Have you ever wondered how someone can transition from the skies of Alaska to the frontlines of healthcare? Meet Hector Bird, our fascinating guest who did just that. A former pilot turned physician assistant, Hector shares his journey from aviation to acute care, driven by a passion for patient interaction and making a difference. This episode promises insights into the versatility of the PA profession, emphasizing the remarkable career shifts possible within the realm of healthcare.
Listen as Hector reflects on his experiences at the University of Florida, where the camaraderie and support from both peers and faculty became a cornerstone of his professional development. His anecdotes reveal the vital role of mentorship and friendships formed during PA school, illustrating the journey from students to lifelong colleagues. We explore how these relationships foster resilience and competence, shaping not just knowledgeable practitioners but compassionate caregivers as well.
Whether it's providing urgent care at a patient's home or embracing non-traditional roles like working with disaster medical teams, Hector's career exemplifies the dynamic opportunities available to PAs. We delve into the nuances of the PA's role across various medical fields, highlighting the importance of understanding practice-specific responsibilities. Join us for this engaging episode that celebrates the collaborative essence of healthcare and the impact of personalized, compassionate care. Hector's story is a testament to the profound fulfillment found in helping others, whether you're in the air or on the ground.
Virtual shadowing is an important tool to use when planning your medical career. At Shadow Me Next! we want to provide you with the resources you need to find your role in healthcare and secure your place in medicine.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-health 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.
(00:43):
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
Me Next, where we will reviewhighlights from this
conversation and where I'll giveyou sneak previews of our
upcoming guests.
And where I'll give you sneakpreviews of our upcoming guests.
(01:05):
This is episode 10 of Shadow MeNext and we have the pleasure of
speaking with Hector Bird, aphysician assistant with a
varied background in acute,urgent and emergent care.
Hector's journey started inaviation, where he earned a
degree in aviation science andworked as a pilot.
However, driven by a passionfor direct patient care and
(01:26):
meaningful contributions, hetransitioned to healthcare,
ultimately becoming a PA.
Hector shares his formativeexperiences as a volunteer EMT
and the support system within PAschool that helped him succeed.
He gives incredible insightinto his current role in
providing in-home urgent medicalcare, emphasizing the
(01:47):
difference it makes for patientswith mobility issues and
chronic conditions.
His insights into team-basedemergency medicine, patient care
at home and the continuouspursuit of learning make this
episode a must-listen foraspiring medical professionals.
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
(02:09):
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
employer or company.
Hi Hector, thank you so muchfor joining me on Shadowing Next
(02:30):
today.
Speaker 2 (02:30):
It's an absolute pleasure to be here and to
contribute to this wonderfulproject.
Speaker 1 (02:35):
So you know it's crazy, hector and I were in PA
school together 10 years ago 10years.
It's been a long time and it'sso good to see you, it's so good
to talk to you.
We did catch up a little bitbefore we dove into the
interview, so Hector's doingamazing things and I'm so
excited to share your storytoday.
Speaker 2 (02:54):
You're so kind, you're so kind, thank you.
Speaker 1 (02:56):
What initially drew you to wanting to be a PA.
Speaker 2 (03:00):
Well, I always liked medicine.
Medicine was always somethingthat I was attracted to, but for
whatever reason, I knew I didnot want to be a doctor or go to
medical school.
I have a big passion foraviation.
I went to undergrad to be apilot I have a bachelor's degree
in aviation science and didthat for a few years but quickly
(03:21):
realized that one the lifestyle, the airline lifestyle
especially.
This was, you know, 2005,.
2010 range was really rough.
The airlines were not doing aswell as they are now.
Pay wasn't great.
It was just a lot to handle andto think about continuing to do
that for at that point almost40 years with a family.
It was a lot.
(03:42):
So I started doing some soulsearching and, at the end of the
day, I really just wanted to dosomething that I felt would be
more meaningful and contributeto people in a direct way.
I had a great career inaviation.
I flew in Alaska.
We literally flew people'sgroceries to them and stuff like
that.
It wasn't like I wasn'tcontributing, but I just felt
driven to do more.
(04:03):
And one night I was a volunteerEMT and one of the lieutenants.
I knew he was a PA.
I had no clue what that was andI started talking to him and I
asked him some medical questions.
I was really impressed at howmuch he knew and I said you know
, so tell me about this PA thing.
And he started telling me aboutit and I was just like, wow,
that's what I want to do, likethat's perfect.
It met medicine, it met thegoal of learning and continuous
(04:28):
education and improvement and itallowed me to do more for
people.
So that's where it started.
And then I went back to schooland had to take a whole bunch of
science classes that I hadsuccessfully avoided in
undergrad.
Lo and behold, three yearslater I started PA school.
It's been a fun and veryinteresting road, but, yeah,
it's been everything that Ithought it would be and more.
Speaker 1 (04:48):
The profession is so lucky to have you too, hector.
I can't imagine the amazingthings that you're doing, so
tell me a little bit about beinga volunteer EMT.
Is that the way that youreceived?
Speaker 2 (04:59):
your patient contact hours.
So I will say that that was oneway.
Some of the programs want youto have paid patient contact
hours.
So it was kind of, in some ofthe applications, kind of the
cherry on top, but it was a goodchunk of my time.
Using the connections and thenetwork that I had built from
the volunteer EMS agency, I wasable to start getting to know
(05:20):
the medical community.
This was in Denver, colorado,where it was good to work and
that sort of thing startedapplying for jobs.
My paid experience was as anemergency room technician or
critical care technician,depending on the hospital I
worked at, basically doing whata needy tech does, and that was
a lot of fun.
I was a tech at a level onetrauma center in Colorado and
(05:41):
Denver and it's probably themost fun I've ever had in a job.
Not that what I do now isn'tfun, but I got to do some really
cool things and not have anyresponsibility at the same time.
I have a lot of very goodmemories from that experience.
Speaker 1 (05:53):
That's fantastic.
You know, I think a lot ofpeople think about their when
they're receiving those contacthours as almost as being a means
to an end.
And that's a conversation Ihave with a lot of students that
come through our office, thathave graduated college and, you
know, are looking towards thatnext goal, and occasionally I do
ask them to pause and realizethat where they're at right now
(06:17):
is a part of their medicaltraining.
And I think, working as an EDtech you, I mean you see so much
, so I'm sure it was a littlebit easier for you to realize
and for you to remember than youknow perhaps someone working in
a smaller clinic or a clinicwhere you don't see the vast
number of disease processes andyou don't have access to the
(06:38):
vast number of tests and all ofthose things that you do in the
ED.
So you know when you're gettingthose hours that's part of your
training and you know you can't, really you can't look past it.
So, speaking of training, hector, pa schools are different All
the PA schools.
They do have core classes, butsometimes the way those are
presented are very different.
(06:58):
Generally speaking, yourexperience in PA school was it
good, was it bad?
What did you think?
Speaker 2 (07:06):
I loved it actually.
I mean I loved it because whatI remember is the camaraderie.
I remember the people I went toschool with.
I remember just that overallexperience.
Was it hard?
Absolutely.
Was it tiring?
Yes, but what I remember reallyis there's very few things in
life and very few experiencesthat you can have as a person
(07:27):
where you're with a group ofpeople and you're all working
towards one goal.
And I was very blessed to go toUniversity of Florida the
atmosphere and the culture there.
Really it wasn't about competingagainst each other, it was
about pushing each other along.
Really, we had to push eachother along at times, but that's
what I remember, you know.
And then, of course, all thestuff that I learned was kind of
(07:48):
I remember.
It still happens where thingsjust pop into my head that I
don't know where that came fromand it's something that I took
in a class almost 10 years agonow.
So, yeah, I loved it because Ilove the people that I went to
school with.
It really was a positiveexperience and, of course, you
always remember the good things,right?
I think one of your guests saidit as well but it really is the
(08:11):
best two years of your lifethat you don't want to repeat.
Speaker 1 (08:15):
It's so true.
You know it's funny when we allstart saying the same things
and you realize that.
You know we all had verysimilar experiences.
I believe that person also wentto the University of Florida
for PA school too, so it doesmake a little bit of sense.
But the camaraderie isfantastic because it's not, it's
not soft camaraderie, it's,it's not.
(08:35):
They are, they're sharpeningyou and they're pushing you, but
it is 100% supportive and, youknow, not just between each
other.
I felt that and I wonder if youdid too, with the faculty as
well.
You know, I remember failing atest and it I was, it was, it
does happen, I can attest to it,and it was a part of medicine
(08:58):
that I just.
It was miserably boring to me,I was not interested, but there
was also a lot going on in mylife and I was so grateful to my
mentor, who's also a professorof the program, a practicing PA,
who just stopped and took timeto sit down and really make sure
that I was okay first and thento make sure that I understood
(09:19):
the material.
And that doesn't mean that Isat the test again.
We just sat there and wereviewed it and we talked
through it and he said I feellike I missed two questions to
pass.
But he said you missed this.
Do you understand this process?
Explain it to me.
It was a test that we will soonexperience in second year on
rotations.
Right, you don't sit down everyday.
You walk into clinic secondyear and take tests like that.
(09:41):
No, you have a preceptor or alead PA, medical doctor,
resident, whatever start askingyou questions on rotation.
You have to explain it verbally.
So you know it was that was fun.
Speaker 2 (09:53):
I laughed because we all have that memory.
We always remember that moment.
Speaker 1 (09:57):
Yeah, and we're not fondly either, but but you know
it's, it's all learning and yourealize that every experience,
whether it's good or bad,hopefully is contributing to
learning.
Speaker 2 (10:06):
Yeah, and I would say that, yes, I completely agree
that that was one of the mostimportant things to me when I
was in PA, when I was looking atPA programs and in PA school is
just that support, because youknow something I tell people
that are considering going to PAschool and are looking at PA
programs is you know, thequestion you want to ask, or one
(10:26):
of the questions obviously youwant to ask, is what happens to
a student when they fail?
Right, because it is anincredibly rigorous program and
it doesn't mean you're a bad PAor that you're never going to
practice medicine or anything.
You didn't get this uber complextopic that you just learned two
weeks ago and it's important toknow what the plan is, because
this goes for any programnursing, nurse, practitioner,
(10:49):
any sort of professional programthat you really want to make
sure that their goal is to makeyou a good practitioner of
medicine, a good clinician orwhatever, and not take your
money and kick you out.
You know, one of the things thatI think we were blessed with
was a program that really wentout of their way to give you all
(11:09):
the tools so that you couldpass.
