in acute, urgent and emergent care.
Speaker 1:Hector's journey started in aviation, where he earned a degree in aviation science and worked as a pilot. However, driven by a passion for direct patient care and meaningful contributions, he transitioned to healthcare, ultimately becoming a PA. Hector shares his formative experiences as a volunteer EMT and the support system within PA school that helped him succeed. He gives incredible insight into his current role in providing in-home urgent medical care, emphasizing the difference it makes for patients with mobility issues and chronic conditions. His insights into team-based emergency medicine, patient care at home and the continuous pursuit of learning make this episode a must-listen for aspiring medical professionals. Please keep in mind that the content of this podcast is intended for informational and entertainment purposes only and should not be considered as professional medical advice. The views and opinions expressed in this podcast are those of the host and guests and do not necessarily reflect the official policy or position of any other agency, organization, employer or company. Hi Hector, thank you so much for joining me on Shadowing Next today.
Speaker 2:It's an absolute pleasure to be here and to contribute to this wonderful project.
Speaker 1:So you know it's crazy, hector and I were in PA school together 10 years ago 10 years. It's been a long time and it's so good to see you, it's so good to talk to you. We did catch up a little bit before we dove into the interview, so Hector's doing amazing things and I'm so excited to share your story today.
Speaker 2:You're so kind, you're so kind, thank you.
Speaker 1:What initially drew you to wanting to be a PA.
Speaker 2:Well, I always liked medicine. Medicine was always something that I was attracted to, but for whatever reason, I knew I did not want to be a doctor or go to medical school. I have a big passion for aviation. I went to undergrad to be a pilot I have a bachelor's degree in aviation science and did that for a few years but quickly realized that one the lifestyle, the airline lifestyle especially. This was, you know, 2005,. 2010 range was really rough. The airlines were not doing as well as they are now. Pay wasn't great. It was just a lot to handle and to think about continuing to do that for at that point almost 40 years with a family. It was a lot. So I started doing some soul searching and, at the end of the day, I really just wanted to do something that I felt would be more meaningful and contribute to people in a direct way. I had a great career in aviation. I flew in Alaska. We literally flew people's groceries to them and stuff like that. It wasn't like I wasn't contributing, but I just felt driven to do more.
Speaker 2:And one night I was a volunteer EMT and one of the lieutenants. I knew he was a PA. I had no clue what that was and I started talking to him and I asked him some medical questions. I was really impressed at how much he knew and I said you know, so tell me about this PA thing. And he started telling me about it and I was just like, wow, that's what I want to do, like that's perfect. It met medicine, it met the goal of learning and continuous education and improvement and it allowed me to do more for people. So that's where it started. And then I went back to school and had to take a whole bunch of science classes that I had successfully avoided in undergrad. Lo and behold, three years later I started PA school. It's been a fun and very interesting road, but, yeah, it's been everything that I thought it would be and more.
Speaker 1:The profession is so lucky to have you too, hector. I can't imagine the amazing things that you're doing, so tell me a little bit about being a volunteer EMT. Is that the way that you received?
Speaker 2:your patient contact hours. So I will say that that was one way. Some of the programs want you to have paid patient contact hours. So it was kind of, in some of the applications, kind of the cherry on top, but it was a good chunk of my time. Using the connections and the network that I had built from the volunteer EMS agency, I was able to start getting to know the medical community. This was in Denver, colorado, where it was good to work and that sort of thing started applying for jobs. My paid experience was as an emergency room technician or critical care technician, depending on the hospital I worked at, basically doing what a needy tech does, and that was a lot of fun. I was a tech at a level one trauma center in Colorado and Denver and it's probably the most fun I've ever had in a job. Not that what I do now isn't fun, but I got to do some really cool things and not have any responsibility at the same time. I have a lot of very good memories from that experience.
Speaker 1:That's fantastic. You know, I think a lot of people think about their when they're receiving those contact hours as almost as being a means to an end. And that's a conversation I have with a lot of students that come through our office, that have graduated college and, you know, are looking towards that next goal, and occasionally I do ask them to pause and realize that where they're at right now is a part of their medical training. And I think, working as an ED tech you, I mean you see so much, so I'm sure it was a little bit easier for you to realize and for you to remember than you know perhaps someone working in a smaller clinic or a clinic where you don't see the vast number of disease processes and you don't have access to the vast number of tests and all of those things that you do in the ED. So you know when you're getting those hours that's part of your training and you know you can't, really you can't look past it.
