%20(2).png)
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!
18 - A Trailblazing Physician Assistant Changing Lives in Interventional Radiology | Carrie Hayes, PA-C
What does it take to become a trailblazer in the world of interventional radiology? In today's episode, we explore this question with Keri Hayes, a remarkable interventional radiology Physician Assistant who has been instrumental in shaping her field. Growing up in a small North Carolina town where specialty care was sparse, Keri's determination to improve healthcare equality has driven her illustrious career. Hear about her pivotal role in advocating for a Certificate of Added Qualification in Interventional Radiology for PAs, setting a new standard for excellence in the profession. Keri's leadership roles in the Society of Interventional Radiology and the Entelios Foundation further emphasize her commitment to advancing medical imaging and radiation safety.
Through compelling stories and personal insights, Keri sheds light on the diverse and dynamic responsibilities of PAs in interventional radiology. From performing intricate procedures like thyroid and liver biopsies to acting as an advocate for patients navigating complex treatments, Keri’s experiences provide a gripping look into the life of a PA in this specialized field. She touches on the challenges of gaining exposure to interventional radiology as a student and shares valuable advice on leveraging networking and initiative to carve out a successful path. Her reflections on collaboration with healthcare teams spotlight the crucial role PAs play in enhancing patient care and outcomes.
We also delve into the empathetic side of healthcare, with Keri sharing moving encounters with patients who are hesitant or fearful of medical procedures. She discusses the emotional resilience required to support patients and families through difficult times, especially in palliative care settings. Keri's dedication to mentorship and professional development is evident as she recounts her journey from being the lone pioneer to building a supportive community of PAs in specialized fields. Listen in to gain a deeper understanding of how PAs are reshaping the healthcare landscape, armed with empathy and a passion for patient-centered care.
Virtual shadowing is an important tool to use when planning your medical career. At Shadow Me Next! we want to provide you with the resources you need to find your role in healthcare and secure your place in medicine.
Check out our pre-health resources. Great for pre-med, pre-PA, pre-nursing, pre-therapy students or anyone else with an upcoming interview!
Mock Interviews: shadowmenext.com/mock-interviews
Personal Statement Review: shadowmenext.com/personal-statement
Free Downloads: shadowmenext.com/free-downloads
Want to request a guest? Shoot me an email: ashley@shadowmenext.com
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.
Ashley:Welcome to shadow Me Next. Today, I'm excited to introduce you to a true trailblazer in the PA profession, keri Hayes. Keri is not only an accomplished interventional radiology PA, but also a dedicated advocate for advancing the role of PAs in highly specialized fields. With a passion for professional development, she has been instrumental in pushing for a Certificate of Added Qualification in Interventional Radiology through the NCCPA, an initiative that will help define standards and elevate recognition for PAs in this growing specialty. Beyond her clinical expertise, keri is actively involved in leadership and mentorship within the PA community. She has played a key role in the Society of Interventional Radiology, working to strengthen the presence and influence of advanced practice providers in the field. She's also engaged in the Entelios Foundation, an organization focused on medical imaging excellence, and has been a vocal advocate for fluoroscopy and radiation safety standards. Through her mentorship efforts, whether speaking at conferences, guiding PA students or connecting with aspiring PAs through professional networks, carrie is shaping the next generation of clinicians and ensuring they have support and knowledge to thrive. In this episode, we'll dive into her journey, her efforts to expand PA opportunities in interventional radiology and the impact of her work on the profession.
Ashley:Whether you're a PA student, a practicing clinician or simply curious about the future of PAs in specialized medicine, or simply curious about the future of PAs in specialized medicine, this conversation is for you. 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. This is Shadow Me Next with Keri Hayes. Hey, keri, thank you so much for joining us here on Shadow Me Next. I am thrilled to have you. I have never met somebody who does what you do as a PA, so thank you so much for joining us.
Carrie:Yeah, thanks for having me. I'm super excited about being here. This is great that you're doing this. Shadow me next. I think it's a really unique opportunity for people. It allows us to kind of brag on our specialty a little bit and then also to sort of I don't know cause you know PAs and P's to think about. Oh, intermature audiology.
