December 16, 2024 • 29 mins
Ever wondered what it takes to thrive in the demanding yet rewarding world of dermatology? Join us on Shadow Me Next as we reveal the daily ins and outs of a dermatology clinic, where a Physician Assistant like me navigates patient care from acne treatments to the intricate Mohs surgery. Through personal anecdotes and real clinic experiences, we unravel the complexities of patient assessments and the pivotal role of education in enabling informed healthcare decisions. Drawing from my own journey as a PA and insights from my time in OBGYN, this episode offers a unique look at the parallels in patient care across different medical fields.
Meet Abby, a college senior on the brink of choosing a medical career path. Her story brings home the crucial role of mentorship and personal guidance, which are cornerstones of our mission here at Shadow Me Next. Through candid conversations with seasoned healthcare professionals, we aim to empower aspiring medical professionals with the knowledge and confidence needed to embark on their own journeys. Delve into the human side of medicine with us, where personal stories and expert advice combine to inspire and inform the next generation of healthcare providers.
Virtual shadowing is an important tool to use when planning your medical career. At Shadow Me Next! we want to provide you with the resources you need to find your role in healthcare and secure your place in medicine.
Check out our pre-health resources. Great for pre-med, pre-PA, pre-nursing, pre-therapy students or anyone else with an upcoming interview!
Mock Interviews: shadowmenext.com/mock-interviews
Personal Statement Review: shadowmenext.com/personal-statement
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Want to request a guest? Shoot me an email: ashley@shadowmenext.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ashley (00:00):
Hello and welcome to Shadow Me Next.
This is a podcast where I takeyou into and behind the scenes
of the medical world to provideyou with a deeper understanding
of the human side of medicine.
I'm Ashley, a physicianassistant and the creator of
Shadow Me Next.
It's my goal to introduce youto the incredible members of the
healthcare field and to uncovertheir unique stories, the joys
(00:22):
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-med student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
Welcome to the inauguralepisode.
You're invited to shadow me.
(00:43):
Next to the inaugural episodeYou're invited to shadow me next
.
In this episode, I'd like tointroduce you to the whole
concept of how shadow me nextwas born, tell you a little bit
about myself and my journey as aPA, and then get you excited
for the episodes to come.
We have some incrediblehealthcare providers that have
amazing stories to share abouttheir own journey in medicine,
(01:06):
but who also have a heart forteaching and a sincere interest
in sharing their personalstories with you.
I don't want you to miss asingle one of these
conversations, so make sure thatyou subscribe to this podcast,
which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at Shadow
(01:26):
Me Next, which is where I'llgive you sneak previews of our
upcoming guests.
In this first episode, I'd liketo tell you a little bit about
me, how I became a PA and how Iarrived at the position where
I'm speaking directly tostudents and encouraging them on
their own journey.
I always knew I wanted to be inmedicine.
(01:48):
I'm a problem solver and apeople person, and I admired how
healthcare providers are ableto discuss some of the most
intimate parts of a person'slife their health and are able
to partner with them to makechanges that will increase their
overall well-being.
Initially, I was unsure if Iwanted to become a physician or
a physician assistant.
(02:08):
Both offered the ability todiagnose and treat patients,
both gave me the ability toprovide for my family
financially and both offered alifetime of learning and
continuous education andself-development, which is so
important to me.
But what ultimately helped memake my decision was
(02:33):
understanding that I was readyto enter the workforce as soon
as possible and that I enjoyedthe idea of lateral mobility as
a PA and that I appreciated thecamaraderie that comes with
working alongside a supervisingphysician.
I have been practicing as a PAfor 10 years now and I can
safely say that I made the rightdecision for me.
However, after mentoringstudents throughout that entire
(02:53):
10-year time, I understand thatwhat works for me might not work
for you, and that is thebeautiful thing about medicine,
because if you desire this,there is a spot for you,
regardless of what your goalsare and regardless of whether
your goals are the same ordifferent from mine.
I have to say, one of myfavorite parts about hosting
(03:16):
Shadows is getting to discusssome of the ways in which we
differ in our views of medicineor ways we differ in the roles
that we wish to pursue.
It's a beautiful thing, and Ithink medicine does it very,
very well.
Something else I frequentlydiscuss with my shadows is the
value of a good mentor.
(03:37):
Mentorship is a gift,especially in medicine.
It's a way for students thatare interested in healthcare to
find guidance and support andencouragement while navigating
their careers.
This podcast serves as a formof mentorship by providing
accessible insights, advice andinspiration through candid
conversations with medicalprofessionals.
(03:57):
It's designed to encourage andempower you and give you a sense
of direction and connection.
However, it does not replacethe value of a personal
relationship with a mentor.
True mentorship involves adeeper, one-on-one connection
where advice is tailored to yourspecific needs, goals and
challenges.
This podcast complements thatrelationship, acting as a
(04:21):
resource to spark ideas andbuild confidence as you take
steps towards your goals.
Throughout this podcast and onour website, shadowmenextcom, I
offer you tangible tools to helpyou develop these relationships
that are so important in yourcurrent and future careers.
I encourage you to find mentorsin every facet of your life
faith, marriage, parenthood andyour hobbies, too.
(04:51):
My goal for Shadow Me Next is toprovide a transparent and
engaging platform that bridgesthe gap between aspiring medical
professionals and thehealthcare community.
By sharing real stories fromclinicians across a wide range
of medical disciplines, I hopeto give you the exposure and
insight you need to makeinformed decisions about your
future careers, while alsohelping the general public gain
a deeper understanding of thehuman side of healthcare.
(05:12):
I am committed to demystifyingthe world of medicine,
showcasing both the challengesand rewards of a career in
healthcare and providingvaluable resources for you to
excel on your journey.
Ultimately, I strive to shape afuture where both students and
patients are empowered withknowledge, feel seen and heard,
(05:34):
and gain a stronger sense oftrust in the medical profession.
