What does it take to become a trailblazer in the world of interventional radiology? In today's episode, we explore this question with Keri Hayes, a remarkable interventional radiology Physician Assistant who has been instrumental in shaping her field. Growing up in a small North Carolina town where specialty care was sparse, Keri's determination to improve healthcare equality has driven her illustrious career. Hear about her pivotal role in advocating for a Certificate of Added Qualification in Interventional Radiology for PAs, setting a new standard for excellence in the profession. Keri's leadership roles in the Society of Interventional Radiology and the Entelios Foundation further emphasize her commitment to advancing medical imaging and radiation safety.
Through compelling stories and personal insights, Keri sheds light on the diverse and dynamic responsibilities of PAs in interventional radiology. From performing intricate procedures like thyroid and liver biopsies to acting as an advocate for patients navigating complex treatments, Keri’s experiences provide a gripping look into the life of a PA in this specialized field. She touches on the challenges of gaining exposure to interventional radiology as a student and shares valuable advice on leveraging networking and initiative to carve out a successful path. Her reflections on collaboration with healthcare teams spotlight the crucial role PAs play in enhancing patient care and outcomes.
We also delve into the empathetic side of healthcare, with Keri sharing moving encounters with patients who are hesitant or fearful of medical procedures. She discusses the emotional resilience required to support patients and families through difficult times, especially in palliative care settings. Keri's dedication to mentorship and professional development is evident as she recounts her journey from being the lone pioneer to building a supportive community of PAs in specialized fields. Listen in to gain a deeper understanding of how PAs are reshaping the healthcare landscape, armed with empathy and a passion for patient-centered care.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ashley (00:01):
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.
(00:44):
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me next, where we will reviewhighlights from this
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upcoming guests.
(01:04):
Welcome to shadow Me Next.
Today, I'm excited to introduceyou to a true trailblazer in
the PA profession, keri Hayes.
Keri is not only anaccomplished interventional
radiology PA, but also adedicated advocate for advancing
the role of PAs in highlyspecialized fields.
With a passion for professionaldevelopment, she has been
(01:27):
instrumental in pushing for aCertificate of Added
Qualification in InterventionalRadiology through the NCCPA, an
initiative that will help definestandards and elevate
recognition for PAs in thisgrowing specialty.
Beyond her clinical expertise,keri is actively involved in
leadership and mentorship withinthe PA community.
(01:48):
She has played a key role inthe Society of Interventional
Radiology, working to strengthenthe presence and influence of
advanced practice providers inthe field.
She's also engaged in theEntelios Foundation, an
organization focused on medicalimaging excellence, and has been
a vocal advocate forfluoroscopy and radiation safety
standards.
(02:09):
Through her mentorship efforts,whether speaking at conferences
, guiding PA students orconnecting with aspiring PAs
through professional networks,carrie is shaping the next
generation of clinicians andensuring they have support and
knowledge to thrive.
In this episode, we'll diveinto her journey, her efforts to
(02:30):
expand PA opportunities ininterventional radiology and the
impact of her work on theprofession.
Whether you're a PA student, apracticing clinician or simply
curious about the future of PAsin specialized medicine, or
simply curious about the futureof PAs in specialized medicine,
this conversation is for you.
Please keep in mind that thecontent of this podcast is
(02:50):
intended for informational andentertainment purposes only and
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.
This is Shadow Me Next withKeri Hayes.
(03:13):
Hey, keri, thank you so muchfor joining us here on Shadow Me
Next.
I am thrilled to have you.
I have never met somebody whodoes what you do as a PA, so
thank you so much for joining us.
Carrie (03:24):
Yeah, thanks for having me.
I'm super excited about beinghere.
This is great that you're doingthis.
Shadow me next.
I think it's a really uniqueopportunity for people.
It allows us to kind of brag onour specialty a little bit and
then also to sort of I don'tknow cause you know PAs and P's
to think about.
Oh, intermature audiology.
Ashley (03:43):
That sounds cool.
I'm so glad because that'sexactly what we're doing.
We're bragging on our specialty.
It was funny One of the guys Ijust recently spoke to, jim.
He said Ash, I've just what Ido is so cool and I just want to
share it with everybody.
This is going to be a reallyinteresting conversation for
pre-health students to kind ofdiscover something else that a
PA can do, and perhaps a reallyeye-opening discussion for
(04:05):
current practicing cliniciansBecause, like I said, I think
what you do is really unique andwe all have a lot to learn from
this conversation today.
So, keri, let's start from thebeginning, because you have a
really interesting story evenbefore your PA career.
Tell us what inspired you topursue a career in medicine and
where did you end up initially.
Carrie (04:25):
Well, I mean, I guess, like all young girls, I thought
I'm going to be a veterinarian.
Of course I mean that's what wewere all going to do as little
girls.
That's sort of the first part,right.
The second part is that I grewup in a really small town in
North Carolina, and when I saysmall town I mean really small.
(04:49):
You know little to no access tospecialty care, like no real
preventative medicine, like youonly go when you're sick.
You know you're not just goingto go to be proactive.
So those people can't evencouldn't even afford insurance,
you know.
And when folks were getting tothe hospital it was normally an
acute state, some advanced stageof disease, low health literacy
, just really few communityresources.
You know our closest specialtycenters were two to three hours
(05:11):
away.
It was often a hardship totravel.
You know this has a huge impacton outcomes for folks.
So I've always felt drawn to lowresource communities to be a
patient advocate.