So if you notice how I saidthey were giving you everything
so that you could get through it.
But they were there to supportyou.
They weren't there to.
They're there to help and makeit so that at the end of the day
, you would pass the pants andbe a successful PA and be you
know, be able to go out andpractice and not just take your
(11:30):
money and say, okay, went to PAschool, but but that is.
I think we were really, reallyblessed there and, you know, it
sounds like both of us still arein contact with many of our
professors and I think that's acommon thing that you'll find
across the country to becomeyour friends.
Speaker 1 (11:45):
They become your colleagues, and then they become
your friends.
It's amazing.
You cannot talk to some of themfor six or seven, eight, nine,
10 years, and then, all of asudden, you drop them a line,
whether it's a call or an emailor a text message and I think,
honestly, you know, I'd love tohave one of them on the show one
day, but I think they willprobably tell you that is.
that is the highlight, you know,10 years from now, to have one
(12:05):
of the students that you workedwith giving you a call.
So you know, I'm so glad thatyou felt you felt so supported
in PA school by your peers andyour colleagues.
Let's transition a little bitinto actual PA practice.
So you've worked in a number ofdifferent arenas urgent care
and emergency medicine, internalmedicine.
How do you feel PAs aresupported generally speaking?
(12:27):
Are we well-respected in thosefields?
Is it something that you'veseen?
Follow you from school?
Is it something that you'veseen?
Speaker 2 (12:34):
follow you from school.
I would say that at a highlevel.
Yes, you know, when you'relooking at, if you were to stop
a random nurse or physician,they're all going to say, yes,
they like their PAs.
That's sort of a thing.
I guess it depends on how youdefine respect.
Where the rubber meets, theroad is like what can you do?
(13:07):
Right, what you're allowed todo, because in some places you
are kind of looked at as aphysician assistant.
Right, they're supposed to behelping do your PA things, which
isn't to negate either of us,it's just we have our areas of
expertise, the things that wecan do.
Well, you made a great examplein your practice where the
physician does the Mohs surgeryand you do the closures.
That was actually kind of myexperience in emergency medicine
(13:29):
.
I did a lot of the suturing.
I did a lot of the woundrepairs because you know what
it's a technical skill.
It's something that you know.
It takes practice but at thesame time, does it need a
physician to do that?
No, they probably can go handleother things and a lot of them
have been handling those thingsfor 20 years and they're not as
great at being a suturing.
But I'll be honest, you know,if I'm having to go in and have
(13:50):
a crashing septic patient andhave to manage all of that,
that's I mean, it's something Ican do and I could probably
fumble through it, but it's notsomething.
I've done a lot.
I work with some amazingphysicians.
That that was a Monday, thatwas just what they did, you know
, and they were exceptional atthat.
And honestly, they should bedoing that, you know, and not
sitting there suturing upwhatever wound walked in the
(14:11):
front door.
That's not, you know.
That might take an hour to makeit look good, especially in the
face, right, but that time isprobably best spent doing
something else.
So, to better answer thequestion, I would say it really
depends.
At the end of the day, Iwouldn't say that people are
talked down to as much.
Thankfully, here in the US We'vebeen around for a very long
time and I think we've builtthat respect on the shoulders of
(14:32):
those that became ahead of us.
I think we've all met thosecolleagues that have been around
for 30 and 40 years.
They're the ones that reallybuilt that level of respect.
Now it's our job to continue it.
But there's some areas, somehospitals I worked at.
They weren't as comfortableallowing PAs to do certain
things, and then many of mypractices, including my current
one.
There's obviously a limit towhat you can actually physically
(14:54):
do in whatever the setting is,you know, equipment wise or
whatever is safe to do, but theywere very open to allowing me
to do whatever I was comfortableand trained to do, which is
pretty cool so, but I've neverreally felt like I've been
talked down to or somebody saidI'm not your PA.
You know they didn't want tosee me.
I think it was.
You know, if anybody ever didthat, I probably don't even
(15:15):
remember it because I said, okay, the doctor can see you and
that's their right, and,selfishly, that was one less
patient I had to see.
Speaker 1 (15:22):
Exactly, exactly, no, and you know, hector, thank you
for being so honest about that,because I think that so often
people will hear stories from,let's say, from an ER PA, and
they will think that that is theexperience of every single ERPA
or derm PA, which is what I am,and and they'll think that, you
know, if I work for adermatologist, I am going to
(15:43):
have the opportunity to close 10most surgeries a day.
Well, no, that's not true, causenot every dermatologist does
most surgery, you know, or theymight employ their PAs
differently, they might havetheir PA seeing people in
clinics and so on and so forth.
So I'm so glad that youhighlighted the fact that it's
different, and sometimes it'scomfortably different and
(16:04):
sometimes it's uncomfortablydifferent, and I think that
these are questions that arefantastic to ask for new grads
entering the workforce orperhaps for people switching
jobs.
These are great questions toask.
You know, tell me about whatyour PA does in clinic, because
it might not be the sameexperience that you had
(16:26):
previously and that was a reallygood lesson and I'm really glad
that you brought that up and Iam so glad, of course, that
you've had really good support.
Working in emergency medicineand that was actually one of my
questions was does it feel morelike solo practice or does it
feel more collaborative?
There's no shortage of varietyin emergency medicine.
Speaker 2 (16:45):
I've worked in emergency departments where
there wasn't a policy.
You know there wasn't like arule Okay, these patients you
have to talk to and these youdon't when I started, actually
it was, you know have to talk to, and these you don't when I
started, actually it was.
You know these patients youknow you can do on your own
these patients you have to.
You know staff, meaning youtalk to the attending and then
these patients have to be seenby the attending physician and
(17:06):
it was very protocolized.
So it, like you said, itdepends, but honestly it's
always, especially in emergencymedicine.
You know, in my opinion youshould have the ability to reach
out to somebody else.
Medicine is a team sport and youknow there are PAs out there
that are working solo in an ERin a rural area, but they have
(17:26):
some sort of backup or they canget on the phone and get you
know their on-call traumasurgeon, critical care doc,
whatever in another hospital.
So there's different levels ofwhat you can and should be doing
in those situations and it'sall based on your training and
experience.
But medicine's a team sport.
So anybody that says that youknow that you are going to do
everything by yourself, oranybody that says that they do
(17:47):
everything by themselves isdriving themselves crazy,
because it's.
You can't know everything aboutthe human body and you can't be
an expert at everything.
I love being a generalist, butat the same time it's impossible
to know everything abouteverything.
Speaker 1 (18:01):
It's true it's true.
And again it's support fromyour colleagues, just like we
talked about in school.
If there's nobody there kind ofpushing you, driving you, then
perhaps that blade is notgetting sharpened like we would
like for it to be.
So, no, I think that's great.
Hector, tell me about whereyou're at right now.
Speaker 2 (18:20):
Let's talk about your current job.
It's so interesting.
So currently I work for acompany.
Their name is Dispatch Health,so we do urgent in-home medical
care.
This is what we do on aday-to-day basis, and then the
other half of the job that we dotransition transitional care,
so people coming out of thehospital or out of the ER to
home, and our goal is tobasically keep people at home.
(18:41):
The slogan is to stay healthyat home.
We really try to serve thepatients that can be seen safely
at home, and that's actually apretty wide spectrum of people
everything from lacerations toCOPD and asthma exacerbations,
chf exacerbations so you knowpeople that are having trouble
breathing, people that are fluidoverloaded because their
heart's failing a little bit butare not at the point where they
need to have everything at thehospital.
(19:03):
Then when they leave, the otherhalf of what we do, at least on
the acute care side that I workin, is making sure that they
have everything they need tostay at home.
So you know all the referralsmake sure they understand their
medicines, make any adjustmentsif someone is not completely
recovered from their condition,if we need to make a small
adjustment or coordinate backwith the physicians in the
(19:23):
hospital or with their PCP andreally prevent them from
bouncing back to prevent theunnecessary readmission, and
we're pretty successful at that.
Actually, there's some goodnumbers floating around there.
So those are the two halves ofwhat I do.
The company also does hospitalat home admissions in some areas
not here locally where I work,but they also do that as well.
What I do for them.
(19:44):
I started as a line APP, soworking in the field, and then a
few months ago I started as oneof the national APP educators
for the company as a whole.
Speaker 1 (19:53):
Which I cannot wait to talk to you about.
This is such a unique position,and it's something that you
really have to be a fantasticAPP in order to do this.
So well done, well done, which,of course, you're perfect for
the role, so I cannot wait totalk to you more about that.
So tell me about the patientsthat you serve.
(20:16):
Are these patients withmobility issues?
Are these patients that justprefer to stay home instead of
going into the hospital setting?
How does that work?
Speaker 2 (20:23):
So most of the patients that I see a lot of
them have some sort of a reasonthey can't make it to their
doctor or the hospital, whetherit's transportation.
A lot of them are bedbound.
A lot of them have mobilityissues.
The nice thing about it, though, is that anybody can access the
service, so anybody can call.
We do get patients that justaren't feeling well, and, as we
all know, the last thing youwant to do when you're sick with
(20:45):
the flu is drag yourself in acar and go to a nursing care and
then sit in the waiting roomwith everybody else coughing,
with God knows what is in thewaiting room floating around.
So we do have I do see thosepatients, you know, but a lot of
them are patients.
The majority of our patientsthat you know live with their
family, and they're not verymobile, and it's hard to get
them out of the house, you know,for whatever reason.
(21:06):
So that's a very that'ssomething that I really enjoy.
We're bringing them, you know,able to care for people that
otherwise would either fallthrough the cracks or would be
unable to seek care in a timelyfashion, and oftentimes just
wait until they get so sick theyhave to call an ambulance and
end up in the hospital when allthey needed was some steroids.
(21:27):
Something as simple as aprescription of steroids would
have saved them a week and ahalf in the hospital.
So it's I really, really enjoythat part of the job.
Speaker 1 (21:37):
Well it's.
You know you're serving acommunity that could be
considered marginalized.
You know transportation issues.
In the first episode I talkabout challenges that we all
face in healthcare andtransportation issues,
regardless of whether it'sbecause of your physique or a
disability, or maybe you don'thave a reliable vehicle.
Transportation issues is a hugething, and the fact that you're
(21:59):
able to still serve thesepatients is incredible.
It really is, I'm sure, to beable to step into these people's
homes and offer your expertisein a place where they're also
still really comfortable.