One of the primary questionsyou'll hear me ask our
healthcare professionals in thecoming episodes is to describe
the challenges they face intheir field.
Challenges are a given in anyprofession, but the challenges
in medicine oftentimes involvethe health and well-being of
(05:55):
another person.
So often our challenges becomeour pain points for burnout, and
understanding this before youenter the medical arena will set
you up for a successful andsatisfying career.
I love a challenge, but thechallenge has to have an end
goal of helping someone else Forme.
That's what makes me tick.
Medicine offers thesechallenges every day and, as
(06:19):
with all things in life, Ibelieve that if you approach
challenges with a positiveattitude, they will move away
from being what caused burnout,which is a huge issue these days
, and will instead be the fuelto your fire, pushing you
towards greater success in lifeand in your career.
As a PA, some of the challengesthat I focus on are regarding
(06:41):
partnering with patients to helpthem improve their health.
This looks like differentthings for different specialties
.
For derm, it could look likeencouraging more sun protection
or for primary care, it couldlook like improving their diet
or encouraging exercise, butgenerally speaking, there are 10
points of challenge that I seeroutinely and that cause
(07:03):
friction in my job as a PA.
I think the biggest thing toremember here is that your
patients are people, notproblems, and this should be
pretty easy to do.
Because I am a patient too, Iknow how hard it is to exercise
frequently.
I know how hard it is to eat abalanced diet or to sun protect
while I'm chasing my childrenall over the pool.
(07:24):
If you remember your patientsas people and not problems,
finding common ground with themto help solve some of these
health issues will be so mucheasier.
As we meet with healthcareproviders over the next several
weeks, you will hear thesethemes presented consistently,
because they are a greaterchallenge for more than just one
(07:46):
practice or even one specialty.
It's a common theme acrossmedicine and I am excited to see
how current and futureadvocates for healthcare improve
these challenges.
So digest these 10 things.
Consider how they may affectyou, your patients and how they
could impact your role as ahealthcare provider.
The first challenge I see sooften are insurance challenges
(08:10):
and financial barriers.
Patients may not have insuranceor may have high deductible
plans which limit their abilityto afford necessary tests,
medications or treatments.
Also, a lot of times we have tonavigate prior authorizations
for medicines or for proceduresand this can delay care.
Delay care.
(08:32):
The second are geographicchallenges.
In rural or underserved areas,patients may have to face long
travel distances to reach aspecialist or healthcare
facility.
I talk about this a little bitmore later and I think you're
really going to enjoy what wehave to say about rural medicine
.
Number three specialistshortages Finding specialists in
your area.
Even in a town like mine wherephysicians and PAs and NPs are
(08:55):
in abundance, it's verychallenging for your patient to
have to wait on a specialistvisit for months just to get
more answers, sometimes whenit's something that you
diagnosed initially but you justdon't have the resources or the
expertise to manage it in yourpractice.
Number four health literacy.
Patients may not fullyunderstand their condition or
(09:17):
their treatment plans andsometimes this leads to
non-compliance and poor outcomes.
Also, miscommunication aboutthe importance of follow-up care
can result in delayed diagnoses.
Five access to medications.
Patients may not be able toafford what you've written,
particularly brand name drugs ornewer therapies.
Number six transportation issues.
(09:39):
Lack of reliable transportationcan prevent patients from
attending appointments orpicking up medications.
I see this so often and I speakto our surgical patients about
this frequently.
Perhaps they were able toarrive at their first
appointment and we've done abiopsy and unfortunately it's
bad news and they have to return.
Well, sometimes scheduling thatreturn visit is hard and it
(10:02):
causes a lot of anxiety knowingthat they have a diagnosis that
needs further treatment but theycannot get to your office.
Number seven systemicinequalities.
Patients from marginalizedgroups may face discrimination
or biases in the healthcaresystem.
This limits their access toequitable care.
Number eight preventive caregaps.
(10:23):
Many patients delay seekingcare until their conditions
become severe, either due tocosts or lack of awareness about
preventative care, or sometimesjust fear or concern over
having to visit a doctor or a PAor an NP in a medical office.
Number nine cultural andlanguage barriers.
(10:44):
Language differences can makeit harder to effectively
communicate diagnoses andtreatments, and cultural beliefs
and practices may impact apatient's willingness to pursue
or adhere to treatment plans.
And number 10, technologicalbarriers.
This is a rather new challenge,but patients without access to
technology may struggle toschedule appointments, access
(11:06):
telehealth services or useonline portals for results and
communication.
Nowadays it's hard to pick upthe phone and speak to your
doctor, and this can cause a bigchallenge for our patients who
are not as technologically savvy.
That's 10 challenges that Iface at my practice pretty
consistently, and I wish I hadthe answers for you as to how to
(11:29):
overcome them consistentlyevery single time, and I don't
you know.
My biggest recommendation is toview your patients as people,
because if you start viewingthem as their technological
challenges or if you startviewing them as their financial
difficulties or as theirlanguage barriers, they have
lost you as a valuable member oftheir care team.
(11:51):
Being my patient's advocate astheir PA involves standing
alongside them, even duringthese challenges, and that is
one of the reasons why I am soproud to be a PA.
It's funny anytime you ask amedical provider for one of
their most memorable patientencounters, they might laugh and
(12:14):
say I know exactly one to tellyou, and it's typically because
that patient encounter beganwith a challenge and it's
usually because we were able towork through that challenge with
that patient and come to aharmonious, beautiful, healthy
conclusion.
And come to a harmonious,beautiful, healthy conclusion.
(12:35):
This happened to me when I hada young mother come into the
office with her husband and itwas for her skin exam.
I was proud of her for takingher health into her own hands
and stepping in, even though shewas so incredibly busy.
And, by all accounts, she hadabsolutely beautiful skin, not a
single spot on her.
She had sun protected well, sheused good moisturizer, she was
the perfect patient and herhusband was with her.
(12:58):
And at the end of the visit I'malready running a little bit
behind for that day and I was sograteful to have a patient who
was just so healthy sitting inmy chair so that I could maybe
get caught up.