Ashley:That sounds cool. I'm so glad because that's exactly what we're doing. We're bragging on our specialty. It was funny One of the guys I just recently spoke to, jim. He said Ash, I've just what I do is so cool and I just want to share it with everybody. This is going to be a really interesting conversation for pre-health students to kind of discover something else that a PA can do, and perhaps a really eye-opening discussion for current practicing clinicians Because, like I said, I think what you do is really unique and we all have a lot to learn from this conversation today. So, keri, let's start from the beginning, because you have a really interesting story even before your PA career. Tell us what inspired you to pursue a career in medicine and where did you end up initially.
Carrie:Well, I mean, I guess, like all young girls, I thought I'm going to be a veterinarian. Of course I mean that's what we were all going to do as little girls. That's sort of the first part, right. The second part is that I grew up in a really small town in North Carolina, and when I say small town I mean really small.
Carrie:You know little to no access to specialty care, like no real preventative medicine, like you only go when you're sick. You know you're not just going to go to be proactive. So those people can't even couldn't even afford insurance, you know. And when folks were getting to the hospital it was normally an acute state, some advanced stage of disease, low health literacy, just really few community resources. You know our closest specialty centers were two to three hours away. It was often a hardship to travel. You know this has a huge impact on outcomes for folks.
Carrie:So I've always felt drawn to low resource communities to be a patient advocate. But you know how could I bring specialty services back to my small community? So that's sort of. I've always known that I was going to take care of people, but I was especially invested in making sure that there was some equality in the care. So that is how I decided I wanted to be in medicine. But then from there, you know, I thought I would be a veterinarian, but now I'm an individual LGPA in Oregon. So of course it makes perfect sense how I went from there to here.
Ashley:A little bit of a wild journey, absolutely, absolutely. You know it's funny veterinary care I spoke about this again. I mean this is there's so many connections in medicine, but I spoke about it with a pediatric resident physician recently and caring for animals and caring for people is still caring for another living thing, you know, and she told me about how much she had learned working as a veterinary technician and how a lot of her patients as pediatric patients. She uses very similar techniques with them because they don't speak. Most of her animal patients also did not speak. You know they have different ways of expressing themselves. Carrie, you worked as a medical sonographer before PA school. Is that correct?
Carrie:Tell us a little bit about that and what that transition looked like yeah, that's so funny that you bring up what you did, because while I thought I was going to be a veterinarian, I ended up working with a veterinary radiologist group, two radiologists on their own practice. We were mobile, we went to veterinary hospitals and clinics and did diagnostic and interventional ultrasound and I became obsessed with ultrasound, like, oh my gosh, you just put this on their belly and oh my gosh, you could see all these things.
Carrie:So it was while I was doing that that I fell in love with ultrasound. And then I thought, okay, I can do this with animals, I want to do this with people too. So that's how I ended up going to ultrasound school. It's like, okay, I want to scan people. And then while scanning people from 24 week preemies to 100 year old patients I hit this glass ceiling of like, oh man, like what happened to them? How did that turn out? Was my ultrasound correct? You know, I really want to know what happened.
Carrie:That patient told me about something that was going on with them personally. How's she doing? She was so sweet when I saw her, so that glass ceiling sort of propelled me forward. You know, okay, I want to have an established relationship with patients. I want to be part of a longitudinal care aspect. So that's how PA school happened. I got into Duke's PA program and I hit the ground running. The first, my first job was in Houston. So that was an interesting transition going from being a sonographer to PA school to now being an IRPA, where I'm not only using ultrasound in diagnostic capacity but now I'm doing using it in an interventional capacity. So yeah, it seemed like a logical step for me it's a very interesting tract really.
Ashley:You saw what you were interested in and then you've really stayed close to that field at least. But your responsibilities have changed and what your abilities, what you can do, has changed. How has Duke's PA program this is one of the best, if not the best, pa programs in the country super challenging, I would imagine.
Carrie:I think they tell you. You know, I went into it thinking, yeah, I'll probably still work part time. No way, man. And they made you sign a piece of paper that said you wouldn't work in any capacity more than 15 hours a week or something. It definitely became a full time job. You know that we've all heard this like drinking information through a fire hydrant. I mean it was really literally. I mean, I think there was one morning I had been studying, for I mean I would go to go to school. Come home I'd study all night, I'd go to sleep, I'd get up, I'd study, then I'd go to school.
Carrie:I think there was one morning where I had studied so hard for a test that I went out to my car and I could not remember how to open the door to my car. Like where is it? I mean it was just my brain was so full of other things Like I had forgotten how to open my car door. But I and I have like a core memory of that moment. It's like Carrie, just breathe. You know it was fine. But you know, great program. I mean we had patient contact really early on. I really feel like they prepared us to be clinicians. So I'm very proud of my time there.