What does a typical day looklike for you on the days that
you're working clinically?
Speaker 2 (22:15):
Yeah, we work a shift , you know, kind of similar to
working in an urgent care in ER.
You show up at a certain timeand then we have our patient
assignments.
We really only know the firstpatient we're going to.
Once we get there we can seethe next one.
But that is dynamic as peoplecall in and someone cancels, and
that's always in flux.
We get to our office, gather ourequipment I work with a
(22:38):
technician and they are kind oflike between an EMT and an MA.
Most of them are either EMTs orMAs.
It's actually a greatopportunity for patient contact
hours because you're workingone-to-one with an NP or a PA.
We then load our vehicle.
We have an SUV.
We don't transport patients, wedon't take anybody to the
hospital, we're not in thatbusiness and then we drive to
our first patient's house Alongthe way.
(22:59):
I have access to internet so Ican start my chart or I can look
up patient information fromvarious sources and get prepared
for the visit.
And then we get on scene whereit's just like a patient visit.
We check them in, we get vitals, we get a history, I verify all
their information, medicationsmore hands-on than what I would
(23:20):
normally do in emergency roomand urgent care.
Normally you're going to have anurse or an MA that's going to
do a lot of that work, butbecause we're kind of both of us
working at the same time withone patient the technician might
be getting vital signs.
I might be verifying history,they check them in.
The technician might be gettingvital signs.
I might be verifying history,they check them in.
They get the administrativethings going and then a typical
visit's 30 minutes-ish 30 to 40minutes and, depending on how
(23:47):
busy the market is, anywherefrom.
I mean, it really depends Ifit's a bad weather day and
nobody wants us to come, it'stwo to four patients and maybe
I've seen as many as eight to 10, which is a lot.
When you're driving around I'veseen more than that, but that's
usually when you see like anentire family and they all have
COVID and they all want to betested and treated.
And you get like the four, youknow four people in a house and
it makes your numbers look great.
You know, it's like wow, sawall these patients.
(24:07):
Today I saw 12 patients and Iwas so fast and it's like, yeah,
no, you saw, you went to sixpeople's houses and saw, you
know, it's the entire family inone.
But yeah, it's pretty much it,you know, and we will do
everything, like I said, flutesting and everything you can
imagine in urgent care.
We do carry an ISTAT so we cando some lab blood labs.
You know I did mention it is alittle more hands-on, so between
(24:29):
me and the technician, we willput IVs in, we'll draw labs,
we'll run the tests.
I have to interpret all thetests because I'm the licensed
practitioner, so you know I lookat the COVID test and say, okay
, yes, it's positive or negativeEKG.
We carry medications, someantibiotics, steroids, a whole
slew of things, but basicallyenough to kind of care for the
stuff again that's safe to takecare of at home and ensure the
(24:53):
patient is.
And then we write prescriptionsand diagnose, treat the whole
nine yards and do that a fewtimes and then at the end of the
shift we drive back to theoffice, clean up and go home.
It's an urgent care emergencyroom type situation when you
look at the job on wheels.
Speaker 1 (25:07):
What happens, or has anything like this happened,
where you arrive and you realize, oh, this is not something we
need to be taking care of athome?
What's the next step?
Speaker 2 (25:18):
My goal is to make sure that the patient's safe,
and we always do the right thingfor the patient, whether that's
treat them or escalate them iswhat we call it.
I did actually a fair amount oftimes I've had to call 911 and
escalate people.
Very rarely has it been thatstereotypical.
A lot of times it's just youknow, you come in, you make your
assessment and the patient'ssick and you're just like look,
(25:38):
you're very sick.
This is beyond what I can dohere at home.
And the flip side of it is, youknow, patients have their
autonomy, they can make thedecision they want.
And we do see a population ofpeople that a lot of times are
very tired of going to thehospital.
In this situation Someone saysI don't want to go to the
hospital.
Then, of course, you know I'mgoing to take care of them as
best I can, telling them youknow, hey, I'm limited to what I
can do, but I'm going to doeverything I can.
(25:59):
Generally, we'll come back thenext day or in two days,
whatever works out for them, tocheck on them and make sure
they're getting better.
If this X, y and Z happens, youcan go to the hospital and go.
Look like this is not going toend well.
I kind of give them that ideaLike this is heading in a
direction that this could takeyour life.
And what do you want to do?
Like, what are your goals here?
(26:20):
A lot of them they just want tostay home.
I've referred a fair number ofpeople to hospice.
Whether or not they stay onhospice or they get better and
come off, that can happen andthat does happen.
But you know if I've been insome situations where people are
just like you know what, I justgot out of the hospital last
week and I am tired of it and Idon't want to go back and I go
okay.
So what can I do for you today?
And then, what are your goals?
(26:40):
And if they're okay with hospice, a lot of times hospice service
can bring a lot into the hometo keep them comfortable, in the
sense of they need more oxygenor they need their palliative
interventions.
They can do that really well,because I don't want anybody
suffering.
I don't want anybody to sitthere at home and suffer, and a
lot of times it's also about thefamily.
The family gets overwhelmed andthen they want to take them to
the hospital and at the end ofthe day.
(27:02):
I want the patient, if theywant to stay home, I want them
to be comfortable, I want themto do well, I want the family to
be supported and I want it tobe a good experience, as best we
can, because honestly I hate tosay it but passing away you
know that that's what theirwishes are.
I'll do it.
And now, if they want to go tothe hospital, obviously I'm
(27:23):
getting them to the hospital orhaving the family take them, or
whatever's appropriate.
Speaker 1 (27:27):
Sure, I'm so glad you brought that up because it is.
It's something that I fearpatients really worry about is
if their wishes are going to beunderstood and heard.
And you know, thankfully in ourclinic we don't see very many
actual emergencies, butinevitably if you see 120
(27:50):
patients in your clinic,somebody is going to walk in
with chest pain and it's not aterm thing, but they're going to
start talking about how theycan't breathe.
And it's something that youmentioned and nobody wants to go
to the hospital and not any ofmy patients at least.
When I tell them hey, I thinkthat your foot isn't in fact
just swollen.
I think you have a deep veinthrombosis, I think you have a
(28:11):
blood clot in your leg.
You're going to the hospitaland then it's never an argument.
I would like to call it aconversation.
Speaker 2 (28:18):
Absolutely.
Speaker 1 (28:19):
Sometimes it might feel like an argument and it's
you provide patient educationand then you have to listen, and
I think that is something thatwe as providers need to remember
is we can't just be spittingeducation at people in that role
(28:44):
to where you can offer thesupport, and then you also are
aware of some alternativeoptions for them, such as
hospice, which is end of lifecare and a fantastic option for
some of these people that havesuffered with chronic diseases
and chronic illnesses.
So I'm really glad youmentioned all of that.
Generally speaking, how dopatients typically respond to
receiving care in their ownhomes?
Speaker 2 (29:00):
No, they love it.
They love it.
That's one of my favoritethings is they appreciate us and
I mean, even in the situationswhere I feel like I did nothing,
they're just happy that I came.
I feel like, if they've calledme and I want to serve them, I
want to do things for them and alot of times there's not a lot
that you should do, there's alot that I can do, but it
(29:23):
probably would hurt them orcause bad side effects, but just
the simple fact of givingreassurance and that's something
that I always have to remindmyself.
You know, our job often iseducation, but a lot of times
it's reassurance that's oftenthe best thing that we can do
and the only thing we can do butjust say, hey, you're okay,
you're going to be okay.
Do X, y and Z, you know, takesome Tylenol water, you know.
All these little minor things,they work, they help giving them
(29:45):
that reassurance.
And then also, just, you know,telling them, hey, if things get
worse, call us back, we're here, you know.
And that can be in any setting.
It doesn't have to be in thistype of setting, this mobile
setting, it's more.
Even when I was working in theclinic, I just told them you
know, get any worse.
I want to hear from you.
Just, you know, opening thatdoor for them it means a lot and
then if we have to do somethingelse we'll do something else.
(30:06):
You know, we kind of figure itout from there.
But our patients when I get tosee them, they're very high
satisfaction rates.
Speaker 1 (30:15):
That's great, I would imagine getting to welcome it's
a house, call Hector.
I mean, that's what it is, it'sa house call and it is the
greatest house call of all timeand I think it's a fantastic
option.
I can think of a lot of peoplein my life and on my schedule
that would really benefit fromthat.
I wish it was something we cando.
We've discussed it.
We've discussed having dayswhere we can go and visit
(30:37):
patients remotely, whether theyare living at home or an
assisted living facility,something like that.
Speaker 2 (30:43):
It's care that you want to give right and I'll say
it's a lot of fun too.
You know, it's fun to go meetthese people and see them, see
where they live and kind of getto know them a little bit.
It's just, it's a.
It's a great experience overall.
Speaker 1 (30:56):
I'm so glad.
So, hector, let's pivot alittle bit, because I think you
have some pretty wonderfulthings to talk about outside of
working as a clinical PA.
What else can PAs do outside ofjust working in clinic?
I think you have a couple ofopportunities that you can share
with us.
Speaker 2 (31:10):
So I've well, I currently work as an educator, I
will say one of the some of themost.
There's some fun, weird jobsout there that PAs can do.
I think was it the medicalexaminer's office in New York
City has PAs working for them.
You can be an ME.
There's actually one of, Ibelieve one of our preceptors
(31:31):
actually works for the StateDepartment now in Southeast Asia
as a health officer for one ofthe embassies, one of our
embassies.
So they get hired there at theFBI.
I mean, I, you know, I live inthe capital region, so there's
lots of those kinds of jobs.
But the FBI, the military, Imean there's all kinds of very
(31:53):
interesting jobs out there thatPAs can do.
You know, for a while Iactually considered I wasn't
able to, for various reasons.
But the disaster medicalassistance teams throughout the
country do hire PAs to covertheir.
Basically they do pop-uphospitals.
It's a big deal and you know usliving in Florida, we're
familiar with those thingscalled hurricanes and when a
(32:15):
hurricane comes into an area andknocks out a hospital, they can
show up and set up a hospital,and each state has a few teams.
They do hire PAs into thoseteams as well.
So, yeah, so many cool thingsyou can do.
I know one PA down in SouthFlorida that I've read I don't
know if she's still doing it butshe critical care PA that
actually does flight medicine,meaning she goes fly as places
(32:36):
and then brings people back as aflight PA.
So there's, yeah, there's anorgan retrieval PA in New York.
I think, yeah, so you can.