Speaker 1:So, speaking of training, hector, pa schools are different All the PA schools. They do have core classes, but sometimes the way those are presented are very different. Generally speaking, your experience in PA school was it good, was it bad? What did you think?
Speaker 2:I loved it actually. I mean I loved it because what I remember is the camaraderie. I remember the people I went to school with. I remember just that overall experience. Was it hard? Absolutely. Was it tiring? Yes, but what I remember really is there's very few things in life and very few experiences that you can have as a person where you're with a group of people and you're all working towards one goal. And I was very blessed to go to University of Florida the atmosphere and the culture there.
Speaker 2:Really it wasn't about competing against each other, it was about pushing each other along. Really, we had to push each other along at times, but that's what I remember, you know. And then, of course, all the stuff that I learned was kind of I remember. It still happens where things just pop into my head that I don't know where that came from and it's something that I took in a class almost 10 years ago now. So, yeah, I loved it because I love the people that I went to school with. It really was a positive experience and, of course, you always remember the good things, right? I think one of your guests said it as well but it really is the best two years of your life that you don't want to repeat.
Speaker 1:It's so true. You know it's funny when we all start saying the same things and you realize that. You know we all had very similar experiences. I believe that person also went to the University of Florida for PA school too, so it does make a little bit of sense. But the camaraderie is fantastic because it's not, it's not soft camaraderie, it's, it's not. They are, they're sharpening you and they're pushing you, but it is 100% supportive and, you know, not just between each other. I felt that and I wonder if you did too, with the faculty as well.
Speaker 1:You know, I remember failing a test and it I was, it was, it does happen, I can attest to it, and it was a part of medicine that I just. It was miserably boring to me, I was not interested, but there was also a lot going on in my life and I was so grateful to my mentor, who's also a professor of the program, a practicing PA, who just stopped and took time to sit down and really make sure that I was okay first and then to make sure that I understood the material. And that doesn't mean that I sat the test again. We just sat there and we reviewed it and we talked through it and he said I feel like I missed two questions to pass. But he said you missed this.
Speaker 1:Do you understand this process? Explain it to me. It was a test that we will soon experience in second year on rotations. Right, you don't sit down every day. You walk into clinic second year and take tests like that. No, you have a preceptor or a lead PA, medical doctor, resident, whatever start asking you questions on rotation. You have to explain it verbally. So you know it was that was fun.
Speaker 2:I laughed because we all have that memory. We always remember that moment.
Speaker 1:Yeah, and we're not fondly either, but but you know it's, it's all learning and you realize that every experience, whether it's good or bad, hopefully is contributing to learning.
Speaker 2:Yeah, and I would say that, yes, I completely agree that that was one of the most important things to me when I was in PA, when I was looking at PA programs and in PA school is just that support, because you know something I tell people that are considering going to PA school and are looking at PA programs is you know, the question you want to ask, or one of the questions obviously you want to ask, is what happens to a student when they fail?
Speaker 2:Right, because it is an incredibly rigorous program and it doesn't mean you're a bad PA or that you're never going to practice medicine or anything.
Speaker 2:You didn't get this uber complex topic that you just learned two weeks ago and it's important to know what the plan is, because this goes for any program nursing, nurse, practitioner, any sort of professional program that you really want to make sure that their goal is to make you a good practitioner of medicine, a good clinician or whatever, and not take your money and kick you out.
Speaker 2:You know, one of the things that I think we were blessed with was a program that really went out of their way to give you all the tools so that you could pass. So if you notice how I said they were giving you everything so that you could get through it. But they were there to support you. They weren't there to. They're there to help and make it so that at the end of the day, you would pass the pants and be a successful PA and be you know, be able to go out and practice and not just take your money and say, okay, went to PA school, but but that is. I think we were really, really blessed there and, you know, it sounds like both of us still are in contact with many of our professors and I think that's a common thing that you'll find across the country to become your friends.
Speaker 1:They become your colleagues, and then they become your friends. It's amazing. You cannot talk to some of them for six or seven, eight, nine, 10 years, and then, all of a sudden, you drop them a line, whether it's a call or an email or a text message and I think, honestly, you know, I'd love to have one of them on the show one day, but I think they will probably tell you that is.
Speaker 1:that is the highlight, you know, 10 years from now, to have one of the students that you worked with giving you a call. So you know, I'm so glad that you felt you felt so supported in PA school by your peers and your colleagues. Let's transition a little bit into actual PA practice. So you've worked in a number of different arenas urgent care and emergency medicine, internal medicine. How do you feel PAs are supported generally speaking? Are we well-respected in those fields? Is it something that you've seen? Follow you from school? Is it something that you've seen?