Ashley:That's awesome. No, it's so true. You know our brains. We become so focused on what we're studying and trying to not just pass our tests but really retain this knowledge. So it sticks.
Carrie:Yeah, and I remember them saying you know, the goal is not to remember everything, it's to remember that that thing exists and to know where to go get that information. And that was super helpful to me. But you know, it's also put me in a unique position now for new PA students, when they are messaging me saying, oh my gosh, I'm studying for blah blah, blah test, it's like you know what.
Ashley:It's going to be a blip. Yeah, ask us in 10 years. And and what we're doing? And, if we remember, you know any of those, any of those exams. So, carrie, when you were, when you were on rotation, when you were doing rotations in PA school, did you have access to an interventional radiology rotation or did you just know that you were interested in that?
Carrie:Well, you know, I leveraged my network at Duke hospital because I was a sonographer there and so I went to and a lot of the physicians that I worked with, a lot of the radiologists, they were very supportive of me going to PA school. And so with my program you could pick two rotations and you could create one. So I went back to my IR you know folks at Duke and said, hey, can I create an IR rotation where I can come and be an IRPA student? And they said, oh yeah, great. So I set that up actually, and so I got to go and spend, you know, that rotation there. So I got to actually do some thyroid biopsies and and do some other things. You know, be more hands on.
Carrie:But the trick was that they had to continue to offer that to other students, right? So once you created it, it has to be maintained. So, yeah, that was how I solved that riddle. Not everybody has that opportunity, not all PA programs allow that. And then you know I would also. You know, even when I was a PA, when I was in my first job, sometimes the PA students that were on surgery rotations would come hang out with me, come spend time with me. But I think there are more of them now than there used to be where you can have a rotation. But as far as fellowships go, I think there are maybe one or two maybe, but when you Google that it's not, it doesn't just pop up. So I think in general you're not really getting a lot of IR exposure. I think you're going to get some radiology lectures, but you're not going to get a lot of IR exposure.
Ashley:Which I'm sure is where your background and, like you said, your network came in such handy. It's the cool thing about being a PA. You know we have access to all of these different fields that we can jump into and and interventional radiology is one of them that we can jump into and interventional radiology is one of them. You mentioned a thyroid biopsy, and the medical nerd in me is freaking out now, so excited to talk about a day in your life. Keri, walk us through what it looks like to be an interventional radiology PA. Now we know you do thyroid biopsies and I'm sure that, just like just the beginning, just to kind, of start it off.
Carrie:We're image guided interventions, image guided procedures, so we're clinical and procedural. So we're either intervening in a clinical capacity, meaning we're trying to find an answer, so maybe like a targeted biopsy of the liver with a mass in it that was a common procedure I might do, where that's answering a question. The oncologists need to know what kind of cancer they're treating to go to the next steps, right? So it's a unique intersection for you to build a relationship with a patient because they're often scared to death. We often become sort of a landing pad for a lot of questions because they get pretty hurried and rushed through this process. It may be that their primary care did some lab work, get pretty hurried and rushed through this process. It may be that their primary care did some lab work. It was abnormal. They messaged them on the portal and said, hey, I'm sending you for this liver biopsy. By the time they get to me they're like what is happening to me? So it's a unique intersection there. So it allows us to be advocates for the patients and to sort of normalize what's happening and say, hey, I'm here rooting for you. This is what comes next. Let me make sure all the connections are in place for you. So there's a lot of that.
Carrie:We offer treatments that allow people to walk in feeling badly and then leave feeling better A joint injection for someone who has osteoarthritis and they just can't lose the weight they need for their knee replacement or whatever it may be. Or cancer patients who've had radiation, who have pain. You know, just this year I've had the pleasure of taking care of two women who are metastatic, like stage four cancer, that their biggest complaint was shoulder pain, just their shoulders hurt, just the tenseness in their body. And they said no one's been able to make this feel better. Little things, you know, doing a suprascapular nerve steroid injection or trigger point injections. These women were in tears when they left because they felt better after a year. So it's that right.