At the end of the appointmentthe husband said excuse me, but
do you have just one second totalk about something that I have
that I'm concerned about?
And oh, it's so hard in thosemoments because, as a medical
(13:21):
provider who's trying to see therest of her 24 patients and
stay on schedule, theseimpromptu visits sometimes can
throw a big wrench into things.
But I felt drawn to say yes andof course he was very kind with
this presentation and explainedbriefly about what he had going
on.
And it turns out that just byspeaking with him I was able to
(13:43):
deduce that he likely had acondition called hydradenitis
suprativa.
I'll link it below.
But hydradenitis suprativa is achronic genetic skin condition
where you have recurrentabscesses or cysts that form in
the most uncomfortable areasunder your arms, in your groin,
(14:04):
under your breasts for womenbehind your neck for men
underneath your chin and theseabscesses become inflamed and
they drain and then they scarand the scars will then scar.
And it's this chronic cycliccondition that becomes worse and
worse over time.
And he was middle-aged and hehad been struggling with this
(14:25):
for a long time.
And just speaking with him Imentioned HS and it's a word
that he had never heard of.
Then I began to talk about thefact that it can be genetic and
it can run in families, and heopened his eyes very big and
said you know, I think my motherand my grandmother probably
struggled with the same thing.
And I asked about his childrenand he said that he had two
(14:45):
young children and they probablyalso were struggling with the
same thing and they probablyalso were struggling with the
same thing.
And so what did we do?
We went ahead and booked anentire family visit.
He and his wife and his twochildren returned to the office
the following week and we openlyhad a conversation about this
type of skin condition and I amso happy to say that they are
(15:06):
all currently symptom-free.
They're living their best lifewithout HS and we were able to
address it early so that thetreatment options for them were
very mild and doable and not animpact on their regular daily
life.
Sometimes, just taking a coupleof minutes with one patient can
(15:28):
change the outlook of an entirefamily, and that is the kind of
stories that I'm here for.
That is the kind of thing thatI want to encourage you about.
Medicine is yes, even if thechallenge presents itself
sometimes.
If you push into that challenge, you are met with the most
wonderful stories and successesthat come from it.
(15:49):
Stories and successes that comefrom it.
If you were to come and shadowme for a day, you would see a PA
who worked, amongst other PAsand physicians, to provide the
best medical and surgicaldermatologic care to our
patients.
Our office is open Mondaythrough Thursday.
During those days, I seeanywhere between 20 and 24
(16:11):
patients with medicaldermatologic conditions.
This includes things like acneand rashes, shingles, etc.
But it also includes regularskin exams and this is a part of
preventive medicine.
When a patient comes to ouroffice.
They usually see a medicalassistant first who walks them
(16:33):
through reviewing their chart,updating any information that
needs to be updated and asksabout any concerns that they
have that day.
At that point I'll come in anddo a full skin exam or address
the specific problem that theypresented with that day.
During the skin exam, ifthere's any suspicious findings,
(16:53):
we'll talk about them.
I'll provide a clinicaldiagnosis and I'll let the
patient know what treatmentoptions they have available.
Occasionally, the patient wantsto think about their options,
and that's okay.
That's part of teaming withthem.
It's part of my job to makesure that they have the
education they need to make aninformed decision about their
(17:14):
own healthcare.
Most of the time, however, ourpatients are ready to make that
decision at our appointment.
Whether the spot that'sworrisome needs to be frozen off
with liquid nitrogen or scrapedoff with an electro desiccation
and curatage, or if it needs tobe biopsied, we can perform
that procedure in that exactmoment and the patient will be
(17:36):
on their way to knowing exactlywhat that lesion was.
While you're enjoying thesepodcasts, you may hear PAs or
physicians or nursepractitioners or nurses
describing certain procedures,or perhaps they'll just state
the name of a certain procedure.
What I like to do is make sureyou know exactly what they're
(17:57):
talking about.
So at the end of every episode,down in the comments, you will
see a link to a video of thatprocedure.
These links are meant to serveas a visual education, if you
will, so that you can betterunderstand what these medical
providers are talking about.
(18:17):
The procedures we do indermatology are all on the skin,
of course.
We do biopsies,electrodessication and curatage
and cryosurgeries, and we dobigger surgeries as well
Excisions for cysts, lipomas andany type of abnormal mole, as
well as a specialized surgerycalled Mohs surgery.
(18:39):
Surgery called Mohs surgery.
Mohs surgery is a specializedprocedure used to treat squamous
cell and basal cell skincancers.
It requires close work with adermatologist who is also a
board certifieddermatopathologist, which is
someone who can look at slidesprepared of the skin.
The patient who has already hada biopsy return as an abnormal
(19:02):
skin lesion, basal cell orsquamous cell, will come back to
the office for furtherprocedures.
We anesthetize the area.
The physician will remove asmall portion of their skin with
a very slim margin, processthat into slides and then
examine that underneath themicroscope If the margins are
(19:24):
positive at any point eitheraround or underneath that sample
.
The surgeon can then re-enterthe operation and remove more of
the specimen.
This allows for the smallestamount of tissue to be removed,
which is really important onareas like the face or the scalp
or the back of the hands, wherethere's not much loose skin to
(19:47):
work with.
Once the physician hascompletely cleared the margins
at our office, the PA gets toenter the procedure and perform
the repair.
This is where we take thisdefect which has been left by
the surgeon and close it in away that is both functional but
(20:08):
also cosmetically beneficial.
Being able to work as a medicaland surgical PA is one of the
most wonderful aspects of mycareer.
Before I was in dermatology, Ialso worked in OBGYN, and in
OBGYN it was a very similarexperience.
We saw patients in clinic wherewe performed routine pap smears
(20:29):
, routine breast exams, any typeof a problem visit.
But I also was able to stepinto the surgical suite and,
right next to the operatingphysician, perform these
incredible surgeries and rightnext to the operating physician,
perform these incrediblesurgeries robotic hysterectomies
, open hysterectomies.