Then the other people made thejob for themselves, like they
got into a position, and thenthey're like hey, can I do that?
And nobody said no, that'sright.
Speaker 1 (32:50):
You just keep asking and you keep knocking.
I think it's always so fun totalk to people about, especially
PAs who have either branchedout of traditional clinical
practice, which I would say isexactly what you're doing right
now, or perhaps PAs that areworking in politics now, or PAs
that are now working ineducation, which is one that is
so common.
If clinical practice isn't yourthing, there are other options,
(33:13):
although I don't know manypeople that chose other options
because clinical practice wasn'ttheir thing.
It was more.
Just, they're looking toaugment, they're looking to
improve, and a lot of timesthey're just asked into those
leadership positions and theyfind themselves there.
So I think that's incredible.
Hector, you know about asegment on our show called
(33:35):
quality questions.
This is one of my favoriteparts.
Do you have a quality questionfor us?
Before we hear what Hector'squality question is, keep in
mind that there's more interviewprep, such as mock interviews
and personal statement reviewover on shadowmenextcom.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Speaker 2 (33:57):
I remember sitting through the interviews and
getting the normal questions andhaving conversations and it was
all great.
And then at the end of thisparticular interview, the
interviewer goes so what are yougoing to do when all the
students that you teach as a PAbecome doctors and they are now
your boss?
And that was a tough one, butit is a reality.
(34:18):
I mean it wasn't like thisperson was being mean, it was
just like that is a truth as aPA and this can be in any
profession really.
I mean, you could be afirefighter and you're teaching
that rookie and then 10, 15years later he's now the chief
of the department.
You know, it's just everybodytakes different roads and you
know what.
I remember answering it kind ofpaused.
(34:39):
I was just like, wow, okay,this is a tough one and I
basically said you know, I wouldhope that, you know, I did a
good job teaching them that wehad, you know, mutual respect
and that I would continue to aimand strive to have that mutual
respect.
Obviously, people you know Iwon't call it rank, but you know
, obviously people move up indifferent positions even as PAs,
(35:00):
that happens and have to be aphysician.
I know many PAs went on to belead PAs or even higher director
level in different companies.
At the end of the day, it'sabout just keeping that mutual
respect and those open lines ofcommunication, and you can only
control how you react in thosesituations and hope that they
react the same way.
I can only control me Ifsomeone doesn't react in a
(35:22):
certain way.
This can be a patient, acolleague, whatever responding
in a respectful fashion and, forlack of a better term, loving
way is always the better roadright.
So that's more or less how Ianswered it and things
apparently went well.
Speaker 1 (35:37):
Got in.
Oh that's so great.
Yeah, it takes me back to whenwe were talking about the
professors at PA school.
Right, it's possible that theyare going to become patients of
some of the PAs that they'vetrained.
You know, if they stay in townlong enough and at the PA stand,
so kind of a similar thing.
You know you expect to see someof these students that you're
(36:01):
training, because I'm sureyou've trained nursing students
and PA students and MD studentsat all at your positions, at
least in the hospital.
We hope that these people aregoing to take care of us one day
and you know, that's kind ofwhy I laugh.
It's part of the reason Istarted the podcast was for the
next generation of pre-healthstudents and I want them to
realize.
I want the next generation ofpre-health students to realize
(36:23):
that there is still so muchhumanity in healthcare and when
you and I are old in five yearsor 10 years or 20 years and we
start needing care, I want tomake sure that humanity, that
element, stays in it Absolutely.
And you know those are thepeople that I hope are attracted
to medicine, not just becauseof the paycheck, which is
(36:46):
fabulous, and not just becauseof the quality of life, which
can be fabulous, but alsobecause you want to help.
You know, and I think it's sucha simple thought, but I think a
lot of times we forget about it.
And, of course, when you throwin insurance and all the
problems with burnout and all ofthat, like, the wanting to help
element is still there.
(37:06):
It just sometimes gets buried.
So it's fun to highlight that.
What an interview question.
That's one that kind of makesyou squirm, doesn't it?
Speaker 2 (37:14):
But you know, when you get those kinds of questions
, it's okay to pause and thinkabout it.
You don't have to just spit outan answer.
You can even acknowledge that'sa very good question.
Yes, sir ma'am, I've notthought of that.
But give me a moment and get asbest of an answer as you can
together.
But it's going to happen ininterviews and I don't think
people are trying to get you.
(37:36):
At least in most situations, Ithink they might think, hey,
this is a very interestingquestion.
I'm just going to ask everybody.
Today I've been an interviewerand sometimes you're just kind
of like today I'm going to askpeople and you get reactions
from people and you almost feelbad.
You're like, oh, that wasn'tmeant that, seriously, you know.
So you got to remember thatthey're.
You know, at the end of the daythey're all medical.
(37:59):
Usually, if you're in a medicalprogram, an interview, they're
medical professionals and, yeah,it's formal.
Yeah, you have to.
You know you're going throughthe process, but a lot of times
they're just trying to have aconversation in the 5, 10, 20
minutes that you awkwardly havetogether.
Speaker 1 (38:11):
I think that's a great point, hector.
It's a conversation, it is aninterview, but if you think
about it as a conversation, Ibet you it makes it a lot easier
.
Speaker 2 (38:21):
Yep, yep.
No, that's what I would, what Itold you know people,
especially the PA programs thatI interviewed at that I'm very
familiar with.
I said look, at the end of theday it's another PA.
They've got a ton of experience.
They're obviously there becausethey love students, they love
the program, they love PAeducation and they just want to
have a conversation and look atit that way and ask them the
(38:41):
questions that you want to knowfrom someone that's been doing
you know whatever crazyspecialty that person told you
they're doing for 20 years.
That could be you in 20 years,right?
So what would you want to knowfrom that person?
You don't even have to ask themthe normal.
Oh.
So what do you like about theprogram type questions?
Those types of questions aregreat and sometimes you can get
a good answer that you mightwant to know about.
(39:06):
But you can ask them questionsabout their practice, about why
they became a PA, the samequestions they're asking you.
It's okay.
That may actually give you amore useful answer as to the
type of program that you'relooking at, as to how they teach
and how they interact withstudents or not interact in some
situations.
Maybe they don't give you agood answer.
That gave you an answer, rightit is.
Also, you're interviewing themas much as you really want to be
in PA school.
The goal is to become a PA,right, but you want to try to
find a place that you're goingto enjoy being for two years or
(39:28):
three years in some cases, andit's a big chunk of your life.
So hopefully it's a place whereyou want to invest that time
and, yeah, part of the job ofthat interview is for you to
find that out.
Speaker 1 (39:39):
Looking back on it, 10 years.
We've done this for 10 years.
My husband will always say,ashley, do you think this is a
good idea?
And I'll say, well, I don'tknow, honey, ask me in 10 years,
was it a good idea?
So I guess the question.
You know it's been 10 years.
You have explored a number ofareas of what a PA can do and
how a PA can be employed.
Was this a good career choice?
Speaker 2 (40:02):
Absolutely.
It's been everything that I waslooking for.
As I alluded to earlier, Iserve people.
I've gone from one interesting,amazing job to another.
You know, I've always been kindof looking, trying to see where
I wanted to go next, and a lotof times things just presented
themselves to me.
Colleagues would just kind ofgo hey, have you heard of this?
And then, you know, in the caseof one of my jobs, I literally
(40:24):
just got cold called because mymom was bragging.
Oh, I love my parents and I'msure they'll listen to this, but
no, seriously, they they're,yeah, they.
My mom kind of just threw outthere hey, if you need a PA, and
they're like, well, actually,so you never know.
Speaker 1 (40:42):
Good job, PA.
Speaker 2 (40:43):
And they're like well , actually, so you never know,
yeah, I mean things presentyourself, but it's been one heck
of an adventure.
That's the way I kind of try tolook at it.
And yeah, there've been ups anddowns and crazy moments and,
just you know, I've had lows,just incredible lows, working,
some places that I knew I neededto get out of, but the great
majority of them have beenplaces that I absolutely loved
and learned and enjoyed forvarious reasons.
(41:06):
It's been awesome and I'm notdone yet.
I mean, this is only 10 yearsin.
Age is a mindset.
Speaker 1 (41:12):
Well, just wrapping up, Hector, what would you tell
a pre-health student that thinksthey want to go into medicine?
Speaker 2 (41:19):
Well, the first thing that comes to mind, if I was
talking to someone that waslooking at healthcare as a
career, wherever they wanted togo, you need to ask yourself why
right?
Why you're doing it?
Because I do feel that thereare some people that get into
many professions that do it forexternal reasons, whether it's
they're pressured into it, theirfamily that's what everybody in
(41:40):
their family does.
A common one is money.
Hey, what's a job that's goingto pay me well?
And really ask yourself, why amI doing this?
Because you want to make surethat there's something that's
driving you internally to getthrough all of those tough spots
, especially healthcare, itdoesn't matter paramedic,
nursing, nurse, practitioner, pa, doctor.
It's a long road, it's a slog.
(42:00):
There are moments where you aregoing to be crying on your
textbooks and it happens, andyou're just going to I mean,
it's not that you know?
I think we've all had thatmoment where you're just so
overwhelmed and then you justremind yourself that people have
been doing this for at leastfor the PA profession 40 to 50
years, and they've somehowgraduated and you will too, and
(42:21):
they all got through it.
So you're going to get throughit and to get through those
moments because there'ssomething beyond you that's
taking you there.
You know, for me it was thatdrive to do more for others, to
serve others, and if you don'thave that internal drive
whatever that is then thosemoments get very hard.
And then when you get intopractice, I hate to say there
are some jobs out there thataren't great and you kind of
have to work through those timesin your life.
(42:43):
You need to find the good inthose situations.
If it's about the paycheck,that's nice but it doesn't keep
you at work, it doesn't keep youhappy there.
You can go buy nice things, butyou still have to go to work
the next day.
You know, drive and then fromthere really exploring what you
(43:04):
want to do.
Because for me I knew I didn'twant to be a physician.
I have great respect for myphysician colleagues.
I have wonderful physiciancolleagues that I've worked with
throughout my entire careerthat I just adore and look up to
.
But that wasn't me.
Through conversations I foundthe PA profession and here I am
and whatever that is for thatperson, it's okay to look around
and take that time because it'sa big decision.
It's a lot of time, effort andmoney.
(43:25):
You know when you're paying fortuition and you want to make
sure that you're doing it forthe right reasons.
So you know, for me it's beenone heck of a road and fun
adventure.