Speaker 2:follow you from school. I would say that at a high level. Yes, you know, when you're looking at, if you were to stop a random nurse or physician, they're all going to say, yes, they like their PAs. That's sort of a thing. I guess it depends on how you define respect. Where the rubber meets, the road is like what can you do? Right, what you're allowed to do, because in some places you are kind of looked at as a physician assistant. Right, they're supposed to be helping do your PA things, which isn't to negate either of us, it's just we have our areas of expertise, the things that we can do.
Speaker 2:Well, you made a great example in your practice where the physician does the Mohs surgery and you do the closures. That was actually kind of my experience in emergency medicine. I did a lot of the suturing. I did a lot of the wound repairs because you know what it's a technical skill. It's something that you know. It takes practice but at the same time, does it need a physician to do that? No, they probably can go handle other things and a lot of them have been handling those things for 20 years and they're not as great at being a suturing. But I'll be honest, you know, if I'm having to go in and have a crashing septic patient and have to manage all of that, that's I mean, it's something I can do and I could probably fumble through it, but it's not something. I've done a lot.
Speaker 2:I work with some amazing physicians. That that was a Monday, that was just what they did, you know, and they were exceptional at that. And honestly, they should be doing that, you know, and not sitting there suturing up whatever wound walked in the front door. That's not, you know. That might take an hour to make it look good, especially in the face, right, but that time is probably best spent doing something else. So, to better answer the question, I would say it really depends. At the end of the day, I wouldn't say that people are talked down to as much.
Speaker 2:Thankfully, here in the US We've been around for a very long time and I think we've built that respect on the shoulders of those that became ahead of us. I think we've all met those colleagues that have been around for 30 and 40 years. They're the ones that really built that level of respect. Now it's our job to continue it.
Speaker 2:But there's some areas, some hospitals I worked at. They weren't as comfortable allowing PAs to do certain things, and then many of my practices, including my current one. There's obviously a limit to what you can actually physically do in whatever the setting is, you know, equipment wise or whatever is safe to do, but they were very open to allowing me to do whatever I was comfortable and trained to do, which is pretty cool so, but I've never really felt like I've been talked down to or somebody said I'm not your PA. You know they didn't want to see me. I think it was. You know, if anybody ever did that, I probably don't even remember it because I said, okay, the doctor can see you and that's their right, and, selfishly, that was one less patient I had to see.
Speaker 1:Exactly, exactly, no, and you know, hector, thank you for being so honest about that, because I think that so often people will hear stories from, let's say, from an ER PA, and they will think that that is the experience of every single ERPA or derm PA, which is what I am, and and they'll think that, you know, if I work for a dermatologist, I am going to have the opportunity to close 10 most surgeries a day.
Speaker 1:Well, no, that's not true, cause not every dermatologist does most surgery, you know, or they might employ their PAs differently, they might have their PA seeing people in clinics and so on and so forth. So I'm so glad that you highlighted the fact that it's different, and sometimes it's comfortably different and sometimes it's uncomfortably different, and I think that these are questions that are fantastic to ask for new grads entering the workforce or perhaps for people switching jobs. These are great questions to ask. You know, tell me about what your PA does in clinic, because it might not be the same experience that you had previously and that was a really good lesson and I'm really glad that you brought that up and I am so glad, of course, that you've had really good support. Working in emergency medicine and that was actually one of my questions was does it feel more like solo practice or does it feel more collaborative? There's no shortage of variety in emergency medicine.
Speaker 2:I've worked in emergency departments where there wasn't a policy. You know there wasn't like a rule Okay, these patients you have to talk to and these you don't when I started, actually it was, you know have to talk to, and these you don't when I started, actually it was. You know these patients you know you can do on your own these patients you have to. You know staff, meaning you talk to the attending and then these patients have to be seen by the attending physician and it was very protocolized. So it, like you said, it depends, but honestly it's always, especially in emergency medicine. You know, in my opinion you should have the ability to reach out to somebody else.
Speaker 2:Medicine is a team sport and you know there are PAs out there that are working solo in an ER in a rural area, but they have some sort of backup or they can get on the phone and get you know their on-call trauma surgeon, critical care doc, whatever in another hospital. So there's different levels of what you can and should be doing in those situations and it's all based on your training and experience. But medicine's a team sport. So anybody that says that you know that you are going to do everything by yourself, or anybody that says that they do everything by themselves is driving themselves crazy, because it's. You can't know everything about the human body and you can't be an expert at everything. I love being a generalist, but at the same time it's impossible to know everything about everything.