It was incredible, and theopportunity to serve patients
(20:52):
face-to-face and also serve themunder big procedures is one of
the highlights of my career,students will ask me well, do
you prefer clinic medicine or doyou prefer surgical medicine?
And it's an impossible questionto answer because I prefer both,
simultaneously working inharmony with each other.
I love the ability to sit andtalk to our patients, to share
(21:12):
in that decision-making withthem, and then I also really
appreciate being the one to helpthem, being the one to fix
their problems, to remove thatskin cancer, to take out their
uterus that is causing themyears of abnormal bleeding.
Ultimately, it goes back to thewhole reason why I entered
medicine I enjoy solvingproblems and I enjoy solving
(21:34):
problems in order to benefitother people.
In the middle of each podcastthat you will hear on Shadow Me
Next, I like to include a placewhere our interviewers can share
their most memorable interviewquestions, and hopefully this
will give you something to thinkabout for your own interviews,
and if it doesn't, thenhopefully it will give you
(21:54):
something to laugh at.
And here is your qualityquestion.
When I was interviewing for PAschool, near the end of one of
my interviews, someone asked meif I was an animal, what animal
would I be?
And it just threw me offbecause I had prepared for every
PA related question in thebooks and I had not thought
(22:16):
about what kind of animal Iwould be.
So, you know, knee jerk, I justI splurted out dog because I
was hardworking and friendly andplayful and, of course, in
retrospect, driving home on theway back from the interview, I
thought of a thousand otheranimals that I could have said.
That would have been morethought provoking, I guess, or
(22:37):
exciting, but what I've realizedis, a lot of times, when they
throw out these offhandedinterview questions something
that you know, not necessarilysomething you could prepare for
they want to see you think, andthey want to see you think on
your feet, because that's a lotof what medicine is.
So if you were an animal, whatanimal would you be?
I am so excited about thatbreak for quality questions and
(23:01):
I think it's going to really bea huge highlight of this podcast
for you.
You can always review thesequality questions on our
Facebook and Instagram at shadowme next, and if you're looking
for more interview resources,head over to our website at
shadow me nextcom for mockinterview opportunities.
When it comes to working as aderm PA, we'll have plenty of
(23:22):
opportunities for me to talkabout certain things that I've
been exposed to and certainexperiences that I've had that
might help to shape yourdecisions and might help to
confirm, one way or the other,where you want to end up in the
medical field.
Getting into the specifics ofit, however, I will leave to my
colleague, who I plan tointerview in the next few
(23:44):
episodes, because I think shehas some incredible insights
into our field and I'm excitedto share those with you.
But now I want to talk to youabout why this podcast matters,
and I'm going to do that bytelling you about Abby.
Abby is a college senior with ascience major who's interested
(24:04):
in a career in medicine but haslimited experience in the field.
Her mother is a teacher and herfather works for the local
sheriff's department.
They are supportive of hergoals and have had excellent
relationships with their ownmedical providers, but they
don't know anyone personally whoAbby can shadow.
Abby's hobbies include running,going to the gym and spending
(24:24):
time with her friends.
She has a full course load thissemester, including two hours
of organic chemistry lab.
She TAs for her bio class andtutors high school students a
few days a week.
She is involved in manyorganizations on campus which
require on-site participation inmeetings, as well as
promotional and volunteeractivities.
She enjoys these organizationsbut realizes they're a means to
(24:47):
an end goal, which is to enrollin a postgraduate medical
program.
During one volunteer activityat a local health department,
abby was able to play an activerole in providing medical care
to underserved people.
Role in providing medical careto underserved people.
This single experiencesolidified her desire to become
a medical professional who iscapable of improving the lives
of others by providing excellenthealth care and sincere social
(25:10):
support.
As the end of her final semesternears, abby has started to feel
more anxious regarding herdecision to enter medicine.
She wishes she had time in herschedule to research medical
professions and wishes that shecould get time off work to
shadow medical providers and askthem the personal questions
that would help make thisdecision easier.
(25:32):
As a result of her lifetimeexperience, she believes a
career in medicine would bestsupport her lifetime goals To
teach like her mother, to servelike her father, to further her
education and desire forlearning, to become financially
independent and to continue withthe community service that
means so much to her.
She understands that a careerin medicine is an ambitious goal
(25:55):
and, as such, wants to be sureshe's making the right decision
about which direction inmedicine to take.
Abby would love to be able topassively listen to her most
important questions being askedas she walked to class or
exercised at the gym.
She would love to discuss thethings she learned with her
parents and her friends so thatthey can help her make the best
(26:15):
decision.
Abby needs more than just thesteps for how to get into
medicine.
She wants access to medicalproviders to help her confirm
why she wants to go intomedicine.
She wants tangible evidencethat the immense effort she will
be dedicating to becomingsuccessful in a professional
program will result in a life oflearning, of service and of
(26:39):
true career satisfaction.
Abby wants to shadow me next.
I talk to students like Abbyall the time.
Students who need more of whywe do what we do.
Students who need assurancethat the efforts that they're
going to put into getting intoschool and surviving school and
(27:00):
then entering their career isall worth it.
Students who want to know if Iam satisfied with my decision,
if I have achieved my dream inmy career, if I have a good
work-life balance and if I'mhappy overall with where I'm at
in my life.
That is why I have created theShadow Me Next podcast so that
(27:26):
we can dive into those questionswith not just me but many other
members of the medicalcommunity.
I think sometimes theirresponses will shock you.
Sometimes you might hear yes,I'm working 100 hours a week,
but it is the most wonderfulwork I have ever done in my
whole life.
Or other responses like I wishI had taken that gap year or
(27:50):
those two gap years or three gapyears to really spend time with
my friends and my family andhone in on my hobbies before I
entered my career.
These questions are for you.
These questions are for you.
These conversations are for you.
By providing accessibleon-demand content and offering
(28:10):
more interactive opportunitiesfor learning about medicine.