Carrie:It's answering the question but also making it more manageable. So I like that. You know, in one day a patient can arrive. We don't know what's wrong with them. I can do an ultrasound. I can say, hey, there's a liver mass. All right, I'm going to do a biopsy of that liver mass. This is all in the same day, right? You don't even have to really be fasting in some settings I get that answer it's off to pathology. Within a day or two we have an answer about what that is and then maybe two weeks from now you come back to me for your port placement because you need chemotherapy. And then maybe, farther down the road, you've got, you know, refractory ascites that I can now take off for you palliatively to make you more comfortable. So being able to intervene at these places where this specialty care is really needed is pretty exciting for me. I like making people feel better and I like solving the puzzle.
Ashley:That's the coolest thing about working procedurally and also clinically as well. You know you get to do, you get to use your hands, you get to fix the problem, but also you have that, that interaction with the patient. That is so wonderful and arguably one of the reasons why we became PAs, right? Oh, carrie, there are so many different ways. I want to go based on everything you just said. First, I want to talk about your autonomy, and this is probably going to lead into a question about how you work in a group setting right, how you collaborate with radiologists and technologists and other healthcare professionals. You mentioned even primary care doctors sitting patients in that sort of thing. What does your autonomy look like in interventional radiology and how do you collaborate with other members of the healthcare field?
Carrie:You know it's different. I mean I think you ask you, ask PAs nationally that are in IR. They're going to tell you, hey, I'm only clinical. One's going to say I'm only procedural, internationally that are in IR, they're going to tell you, hey, I'm only clinical. One's going to say I'm only procedural. One's going to say I'm a mixture One.
Carrie:You know we use these terms, you know, like a physician surrogate versus a replacement. You know, I think in my role, in my years of experience, you know I enjoy working in that. The outpatient setting, so I outpatient based labs, I like that setting. It can be very, very fluid. You can get a lot done. But for me I can be pretty independent. I mean I have that. I have that support that I know my attendings in the other room or he's a phone call away, but for the most part they trust me and I also know that if I need them they're going to be there. So they do allow me to practice within my full scope, which I feel very lucky about.
Carrie:I work in the state of Oregon right now and it's very PANP friendly, so there are not a lot of limitations in that standpoint. But you know, one of the unique things about my practice is that we have diagnostic radiologists those are the folks who are spending time in front of the computer screen reading CTs, mrs etc. And you have interventional radiologists and in the last several years it used to just be radiology and they've separated. So for a private practice it's more, you know, from that standpoint of generating RVUs and keeping the doors open for patients. I can see, you know, the paracentesis, the thoracentesis, the consultations for cancer treatment, the women's health consultations, the problem visits, the catheter exchanges. I can see all of that.
Carrie:While he's able to read these high-level acute CTs and MRs and x-rays and get people answers, like keeping the wheels turning. So if he were to be pulled away from that reading, then someone like you or me is waiting to find out what mom CT said, or waiting to get that answer, so we know what to do next. Or or that patient who's you know now finished chemo and we want to know did it respond? Is the cancer still there? It allows them to keep answering those questions. Right, we're keeping the other part going. So I've been fortunate enough in practice to be to be very autonomous, but also like knowing what my limits are. So if I, if I call and ask for help. They're like, okay, something's up right and they've learned to trust me in that way. It's definitely, I think, can be a little bit harder to build that in a procedural specialty because of the liability.
Ashley:I absolutely agree with you and Carrie. You just beautifully described how a PA working at the top of their license in conjunction with an attending who trusts that PA is so efficient. Once you've developed that trust and that relationship with your attending physician or your supervising physician, when you call on them for their opinion or for advice or for help, they respond. They know that you know what you know and they're also aware of the fact that you know what you don. They know that you know what you know and they're also aware of the fact that you know what you don't know as well. And that's equally disappointed, right? No?
Carrie:it's true. It's true, something as simple as a paracentesis. You know we'll take that fluid in the belly. We need to take it off. That's something I was doing 25 of those a day at a prior practice and I had a patient come in really complex history cholangia, car carcinoma we're seeing frequently for various drains, catheters, tubes that he had. But when he came down for parasitesis I thought you know, this just looks funny, like the fluid doesn't look normal, something's not right about it.
Carrie:It just bothered me and I think as PAs we have that little voice that says something's not right here, I need to go get somebody. And that's the beauty of being a PA, right Is that you always have that person that you can go grab and say look at this with me. I love that and that's how I became a PA. I mean I think there are misconceptions about, well, you couldn't go to medical school or you weren't smart enough. No, absolutely not. It was just not that at all. I just I like the team, like I want to have a group of people. I'll be better having that support.