Speaker 1:It's true it's true. And again it's support from your colleagues, just like we talked about in school. If there's nobody there kind of pushing you, driving you, then perhaps that blade is not getting sharpened like we would like for it to be. So, no, I think that's great. Hector, tell me about where you're at right now.
Speaker 2:Let's talk about your current job. It's so interesting. So currently I work for a company. Their name is Dispatch Health, so we do urgent in-home medical care. This is what we do on a day-to-day basis, and then the other half of the job that we do transition transitional care, so people coming out of the hospital or out of the ER to home, and our goal is to basically keep people at home. The slogan is to stay healthy at home.
Speaker 2:We really try to serve the patients that can be seen safely at home, and that's actually a pretty wide spectrum of people everything from lacerations to COPD and asthma exacerbations, chf exacerbations so you know people that are having trouble breathing, people that are fluid overloaded because their heart's failing a little bit but are not at the point where they need to have everything at the hospital.
Speaker 2:Then when they leave, the other half of what we do, at least on the acute care side that I work in, is making sure that they have everything they need to stay at home. So you know all the referrals make sure they understand their medicines, make any adjustments if someone is not completely recovered from their condition, if we need to make a small adjustment or coordinate back with the physicians in the hospital or with their PCP and really prevent them from bouncing back to prevent the unnecessary readmission, and we're pretty successful at that. Actually, there's some good numbers floating around there. So those are the two halves of what I do. The company also does hospital at home admissions in some areas not here locally where I work, but they also do that as well. What I do for them. I started as a line APP, so working in the field, and then a few months ago I started as one of the national APP educators for the company as a whole.
Speaker 1:Which I cannot wait to talk to you about. This is such a unique position, and it's something that you really have to be a fantastic APP in order to do this. So well done, well done, which, of course, you're perfect for the role, so I cannot wait to talk to you more about that. So tell me about the patients that you serve. Are these patients with mobility issues? Are these patients that just prefer to stay home instead of going into the hospital setting? How does that work?
Speaker 2:So most of the patients that I see a lot of them have some sort of a reason they can't make it to their doctor or the hospital, whether it's transportation. A lot of them are bedbound. A lot of them have mobility issues. The nice thing about it, though, is that anybody can access the service, so anybody can call. We do get patients that just aren't feeling well, and, as we all know, the last thing you want to do when you're sick with the flu is drag yourself in a car and go to a nursing care and then sit in the waiting room with everybody else coughing, with God knows what is in the waiting room floating around. So we do have I do see those patients, you know, but a lot of them are patients.
Speaker 2:The majority of our patients that you know live with their family, and they're not very mobile, and it's hard to get them out of the house, you know, for whatever reason. So that's a very that's something that I really enjoy. We're bringing them, you know, able to care for people that otherwise would either fall through the cracks or would be unable to seek care in a timely fashion, and oftentimes just wait until they get so sick they have to call an ambulance and end up in the hospital when all they needed was some steroids. Something as simple as a prescription of steroids would have saved them a week and a half in the hospital. So it's I really, really enjoy that part of the job.
Speaker 1:Well it's. You know you're serving a community that could be considered marginalized. You know transportation issues. In the first episode I talk about challenges that we all face in healthcare and transportation issues, regardless of whether it's because of your physique or a disability, or maybe you don't have a reliable vehicle. Transportation issues is a huge thing, and the fact that you're able to still serve these patients is incredible. It really is, I'm sure, to be able to step into these people's homes and offer your expertise in a place where they're also still really comfortable. What does a typical day look like for you on the days that you're working clinically?
Speaker 2:Yeah, we work a shift, you know, kind of similar to working in an urgent care in ER. You show up at a certain time and then we have our patient assignments. We really only know the first patient we're going to. Once we get there we can see the next one. But that is dynamic as people call in and someone cancels, and that's always in flux.
Speaker 2:We get to our office, gather our equipment I work with a technician and they are kind of like between an EMT and an MA. Most of them are either EMTs or MAs. It's actually a great opportunity for patient contact hours because you're working one-to-one with an NP or a PA. We then load our vehicle. We have an SUV. We don't transport patients, we don't take anybody to the hospital, we're not in that business and then we drive to our first patient's house Along the way.
Speaker 2:I have access to internet so I can start my chart or I can look up patient information from various sources and get prepared for the visit. And then we get on scene where it's just like a patient visit. We check them in, we get vitals, we get a history, I verify all their information, medications more hands-on than what I would normally do in emergency room and urgent care. Normally you're going to have a nurse or an MA that's going to do a lot of that work, but because we're kind of both of us working at the same time with one patient the technician might be getting vital signs.