Shadow Me Next stands out in aspace that is otherwise limited
to formal in-person shadowing orlecture-based resources.
This allows you to explorehealthcare careers in a flexible
, less rigid and more personalway, which is a growing need in
(28:32):
today's fast-paced, digitallyconnected world.
My goal is to move beyondsimply outlining how to get
involved in healthcare andinstead help you clarify why
you're driven to pursue a careerin this field.
Thank you so very much forlistening to this inaugural
episode of Shadow Me Next.
If you liked this episode or ifyou think it could be useful
(28:55):
for a friend, please subscribeand invite them to join us next
Monday, as always.
If you have any questions, letme know on Facebook or Instagram
Access.
You want stories you need?
You're always invited to shadowme next.
Hello and welcome to Shadow Me Next.
This is a podcast where I takeyou into and behind the scenes
of the medical world to provideyou with a deeper understanding
of the human side of medicine.
I'm Ashley, a physicianassistant and the creator of
Shadow Me Next.
It's my goal to introduce youto the incredible members of the
healthcare field and to uncovertheir unique stories, the joys
(00:22):
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-med student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
Welcome to the inauguralepisode.
You're invited to shadow me.
(00:43):
Next to the inaugural episodeYou're invited to shadow me next
.
In this episode, I'd like tointroduce you to the whole
concept of how shadow me nextwas born, tell you a little bit
about myself and my journey as aPA, and then get you excited
for the episodes to come.
We have some incrediblehealthcare providers that have
amazing stories to share abouttheir own journey in medicine,
(01:06):
but who also have a heart forteaching and a sincere interest
in sharing their personalstories with you.
I don't want you to miss asingle one of these
conversations, so make sure thatyou subscribe to this podcast,
which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at Shadow
(01:26):
Me Next, which is where I'llgive you sneak previews of our
upcoming guests.
In this first episode, I'd liketo tell you a little bit about
me, how I became a PA and how Iarrived at the position where
I'm speaking directly tostudents and encouraging them on
their own journey.
I always knew I wanted to be inmedicine.
(01:48):
I'm a problem solver and apeople person, and I admired how
healthcare providers are ableto discuss some of the most
intimate parts of a person'slife their health and are able
to partner with them to makechanges that will increase their
overall well-being.
Initially, I was unsure if Iwanted to become a physician or
a physician assistant.
(02:08):
Both offered the ability todiagnose and treat patients,
both gave me the ability toprovide for my family
financially and both offered alifetime of learning and
continuous education andself-development, which is so
important to me.
But what ultimately helped memake my decision was
(02:33):
understanding that I was readyto enter the workforce as soon
as possible and that I enjoyedthe idea of lateral mobility as
a PA and that I appreciated thecamaraderie that comes with
working alongside a supervisingphysician.
I have been practicing as a PAfor 10 years now and I can
safely say that I made the rightdecision for me.
However, after mentoringstudents throughout that entire
(02:53):
10-year time, I understand thatwhat works for me might not work
for you, and that is thebeautiful thing about medicine,
because if you desire this,there is a spot for you,
regardless of what your goalsare and regardless of whether
your goals are the same ordifferent from mine.
I have to say, one of myfavorite parts about hosting
(03:16):
Shadows is getting to discusssome of the ways in which we
differ in our views of medicineor ways we differ in the roles
that we wish to pursue.
It's a beautiful thing, and Ithink medicine does it very,
very well.
Something else I frequentlydiscuss with my shadows is the
value of a good mentor.
(03:37):
Mentorship is a gift,especially in medicine.
It's a way for students thatare interested in healthcare to
find guidance and support andencouragement while navigating
their careers.
This podcast serves as a formof mentorship by providing
accessible insights, advice andinspiration through candid
conversations with medicalprofessionals.
(03:57):
It's designed to encourage andempower you and give you a sense
of direction and connection.
However, it does not replacethe value of a personal
relationship with a mentor.
True mentorship involves adeeper, one-on-one connection
where advice is tailored to yourspecific needs, goals and
challenges.
This podcast complements thatrelationship, acting as a
(04:21):
resource to spark ideas andbuild confidence as you take
steps towards your goals.
Throughout this podcast and onour website, shadowmenextcom, I
offer you tangible tools to helpyou develop these relationships
that are so important in yourcurrent and future careers.
I encourage you to find mentorsin every facet of your life
faith, marriage, parenthood andyour hobbies, too.
(04:51):
My goal for Shadow Me Next is toprovide a transparent and
engaging platform that bridgesthe gap between aspiring medical
professionals and thehealthcare community.
By sharing real stories fromclinicians across a wide range
of medical disciplines, I hopeto give you the exposure and
insight you need to makeinformed decisions about your
future careers, while alsohelping the general public gain
a deeper understanding of thehuman side of healthcare.
(05:12):
I am committed to demystifyingthe world of medicine,
showcasing both the challengesand rewards of a career in
healthcare and providingvaluable resources for you to
excel on your journey.
Ultimately, I strive to shape afuture where both students and
patients are empowered withknowledge, feel seen and heard,
(05:34):
and gain a stronger sense oftrust in the medical profession.
One of the primary questionsyou'll hear me ask our
healthcare professionals in thecoming episodes is to describe
the challenges they face intheir field.
Challenges are a given in anyprofession, but the challenges
in medicine oftentimes involvethe health and well-being of
(05:55):
another person.
So often our challenges becomeour pain points for burnout, and
understanding this before youenter the medical arena will set
you up for a successful andsatisfying career.
I love a challenge, but thechallenge has to have an end
goal of helping someone else Forme.
That's what makes me tick.
Medicine offers thesechallenges every day and, as
(06:19):
with all things in life, Ibelieve that if you approach
challenges with a positiveattitude, they will move away
from being what caused burnout,which is a huge issue these days
, and will instead be the fuelto your fire, pushing you
towards greater success in lifeand in your career.