Carrie:But yeah, I went and grabbed one of my attendings. Now, keeping in mind, I've been doing these for years and years, thousands and thousands of these procedures. And I went and grabbed him and said, hey, this does not look right. So he kind of rushed in and was looking around. He's like, oh, wait a second.
Carrie:Yeah, what had turned out is that this patient had a gastric outlet of he had a gastric outlet obstruction, and so that what, what I was actually, what was like funny looking fluid was actually his stomach, because they had two stairs. So he was in trouble and you know, and afterwards the radiologist went to the side and he said you know, I gotta be honest, I probably wouldn't have caught that, I probably would have just done it, and then that would have been a whole other, a whole other situation. But it's in that moment where I took the chance that he was gonna go oh, it's fine, would have just done it, and then that would have been a whole other, a whole other situation. But it's in that moment where I took the chance that he was going to go oh, it's fine, carrie, like she should have been able to do that, but instead it was a winning moment in his eyes because she's going to come get me and I don't worry about it.
Carrie:So, yeah, I think that's what I hope for every advanced practice provider, you know. But I think we ultimately are a product of the investment of our collaborative physicians. Right, if you invest time in us, we're going to be great. If you don't, we're not going to be great, we'll have our own way. But we were created to help extend them, to help make their day easier and to just have better access for patients. So, with physician shortages, especially in radiology, I am a product of a lot of great radiologists and mentors.
Ashley:That's incredible. Some of us work very, very closely with our attendings, with our supervising physicians, and others don't have that opportunity and, while I think they can still be incredible PAs, they will also tell you that perhaps their road to where they're at was a lot steeper, a lot scarier and a lot less supportive period. I think the confidence that I have in my practice has largely come from the fact that I have significant access to my supervising physician. Something you mentioned, Carrie, that I would love to go back to just because it's interesting, is when you have patients come in. You mentioned some of them come in incredibly fearful because they're there. Somebody told them there is something wrong with their body and they are there to find out what it is and how, how wrong, how bad it is. And then other patients come in and they're so hopeful because they found out maybe you can help them with chronic pain or with a chronic disease or chronic issue. How do you manage that? How do you address the patient's emotions? Going into this, I think?
Carrie:that's probably one of my favorite parts, you know, because you have patients that are afraid. Of course. You have patients who've been in chronic pain for a long time, and that changes people. And then you have people who have just sort of given up. You've people who haven't really been heard, that feel sort of hopeless. And then you have the people that you walk in the room and they're very skeptical. They're very skeptical of you. They've had bad experiences and maybe they're skeptical of you because you're a PA or an NP had bad experiences, and maybe they're skeptical of you because you're a PA or an NP, not a physician. So, being able to walk in the room, establish a rapport and win them over, where at the end they're saying, oh, can I, can I get your card, I like that. I like that opportunity to get in there and reshape the way they're seeing it, you know, as a more of a victory and less of a setback, that we're going to make that better. We're going to work on making it better and if we can't, we're going to get you connected to the next step, because sometimes that's what I'm doing. Hey, I can't fix this or make this better, but I know who can and I'll take that responsibility of getting you to the next step.
Carrie:You know, when patients come in the room, they trust you. They're very vulnerable to you to share this sort of problem, so I think we take that for granted as providers. You know they're our seventh patient today, but this is their unique situation. So it's very important for me that I walk in the room knowledgeable about that patient, especially the skeptical ones, and you never know when you're going to hit the skeptical ones. But when they start sharing past experiences, when they start sharing other things that have happened, you need to be able to say, yeah, I read about that. That must have been really difficult. Or you know what about this? You know I had a patient who needed a biopsy, a lung biopsy done, but he kept canceling, he wouldn't get the biopsy done and I said you know, let's, let's bring him in. I want to sit and talk to him.
Carrie:This guy was in his 70s, sweet guy, but was very, was very withdrawn, very shielded. I could just tell I was like, hey, you know, it's really important that we get this done for you. So I want you to talk to me. What's happening, tell me and you could tell, as an older man from a generation of not really complaining or being upset. It was hard for him to talk to me about it, and I said you know, are you afraid it's going to hurt? Are you afraid that you know you're going to pass away? Like what? Tell me, talk to me.