But you know how could I bringspecialty services back to my
small community?
So that's sort of.
I've always known that I wasgoing to take care of people,
but I was especially invested inmaking sure that there was some
(05:32):
equality in the care.
So that is how I decided Iwanted to be in medicine.
But then from there, you know,I thought I would be a
veterinarian, but now I'm anindividual LGPA in Oregon.
So of course it makes perfectsense how I went from there to
here.
Ashley (05:47):
A little bit of a wild journey, absolutely, absolutely.
You know it's funny veterinarycare I spoke about this again.
I mean this is there's so manyconnections in medicine, but I
spoke about it with a pediatricresident physician recently and
caring for animals and caringfor people is still caring for
another living thing, you know,and she told me about how much
she had learned working as aveterinary technician and how a
(06:09):
lot of her patients as pediatricpatients.
She uses very similartechniques with them because
they don't speak.
Most of her animal patientsalso did not speak.
You know they have differentways of expressing themselves.
Carrie, you worked as a medicalsonographer before PA school.
Is that correct?
Carrie (06:25):
Tell us a little bit about that and what that
transition looked like yeah,that's so funny that you bring
up what you did, because while Ithought I was going to be a
veterinarian, I ended up workingwith a veterinary radiologist
group, two radiologists on theirown practice.
We were mobile, we went toveterinary hospitals and clinics
and did diagnostic andinterventional ultrasound and I
became obsessed with ultrasound,like, oh my gosh, you just put
(06:45):
this on their belly and oh mygosh, you could see all these
things.
So it was while I was doing thatthat I fell in love with
ultrasound.
And then I thought, okay, I cando this with animals, I want to
do this with people too.
So that's how I ended up goingto ultrasound school.
It's like, okay, I want to scanpeople.
And then while scanning peoplefrom 24 week preemies to 100
year old patients I hit thisglass ceiling of like, oh man,
(07:10):
like what happened to them?
How did that turn out?
Was my ultrasound correct?
You know, I really want to knowwhat happened.
That patient told me aboutsomething that was going on with
them personally.
How's she doing?
She was so sweet when I saw her, so that glass ceiling sort of
propelled me forward.
You know, okay, I want to havean established relationship with
patients.
(07:30):
I want to be part of alongitudinal care aspect.
So that's how PA schoolhappened.
I got into Duke's PA programand I hit the ground running.
The first, my first job was inHouston.
So that was an interestingtransition going from being a
sonographer to PA school to nowbeing an IRPA, where I'm not
(07:50):
only using ultrasound indiagnostic capacity but now I'm
doing using it in aninterventional capacity.
So yeah, it seemed like alogical step for me it's a very
interesting tract really.
Ashley (08:01):
You saw what you were interested in and then you've
really stayed close to thatfield at least.
But your responsibilities havechanged and what your abilities,
what you can do, has changed.
How has Duke's PA program thisis one of the best, if not the
best, pa programs in the countrysuper challenging, I would
(08:21):
imagine.
Carrie (08:21):
I think they tell you.
You know, I went into itthinking, yeah, I'll probably
still work part time.
No way, man.
And they made you sign a pieceof paper that said you wouldn't
work in any capacity more than15 hours a week or something.
It definitely became a fulltime job.
You know that we've all heardthis like drinking information
(08:43):
through a fire hydrant.
I mean it was really literally.
I mean, I think there was onemorning I had been studying, for
I mean I would go to go toschool.
Come home I'd study all night,I'd go to sleep, I'd get up, I'd
study, then I'd go to school.
I think there was one morningwhere I had studied so hard for
a test that I went out to my carand I could not remember how to
open the door to my car.
(09:05):
Like where is it?
I mean it was just my brain wasso full of other things Like I
had forgotten how to open my cardoor.
But I and I have like a corememory of that moment.
It's like Carrie, just breathe.
You know it was fine.
But you know, great program.
I mean we had patient contactreally early on.
I really feel like theyprepared us to be clinicians.
(09:27):
So I'm very proud of my timethere.
Ashley (09:29):
That's awesome.
No, it's so true.
You know our brains.
We become so focused on whatwe're studying and trying to not
just pass our tests but reallyretain this knowledge.
So it sticks.
Carrie (09:41):
Yeah, and I remember them saying you know, the goal
is not to remember everything,it's to remember that that thing
exists and to know where to goget that information.
And that was super helpful tome.
But you know, it's also put mein a unique position now for new
PA students, when they aremessaging me saying, oh my gosh,
I'm studying for blah blah,blah test, it's like you know
what.
Ashley (10:00):
It's going to be a blip.
Yeah, ask us in 10 years.
And and what we're doing?
And, if we remember, you knowany of those, any of those exams
.
So, carrie, when you were, whenyou were on rotation, when you
were doing rotations in PAschool, did you have access to
an interventional radiologyrotation or did you just know
that you were interested in that?
Carrie (10:19):
Well, you know, I leveraged my network at Duke
hospital because I was asonographer there and so I went
to and a lot of the physiciansthat I worked with, a lot of the
radiologists, they were verysupportive of me going to PA
school.
And so with my program youcould pick two rotations and you
could create one.
So I went back to my IR youknow folks at Duke and said, hey
(10:42):
, can I create an IR rotationwhere I can come and be an IRPA
student?
And they said, oh yeah, great.
So I set that up actually, andso I got to go and spend, you
know, that rotation there.
So I got to actually do somethyroid biopsies and and do some
other things.
You know, be more hands on.