As a PA, some of the challengesthat I focus on are regarding
(06:41):
partnering with patients to helpthem improve their health.
This looks like differentthings for different specialties
.
For derm, it could look likeencouraging more sun protection
or for primary care, it couldlook like improving their diet
or encouraging exercise, butgenerally speaking, there are 10
points of challenge that I seeroutinely and that cause
(07:03):
friction in my job as a PA.
I think the biggest thing toremember here is that your
patients are people, notproblems, and this should be
pretty easy to do.
Because I am a patient too, Iknow how hard it is to exercise
frequently.
I know how hard it is to eat abalanced diet or to sun protect
while I'm chasing my childrenall over the pool.
(07:24):
If you remember your patientsas people and not problems,
finding common ground with themto help solve some of these
health issues will be so mucheasier.
As we meet with healthcareproviders over the next several
weeks, you will hear thesethemes presented consistently,
because they are a greaterchallenge for more than just one
(07:46):
practice or even one specialty.
It's a common theme acrossmedicine and I am excited to see
how current and futureadvocates for healthcare improve
these challenges.
So digest these 10 things.
Consider how they may affectyou, your patients and how they
could impact your role as ahealthcare provider.
The first challenge I see sooften are insurance challenges
(08:10):
and financial barriers.
Patients may not have insuranceor may have high deductible
plans which limit their abilityto afford necessary tests,
medications or treatments.
Also, a lot of times we have tonavigate prior authorizations
for medicines or for proceduresand this can delay care.
Delay care.
(08:32):
The second are geographicchallenges.
In rural or underserved areas,patients may have to face long
travel distances to reach aspecialist or healthcare
facility.
I talk about this a little bitmore later and I think you're
really going to enjoy what wehave to say about rural medicine
.
Number three specialistshortages Finding specialists in
your area.
Even in a town like mine wherephysicians and PAs and NPs are
(08:55):
in abundance, it's verychallenging for your patient to
have to wait on a specialistvisit for months just to get
more answers, sometimes whenit's something that you
diagnosed initially but you justdon't have the resources or the
expertise to manage it in yourpractice.
Number four health literacy.
Patients may not fullyunderstand their condition or
(09:17):
their treatment plans andsometimes this leads to
non-compliance and poor outcomes.
Also, miscommunication aboutthe importance of follow-up care
can result in delayed diagnoses.
Five access to medications.
Patients may not be able toafford what you've written,
particularly brand name drugs ornewer therapies.
Number six transportation issues.
(09:39):
Lack of reliable transportationcan prevent patients from
attending appointments orpicking up medications.
I see this so often and I speakto our surgical patients about
this frequently.
Perhaps they were able toarrive at their first
appointment and we've done abiopsy and unfortunately it's
bad news and they have to return.
Well, sometimes scheduling thatreturn visit is hard and it
(10:02):
causes a lot of anxiety knowingthat they have a diagnosis that
needs further treatment but theycannot get to your office.
Number seven systemicinequalities.
Patients from marginalizedgroups may face discrimination
or biases in the healthcaresystem.
This limits their access toequitable care.
Number eight preventive caregaps.
(10:23):
Many patients delay seekingcare until their conditions
become severe, either due tocosts or lack of awareness about
preventative care, or sometimesjust fear or concern over
having to visit a doctor or a PAor an NP in a medical office.
Number nine cultural andlanguage barriers.
(10:44):
Language differences can makeit harder to effectively
communicate diagnoses andtreatments, and cultural beliefs
and practices may impact apatient's willingness to pursue
or adhere to treatment plans.
And number 10, technologicalbarriers.
This is a rather new challenge,but patients without access to
technology may struggle toschedule appointments, access
(11:06):
telehealth services or useonline portals for results and
communication.
Nowadays it's hard to pick upthe phone and speak to your
doctor, and this can cause a bigchallenge for our patients who
are not as technologically savvy.
That's 10 challenges that Iface at my practice pretty
consistently, and I wish I hadthe answers for you as to how to
(11:29):
overcome them consistentlyevery single time, and I don't
you know.
My biggest recommendation is toview your patients as people,
because if you start viewingthem as their technological
challenges or if you startviewing them as their financial
difficulties or as theirlanguage barriers, they have
lost you as a valuable member oftheir care team.
(11:51):
Being my patient's advocate astheir PA involves standing
alongside them, even duringthese challenges, and that is
one of the reasons why I am soproud to be a PA.
It's funny anytime you ask amedical provider for one of
their most memorable patientencounters, they might laugh and
(12:14):
say I know exactly one to tellyou, and it's typically because
that patient encounter beganwith a challenge and it's
usually because we were able towork through that challenge with
that patient and come to aharmonious, beautiful, healthy
conclusion.
And come to a harmonious,beautiful, healthy conclusion.
(12:35):
This happened to me when I hada young mother come into the
office with her husband and itwas for her skin exam.
I was proud of her for takingher health into her own hands
and stepping in, even though shewas so incredibly busy.
And, by all accounts, she hadabsolutely beautiful skin, not a
single spot on her.
She had sun protected well, sheused good moisturizer, she was
the perfect patient and herhusband was with her.
(12:58):
And at the end of the visit I'malready running a little bit
behind for that day and I was sograteful to have a patient who
was just so healthy sitting inmy chair so that I could maybe
get caught up.
At the end of the appointmentthe husband said excuse me, but
do you have just one second totalk about something that I have
that I'm concerned about?
And oh, it's so hard in thosemoments because, as a medical
(13:21):
provider who's trying to see therest of her 24 patients and
stay on schedule, theseimpromptu visits sometimes can
throw a big wrench into things.
But I felt drawn to say yes andof course he was very kind with
this presentation and explainedbriefly about what he had going
on.
And it turns out that just byspeaking with him I was able to
(13:43):
deduce that he likely had acondition called hydradenitis
suprativa.
I'll link it below.