Carrie:And so he shared an experience when he was a kid. This was many, many years ago. It was probably eight, nine years old maybe, and it sounds like he had pneumonia and he had pleural effusions, and so he said that daily someone would come in the room hold his arms and they would drain his chest, and they did that for days. And so he has trauma. He has trauma as a man in his 70s, and that trauma is preventing him from getting his lung biopsy. So I needed to create a space where we could talk about that before we could even get to the risks and benefits of a lung biopsy, and so what I was able to zero in on is OK, he needs to feel like he has some control and he needs to know that it's not going to hurt, and we need to deal with his anxiety surrounding having the procedure done, and so we laid out a plan that he felt good about, and we got it done and we're able to move on to the next step.
Carrie:But sometimes you think you're going to go in and talk about a pneumothorax as a risk, but instead you've got to hear them and say that's awful, that should have never happened to you and nothing like that is happening on my watch. So it's awful, that should have never happened to you and nothing like that has happened on my watch. So it's interesting how I think you do have to be prepared for whatever you're going to walk into. But I love when patients can be that way with me. I love when they come in afraid and feel overwhelmed by it and we make it more manageable together. I like that.
Ashley:That is such a great story and those stories believe it or not, those stories usually do have happy endings. I have found, at least in my practice. It's inevitably the patients when you walk in the room and the temperature literally drops. They're so reserved and they're so protected and guarded. And being able to disarm a patient like that with your words and your questions and maybe a physical touch if it's required, is so rewarding.
Carrie:It can be exhausting if you have to do that multiple times a day.
Carrie:Yes, there is a cost to that to become that fully effective right. Especially in IR, we deal with a lot of palliative patients. So you know, sometimes you're going to get asked those tough questions. You know, why is this happening to me? I've accepted what's happening to me and I'm ready to go, but I don't know how to let go, like I don't know how to die Carrie, like how do I even do that? My husband isn't ready to let me go. You got to talk to him. So sometimes you could ask these questions, especially around procedures and interventions of you know, is my mom going to make it through this? They'll bring daughter and granddaughter and sons, and so you're not just treating the patient, you're often treating the families too.
Carrie:I think it's just being really clear about you know how we're going to help and how we're going to address all the other things too, because maybe they're coming to me for liver directed therapy for a tumor in their liver, but they also really need a nephrologist because their renal function is not great but they don't have a nephrologist. So now, okay, I got to get them safely to that next destination, because it's more than just I do IR, and I think that's different. It's different for everybody, but for me it's all encompassing. In my current practice I'm working with advanced vascular centers in Portland and we do a lot of women's health but a lot of limb salvage, like preventing amputation. And these people come in afraid, someone going from being able to walk to not being able to walk. What an equalizer right. The morbidity and mortality associated with patients after that happens. We got to fight really hard for them. So you know how do we intervene at these acute and scary times in a you do, Carrie.
Ashley:You've talked about some really mind-blowing things that you get to do and ways that you get to help these patients. Thinking back when you first started PA school, or maybe right after you graduated, is this what you thought your life was going to look like? I mean, do you take a step back every now and then and go oh my goodness, look at what I am doing right now, Look at how amazing this is?
Carrie:You know, like I said, I think I knew I always want to take care of people, but I didn't know that this is where I would end up or how it would end up when I knew I wanted to be in radiology as a PA. I only knew one other one, you know I was in North Carolina. I had never lived outside of North Carolina so I didn't know any other ones. But I thought, oh my gosh, we need more of these. So I kind of set out in this unfamiliar territory and thought if I can at least land safely in some of these spots, then there'll be a place for others to land safely. And so it's been really cool seeing more and more and more of us, you know. And then there were people doing it before me, but more and more and more of us, you know. And then there were people doing it before me but I didn't know how to reach them or connect with them. So now, going from being the only one I know to being in a room with 200 of us, it's pretty amazing that they you can say, hey, this happened or that happened. They're like, yeah, I know exactly what you're talking about. So that feels pretty awesome. And then, you know, increasing access to patients, because, especially from the small community I came from, there's no one like me. I also have become sort of that center hub for a lot of people that know I'm in the medical field that will reach out like with a question or a concern. I don't always have the answer, but I can at least point them in a direction. So, yeah, it's, it's been really cool.
Carrie:And then when I have someone message me on LinkedIn and be like hey, you look, you looks really cool what you're doing. How did you do that? I mean this, this mentorship idea, any chance I get, any chance I get. If someone says, oh, like we had an equipment vendor said my son's thinking about going to PA school, hey, give him my, give him my cell number, have him call me. Or I'm working on my letter for PA school, send it to me, let me look at it with you. Can I do a workshop for the PA class? This is when I was at Stanford. Yeah, okay, let me do that. I can't wait. Make a workshop, any chance I get, like what you're doing.