Speaker 1 (43:33):
It's amazing and it really just is the beginning.
You know, there's there's somuch and I'm so hopeful for the
field of medicine and so hopefulfor the next generation of
health students that are comingup behind us.
So it's going to be good.
Hector, thank you so much forjoining us on Shadow Me Next.
We have just learned so muchand I'm so glad that you shared
(43:53):
everything with us, so thank you.
Speaker 2 (43:55):
Absolutely, absolutely.
It's been a pleasure, ashley.
All the best.
Speaker 1 (43:59):
Thank you so very much for listening to this
episode of Shadow Me Next.
If you liked this episode or ifyou think it could be useful
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, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-health 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.
(00:43):
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
Me Next, where we will reviewhighlights from this
conversation and where I'll giveyou sneak previews of our
upcoming guests.
And where I'll give you sneakpreviews of our upcoming guests.
(01:05):
This is episode 10 of Shadow MeNext and we have the pleasure of
speaking with Hector Bird, aphysician assistant with a
varied background in acute,urgent and emergent care.
Hector's journey started inaviation, where he earned a
degree in aviation science andworked as a pilot.
However, driven by a passionfor direct patient care and
(01:26):
meaningful contributions, hetransitioned to healthcare,
ultimately becoming a PA.
Hector shares his formativeexperiences as a volunteer EMT
and the support system within PAschool that helped him succeed.
He gives incredible insightinto his current role in
providing in-home urgent medicalcare, emphasizing the
(01:47):
difference it makes for patientswith mobility issues and
chronic conditions.
His insights into team-basedemergency medicine, patient care
at home and the continuouspursuit of learning make this
episode a must-listen foraspiring medical professionals.
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
(02:09):
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
employer or company.
Hi Hector, thank you so muchfor joining me on Shadowing Next
(02:30):
today.
Speaker 2 (02:30):
It's an absolute pleasure to be here and to
contribute to this wonderfulproject.
Speaker 1 (02:35):
So you know it's crazy, hector and I were in PA
school together 10 years ago 10years.
It's been a long time and it'sso good to see you, it's so good
to talk to you.
We did catch up a little bitbefore we dove into the
interview, so Hector's doingamazing things and I'm so
excited to share your storytoday.
Speaker 2 (02:54):
You're so kind, you're so kind, thank you.
Speaker 1 (02:56):
What initially drew you to wanting to be a PA.
Speaker 2 (03:00):
Well, I always liked medicine.
Medicine was always somethingthat I was attracted to, but for
whatever reason, I knew I didnot want to be a doctor or go to
medical school.
I have a big passion foraviation.
I went to undergrad to be apilot I have a bachelor's degree
in aviation science and didthat for a few years but quickly
(03:21):
realized that one the lifestyle, the airline lifestyle
especially.
This was, you know, 2005,.
2010 range was really rough.
The airlines were not doing aswell as they are now.
Pay wasn't great.
It was just a lot to handle andto think about continuing to do
that for at that point almost40 years with a family.
It was a lot.
(03:42):
So I started doing some soulsearching and, at the end of the
day, I really just wanted to dosomething that I felt would be
more meaningful and contributeto people in a direct way.
I had a great career inaviation.
I flew in Alaska.
We literally flew people'sgroceries to them and stuff like
that.
It wasn't like I wasn'tcontributing, but I just felt
driven to do more.
(04:03):
And one night I was a volunteerEMT and one of the lieutenants.
I knew he was a PA.
I had no clue what that was andI started talking to him and I
asked him some medical questions.
I was really impressed at howmuch he knew and I said you know
, so tell me about this PA thing.
And he started telling me aboutit and I was just like, wow,
that's what I want to do, likethat's perfect.
It met medicine, it met thegoal of learning and continuous
(04:28):
education and improvement and itallowed me to do more for
people.
So that's where it started.
And then I went back to schooland had to take a whole bunch of
science classes that I hadsuccessfully avoided in
undergrad.
Lo and behold, three yearslater I started PA school.
It's been a fun and veryinteresting road, but, yeah,
it's been everything that Ithought it would be and more.
Speaker 1 (04:48):
The profession is so lucky to have you too, hector.
I can't imagine the amazingthings that you're doing, so
tell me a little bit about beinga volunteer EMT.
Is that the way that youreceived?
Speaker 2 (04:59):
your patient contact hours.
So I will say that that was oneway.
Some of the programs want youto have paid patient contact
hours.
So it was kind of, in some ofthe applications, kind of the
cherry on top, but it was a goodchunk of my time.
Using the connections and thenetwork that I had built from
the volunteer EMS agency, I wasable to start getting to know
(05:20):
the medical community.
This was in Denver, colorado,where it was good to work and
that sort of thing startedapplying for jobs.
My paid experience was as anemergency room technician or
critical care technician,depending on the hospital I
worked at, basically doing whata needy tech does, and that was
a lot of fun.
I was a tech at a level onetrauma center in Colorado and
(05:41):
Denver and it's probably themost fun I've ever had in a job.
Not that what I do now isn'tfun, but I got to do some really
cool things and not have anyresponsibility at the same time.
I have a lot of very goodmemories from that experience.
Speaker 1 (05:53):
That's fantastic.
You know, I think a lot ofpeople think about their when
they're receiving those contacthours as almost as being a means
to an end.
And that's a conversation Ihave with a lot of students that
come through our office, thathave graduated college and, you
know, are looking towards thatnext goal, and occasionally I do
ask them to pause and realizethat where they're at right now
(06:17):
is a part of their medicaltraining.
And I think, working as an EDtech you, I mean you see so much
, so I'm sure it was a littlebit easier for you to realize
and for you to remember than youknow perhaps someone working in
a smaller clinic or a clinicwhere you don't see the vast
number of disease processes andyou don't have access to the
(06:38):
vast number of tests and all ofthose things that you do in the
ED.
So you know when you're gettingthose hours that's part of your
training and you know you can't, really you can't look past it.
So, speaking of training, hector, pa schools are different All
the PA schools.
They do have core classes, butsometimes the way those are
presented are very different.
(06:58):
Generally speaking, yourexperience in PA school was it
good, was it bad?
What did you think?
Speaker 2 (07:06):
I loved it actually.
I mean I loved it because whatI remember is the camaraderie.
I remember the people I went toschool with.
I remember just that overallexperience.
Was it hard?
Absolutely.
Was it tiring?
Yes, but what I remember reallyis there's very few things in
life and very few experiencesthat you can have as a person
(07:27):
where you're with a group ofpeople and you're all working
towards one goal.
And I was very blessed to go toUniversity of Florida the
atmosphere and the culture there.
Really it wasn't about competingagainst each other, it was
about pushing each other along.
Really, we had to push eachother along at times, but that's
what I remember, you know.
And then, of course, all thestuff that I learned was kind of
(07:48):
I remember.
It still happens where thingsjust pop into my head that I
don't know where that came fromand it's something that I took
in a class almost 10 years agonow.
So, yeah, I loved it because Ilove the people that I went to
school with.
It really was a positiveexperience and, of course, you
always remember the good things,right?
I think one of your guests saidit as well but it really is the
(08:11):
best two years of your lifethat you don't want to repeat.
Speaker 1 (08:15):
It's so true.
You know it's funny when we allstart saying the same things
and you realize that.
You know we all had verysimilar experiences.
I believe that person also wentto the University of Florida
for PA school too, so it doesmake a little bit of sense.
But the camaraderie isfantastic because it's not, it's
not soft camaraderie, it's,it's not.
(08:35):
They are, they're sharpeningyou and they're pushing you, but
it is 100% supportive and, youknow, not just between each
other.
I felt that and I wonder if youdid too, with the faculty as
well.
You know, I remember failing atest and it I was, it was, it
does happen, I can attest to it,and it was a part of medicine
(08:58):
that I just.
It was miserably boring to me,I was not interested, but there
was also a lot going on in mylife and I was so grateful to my
mentor, who's also a professorof the program, a practicing PA,
who just stopped and took timeto sit down and really make sure
that I was okay first and thento make sure that I understood
(09:19):
the material.
And that doesn't mean that Isat the test again.
We just sat there and wereviewed it and we talked
through it and he said I feellike I missed two questions to
pass.
But he said you missed this.
Do you understand this process?
Explain it to me.
It was a test that we will soonexperience in second year on
rotations.
Right, you don't sit down everyday.
You walk into clinic secondyear and take tests like that.
(09:41):
No, you have a preceptor or alead PA, medical doctor,
resident, whatever start askingyou questions on rotation.
You have to explain it verbally.
So you know it was that was fun.
Speaker 2 (09:53):
I laughed because we all have that memory.
We always remember that moment.
Speaker 1 (09:57):
Yeah, and we're not fondly either, but but you know
it's, it's all learning and yourealize that every experience,
whether it's good or bad,hopefully is contributing to
learning.
Speaker 2 (10:06):
Yeah, and I would say that, yes, I completely agree
that that was one of the mostimportant things to me when I
was in PA, when I was looking atPA programs and in PA school is
just that support, because youknow something I tell people
that are considering going to PAschool and are looking at PA
programs is you know, thequestion you want to ask, or one
(10:26):
of the questions obviously youwant to ask, is what happens to
a student when they fail?
Right, because it is anincredibly rigorous program and
it doesn't mean you're a bad PAor that you're never going to
practice medicine or anything.
You didn't get this uber complextopic that you just learned two
weeks ago and it's important toknow what the plan is, because
this goes for any programnursing, nurse, practitioner,
(10:49):
any sort of professional programthat you really want to make
sure that their goal is to makeyou a good practitioner of
medicine, a good clinician orwhatever, and not take your
money and kick you out.
You know, one of the things thatI think we were blessed with
was a program that really wentout of their way to give you all
(11:09):
the tools so that you couldpass.
So if you notice how I saidthey were giving you everything
so that you could get through it.
But they were there to supportyou.
They weren't there to.
They're there to help and makeit so that at the end of the day
, you would pass the pants andbe a successful PA and be you
know, be able to go out andpractice and not just take your
(11:30):
money and say, okay, went to PAschool, but but that is.
I think we were really, reallyblessed there and, you know, it
sounds like both of us still arein contact with many of our
professors and I think that's acommon thing that you'll find
across the country to becomeyour friends.
Speaker 1 (11:45):
They become your colleagues, and then they become
your friends.
It's amazing.