But the trick was that they hadto continue to offer that to
(11:02):
other students, right?
So once you created it, it hasto be maintained.
So, yeah, that was how I solvedthat riddle.
Not everybody has thatopportunity, not all PA programs
allow that.
And then you know I would also.
You know, even when I was a PA,when I was in my first job,
sometimes the PA students thatwere on surgery rotations would
(11:24):
come hang out with me, comespend time with me.
But I think there are more ofthem now than there used to be
where you can have a rotation.
But as far as fellowships go, Ithink there are maybe one or
two maybe, but when you Googlethat it's not, it doesn't just
pop up.
So I think in general you'renot really getting a lot of IR
(11:44):
exposure.
I think you're going to getsome radiology lectures, but
you're not going to get a lot ofIR exposure.
Ashley (11:50):
Which I'm sure is where your background and, like you
said, your network came in suchhandy.
It's the cool thing about beinga PA.
You know we have access to allof these different fields that
we can jump into and andinterventional radiology is one
of them that we can jump intoand interventional radiology is
one of them.
You mentioned a thyroid biopsy,and the medical nerd in me is
freaking out now, so excited totalk about a day in your life.
(12:13):
Keri, walk us through what itlooks like to be an
interventional radiology PA.
Now we know you do thyroidbiopsies and I'm sure that, just
like just the beginning, justto kind, of start it off.
Carrie (12:31):
We're image guided interventions, image guided
procedures, so we're clinicaland procedural.
So we're either intervening ina clinical capacity, meaning
we're trying to find an answer,so maybe like a targeted biopsy
of the liver with a mass in itthat was a common procedure I
might do, where that's answeringa question.
The oncologists need to knowwhat kind of cancer they're
treating to go to the next steps, right?
So it's a unique intersectionfor you to build a relationship
(12:54):
with a patient because they'reoften scared to death.
We often become sort of alanding pad for a lot of
questions because they getpretty hurried and rushed
through this process.
It may be that their primarycare did some lab work, get
pretty hurried and rushedthrough this process.
It may be that their primarycare did some lab work.
It was abnormal.
They messaged them on theportal and said, hey, I'm
sending you for this liverbiopsy.
By the time they get to methey're like what is happening
to me?
So it's a unique intersectionthere.
(13:15):
So it allows us to be advocatesfor the patients and to sort of
normalize what's happening andsay, hey, I'm here rooting for
you.
This is what comes next.
Let me make sure all theconnections are in place for you
.
So there's a lot of that.
We offer treatments that allowpeople to walk in feeling badly
and then leave feeling better Ajoint injection for someone who
(13:39):
has osteoarthritis and they justcan't lose the weight they need
for their knee replacement orwhatever it may be.
Or cancer patients who've hadradiation, who have pain.
You know, just this year I'vehad the pleasure of taking care
of two women who are metastatic,like stage four cancer, that
(14:00):
their biggest complaint wasshoulder pain, just their
shoulders hurt, just thetenseness in their body.
And they said no one's beenable to make this feel better.
Little things, you know, doinga suprascapular nerve steroid
injection or trigger pointinjections.
These women were in tears whenthey left because they felt
better after a year.
So it's that right.
It's answering the question butalso making it more manageable.
(14:24):
So I like that.
You know, in one day a patientcan arrive.
We don't know what's wrong withthem.
I can do an ultrasound.
I can say, hey, there's a livermass.
All right, I'm going to do abiopsy of that liver mass.
This is all in the same day,right?
You don't even have to reallybe fasting in some settings I
get that answer it's off topathology.
(14:45):
Within a day or two we have ananswer about what that is and
then maybe two weeks from nowyou come back to me for your
port placement because you needchemotherapy.
And then maybe, farther downthe road, you've got, you know,
refractory ascites that I cannow take off for you
palliatively to make you morecomfortable.
So being able to intervene atthese places where this
specialty care is really neededis pretty exciting for me.
(15:07):
I like making people feelbetter and I like solving the
puzzle.
Ashley (15:10):
That's the coolest thing about working procedurally and
also clinically as well.
You know you get to do, you getto use your hands, you get to
fix the problem, but also youhave that, that interaction with
the patient.
That is so wonderful andarguably one of the reasons why
we became PAs, right?
Oh, carrie, there are so manydifferent ways.
I want to go based oneverything you just said.
(15:32):
First, I want to talk aboutyour autonomy, and this is
probably going to lead into aquestion about how you work in a
group setting right, how youcollaborate with radiologists
and technologists and otherhealthcare professionals.
You mentioned even primary caredoctors sitting patients in
that sort of thing.
What does your autonomy looklike in interventional radiology
and how do you collaborate withother members of the healthcare
(15:55):
field?
Carrie (15:56):
You know it's different.
I mean I think you ask you, askPAs nationally that are in IR.
They're going to tell you, hey,I'm only clinical.
One's going to say I'm onlyprocedural, internationally that
are in IR, they're going totell you, hey, I'm only clinical
.
One's going to say I'm onlyprocedural.
One's going to say I'm amixture One.
You know we use these terms, youknow, like a physician
surrogate versus a replacement.
You know, I think in my role,in my years of experience, you
(16:18):
know I enjoy working in that.
The outpatient setting, so Ioutpatient based labs, I like
that setting.
It can be very, very fluid.
You can get a lot done.
But for me I can be prettyindependent.
I mean I have that.
I have that support that I knowmy attendings in the other room
or he's a phone call away, butfor the most part they trust me
(16:39):
and I also know that if I needthem they're going to be there.