Ashley:You know I love this, being able to talk about it, not just as an IRPA but as a PA in general, because I wish this resource had been available to me or I knew how to access it when I was coming through Right Exactly, and you know, speaking on professional development, what you do is amazing and the fact that you realize that it is growing but it has so much farther to go is pivotal, and this is a perfect segue. You know I've I talked about a bunch of the other things that you're involved with in the introduction, but this is a perfect segue into talking about something that is so interesting that you are involved with, and it is creating a certificate of added qualification for interventional radiology. This is through the NCCPA, which maybe we can talk a little bit about. Caqs. I have one in dermatology. They're specific to our field in medicine. Tell me about how that process is going for you.
Ashley:Before we hear about this incredible experience that Keri is having creating the CAQ, I want to talk to you about quality questions. This is a segment on our show where we ask these leaders in medicine that we are talking to if they have ever had an interview question. That has been extremely memorable. Now, Carrie and I did not have the opportunity to discuss a quality question. However, her conversation here about CAQs brings up a fantastic opportunity opportunity. This is directed at pre-PA students, but if you're a pre-health student that's interested in a different field of medicine, this can be directly applicable to you as well.
Ashley:A CAQ, or certificate of added qualification, is a certificate that you get after you achieve your degree. So in this case, my quality question would be do you believe specialty certifications are beneficial for the future of the PA profession or insert your profession here, or do they create unnecessary barriers? It's a great question to think about before you go for your own interview. 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.
Carrie:You know it's interesting, I think, first off figuring out why it makes sense, why we'd want to do it. You know, wanting to be, I think, because radiology for so many years was just considered a procedural specialty. We are a heavily clinical specialty as well. You know we're more. You send a consult our way for an intervention. Then we've got to look at the patient holistically and say this is a good idea or not a good idea for them. So we're a part of that multidisciplinary care team, right. So we are a heavily clinical specialty, but I think we're still viewed for those of us, for those that even know what we are, as a procedural field.
Carrie:So this is a way to demonstrate clinical proficiency in this specialty as a PA. So this certificate of added qualification, as you know, is created within the specialty through NCCPA and it's basically a way for you to say I have taken extra time and paid extra attention and put extra efforts towards demonstrating my proficiency in this specialty and I think that it's time for us to do that. I mean, we are still a small number. I don't know. Do you know what percentage of PAs and MPs are in dermatology? Do you have ways to get those numbers, do you?
Ashley:know. I'm sure we could figure it out. I don't know off the top of my head, but it's a larger percentage than PAs in interventional radiology. Can I tell you that?
Carrie:We're in that probably 1%, 1% to 2% of PAs nationally that are in IR Very small number but growing, growing. There's more and more interest. We have folks leaving other specialties to come to us, you know, et cetera. So the CAQ is a way for us to show others, hey, ir is my thing, it's important to me. It also demonstrates to others. You know, I think if you're a person who says, well, what does an IRPA do, then you've got this blueprint that says these are the things from a knowledge-based standpoint. This is what they are expected to know and be familiar with. You know, it's not saying that I'm proficient at placing a port. It just says that I have knowledge of this and I know what it's about and I know the pertinent key things to do. It's not a certification. So I think we have to be really mindful about that.
Carrie:There's some concern that these say that we can do things that we can't do. I can place ports, but that's more than a CAQ. That's mentorship, that's years of training. So I think it's a way and also to demonstrate to other providers like, say, you're an IR physician or radiologist has a private practice and you've got a list of candidates you know like, hey, okay, great, this person, you know, has a dedication to this field, so it might give you the upper hand as a, as a PA or an MP as you're like, fighting for that, that role I.
Carrie:But interestingly, I need an endorsement from sort of our governing body or our, our, our specialty organization, that society of interventional radiology. So I'm still in the process of getting their endorsement. It's just taking longer than I thought it would, but we're just wanting to make sure that we we think of all the things um, and the place I'm at currently is obtaining physician champions to be collaborative and support me in it, and we're probably going to be meeting for a SWOT analysis. So it gets very it's important, though we want to do it the right way. So I mean, this is down the road, but it'll be really valuable once it's done.
Ashley:And I'm not giving up.
Carrie:I'm not giving up.