You cannot talk to some of themfor six or seven, eight, nine,
10 years, and then, all of asudden, you drop them a line,
whether it's a call or an emailor a text message and I think,
honestly, you know, I'd love tohave one of them on the show one
day, but I think they willprobably tell you that is.
that is the highlight, you know,10 years from now, to have one
(12:05):
of the students that you workedwith giving you a call.
So you know, I'm so glad thatyou felt you felt so supported
in PA school by your peers andyour colleagues.
Let's transition a little bitinto actual PA practice.
So you've worked in a number ofdifferent arenas urgent care
and emergency medicine, internalmedicine.
How do you feel PAs aresupported generally speaking?
(12:27):
Are we well-respected in thosefields?
Is it something that you'veseen?
Follow you from school?
Is it something that you'veseen?
Speaker 2 (12:34):
follow you from school.
I would say that at a highlevel.
Yes, you know, when you'relooking at, if you were to stop
a random nurse or physician,they're all going to say, yes,
they like their PAs.
That's sort of a thing.
I guess it depends on how youdefine respect.
Where the rubber meets, theroad is like what can you do?
(13:07):
Right, what you're allowed todo, because in some places you
are kind of looked at as aphysician assistant.
Right, they're supposed to behelping do your PA things, which
isn't to negate either of us,it's just we have our areas of
expertise, the things that wecan do.
Well, you made a great examplein your practice where the
physician does the Mohs surgeryand you do the closures.
That was actually kind of myexperience in emergency medicine
(13:29):
.
I did a lot of the suturing.
I did a lot of the woundrepairs because you know what
it's a technical skill.
It's something that you know.
It takes practice but at thesame time, does it need a
physician to do that?
No, they probably can go handleother things and a lot of them
have been handling those thingsfor 20 years and they're not as
great at being a suturing.
But I'll be honest, you know,if I'm having to go in and have
(13:50):
a crashing septic patient andhave to manage all of that,
that's I mean, it's something Ican do and I could probably
fumble through it, but it's notsomething.
I've done a lot.
I work with some amazingphysicians.
That that was a Monday, thatwas just what they did, you know
, and they were exceptional atthat.
And honestly, they should bedoing that, you know, and not
sitting there suturing upwhatever wound walked in the
(14:11):
front door.
That's not, you know.
That might take an hour to makeit look good, especially in the
face, right, but that time isprobably best spent doing
something else.
So, to better answer thequestion, I would say it really
depends.
At the end of the day, Iwouldn't say that people are
talked down to as much.
Thankfully, here in the US We'vebeen around for a very long
time and I think we've builtthat respect on the shoulders of
(14:32):
those that became ahead of us.
I think we've all met thosecolleagues that have been around
for 30 and 40 years.
They're the ones that reallybuilt that level of respect.
Now it's our job to continue it.
But there's some areas, somehospitals I worked at.
They weren't as comfortableallowing PAs to do certain
things, and then many of mypractices, including my current
one.
There's obviously a limit towhat you can actually physically
(14:54):
do in whatever the setting is,you know, equipment wise or
whatever is safe to do, but theywere very open to allowing me
to do whatever I was comfortableand trained to do, which is
pretty cool so, but I've neverreally felt like I've been
talked down to or somebody saidI'm not your PA.
You know they didn't want tosee me.
I think it was.
You know, if anybody ever didthat, I probably don't even
(15:15):
remember it because I said, okay, the doctor can see you and
that's their right, and,selfishly, that was one less
patient I had to see.
Speaker 1 (15:22):
Exactly, exactly, no, and you know, hector, thank you
for being so honest about that,because I think that so often
people will hear stories from,let's say, from an ER PA, and
they will think that that is theexperience of every single ERPA
or derm PA, which is what I am,and and they'll think that, you
know, if I work for adermatologist, I am going to
(15:43):
have the opportunity to close 10most surgeries a day.
Well, no, that's not true, causenot every dermatologist does
most surgery, you know, or theymight employ their PAs
differently, they might havetheir PA seeing people in
clinics and so on and so forth.
So I'm so glad that youhighlighted the fact that it's
different, and sometimes it'scomfortably different and
(16:04):
sometimes it's uncomfortablydifferent, and I think that
these are questions that arefantastic to ask for new grads
entering the workforce orperhaps for people switching
jobs.
These are great questions toask.
You know, tell me about whatyour PA does in clinic, because
it might not be the sameexperience that you had
(16:26):
previously and that was a reallygood lesson and I'm really glad
that you brought that up and Iam so glad, of course, that
you've had really good support.
Working in emergency medicineand that was actually one of my
questions was does it feel morelike solo practice or does it
feel more collaborative?
There's no shortage of varietyin emergency medicine.
Speaker 2 (16:45):
I've worked in emergency departments where
there wasn't a policy.
You know there wasn't like arule Okay, these patients you
have to talk to and these youdon't when I started, actually
it was, you know have to talk to, and these you don't when I
started, actually it was.
You know these patients youknow you can do on your own
these patients you have to.
You know staff, meaning youtalk to the attending and then
these patients have to be seenby the attending physician and
(17:06):
it was very protocolized.
So it, like you said, itdepends, but honestly it's
always, especially in emergencymedicine.
You know, in my opinion youshould have the ability to reach
out to somebody else.
Medicine is a team sport and youknow there are PAs out there
that are working solo in an ERin a rural area, but they have
(17:26):
some sort of backup or they canget on the phone and get you
know their on-call traumasurgeon, critical care doc,
whatever in another hospital.
So there's different levels ofwhat you can and should be doing
in those situations and it'sall based on your training and
experience.
But medicine's a team sport.
So anybody that says that youknow that you are going to do
everything by yourself, oranybody that says that they do
(17:47):
everything by themselves isdriving themselves crazy,
because it's.
You can't know everything aboutthe human body and you can't be
an expert at everything.
I love being a generalist, butat the same time it's impossible
to know everything abouteverything.
Speaker 1 (18:01):
It's true it's true.
And again it's support fromyour colleagues, just like we
talked about in school.
If there's nobody there kind ofpushing you, driving you, then
perhaps that blade is notgetting sharpened like we would
like for it to be.
So, no, I think that's great.
Hector, tell me about whereyou're at right now.
Speaker 2 (18:20):
Let's talk about your current job.
It's so interesting.
So currently I work for acompany.
Their name is Dispatch Health,so we do urgent in-home medical
care.
This is what we do on aday-to-day basis, and then the
other half of the job that we dotransition transitional care,
so people coming out of thehospital or out of the ER to
home, and our goal is tobasically keep people at home.
(18:41):
The slogan is to stay healthyat home.
We really try to serve thepatients that can be seen safely
at home, and that's actually apretty wide spectrum of people
everything from lacerations toCOPD and asthma exacerbations,
chf exacerbations so you knowpeople that are having trouble
breathing, people that are fluidoverloaded because their
heart's failing a little bit butare not at the point where they
need to have everything at thehospital.
(19:03):
Then when they leave, the otherhalf of what we do, at least on
the acute care side that I workin, is making sure that they
have everything they need tostay at home.
So you know all the referralsmake sure they understand their
medicines, make any adjustmentsif someone is not completely
recovered from their condition,if we need to make a small
adjustment or coordinate backwith the physicians in the
(19:23):
hospital or with their PCP andreally prevent them from
bouncing back to prevent theunnecessary readmission, and
we're pretty successful at that.
Actually, there's some goodnumbers floating around there.
So those are the two halves ofwhat I do.
The company also does hospitalat home admissions in some areas
not here locally where I work,but they also do that as well.
What I do for them.
(19:44):
I started as a line APP, soworking in the field, and then a
few months ago I started as oneof the national APP educators
for the company as a whole.
Speaker 1 (19:53):
Which I cannot wait to talk to you about.
This is such a unique position,and it's something that you
really have to be a fantasticAPP in order to do this.
So well done, well done, which,of course, you're perfect for
the role, so I cannot wait totalk to you more about that.
So tell me about the patientsthat you serve.
(20:16):
Are these patients withmobility issues?
Are these patients that justprefer to stay home instead of
going into the hospital setting?
How does that work?
Speaker 2 (20:23):
So most of the patients that I see a lot of
them have some sort of a reasonthey can't make it to their
doctor or the hospital, whetherit's transportation.
A lot of them are bedbound.
A lot of them have mobilityissues.
The nice thing about it, though, is that anybody can access the
service, so anybody can call.
We do get patients that justaren't feeling well, and, as we
all know, the last thing youwant to do when you're sick with
(20:45):
the flu is drag yourself in acar and go to a nursing care and
then sit in the waiting roomwith everybody else coughing,
with God knows what is in thewaiting room floating around.
So we do have I do see thosepatients, you know, but a lot of
them are patients.
The majority of our patientsthat you know live with their
family, and they're not verymobile, and it's hard to get
them out of the house, you know,for whatever reason.
(21:06):
So that's a very that'ssomething that I really enjoy.
We're bringing them, you know,able to care for people that
otherwise would either fallthrough the cracks or would be
unable to seek care in a timelyfashion, and oftentimes just
wait until they get so sick theyhave to call an ambulance and
end up in the hospital when allthey needed was some steroids.
(21:27):
Something as simple as aprescription of steroids would
have saved them a week and ahalf in the hospital.
So it's I really, really enjoythat part of the job.
Speaker 1 (21:37):
Well it's.
You know you're serving acommunity that could be
considered marginalized.
You know transportation issues.
In the first episode I talkabout challenges that we all
face in healthcare andtransportation issues,
regardless of whether it'sbecause of your physique or a
disability, or maybe you don'thave a reliable vehicle.
Transportation issues is a hugething, and the fact that you're
(21:59):
able to still serve thesepatients is incredible.
It really is, I'm sure, to beable to step into these people's
homes and offer your expertisein a place where they're also
still really comfortable.
What does a typical day looklike for you on the days that
you're working clinically?
Speaker 2 (22:15):
Yeah, we work a shift , you know, kind of similar to
working in an urgent care in ER.
You show up at a certain timeand then we have our patient
assignments.
We really only know the firstpatient we're going to.
Once we get there we can seethe next one.
But that is dynamic as peoplecall in and someone cancels, and
that's always in flux.
We get to our office, gather ourequipment I work with a
(22:38):
technician and they are kind oflike between an EMT and an MA.
Most of them are either EMTs orMAs.
It's actually a greatopportunity for patient contact
hours because you're workingone-to-one with an NP or a PA.
We then load our vehicle.
We have an SUV.