So they do allow me to practicewithin my full scope, which I
feel very lucky about.
I work in the state of Oregonright now and it's very PANP
friendly, so there are not a lotof limitations in that
standpoint.
But you know, one of the uniquethings about my practice is
that we have diagnosticradiologists those are the folks
(17:00):
who are spending time in frontof the computer screen reading
CTs, mrs etc.
And you have interventionalradiologists and in the last
several years it used to just beradiology and they've separated
.
So for a private practice it'smore, you know, from that
standpoint of generating RVUsand keeping the doors open for
patients.
I can see, you know, theparacentesis, the thoracentesis,
(17:22):
the consultations for cancertreatment, the women's health
consultations, the problemvisits, the catheter exchanges.
I can see all of that.
While he's able to read thesehigh-level acute CTs and MRs and
x-rays and get people answers,like keeping the wheels turning.
So if he were to be pulled awayfrom that reading, then someone
(17:42):
like you or me is waiting tofind out what mom CT said, or
waiting to get that answer, sowe know what to do next.
Or or that patient who's youknow now finished chemo and we
want to know did it respond?
Is the cancer still there?
It allows them to keepanswering those questions.
Right, we're keeping the otherpart going.
So I've been fortunate enoughin practice to be to be very
(18:05):
autonomous, but also likeknowing what my limits are.
So if I, if I call and ask forhelp.
They're like, okay, something'sup right and they've learned to
trust me in that way.
It's definitely, I think, canbe a little bit harder to build
that in a procedural specialtybecause of the liability.
Ashley (18:25):
I absolutely agree with you and Carrie.
You just beautifully describedhow a PA working at the top of
their license in conjunctionwith an attending who trusts
that PA is so efficient.
Once you've developed thattrust and that relationship with
your attending physician oryour supervising physician, when
(18:46):
you call on them for theiropinion or for advice or for
help, they respond.
They know that you know whatyou know and they're also aware
of the fact that you know whatyou don.
They know that you know whatyou know and they're also aware
of the fact that you know whatyou don't know as well.
And that's equally disappointed, right?
No?
Carrie (19:04):
it's true.
It's true, something as simpleas a paracentesis.
You know we'll take that fluidin the belly.
We need to take it off.
That's something I was doing 25of those a day at a prior
practice and I had a patientcome in really complex history
cholangia, car carcinoma we'reseeing frequently for various
drains, catheters, tubes that hehad.
But when he came down forparasitesis I thought you know,
(19:26):
this just looks funny, like thefluid doesn't look normal,
something's not right about it.
It just bothered me and I thinkas PAs we have that little voice
that says something's not righthere, I need to go get somebody
.
And that's the beauty of beinga PA, right Is that you always
have that person that you can gograb and say look at this with
me.
I love that and that's how Ibecame a PA.
I mean I think there aremisconceptions about, well, you
(19:47):
couldn't go to medical school oryou weren't smart enough.
No, absolutely not.
It was just not that at all.
I just I like the team, like Iwant to have a group of people.
I'll be better having thatsupport.
But yeah, I went and grabbed oneof my attendings.
Now, keeping in mind, I've beendoing these for years and years
, thousands and thousands ofthese procedures.
And I went and grabbed him andsaid, hey, this does not look
(20:08):
right.
So he kind of rushed in and waslooking around.
He's like, oh, wait a second.
Yeah, what had turned out isthat this patient had a gastric
outlet of he had a gastricoutlet obstruction, and so that
what, what I was actually, whatwas like funny looking fluid was
actually his stomach, becausethey had two stairs.
(20:28):
So he was in trouble and youknow, and afterwards the
radiologist went to the side andhe said you know, I gotta be
honest, I probably wouldn't havecaught that, I probably would
have just done it, and then thatwould have been a whole other,
a whole other situation.
But it's in that moment where Itook the chance that he was
gonna go oh, it's fine, wouldhave just done it, and then that
would have been a whole other,a whole other situation.
But it's in that moment where Itook the chance that he was
going to go oh, it's fine,carrie, like she should have
been able to do that, butinstead it was a winning moment
in his eyes because she's goingto come get me and I don't worry
(20:51):
about it.
So, yeah, I think that's what Ihope for every advanced practice
provider, you know.
But I think we ultimately are aproduct of the investment of
our collaborative physicians.
Right, if you invest time in us, we're going to be great.
If you don't, we're not goingto be great, we'll have our own
way.
But we were created to helpextend them, to help make their
(21:14):
day easier and to just havebetter access for patients.
So, with physician shortages,especially in radiology, I am a
product of a lot of greatradiologists and mentors.
Ashley (21:26):
That's incredible.
Some of us work very, veryclosely with our attendings,
with our supervising physicians,and others don't have that
opportunity and, while I thinkthey can still be incredible PAs
, they will also tell you thatperhaps their road to where
they're at was a lot steeper, alot scarier and a lot less
(21:49):
supportive period.
I think the confidence that Ihave in my practice has largely
come from the fact that I havesignificant access to my
supervising physician.
Something you mentioned, Carrie, that I would love to go back
to just because it's interesting, is when you have patients come
in.
You mentioned some of them comein incredibly fearful because
they're there.
Somebody told them there issomething wrong with their body
(22:11):
and they are there to find outwhat it is and how, how wrong,
how bad it is.
And then other patients come inand they're so hopeful because
they found out maybe you canhelp them with chronic pain or
with a chronic disease orchronic issue.