Ashley:You've already done so much for the field of's done and I'm not giving up. I'm not giving up. You've already done so much for the field of medicine alone and then for the field of medicine for PAs. The fact that you're working on this number one, after talking with you and now knowing so much more about interventional radiology than I did before, it is absolutely needed to have a CAQ in interventional radiology. Really, like you said, it's just. It's just proof that you know what you know. You know this isn't this doesn't train you any better. I mean, really this is going to sound silly, but really getting my CAQ and DERM was quite easy because it was all this stuff I already knew how to do. Right, the test questions were questions I knew the answers to because I've done this for 10 years, you know. So it's just a proof.
Carrie:Yeah, and I think for us, because IR is very specialized.
Carrie:We have folks that just do neuro IR, we have folks that do interventional IR, we have women's health, we have men's health, we have diagnostic.
Carrie:We have so many different areas that it may be that a PA or an MP may just be practicing in a certain one. So when you look at getting the CAQ, it's like, well, hey, you're going to have to know some things about neuro IR and you're going to have some things about all the different sections. So the beauty of being able to create it you know, having an expert panel convene, physicians included, to come up with the blueprint, the questions, all of that stuff will make it, you know, difficult or challenging, but fair right, and it gives some people a better understanding of well, how does Carrie know how to do that? Or how do I know Carrie can go sit and have that conversation? Well, you know, here's an additional demonstration of that. I would be super proud to have it. It's definitely not, it's an investment in me, but it also demonstrates my commitment to my specialty, carrie as we wrap up, let's speak directly to someone who's interested in pre-health, right?
Ashley:I mean, you've seen healthcare from a variety of different standpoints. Right now, what advice would you give them as they're looking towards their future, considering a career in medicine? They're hearing all of the challenges and everything about burnout that everybody's talking about. I, in my opinion, I, I it sounds like you are still super passionate about clinical medicine. So tell me, tell me what you would tell them, what you would tell those students.
Carrie:You're either going to feel drawn to it, have a calling to it. I mean I think that's important First off, I mean just saying, oh well, I could be a PA. I mean I think, starting from a place that I really want to make a difference and I want to make things better, you know that that's an important place. I mean I think there needs to be something about it that speaks to you or drives you just from the beginning. But I think medicine is just for me, it's been very rewarding. I mean I wouldn't I wouldn't change a thing. It changed me. It changed the way I see the world. The relationships that I have made with you know other providers, relationships I've made with patients I mean it's part of who I am now and it was finding an outlet for that part of me that wanted to care for people. So I think it needs to be meaningful to you If you're thinking about being a PA. It needs to be meaningful, it needs to come from a meaningful place and you know I think we as PAs have a responsibility to mentor and support those people when they're talking about it. You know there are very traditional ways to mentor. We know preceptorships you know I've done that. But they're also really like non-traditional ways to mentor and that could be again, just a phone call or responding on LinkedIn or talking to that vendor's son, you know, talk to them on your way home from work, send them an email, you know, anytime you get a chance to do that.
Carrie:But I would say if you want to get into medicine, it needs to come from a place of meaning for you. And with the burnout stuff, gosh, I'm so much better at giving advice about that than I am taking advice about it. You know what I mean. Like, oh man, you really need to have some self care. Like you really should, gosh. Like, forget it. I'm like terrible at it. I'm terrible at that. I'm terrible at being a patient. Like, I'm just terrible. So I cannot. I have no credibility, but I know it's real.
Carrie:I mean I would say I probably failed it the most and hardest during COVID and then after COVID, and I don't know that I've gotten back to where I was pre-COVID and I don't know why exactly that is. We were still doing the same medicine. I mean, I was still, you know, frontline, still taking care of patients. I think it's because in my specialty we didn't get to take a break. You know, we just still had to be there, so I never really had a mental break from it. But yeah, it definitely has impacted me as a person and a provider and it caused me to say, you know, oh, I'll have that house in the mountains one day. Or oh, I'm going to get that Jeep gladiator that I really wanted. I got my house in the mountains and I got my Jeep gladiator. So, like, don't, don't wait on those things, for you know, when it's less busy at work, you know, go, go do those things, take the time off Right.
Ashley:It's great advice for for pre-health students, but that's also really really great advice for current clinicians too. You know, I think that's incredible. Thank you so much for taking your time your valuable time to join us on shadow me next, as promised. You are just a wealth of information and I'm so motivated by what you're doing for PAs now and what you will continue to do that CAQ is going to be great. I know it's going to happen. So thank you, thank you for what you do and thank you for joining us today. Yeah, thank you for your time. It was awesome. 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.