But hydradenitis suprativa is achronic genetic skin condition
where you have recurrentabscesses or cysts that form in
the most uncomfortable areasunder your arms, in your groin,
(14:04):
under your breasts for womenbehind your neck for men
underneath your chin and theseabscesses become inflamed and
they drain and then they scarand the scars will then scar.
And it's this chronic cycliccondition that becomes worse and
worse over time.
And he was middle-aged and hehad been struggling with this
(14:25):
for a long time.
And just speaking with him Imentioned HS and it's a word
that he had never heard of.
Then I began to talk about thefact that it can be genetic and
it can run in families, and heopened his eyes very big and
said you know, I think my motherand my grandmother probably
struggled with the same thing.
And I asked about his childrenand he said that he had two
(14:45):
young children and they probablyalso were struggling with the
same thing and they probablyalso were struggling with the
same thing.
And so what did we do?
We went ahead and booked anentire family visit.
He and his wife and his twochildren returned to the office
the following week and we openlyhad a conversation about this
type of skin condition and I amso happy to say that they are
(15:06):
all currently symptom-free.
They're living their best lifewithout HS and we were able to
address it early so that thetreatment options for them were
very mild and doable and not animpact on their regular daily
life.
Sometimes, just taking a coupleof minutes with one patient can
(15:28):
change the outlook of an entirefamily, and that is the kind of
stories that I'm here for.
That is the kind of thing thatI want to encourage you about.
Medicine is yes, even if thechallenge presents itself
sometimes.
If you push into that challenge, you are met with the most
wonderful stories and successesthat come from it.
(15:49):
Stories and successes that comefrom it.
If you were to come and shadowme for a day, you would see a PA
who worked, amongst other PAsand physicians, to provide the
best medical and surgicaldermatologic care to our
patients.
Our office is open Mondaythrough Thursday.
During those days, I seeanywhere between 20 and 24
(16:11):
patients with medicaldermatologic conditions.
This includes things like acneand rashes, shingles, etc.
But it also includes regularskin exams and this is a part of
preventive medicine.
When a patient comes to ouroffice.
They usually see a medicalassistant first who walks them
(16:33):
through reviewing their chart,updating any information that
needs to be updated and asksabout any concerns that they
have that day.
At that point I'll come in anddo a full skin exam or address
the specific problem that theypresented with that day.
During the skin exam, ifthere's any suspicious findings,
(16:53):
we'll talk about them.
I'll provide a clinicaldiagnosis and I'll let the
patient know what treatmentoptions they have available.
Occasionally, the patient wantsto think about their options,
and that's okay.
That's part of teaming withthem.
It's part of my job to makesure that they have the
education they need to make aninformed decision about their
(17:14):
own healthcare.
Most of the time, however, ourpatients are ready to make that
decision at our appointment.
Whether the spot that'sworrisome needs to be frozen off
with liquid nitrogen or scrapedoff with an electro desiccation
and curatage, or if it needs tobe biopsied, we can perform
that procedure in that exactmoment and the patient will be
(17:36):
on their way to knowing exactlywhat that lesion was.
While you're enjoying thesepodcasts, you may hear PAs or
physicians or nursepractitioners or nurses
describing certain procedures,or perhaps they'll just state
the name of a certain procedure.
What I like to do is make sureyou know exactly what they're
(17:57):
talking about.
So at the end of every episode,down in the comments, you will
see a link to a video of thatprocedure.
These links are meant to serveas a visual education, if you
will, so that you can betterunderstand what these medical
providers are talking about.
(18:17):
The procedures we do indermatology are all on the skin,
of course.
We do biopsies,electrodessication and curatage
and cryosurgeries, and we dobigger surgeries as well
Excisions for cysts, lipomas andany type of abnormal mole, as
well as a specialized surgerycalled Mohs surgery.
(18:39):
Surgery called Mohs surgery.
Mohs surgery is a specializedprocedure used to treat squamous
cell and basal cell skincancers.
It requires close work with adermatologist who is also a
board certifieddermatopathologist, which is
someone who can look at slidesprepared of the skin.
The patient who has already hada biopsy return as an abnormal
(19:02):
skin lesion, basal cell orsquamous cell, will come back to
the office for furtherprocedures.
We anesthetize the area.
The physician will remove asmall portion of their skin with
a very slim margin, processthat into slides and then
examine that underneath themicroscope If the margins are
(19:24):
positive at any point eitheraround or underneath that sample
.
The surgeon can then re-enterthe operation and remove more of
the specimen.
This allows for the smallestamount of tissue to be removed,
which is really important onareas like the face or the scalp
or the back of the hands, wherethere's not much loose skin to
(19:47):
work with.
Once the physician hascompletely cleared the margins
at our office, the PA gets toenter the procedure and perform
the repair.
This is where we take thisdefect which has been left by
the surgeon and close it in away that is both functional but
(20:08):
also cosmetically beneficial.
Being able to work as a medicaland surgical PA is one of the
most wonderful aspects of mycareer.
Before I was in dermatology, Ialso worked in OBGYN, and in
OBGYN it was a very similarexperience.
We saw patients in clinic wherewe performed routine pap smears
(20:29):
, routine breast exams, any typeof a problem visit.
But I also was able to stepinto the surgical suite and,
right next to the operatingphysician, perform these
incredible surgeries and rightnext to the operating physician,
perform these incrediblesurgeries robotic hysterectomies
, open hysterectomies.
It was incredible, and theopportunity to serve patients
(20:52):
face-to-face and also serve themunder big procedures is one of
the highlights of my career,students will ask me well, do
you prefer clinic medicine or doyou prefer surgical medicine?
And it's an impossible questionto answer because I prefer both,
simultaneously working inharmony with each other.
I love the ability to sit andtalk to our patients, to share
(21:12):
in that decision-making withthem, and then I also really
appreciate being the one to helpthem, being the one to fix
their problems, to remove thatskin cancer, to take out their
uterus that is causing themyears of abnormal bleeding.
Ultimately, it goes back to thewhole reason why I entered
medicine I enjoy solvingproblems and I enjoy solving
(21:34):
problems in order to benefitother people.