How do you manage that?
How do you address thepatient's emotions?
Going into this, I think?
Carrie (22:30):
that's probably one of my favorite parts, you know,
because you have patients thatare afraid.
Of course.
You have patients who've beenin chronic pain for a long time,
and that changes people.
And then you have people whohave just sort of given up.
You've people who haven'treally been heard, that feel
sort of hopeless.
And then you have the peoplethat you walk in the room and
they're very skeptical.
(22:51):
They're very skeptical of you.
They've had bad experiences andmaybe they're skeptical of you
because you're a PA or an NP hadbad experiences, and maybe
they're skeptical of you becauseyou're a PA or an NP, not a
physician.
So, being able to walk in theroom, establish a rapport and
win them over, where at the endthey're saying, oh, can I, can I
get your card, I like that.
I like that opportunity to getin there and reshape the way
(23:13):
they're seeing it, you know, asa more of a victory and less of
a setback, that we're going tomake that better.
We're going to work on makingit better and if we can't, we're
going to get you connected tothe next step, because sometimes
that's what I'm doing.
Hey, I can't fix this or makethis better, but I know who can
and I'll take thatresponsibility of getting you to
the next step.
(23:34):
You know, when patients come inthe room, they trust you.
They're very vulnerable to youto share this sort of problem,
so I think we take that forgranted as providers.
You know they're our seventhpatient today, but this is their
unique situation.
So it's very important for methat I walk in the room
knowledgeable about that patient, especially the skeptical ones,
(23:57):
and you never know when you'regoing to hit the skeptical ones.
But when they start sharingpast experiences, when they
start sharing other things thathave happened, you need to be
able to say, yeah, I read aboutthat.
That must have been reallydifficult.
Or you know what about this?
You know I had a patient whoneeded a biopsy, a lung biopsy
done, but he kept canceling, hewouldn't get the biopsy done and
(24:19):
I said you know, let's, let'sbring him in.
I want to sit and talk to him.
This guy was in his 70s, sweetguy, but was very, was very
withdrawn, very shielded.
I could just tell I was like,hey, you know, it's really
important that we get this donefor you.
So I want you to talk to me.
What's happening, tell me andyou could tell, as an older man
(24:42):
from a generation of not reallycomplaining or being upset.
It was hard for him to talk tome about it, and I said you know
, are you afraid it's going tohurt?
Are you afraid that you knowyou're going to pass away?
Like what?
Tell me, talk to me.
And so he shared an experiencewhen he was a kid.
This was many, many years ago.
It was probably eight, nineyears old maybe, and it sounds
like he had pneumonia and he hadpleural effusions, and so he
(25:04):
said that daily someone wouldcome in the room hold his arms
and they would drain his chest,and they did that for days.
And so he has trauma.
He has trauma as a man in his70s, and that trauma is
preventing him from getting hislung biopsy.
So I needed to create a spacewhere we could talk about that
(25:24):
before we could even get to therisks and benefits of a lung
biopsy, and so what I was ableto zero in on is OK, he needs to
feel like he has some controland he needs to know that it's
not going to hurt, and we needto deal with his anxiety
surrounding having the proceduredone, and so we laid out a plan
that he felt good about, and wegot it done and we're able to
move on to the next step.
(25:45):
But sometimes you think you'regoing to go in and talk about a
pneumothorax as a risk, butinstead you've got to hear them
and say that's awful, thatshould have never happened to
you and nothing like that ishappening on my watch.
So it's awful, that should havenever happened to you and
nothing like that has happenedon my watch.
So it's interesting how I thinkyou do have to be prepared for
(26:06):
whatever you're going to walkinto.
But I love when patients can bethat way with me.
I love when they come in afraidand feel overwhelmed by it and
we make it more manageabletogether.
I like that.
Ashley (26:20):
That is such a great story and those stories believe
it or not, those stories usuallydo have happy endings.
I have found, at least in mypractice.
It's inevitably the patientswhen you walk in the room and
the temperature literally drops.
They're so reserved and they'reso protected and guarded.
And being able to disarm apatient like that with your
(26:41):
words and your questions andmaybe a physical touch if it's
required, is so rewarding.
Carrie (26:49):
It can be exhausting if you have to do that multiple
times a day.
Yes, there is a cost to that tobecome that fully effective
right.
Especially in IR, we deal witha lot of palliative patients.
So you know, sometimes you'regoing to get asked those tough
questions.
You know, why is this happeningto me?
I've accepted what's happeningto me and I'm ready to go, but I
(27:10):
don't know how to let go, likeI don't know how to die Carrie,
like how do I even do that?
My husband isn't ready to letme go.
You got to talk to him.
So sometimes you could askthese questions, especially
around procedures andinterventions of you know, is my
mom going to make it throughthis?
They'll bring daughter andgranddaughter and sons, and so
(27:32):
you're not just treating thepatient, you're often treating
the families too.
I think it's just being reallyclear about you know how we're
going to help and how we'regoing to address all the other
things too, because maybethey're coming to me for liver
directed therapy for a tumor intheir liver, but they also
really need a nephrologistbecause their renal function is
(27:52):
not great but they don't have anephrologist.
So now, okay, I got to get themsafely to that next destination
, because it's more than just Ido IR, and I think that's
different.
It's different for everybody,but for me it's all encompassing
.
In my current practice I'mworking with advanced vascular
centers in Portland and we do alot of women's health but a lot
(28:15):
of limb salvage, like preventingamputation.