Speaker 2:I might be verifying history, they check them in. The technician might be getting vital signs. I might be verifying history, they check them in. They get the administrative things going and then a typical visit's 30 minutes-ish 30 to 40 minutes and, depending on how busy the market is, anywhere from. I mean, it really depends If it's a bad weather day and nobody wants us to come, it's two to four patients and maybe I've seen as many as eight to 10, which is a lot. When you're driving around I've seen more than that, but that's usually when you see like an entire family and they all have COVID and they all want to be tested and treated.
Speaker 2:And you get like the four, you know four people in a house and it makes your numbers look great. You know, it's like wow, saw all these patients. Today I saw 12 patients and I was so fast and it's like, yeah, no, you saw, you went to six people's houses and saw, you know, it's the entire family in one. But yeah, it's pretty much it, you know, and we will do everything, like I said, flu testing and everything you can imagine in urgent care.
Speaker 2:We do carry an ISTAT so we can do some lab blood labs. You know I did mention it is a little more hands-on, so between me and the technician, we will put IVs in, we'll draw labs, we'll run the tests. I have to interpret all the tests because I'm the licensed practitioner, so you know I look at the COVID test and say, okay, yes, it's positive or negative EKG. We carry medications, some antibiotics, steroids, a whole slew of things, but basically enough to kind of care for the stuff again that's safe to take care of at home and ensure the patient is. And then we write prescriptions and diagnose, treat the whole nine yards and do that a few times and then at the end of the shift we drive back to the office, clean up and go home. It's an urgent care emergency room type situation when you look at the job on wheels.
Speaker 1:What happens, or has anything like this happened, where you arrive and you realize, oh, this is not something we need to be taking care of at home? What's the next step?
Speaker 2:My goal is to make sure that the patient's safe, and we always do the right thing for the patient, whether that's treat them or escalate them is what we call it. I did actually a fair amount of times I've had to call 911 and escalate people. Very rarely has it been that stereotypical. A lot of times it's just you know, you come in, you make your assessment and the patient's sick and you're just like look, you're very sick. This is beyond what I can do here at home. And the flip side of it is, you know, patients have their autonomy, they can make the decision they want.
Speaker 2:And we do see a population of people that a lot of times are very tired of going to the hospital. In this situation Someone says I don't want to go to the hospital. Then, of course, you know I'm going to take care of them as best I can, telling them you know, hey, I'm limited to what I can do, but I'm going to do everything I can. Generally, we'll come back the next day or in two days, whatever works out for them, to check on them and make sure they're getting better. If this X, y and Z happens, you can go to the hospital and go. Look like this is not going to end well. I kind of give them that idea Like this is heading in a direction that this could take your life. And what do you want to do? Like, what are your goals here? A lot of them they just want to stay home.
Speaker 2:I've referred a fair number of people to hospice. Whether or not they stay on hospice or they get better and come off, that can happen and that does happen. But you know if I've been in some situations where people are just like you know what, I just got out of the hospital last week and I am tired of it and I don't want to go back and I go okay. So what can I do for you today? And then, what are your goals?
Speaker 2:And if they're okay with hospice, a lot of times hospice service can bring a lot into the home to keep them comfortable, in the sense of they need more oxygen or they need their palliative interventions. They can do that really well, because I don't want anybody suffering. I don't want anybody to sit there at home and suffer, and a lot of times it's also about the family. The family gets overwhelmed and then they want to take them to the hospital and at the end of the day. I want the patient, if they want to stay home, I want them to be comfortable, I want them to do well, I want the family to be supported and I want it to be a good experience, as best we can, because honestly I hate to say it but passing away you know that that's what their wishes are. I'll do it. And now, if they want to go to the hospital, obviously I'm getting them to the hospital or having the family take them, or whatever's appropriate.
Speaker 1:Sure, I'm so glad you brought that up because it is. It's something that I fear patients really worry about is if their wishes are going to be understood and heard. And you know, thankfully in our clinic we don't see very many actual emergencies, but inevitably if you see 120 patients in your clinic, somebody is going to walk in with chest pain and it's not a term thing, but they're going to start talking about how they can't breathe.
Speaker 1:And it's something that you mentioned and nobody wants to go to the hospital and not any of my patients at least. When I tell them hey, I think that your foot isn't in fact just swollen. I think you have a deep vein thrombosis, I think you have a blood clot in your leg. You're going to the hospital and then it's never an argument. I would like to call it a conversation.