We don't transport patients, wedon't take anybody to the
hospital, we're not in thatbusiness and then we drive to
our first patient's house Alongthe way.
(22:59):
I have access to internet so Ican start my chart or I can look
up patient information fromvarious sources and get prepared
for the visit.
And then we get on scene whereit's just like a patient visit.
We check them in, we get vitals, we get a history, I verify all
their information, medicationsmore hands-on than what I would
(23:20):
normally do in emergency roomand urgent care.
Normally you're going to have anurse or an MA that's going to
do a lot of that work, butbecause we're kind of both of us
working at the same time withone patient the technician might
be getting vital signs.
I might be verifying history,they check them in.
The technician might be gettingvital signs.
I might be verifying history,they check them in.
They get the administrativethings going and then a typical
visit's 30 minutes-ish 30 to 40minutes and, depending on how
(23:47):
busy the market is, anywherefrom.
I mean, it really depends Ifit's a bad weather day and
nobody wants us to come, it'stwo to four patients and maybe
I've seen as many as eight to 10, which is a lot.
When you're driving around I'veseen more than that, but that's
usually when you see like anentire family and they all have
COVID and they all want to betested and treated.
And you get like the four, youknow four people in a house and
it makes your numbers look great.
You know, it's like wow, sawall these patients.
(24:07):
Today I saw 12 patients and Iwas so fast and it's like, yeah,
no, you saw, you went to sixpeople's houses and saw, you
know, it's the entire family inone.
But yeah, it's pretty much it,you know, and we will do
everything, like I said, flutesting and everything you can
imagine in urgent care.
We do carry an ISTAT so we cando some lab blood labs.
You know I did mention it is alittle more hands-on, so between
(24:29):
me and the technician, we willput IVs in, we'll draw labs,
we'll run the tests.
I have to interpret all thetests because I'm the licensed
practitioner, so you know I lookat the COVID test and say, okay
, yes, it's positive or negativeEKG.
We carry medications, someantibiotics, steroids, a whole
slew of things, but basicallyenough to kind of care for the
stuff again that's safe to takecare of at home and ensure the
(24:53):
patient is.
And then we write prescriptionsand diagnose, treat the whole
nine yards and do that a fewtimes and then at the end of the
shift we drive back to theoffice, clean up and go home.
It's an urgent care emergencyroom type situation when you
look at the job on wheels.
Speaker 1 (25:07):
What happens, or has anything like this happened,
where you arrive and you realize, oh, this is not something we
need to be taking care of athome?
What's the next step?
Speaker 2 (25:18):
My goal is to make sure that the patient's safe,
and we always do the right thingfor the patient, whether that's
treat them or escalate them iswhat we call it.
I did actually a fair amount oftimes I've had to call 911 and
escalate people.
Very rarely has it been thatstereotypical.
A lot of times it's just youknow, you come in, you make your
assessment and the patient'ssick and you're just like look,
(25:38):
you're very sick.
This is beyond what I can dohere at home.
And the flip side of it is, youknow, patients have their
autonomy, they can make thedecision they want.
And we do see a population ofpeople that a lot of times are
very tired of going to thehospital.
In this situation Someone saysI don't want to go to the
hospital.
Then, of course, you know I'mgoing to take care of them as
best I can, telling them youknow, hey, I'm limited to what I
can do, but I'm going to doeverything I can.
(25:59):
Generally, we'll come back thenext day or in two days,
whatever works out for them, tocheck on them and make sure
they're getting better.
If this X, y and Z happens, youcan go to the hospital and go.
Look like this is not going toend well.
I kind of give them that ideaLike this is heading in a
direction that this could takeyour life.
And what do you want to do?
Like, what are your goals here?
(26:20):
A lot of them they just want tostay home.
I've referred a fair number ofpeople to hospice.
Whether or not they stay onhospice or they get better and
come off, that can happen andthat does happen.
But you know if I've been insome situations where people are
just like you know what, I justgot out of the hospital last
week and I am tired of it and Idon't want to go back and I go
okay.
So what can I do for you today?
And then, what are your goals?
(26:40):
And if they're okay with hospice, a lot of times hospice service
can bring a lot into the hometo keep them comfortable, in the
sense of they need more oxygenor they need their palliative
interventions.
They can do that really well,because I don't want anybody
suffering.
I don't want anybody to sitthere at home and suffer, and a
lot of times it's also about thefamily.
The family gets overwhelmed andthen they want to take them to
the hospital and at the end ofthe day.
(27:02):
I want the patient, if theywant to stay home, I want them
to be comfortable, I want themto do well, I want the family to
be supported and I want it tobe a good experience, as best we
can, because honestly I hate tosay it but passing away you
know that that's what theirwishes are.
I'll do it.
And now, if they want to go tothe hospital, obviously I'm
(27:23):
getting them to the hospital orhaving the family take them, or
whatever's appropriate.
Speaker 1 (27:27):
Sure, I'm so glad you brought that up because it is.
It's something that I fearpatients really worry about is
if their wishes are going to beunderstood and heard.
And you know, thankfully in ourclinic we don't see very many
actual emergencies, butinevitably if you see 120
(27:50):
patients in your clinic,somebody is going to walk in
with chest pain and it's not aterm thing, but they're going to
start talking about how theycan't breathe.
And it's something that youmentioned and nobody wants to go
to the hospital and not any ofmy patients at least.
When I tell them hey, I thinkthat your foot isn't in fact
just swollen.
I think you have a deep veinthrombosis, I think you have a
(28:11):
blood clot in your leg.
You're going to the hospitaland then it's never an argument.
I would like to call it aconversation.
Speaker 2 (28:18):
Absolutely.
Speaker 1 (28:19):
Sometimes it might feel like an argument and it's
you provide patient educationand then you have to listen, and
I think that is something thatwe as providers need to remember
is we can't just be spittingeducation at people in that role
(28:44):
to where you can offer thesupport, and then you also are
aware of some alternativeoptions for them, such as
hospice, which is end of lifecare and a fantastic option for
some of these people that havesuffered with chronic diseases
and chronic illnesses.
So I'm really glad youmentioned all of that.
Generally speaking, how dopatients typically respond to
receiving care in their ownhomes?
Speaker 2 (29:00):
No, they love it.
They love it.
That's one of my favoritethings is they appreciate us and
I mean, even in the situationswhere I feel like I did nothing,
they're just happy that I came.
I feel like, if they've calledme and I want to serve them, I
want to do things for them and alot of times there's not a lot
that you should do, there's alot that I can do, but it
(29:23):
probably would hurt them orcause bad side effects, but just
the simple fact of givingreassurance and that's something
that I always have to remindmyself.
You know, our job often iseducation, but a lot of times
it's reassurance that's oftenthe best thing that we can do
and the only thing we can do butjust say, hey, you're okay,
you're going to be okay.
Do X, y and Z, you know, takesome Tylenol water, you know.
All these little minor things,they work, they help giving them
(29:45):
that reassurance.
And then also, just, you know,telling them, hey, if things get
worse, call us back, we're here, you know.
And that can be in any setting.
It doesn't have to be in thistype of setting, this mobile
setting, it's more.
Even when I was working in theclinic, I just told them you
know, get any worse.
I want to hear from you.
Just, you know, opening thatdoor for them it means a lot and
then if we have to do somethingelse we'll do something else.
(30:06):
You know, we kind of figure itout from there.
But our patients when I get tosee them, they're very high
satisfaction rates.
Speaker 1 (30:15):
That's great, I would imagine getting to welcome it's
a house, call Hector.
I mean, that's what it is, it'sa house call and it is the
greatest house call of all timeand I think it's a fantastic
option.
I can think of a lot of peoplein my life and on my schedule
that would really benefit fromthat.
I wish it was something we cando.
We've discussed it.
We've discussed having dayswhere we can go and visit
(30:37):
patients remotely, whether theyare living at home or an
assisted living facility,something like that.
Speaker 2 (30:43):
It's care that you want to give right and I'll say
it's a lot of fun too.
You know, it's fun to go meetthese people and see them, see
where they live and kind of getto know them a little bit.
It's just, it's a.
It's a great experience overall.
Speaker 1 (30:56):
I'm so glad.
So, hector, let's pivot alittle bit, because I think you
have some pretty wonderfulthings to talk about outside of
working as a clinical PA.
What else can PAs do outside ofjust working in clinic?
I think you have a couple ofopportunities that you can share
with us.
Speaker 2 (31:10):
So I've well, I currently work as an educator, I
will say one of the some of themost.
There's some fun, weird jobsout there that PAs can do.
I think was it the medicalexaminer's office in New York
City has PAs working for them.
You can be an ME.
There's actually one of, Ibelieve one of our preceptors
(31:31):
actually works for the StateDepartment now in Southeast Asia
as a health officer for one ofthe embassies, one of our
embassies.
So they get hired there at theFBI.
I mean, I, you know, I live inthe capital region, so there's
lots of those kinds of jobs.
But the FBI, the military, Imean there's all kinds of very
(31:53):
interesting jobs out there thatPAs can do.
You know, for a while Iactually considered I wasn't
able to, for various reasons.
But the disaster medicalassistance teams throughout the
country do hire PAs to covertheir.
Basically they do pop-uphospitals.
It's a big deal and you know usliving in Florida, we're
familiar with those thingscalled hurricanes and when a
(32:15):
hurricane comes into an area andknocks out a hospital, they can
show up and set up a hospital,and each state has a few teams.
They do hire PAs into thoseteams as well.
So, yeah, so many cool thingsyou can do.
I know one PA down in SouthFlorida that I've read I don't
know if she's still doing it butshe critical care PA that
actually does flight medicine,meaning she goes fly as places
(32:36):
and then brings people back as aflight PA.
So there's, yeah, there's anorgan retrieval PA in New York.
I think, yeah, so you can.
Then the other people made thejob for themselves, like they
got into a position, and thenthey're like hey, can I do that?
And nobody said no, that'sright.
Speaker 1 (32:50):
You just keep asking and you keep knocking.
I think it's always so fun totalk to people about, especially
PAs who have either branchedout of traditional clinical
practice, which I would say isexactly what you're doing right
now, or perhaps PAs that areworking in politics now, or PAs
that are now working ineducation, which is one that is
so common.
If clinical practice isn't yourthing, there are other options,
(33:13):
although I don't know manypeople that chose other options
because clinical practice wasn'ttheir thing.
It was more.
Just, they're looking toaugment, they're looking to
improve, and a lot of timesthey're just asked into those
leadership positions and theyfind themselves there.