And these people come in afraid, someone going from being able
to walk to not being able towalk.
What an equalizer right.
The morbidity and mortalityassociated with patients after
that happens.
We got to fight really hard forthem.
So you know how do we interveneat these acute and scary times
(28:38):
in a you do, Carrie.
Ashley (28:45):
You've talked about some really mind-blowing things that
you get to do and ways that youget to help these patients.
Thinking back when you firststarted PA school, or maybe
right after you graduated, isthis what you thought your life
was going to look like?
I mean, do you take a step backevery now and then and go oh my
goodness, look at what I amdoing right now, Look at how
(29:07):
amazing this is?
Carrie (29:09):
You know, like I said, I think I knew I always want to
take care of people, but Ididn't know that this is where I
would end up or how it wouldend up when I knew I wanted to
be in radiology as a PA.
I only knew one other one, youknow I was in North Carolina.
I had never lived outside ofNorth Carolina so I didn't know
any other ones.
But I thought, oh my gosh, weneed more of these.
(29:31):
So I kind of set out in thisunfamiliar territory and thought
if I can at least land safelyin some of these spots, then
there'll be a place for othersto land safely.
And so it's been really coolseeing more and more and more of
us, you know.
And then there were peopledoing it before me, but more and
(29:52):
more and more of us, you know.
And then there were peopledoing it before me but I didn't
know how to reach them orconnect with them.
So now, going from being theonly one I know to being in a
room with 200 of us, it's prettyamazing that they you can say,
hey, this happened or thathappened.
They're like, yeah, I knowexactly what you're talking
about.
So that feels pretty awesome.
And then, you know, increasingaccess to patients, because,
especially from the smallcommunity I came from, there's
no one like me.
I also have become sort of thatcenter hub for a lot of people
(30:17):
that know I'm in the medicalfield that will reach out like
with a question or a concern.
I don't always have the answer,but I can at least point them
in a direction.
So, yeah, it's, it's beenreally cool.
And then when I have someonemessage me on LinkedIn and be
like hey, you look, you looksreally cool what you're doing.
How did you do that?
(30:39):
I mean this, this mentorshipidea, any chance I get, any
chance I get.
If someone says, oh, like wehad an equipment vendor said my
son's thinking about going to PAschool, hey, give him my, give
him my cell number, have himcall me.
Or I'm working on my letter forPA school, send it to me, let
me look at it with you.
Can I do a workshop for the PAclass?
This is when I was at Stanford.
Yeah, okay, let me do that.
I can't wait.
Make a workshop, any chance Iget, like what you're doing.
Ashley (31:01):
You know I love this, being able to talk about it, not
just as an IRPA but as a PA ingeneral, because I wish this
resource had been available tome or I knew how to access it
when I was coming through RightExactly, and you know, speaking
on professional development,what you do is amazing and the
fact that you realize that it isgrowing but it has so much
(31:22):
farther to go is pivotal, andthis is a perfect segue.
You know I've I talked about abunch of the other things that
you're involved with in theintroduction, but this is a
perfect segue into talking aboutsomething that is so
interesting that you areinvolved with, and it is
creating a certificate of addedqualification for interventional
(31:42):
radiology.
This is through the NCCPA,which maybe we can talk a little
bit about.
Caqs.
I have one in dermatology.
They're specific to our fieldin medicine.
Tell me about how that processis going for you.
Before we hear about thisincredible experience that Keri
is having creating the CAQ, Iwant to talk to you about
quality questions.
(32:03):
This is a segment on our showwhere we ask these leaders in
medicine that we are talking toif they have ever had an
interview question.
That has been extremelymemorable.
Now, Carrie and I did not havethe opportunity to discuss a
quality question.
However, her conversation hereabout CAQs brings up a fantastic
(32:24):
opportunity opportunity.
This is directed at pre-PAstudents, but if you're a
pre-health student that'sinterested in a different field
of medicine, this can bedirectly applicable to you as
well.
A CAQ, or certificate of addedqualification, is a certificate
that you get after you achieveyour degree.
So in this case, my qualityquestion would be do you believe
(32:46):
specialty certifications arebeneficial for the future of the
PA profession or insert yourprofession here, or do they
create unnecessary barriers?
It's a great question to thinkabout before you go for your own
interview.
Keep in mind that there's moreinterview prep, such as mock
interviews and personalstatement review over on
(33:09):
shadowmenextcom.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Carrie (33:17):
You know it's interesting, I think, first off
figuring out why it makes sense,why we'd want to do it.
You know, wanting to be, Ithink, because radiology for so
many years was just considered aprocedural specialty.
We are a heavily clinicalspecialty as well.
You know we're more.
You send a consult our way foran intervention.
Then we've got to look at thepatient holistically and say
(33:39):
this is a good idea or not agood idea for them.
So we're a part of thatmultidisciplinary care team,
right.
So we are a heavily clinicalspecialty, but I think we're
still viewed for those of us,for those that even know what we
are, as a procedural field.
So this is a way to demonstrateclinical proficiency in this
specialty as a PA.
(34:00):
So this certificate of addedqualification, as you know, is
created within the specialtythrough NCCPA and it's basically
a way for you to say I havetaken extra time and paid extra
attention and put extra effortstowards demonstrating my
proficiency in this specialtyand I think that it's time for
us to do that.
(34:20):
I mean, we are still a smallnumber.
I don't know.
Do you know what percentage ofPAs and MPs are in dermatology?
Do you have ways to get thosenumbers, do you?