In the middle of each podcastthat you will hear on Shadow Me
Next, I like to include a placewhere our interviewers can share
their most memorable interviewquestions, and hopefully this
will give you something to thinkabout for your own interviews,
and if it doesn't, thenhopefully it will give you
(21:54):
something to laugh at.
And here is your qualityquestion.
When I was interviewing for PAschool, near the end of one of
my interviews, someone asked meif I was an animal, what animal
would I be?
And it just threw me offbecause I had prepared for every
PA related question in thebooks and I had not thought
(22:16):
about what kind of animal Iwould be.
So, you know, knee jerk, I justI splurted out dog because I
was hardworking and friendly andplayful and, of course, in
retrospect, driving home on theway back from the interview, I
thought of a thousand otheranimals that I could have said.
That would have been morethought provoking, I guess, or
(22:37):
exciting, but what I've realizedis, a lot of times, when they
throw out these offhandedinterview questions something
that you know, not necessarilysomething you could prepare for
they want to see you think, andthey want to see you think on
your feet, because that's a lotof what medicine is.
So if you were an animal, whatanimal would you be?
I am so excited about thatbreak for quality questions and
(23:01):
I think it's going to really bea huge highlight of this podcast
for you.
You can always review thesequality questions on our
Facebook and Instagram at shadowme next, and if you're looking
for more interview resources,head over to our website at
shadow me nextcom for mockinterview opportunities.
When it comes to working as aderm PA, we'll have plenty of
(23:22):
opportunities for me to talkabout certain things that I've
been exposed to and certainexperiences that I've had that
might help to shape yourdecisions and might help to
confirm, one way or the other,where you want to end up in the
medical field.
Getting into the specifics ofit, however, I will leave to my
colleague, who I plan tointerview in the next few
(23:44):
episodes, because I think shehas some incredible insights
into our field and I'm excitedto share those with you.
But now I want to talk to youabout why this podcast matters,
and I'm going to do that bytelling you about Abby.
Abby is a college senior with ascience major who's interested
(24:04):
in a career in medicine but haslimited experience in the field.
Her mother is a teacher and herfather works for the local
sheriff's department.
They are supportive of hergoals and have had excellent
relationships with their ownmedical providers, but they
don't know anyone personally whoAbby can shadow.
Abby's hobbies include running,going to the gym and spending
(24:24):
time with her friends.
She has a full course load thissemester, including two hours
of organic chemistry lab.
She TAs for her bio class andtutors high school students a
few days a week.
She is involved in manyorganizations on campus which
require on-site participation inmeetings, as well as
promotional and volunteeractivities.
She enjoys these organizationsbut realizes they're a means to
(24:47):
an end goal, which is to enrollin a postgraduate medical
program.
During one volunteer activityat a local health department,
abby was able to play an activerole in providing medical care
to underserved people.
Role in providing medical careto underserved people.
This single experiencesolidified her desire to become
a medical professional who iscapable of improving the lives
of others by providing excellenthealth care and sincere social
(25:10):
support.
As the end of her final semesternears, abby has started to feel
more anxious regarding herdecision to enter medicine.
She wishes she had time in herschedule to research medical
professions and wishes that shecould get time off work to
shadow medical providers and askthem the personal questions
that would help make thisdecision easier.
(25:32):
As a result of her lifetimeexperience, she believes a
career in medicine would bestsupport her lifetime goals To
teach like her mother, to servelike her father, to further her
education and desire forlearning, to become financially
independent and to continue withthe community service that
means so much to her.
She understands that a careerin medicine is an ambitious goal
(25:55):
and, as such, wants to be sureshe's making the right decision
about which direction inmedicine to take.
Abby would love to be able topassively listen to her most
important questions being askedas she walked to class or
exercised at the gym.
She would love to discuss thethings she learned with her
parents and her friends so thatthey can help her make the best
(26:15):
decision.
Abby needs more than just thesteps for how to get into
medicine.
She wants access to medicalproviders to help her confirm
why she wants to go intomedicine.
She wants tangible evidencethat the immense effort she will
be dedicating to becomingsuccessful in a professional
program will result in a life oflearning, of service and of
(26:39):
true career satisfaction.
Abby wants to shadow me next.
I talk to students like Abbyall the time.
Students who need more of whywe do what we do.
Students who need assurancethat the efforts that they're
going to put into getting intoschool and surviving school and
(27:00):
then entering their career isall worth it.
Students who want to know if Iam satisfied with my decision,
if I have achieved my dream inmy career, if I have a good
work-life balance and if I'mhappy overall with where I'm at
in my life.
That is why I have created theShadow Me Next podcast so that
(27:26):
we can dive into those questionswith not just me but many other
members of the medicalcommunity.
I think sometimes theirresponses will shock you.
Sometimes you might hear yes,I'm working 100 hours a week,
but it is the most wonderfulwork I have ever done in my
whole life.
Or other responses like I wishI had taken that gap year or
(27:50):
those two gap years or three gapyears to really spend time with
my friends and my family andhone in on my hobbies before I
entered my career.
These questions are for you.
These questions are for you.
These conversations are for you.
By providing accessibleon-demand content and offering
(28:10):
more interactive opportunitiesfor learning about medicine.
Shadow Me Next stands out in aspace that is otherwise limited
to formal in-person shadowing orlecture-based resources.
This allows you to explorehealthcare careers in a flexible
, less rigid and more personalway, which is a growing need in
(28:32):
today's fast-paced, digitallyconnected world.
My goal is to move beyondsimply outlining how to get
involved in healthcare andinstead help you clarify why
you're driven to pursue a careerin this field.
Thank you so very much forlistening to this inaugural
episode of Shadow Me Next.
If you liked this episode or ifyou think it could be useful
(28:55):
for a friend, please subscribeand invite them to join us next
Monday, as always.
If you have any questions, letme know on Facebook or Instagram
Access.
You want stories you need?
You're always invited to shadowme next.
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