Speaker 2:Absolutely.
Speaker 1:Sometimes it might feel like an argument and it's you provide patient education and then you have to listen, and I think that is something that we as providers need to remember is we can't just be spitting education at people in that role to where you can offer the support, and then you also are aware of some alternative options for them, such as hospice, which is end of life care and a fantastic option for some of these people that have suffered with chronic diseases and chronic illnesses. So I'm really glad you mentioned all of that. Generally speaking, how do patients typically respond to receiving care in their own homes?
Speaker 2:No, they love it.
Speaker 2:They love it. That's one of my favorite things is they appreciate us and I mean, even in the situations where I feel like I did nothing, they're just happy that I came. I feel like, if they've called me and I want to serve them, I want to do things for them and a lot of times there's not a lot that you should do, there's a lot that I can do, but it probably would hurt them or cause bad side effects, but just the simple fact of giving reassurance and that's something that I always have to remind myself. You know, our job often is education, but a lot of times it's reassurance that's often the best thing that we can do and the only thing we can do but just say, hey, you're okay, you're going to be okay. Do X, y and Z, you know, take some Tylenol water, you know.
Speaker 2:All these little minor things, they work, they help giving them that reassurance. And then also, just, you know, telling them, hey, if things get worse, call us back, we're here, you know. And that can be in any setting. It doesn't have to be in this type of setting, this mobile setting, it's more. Even when I was working in the clinic, I just told them you know, get any worse. I want to hear from you. Just, you know, opening that door for them it means a lot and then if we have to do something else we'll do something else. You know, we kind of figure it out from there. But our patients when I get to see them, they're very high satisfaction rates.
Speaker 1:That's great, I would imagine getting to welcome it's a house, call Hector. I mean, that's what it is, it's a house call and it is the greatest house call of all time and I think it's a fantastic option. I can think of a lot of people in my life and on my schedule that would really benefit from that. I wish it was something we can do. We've discussed it. We've discussed having days where we can go and visit patients remotely, whether they are living at home or an assisted living facility, something like that.
Speaker 2:It's care that you want to give right and I'll say it's a lot of fun too. You know, it's fun to go meet these people and see them, see where they live and kind of get to know them a little bit. It's just, it's a. It's a great experience overall.
Speaker 1:I'm so glad. So, hector, let's pivot a little bit, because I think you have some pretty wonderful things to talk about outside of working as a clinical PA. What else can PAs do outside of just working in clinic? I think you have a couple of opportunities that you can share with us.
Speaker 2:So I've well, I currently work as an educator, I will say one of the some of the most. There's some fun, weird jobs out there that PAs can do. I think was it the medical examiner's office in New York City has PAs working for them. You can be an ME. There's actually one of, I believe one of our preceptors actually works for the State Department now in Southeast Asia as a health officer for one of the embassies, one of our embassies.
Speaker 2:So they get hired there at the FBI. I mean, I, you know, I live in the capital region, so there's lots of those kinds of jobs. But the FBI, the military, I mean there's all kinds of very interesting jobs out there that PAs can do. You know, for a while I actually considered I wasn't able to, for various reasons. But the disaster medical assistance teams throughout the country do hire PAs to cover their. Basically they do pop-up hospitals.
Speaker 2:It's a big deal and you know us living in Florida, we're familiar with those things called hurricanes and when a hurricane comes into an area and knocks out a hospital, they can show up and set up a hospital, and each state has a few teams. They do hire PAs into those teams as well. So, yeah, so many cool things you can do. I know one PA down in South Florida that I've read I don't know if she's still doing it but she critical care PA that actually does flight medicine, meaning she goes fly as places and then brings people back as a flight PA. So there's, yeah, there's an organ retrieval PA in New York. I think, yeah, so you can. Then the other people made the job for themselves, like they got into a position, and then they're like hey, can I do that? And nobody said no, that's right.
Speaker 1:You just keep asking and you keep knocking. I think it's always so fun to talk to people about, especially PAs who have either branched out of traditional clinical practice, which I would say is exactly what you're doing right now, or perhaps PAs that are working in politics now, or PAs that are now working in education, which is one that is so common. If clinical practice isn't your thing, there are other options, although I don't know many people that chose other options because clinical practice wasn't their thing. It was more. Just, they're looking to augment, they're looking to improve, and a lot of times they're just asked into those leadership positions and they find themselves there. So I think that's incredible. Hector, you know about a segment on our show called quality questions. This is one of my favorite parts. Do you have a quality question for us? Before we hear what Hector's quality question is, keep in mind that there's more interview prep, such as mock interviews and personal statement review over on shadowmenextcom. There you'll find amazing resources to help you as you prepare to answer your own quality questions.