Ashley (34:28):
know.
I'm sure we could figure it out.
I don't know off the top of myhead, but it's a larger
percentage than PAs ininterventional radiology.
Can I tell you that?
Carrie (34:37):
We're in that probably 1%, 1% to 2% of PAs nationally
that are in IR Very small numberbut growing, growing.
There's more and more interest.
We have folks leaving otherspecialties to come to us, you
know, et cetera.
So the CAQ is a way for us toshow others, hey, ir is my thing
, it's important to me.
(34:58):
It also demonstrates to others.
You know, I think if you're aperson who says, well, what does
an IRPA do, then you've gotthis blueprint that says these
are the things from aknowledge-based standpoint.
This is what they are expectedto know and be familiar with.
You know, it's not saying thatI'm proficient at placing a port
(35:18):
.
It just says that I haveknowledge of this and I know
what it's about and I know thepertinent key things to do.
It's not a certification.
So I think we have to be reallymindful about that.
There's some concern that thesesay that we can do things that
we can't do.
I can place ports, but that'smore than a CAQ.
(35:38):
That's mentorship, that's yearsof training.
So I think it's a way and alsoto demonstrate to other
providers like, say, you're anIR physician or radiologist has
a private practice and you'vegot a list of candidates you
know like, hey, okay, great,this person, you know, has a
dedication to this field, so itmight give you the upper hand as
(36:00):
a, as a PA or an MP as you'relike, fighting for that, that
role I.
But interestingly, I need anendorsement from sort of our
governing body or our, our, ourspecialty organization, that
society of interventionalradiology.
So I'm still in the process ofgetting their endorsement.
It's just taking longer than Ithought it would, but we're just
(36:21):
wanting to make sure that we wethink of all the things um, and
the place I'm at currently isobtaining physician champions to
be collaborative and support mein it, and we're probably going
to be meeting for a SWOTanalysis.
So it gets very it's important,though we want to do it the
right way.
So I mean, this is down theroad, but it'll be really
(36:44):
valuable once it's done.
Ashley (36:47):
And I'm not giving up.
Carrie (36:48):
I'm not giving up.
Ashley (36:48):
You've already done so much for the field of's done and
I'm not giving up.
I'm not giving up.
You've already done so much forthe field of medicine alone and
then for the field of medicinefor PAs.
The fact that you're working onthis number one, after talking
with you and now knowing so muchmore about interventional
radiology than I did before, itis absolutely needed to have a
CAQ in interventional radiology.
Really, like you said, it'sjust.
(37:09):
It's just proof that you knowwhat you know.
You know this isn't thisdoesn't train you any better.
I mean, really this is going tosound silly, but really getting
my CAQ and DERM was quite easybecause it was all this stuff I
already knew how to do.
Right, the test questions werequestions I knew the answers to
because I've done this for 10years, you know.
(37:31):
So it's just a proof.
Carrie (37:34):
Yeah, and I think for us , because IR is very specialized
.
We have folks that just do neuroIR, we have folks that do
interventional IR, we havewomen's health, we have men's
health, we have diagnostic.
We have so many different areasthat it may be that a PA or an
MP may just be practicing in acertain one.
So when you look at getting theCAQ, it's like, well, hey,
(37:55):
you're going to have to knowsome things about neuro IR and
you're going to have some thingsabout all the different
sections.
So the beauty of being able tocreate it you know, having an
expert panel convene, physiciansincluded, to come up with the
blueprint, the questions, all ofthat stuff will make it, you
know, difficult or challenging,but fair right, and it gives
(38:20):
some people a betterunderstanding of well, how does
Carrie know how to do that?
Or how do I know Carrie can gosit and have that conversation?
Well, you know, here's anadditional demonstration of that
.
I would be super proud to haveit.
It's definitely not, it's aninvestment in me, but it also
demonstrates my commitment to myspecialty, carrie as we wrap up
(38:40):
, let's speak directly tosomeone who's interested in
pre-health, right?
Ashley (38:45):
I mean, you've seen healthcare from a variety of
different standpoints.
Right now, what advice wouldyou give them as they're looking
towards their future,considering a career in medicine
?
They're hearing all of thechallenges and everything about
burnout that everybody's talkingabout.
I, in my opinion, I, I itsounds like you are still super
passionate about clinicalmedicine.
(39:07):
So tell me, tell me what youwould tell them, what you would
tell those students.
Carrie (39:11):
You're either going to feel drawn to it, have a calling
to it.
I mean I think that's importantFirst off, I mean just saying,
oh well, I could be a PA.
I mean I think, starting from aplace that I really want to
make a difference and I want tomake things better, you know
that that's an important place.
I mean I think there needs tobe something about it that
speaks to you or drives you justfrom the beginning.
(39:31):
But I think medicine is justfor me, it's been very rewarding
.
I mean I wouldn't I wouldn'tchange a thing.
It changed me.
It changed the way I see theworld.
The relationships that I havemade with you know other
providers, relationships I'vemade with patients I mean it's
(39:55):
part of who I am now and it wasfinding an outlet for that part
of me that wanted to care forpeople.
So I think it needs to bemeaningful to you If you're
thinking about being a PA.
It needs to be meaningful, itneeds to come from a meaningful
place and you know I think we asPAs have a responsibility to
mentor and support those peoplewhen they're talking about it.
(40:18):
You know there are verytraditional ways to mentor.
We know preceptorships you knowI've done that.