So I think that's incredible.
Hector, you know about asegment on our show called
(33:35):
quality questions.
This is one of my favoriteparts.
Do you have a quality questionfor us?
Before we hear what Hector'squality question is, keep in
mind that there's more interviewprep, such as mock interviews
and personal statement reviewover on shadowmenextcom.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Speaker 2 (33:57):
I remember sitting through the interviews and
getting the normal questions andhaving conversations and it was
all great.
And then at the end of thisparticular interview, the
interviewer goes so what are yougoing to do when all the
students that you teach as a PAbecome doctors and they are now
your boss?
And that was a tough one, butit is a reality.
(34:18):
I mean it wasn't like thisperson was being mean, it was
just like that is a truth as aPA and this can be in any
profession really.
I mean, you could be afirefighter and you're teaching
that rookie and then 10, 15years later he's now the chief
of the department.
You know, it's just everybodytakes different roads and you
know what.
I remember answering it kind ofpaused.
(34:39):
I was just like, wow, okay,this is a tough one and I
basically said you know, I wouldhope that, you know, I did a
good job teaching them that wehad, you know, mutual respect
and that I would continue to aimand strive to have that mutual
respect.
Obviously, people you know Iwon't call it rank, but you know
, obviously people move up indifferent positions even as PAs,
(35:00):
that happens and have to be aphysician.
I know many PAs went on to belead PAs or even higher director
level in different companies.
At the end of the day, it'sabout just keeping that mutual
respect and those open lines ofcommunication, and you can only
control how you react in thosesituations and hope that they
react the same way.
I can only control me Ifsomeone doesn't react in a
(35:22):
certain way.
This can be a patient, acolleague, whatever responding
in a respectful fashion and, forlack of a better term, loving
way is always the better roadright.
So that's more or less how Ianswered it and things
apparently went well.
Speaker 1 (35:37):
Got in.
Oh that's so great.
Yeah, it takes me back to whenwe were talking about the
professors at PA school.
Right, it's possible that theyare going to become patients of
some of the PAs that they'vetrained.
You know, if they stay in townlong enough and at the PA stand,
so kind of a similar thing.
You know you expect to see someof these students that you're
(36:01):
training, because I'm sureyou've trained nursing students
and PA students and MD studentsat all at your positions, at
least in the hospital.
We hope that these people aregoing to take care of us one day
and you know, that's kind ofwhy I laugh.
It's part of the reason Istarted the podcast was for the
next generation of pre-healthstudents and I want them to
realize.
I want the next generation ofpre-health students to realize
(36:23):
that there is still so muchhumanity in healthcare and when
you and I are old in five yearsor 10 years or 20 years and we
start needing care, I want tomake sure that humanity, that
element, stays in it Absolutely.
And you know those are thepeople that I hope are attracted
to medicine, not just becauseof the paycheck, which is
(36:46):
fabulous, and not just becauseof the quality of life, which
can be fabulous, but alsobecause you want to help.
You know, and I think it's sucha simple thought, but I think a
lot of times we forget about it.
And, of course, when you throwin insurance and all the
problems with burnout and all ofthat, like, the wanting to help
element is still there.
(37:06):
It just sometimes gets buried.
So it's fun to highlight that.
What an interview question.
That's one that kind of makesyou squirm, doesn't it?
Speaker 2 (37:14):
But you know, when you get those kinds of questions
, it's okay to pause and thinkabout it.
You don't have to just spit outan answer.
You can even acknowledge that'sa very good question.
Yes, sir ma'am, I've notthought of that.
But give me a moment and get asbest of an answer as you can
together.
But it's going to happen ininterviews and I don't think
people are trying to get you.
(37:36):
At least in most situations, Ithink they might think, hey,
this is a very interestingquestion.
I'm just going to ask everybody.
Today I've been an interviewerand sometimes you're just kind
of like today I'm going to askpeople and you get reactions
from people and you almost feelbad.
You're like, oh, that wasn'tmeant that, seriously, you know.
So you got to remember thatthey're.
You know, at the end of the daythey're all medical.
(37:59):
Usually, if you're in a medicalprogram, an interview, they're
medical professionals and, yeah,it's formal.
Yeah, you have to.
You know you're going throughthe process, but a lot of times
they're just trying to have aconversation in the 5, 10, 20
minutes that you awkwardly havetogether.
Speaker 1 (38:11):
I think that's a great point, hector.
It's a conversation, it is aninterview, but if you think
about it as a conversation, Ibet you it makes it a lot easier
.
Speaker 2 (38:21):
Yep, yep.
No, that's what I would, what Itold you know people,
especially the PA programs thatI interviewed at that I'm very
familiar with.
I said look, at the end of theday it's another PA.
They've got a ton of experience.
They're obviously there becausethey love students, they love
the program, they love PAeducation and they just want to
have a conversation and look atit that way and ask them the
(38:41):
questions that you want to knowfrom someone that's been doing
you know whatever crazyspecialty that person told you
they're doing for 20 years.
That could be you in 20 years,right?
So what would you want to knowfrom that person?
You don't even have to ask themthe normal.
Oh.
So what do you like about theprogram type questions?
Those types of questions aregreat and sometimes you can get
a good answer that you mightwant to know about.
(39:06):
But you can ask them questionsabout their practice, about why
they became a PA, the samequestions they're asking you.
It's okay.
That may actually give you amore useful answer as to the
type of program that you'relooking at, as to how they teach
and how they interact withstudents or not interact in some
situations.
Maybe they don't give you agood answer.
That gave you an answer, rightit is.
Also, you're interviewing themas much as you really want to be
in PA school.
The goal is to become a PA,right, but you want to try to
find a place that you're goingto enjoy being for two years or
(39:28):
three years in some cases, andit's a big chunk of your life.
So hopefully it's a place whereyou want to invest that time
and, yeah, part of the job ofthat interview is for you to
find that out.
Speaker 1 (39:39):
Looking back on it, 10 years.
We've done this for 10 years.
My husband will always say,ashley, do you think this is a
good idea?
And I'll say, well, I don'tknow, honey, ask me in 10 years,
was it a good idea?
So I guess the question.
You know it's been 10 years.
You have explored a number ofareas of what a PA can do and
how a PA can be employed.
Was this a good career choice?
Speaker 2 (40:02):
Absolutely.
It's been everything that I waslooking for.
As I alluded to earlier, Iserve people.
I've gone from one interesting,amazing job to another.
You know, I've always been kindof looking, trying to see where
I wanted to go next, and a lotof times things just presented
themselves to me.
Colleagues would just kind ofgo hey, have you heard of this?
And then, you know, in the caseof one of my jobs, I literally
(40:24):
just got cold called because mymom was bragging.
Oh, I love my parents and I'msure they'll listen to this, but
no, seriously, they they're,yeah, they.
My mom kind of just threw outthere hey, if you need a PA, and
they're like, well, actually,so you never know.
Speaker 1 (40:42):
Good job, PA.
Speaker 2 (40:43):
And they're like well , actually, so you never know,
yeah, I mean things presentyourself, but it's been one heck
of an adventure.
That's the way I kind of try tolook at it.
And yeah, there've been ups anddowns and crazy moments and,
just you know, I've had lows,just incredible lows, working,
some places that I knew I neededto get out of, but the great
majority of them have beenplaces that I absolutely loved
and learned and enjoyed forvarious reasons.
(41:06):
It's been awesome and I'm notdone yet.
I mean, this is only 10 yearsin.
Age is a mindset.
Speaker 1 (41:12):
Well, just wrapping up, Hector, what would you tell
a pre-health student that thinksthey want to go into medicine?
Speaker 2 (41:19):
Well, the first thing that comes to mind, if I was
talking to someone that waslooking at healthcare as a
career, wherever they wanted togo, you need to ask yourself why
right?
Why you're doing it?
Because I do feel that thereare some people that get into
many professions that do it forexternal reasons, whether it's
they're pressured into it, theirfamily that's what everybody in
(41:40):
their family does.
A common one is money.
Hey, what's a job that's goingto pay me well?
And really ask yourself, why amI doing this?
Because you want to make surethat there's something that's
driving you internally to getthrough all of those tough spots
, especially healthcare, itdoesn't matter paramedic,
nursing, nurse, practitioner, pa, doctor.
It's a long road, it's a slog.
(42:00):
There are moments where you aregoing to be crying on your
textbooks and it happens, andyou're just going to I mean,
it's not that you know?
I think we've all had thatmoment where you're just so
overwhelmed and then you justremind yourself that people have
been doing this for at leastfor the PA profession 40 to 50
years, and they've somehowgraduated and you will too, and
(42:21):
they all got through it.
So you're going to get throughit and to get through those
moments because there'ssomething beyond you that's
taking you there.
You know, for me it was thatdrive to do more for others, to
serve others, and if you don'thave that internal drive
whatever that is then thosemoments get very hard.
And then when you get intopractice, I hate to say there
are some jobs out there thataren't great and you kind of
have to work through those timesin your life.
(42:43):
You need to find the good inthose situations.
If it's about the paycheck,that's nice but it doesn't keep
you at work, it doesn't keep youhappy there.
You can go buy nice things, butyou still have to go to work
the next day.
You know, drive and then fromthere really exploring what you
(43:04):
want to do.
Because for me I knew I didn'twant to be a physician.
I have great respect for myphysician colleagues.
I have wonderful physiciancolleagues that I've worked with
throughout my entire careerthat I just adore and look up to
.
But that wasn't me.
Through conversations I foundthe PA profession and here I am
and whatever that is for thatperson, it's okay to look around
and take that time because it'sa big decision.
It's a lot of time, effort andmoney.
(43:25):
You know when you're paying fortuition and you want to make
sure that you're doing it forthe right reasons.
So you know, for me it's beenone heck of a road and fun
adventure.
Speaker 1 (43:33):
It's amazing and it really just is the beginning.
You know, there's there's somuch and I'm so hopeful for the
field of medicine and so hopefulfor the next generation of
health students that are comingup behind us.
So it's going to be good.
Hector, thank you so much forjoining us on Shadow Me Next.
We have just learned so muchand I'm so glad that you shared
(43:53):
everything with us, so thank you.
Speaker 2 (43:55):
Absolutely, absolutely.
It's been a pleasure, ashley.
All the best.
Speaker 1 (43:59):
Thank you so very much for listening to this
episode of Shadow Me Next.
If you liked this episode or ifyou think it could be useful
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.
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You're always invited to ShadowMe Next.
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