Speaker 2:I remember sitting through the interviews and getting the normal questions and having conversations and it was all great. And then at the end of this particular interview, the interviewer goes so what are you going to do when all the students that you teach as a PA become doctors and they are now your boss? And that was a tough one, but it is a reality. I mean it wasn't like this person was being mean, it was just like that is a truth as a PA and this can be in any profession really. I mean, you could be a firefighter and you're teaching that rookie and then 10, 15 years later he's now the chief of the department. You know, it's just everybody takes different roads and you know what.
Speaker 2:I remember answering it kind of paused. I was just like, wow, okay, this is a tough one and I basically said you know, I would hope that, you know, I did a good job teaching them that we had, you know, mutual respect and that I would continue to aim and strive to have that mutual respect. Obviously, people you know I won't call it rank, but you know, obviously people move up in different positions even as PAs, that happens and have to be a physician. I know many PAs went on to be lead PAs or even higher director level in different companies. At the end of the day, it's about just keeping that mutual respect and those open lines of communication, and you can only control how you react in those situations and hope that they react the same way. I can only control me If someone doesn't react in a certain way. This can be a patient, a colleague, whatever responding in a respectful fashion and, for lack of a better term, loving way is always the better road right. So that's more or less how I answered it and things apparently went well.
Speaker 1:Got in.
Speaker 1:Oh that's so great. Yeah, it takes me back to when we were talking about the professors at PA school. Right, it's possible that they are going to become patients of some of the PAs that they've trained. You know, if they stay in town long enough and at the PA stand, so kind of a similar thing. You know you expect to see some of these students that you're training, because I'm sure you've trained nursing students and PA students and MD students at all at your positions, at least in the hospital.
Speaker 1:We hope that these people are going to take care of us one day and you know, that's kind of why I laugh. It's part of the reason I started the podcast was for the next generation of pre-health students and I want them to realize. I want the next generation of pre-health students to realize that there is still so much humanity in healthcare and when you and I are old in five years or 10 years or 20 years and we start needing care, I want to make sure that humanity, that element, stays in it Absolutely. And you know those are the people that I hope are attracted to medicine, not just because of the paycheck, which is fabulous, and not just because of the quality of life, which can be fabulous, but also because you want to help. You know, and I think it's such a simple thought, but I think a lot of times we forget about it.
Speaker 1:And, of course, when you throw in insurance and all the problems with burnout and all of that, like, the wanting to help element is still there. It just sometimes gets buried. So it's fun to highlight that. What an interview question. That's one that kind of makes you squirm, doesn't it?
Speaker 2:But you know, when you get those kinds of questions, it's okay to pause and think about it. You don't have to just spit out an answer. You can even acknowledge that's a very good question. Yes, sir ma'am, I've not thought of that. But give me a moment and get as best of an answer as you can together. But it's going to happen in interviews and I don't think people are trying to get you. At least in most situations, I think they might think, hey, this is a very interesting question. I'm just going to ask everybody.
Speaker 2:Today I've been an interviewer and sometimes you're just kind of like today I'm going to ask people and you get reactions from people and you almost feel bad. You're like, oh, that wasn't meant that, seriously, you know. So you got to remember that they're. You know, at the end of the day they're all medical. Usually, if you're in a medical program, an interview, they're medical professionals and, yeah, it's formal. Yeah, you have to. You know you're going through the process, but a lot of times they're just trying to have a conversation in the 5, 10, 20 minutes that you awkwardly have together.
Speaker 1:I think that's a great point, hector. It's a conversation, it is an interview, but if you think about it as a conversation, I bet you it makes it a lot easier.
Speaker 2:Yep, yep. No, that's what I would, what I told you know people, especially the PA programs that I interviewed at that I'm very familiar with. I said look, at the end of the day it's another PA. They've got a ton of experience. They're obviously there because they love students, they love the program, they love PA education and they just want to have a conversation and look at it that way and ask them the questions that you want to know from someone that's been doing you know whatever crazy specialty that person told you they're doing for 20 years.
Speaker 2:That could be you in 20 years, right? So what would you want to know from that person? You don't even have to ask them the normal. Oh. So what do you like about the program type questions? Those types of questions are great and sometimes you can get a good answer that you might want to know about.
Speaker 2:But you can ask them questions about their practice, about why they became a PA, the same questions they're asking you. It's okay. That may actually give you a more useful answer as to the type of program that you're looking at, as to how they teach and how they interact with students or not interact in some situations. Maybe they don't give you a good answer. That gave you an answer, right it is. Also, you're interviewing them as much as you really want to be in PA school. The goal is to become a PA, right, but you want to try to find a place that you're going to enjoy being for two years or three years in some cases, and it's a big chunk of your life. So hopefully it's a place where you want to invest that time and, yeah, part of the job of that interview is for you to find that out.
Speaker 1:Looking back on it, 10 years. We've done this for 10 years. My husband will always say, ashley, do you think this is a good idea? And I'll say, well, I don't know, honey, ask me in 10 years, was it a good idea? So I guess the question. You know it's been 10 years. You have explored a number of areas of what a PA can do and how a PA can be employed. Was this a good career choice?
Speaker 2:Absolutely. It's been everything that I was looking for. As I alluded to earlier, I serve people. I've gone from one interesting, amazing job to another. You know, I've always been kind of looking, trying to see where I wanted to go next, and a lot of times things just presented themselves to me. Colleagues would just kind of go hey, have you heard of this? And then, you know, in the case of one of my jobs, I literally just got cold called because my mom was bragging. Oh, I love my parents and I'm sure they'll listen to this, but no, seriously, they they're, yeah, they. My mom kind of just threw out there hey, if you need a PA, and they're like, well, actually, so you never know.
Speaker 1:Good job, PA.
Speaker 2:And they're like well, actually, so you never know, yeah, I mean things present yourself, but it's been one heck of an adventure. That's the way I kind of try to look at it. And yeah, there've been ups and downs and crazy moments and, just you know, I've had lows, just incredible lows, working, some places that I knew I needed to get out of, but the great majority of them have been places that I absolutely loved and learned and enjoyed for various reasons. It's been awesome and I'm not done yet. I mean, this is only 10 years in.
Speaker 2:Age is a mindset.
Speaker 1:Well, just wrapping up, Hector, what would you tell a pre-health student that thinks they want to go into medicine?
Speaker 2:Well, the first thing that comes to mind, if I was talking to someone that was looking at healthcare as a career, wherever they wanted to go, you need to ask yourself why right? Why you're doing it? Because I do feel that there are some people that get into many professions that do it for external reasons, whether it's they're pressured into it, their family that's what everybody in their family does. A common one is money. Hey, what's a job that's going to pay me well? And really ask yourself, why am I doing this? Because you want to make sure that there's something that's driving you internally to get through all of those tough spots, especially healthcare, it doesn't matter paramedic, nursing, nurse, practitioner, pa, doctor. It's a long road, it's a slog. There are moments where you are going to be crying on your textbooks and it happens, and you're just going to I mean, it's not that you know? I think we've all had that moment where you're just so overwhelmed and then you just remind yourself that people have been doing this for at least for the PA profession 40 to 50 years, and they've somehow graduated and you will too, and they all got through it. So you're going to get through it and to get through those moments because there's something beyond you that's taking you there.
Speaker 2:You know, for me it was that drive to do more for others, to serve others, and if you don't have that internal drive whatever that is then those moments get very hard. And then when you get into practice, I hate to say there are some jobs out there that aren't great and you kind of have to work through those times in your life. You need to find the good in those situations. If it's about the paycheck, that's nice but it doesn't keep you at work, it doesn't keep you happy there. You can go buy nice things, but you still have to go to work the next day. You know, drive and then from there really exploring what you want to do.
Speaker 2:Because for me I knew I didn't want to be a physician. I have great respect for my physician colleagues. I have wonderful physician colleagues that I've worked with throughout my entire career that I just adore and look up to. But that wasn't me. Through conversations I found the PA profession and here I am and whatever that is for that person, it's okay to look around and take that time because it's a big decision. It's a lot of time, effort and money. You know when you're paying for tuition and you want to make sure that you're doing it for the right reasons. So you know, for me it's been one heck of a road and fun adventure.
Speaker 1:It's amazing and it really just is the beginning. You know, there's there's so much and I'm so hopeful for the field of medicine and so hopeful for the next generation of health students that are coming up behind us. So it's going to be good. Hector, thank you so much for joining us on Shadow Me Next. We have just learned so much and I'm so glad that you shared everything with us, so thank you.
Speaker 2:Absolutely, absolutely. It's been a pleasure, ashley. All the best.
Speaker 1: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.