But they're also really likenon-traditional ways to mentor
and that could be again, just aphone call or responding on
LinkedIn or talking to thatvendor's son, you know, talk to
them on your way home from work,send them an email, you know,
(40:40):
anytime you get a chance to dothat.
But I would say if you want toget into medicine, it needs to
come from a place of meaning foryou.
And with the burnout stuff,gosh, I'm so much better at
giving advice about that than Iam taking advice about it.
You know what I mean.
(41:01):
Like, oh man, you really needto have some self care.
Like you really should, gosh.
Like, forget it.
I'm like terrible at it.
I'm terrible at that.
I'm terrible at being a patient.
Like, I'm just terrible.
So I cannot.
I have no credibility, but Iknow it's real.
I mean I would say I probablyfailed it the most and hardest
during COVID and then afterCOVID, and I don't know that
(41:22):
I've gotten back to where I waspre-COVID and I don't know why
exactly that is.
We were still doing the samemedicine.
I mean, I was still, you know,frontline, still taking care of
patients.
I think it's because in myspecialty we didn't get to take
a break.
You know, we just still had tobe there, so I never really had
a mental break from it.
But yeah, it definitely hasimpacted me as a person and a
(41:44):
provider and it caused me to say, you know, oh, I'll have that
house in the mountains one day.
Or oh, I'm going to get thatJeep gladiator that I really
wanted.
I got my house in the mountainsand I got my Jeep gladiator.
So, like, don't, don't wait onthose things, for you know, when
it's less busy at work, youknow, go, go do those things,
take the time off Right.
Ashley (42:13):
It's great advice for for pre-health students, but
that's also really really greatadvice for current clinicians
too.
You know, I think that'sincredible.
Thank you so much for takingyour time your valuable time to
join us on shadow me next, aspromised.
You are just a wealth ofinformation and I'm so motivated
by what you're doing for PAsnow and what you will continue
to do that CAQ is going to begreat.
I know it's going to happen.
So thank you, thank you forwhat you do and thank you for
joining us today.
Yeah, thank you for your time.
(42:34):
It was awesome.
Thank you so very much forlistening 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.
(00:44):
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.
(01:04):
Welcome to shadow Me Next.
Today, I'm excited to introduceyou to a true trailblazer in
the PA profession, keri Hayes.
Keri is not only anaccomplished interventional
radiology PA, but also adedicated advocate for advancing
the role of PAs in highlyspecialized fields.
With a passion for professionaldevelopment, she has been
(01:27):
instrumental in pushing for aCertificate of Added
Qualification in InterventionalRadiology through the NCCPA, an
initiative that will help definestandards and elevate
recognition for PAs in thisgrowing specialty.
Beyond her clinical expertise,keri is actively involved in
leadership and mentorship withinthe PA community.
(01:48):
She has played a key role inthe Society of Interventional
Radiology, working to strengthenthe presence and influence of
advanced practice providers inthe field.
She's also engaged in theEntelios Foundation, an
organization focused on medicalimaging excellence, and has been
a vocal advocate forfluoroscopy and radiation safety
standards.
(02:09):
Through her mentorship efforts,whether speaking at conferences
, guiding PA students orconnecting with aspiring PAs
through professional networks,carrie is shaping the next
generation of clinicians andensuring they have support and
knowledge to thrive.
In this episode, we'll diveinto her journey, her efforts to
(02:30):
expand PA opportunities ininterventional radiology and the
impact of her work on theprofession.
Whether you're a PA student, apracticing clinician or simply
curious about the future of PAsin specialized medicine, or
simply curious about the futureof PAs in specialized medicine,
this conversation is for you.
Please keep in mind that thecontent of this podcast is
(02:50):
intended for informational andentertainment purposes only and
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.
This is Shadow Me Next withKeri Hayes.
(03:13):
Hey, keri, thank you so muchfor joining us here on Shadow Me
Next.
I am thrilled to have you.
I have never met somebody whodoes what you do as a PA, so
thank you so much for joining us.
Carrie (03:24):
Yeah, thanks for having me.
I'm super excited about beinghere.
This is great that you're doingthis.
Shadow me next.
I think it's a really uniqueopportunity for people.
It allows us to kind of brag onour specialty a little bit and
then also to sort of I don'tknow cause you know PAs and P's
to think about.
Oh, intermature audiology.
Ashley (03:43):
That sounds cool.
I'm so glad because that'sexactly what we're doing.
We're bragging on our specialty.
It was funny One of the guys Ijust recently spoke to, jim.
He said Ash, I've just what Ido is so cool and I just want to
share it with everybody.
This is going to be a reallyinteresting conversation for
pre-health students to kind ofdiscover something else that a
PA can do, and perhaps a reallyeye-opening discussion for
(04:05):
current practicing cliniciansBecause, like I said, I think
what you do is really unique andwe all have a lot to learn from
this conversation today.
So, keri, let's start from thebeginning, because you have a
really interesting story evenbefore your PA career.
Tell us what inspired you topursue a career in medicine and
where did you end up initially.
Carrie (04:25):
Well, I mean, I guess, like all young girls, I thought
I'm going to be a veterinarian.
Of course I mean that's what wewere all going to do as little
girls.
That's sort of the first part,right.
The second part is that I grewup in a really small town in
North Carolina, and when I saysmall town I mean really small.
(04:49):
You know little to no access tospecialty care, like no real
preventative medicine, like youonly go when you're sick.
You know you're not just goingto go to be proactive.
So those people can't evencouldn't even afford insurance,
you know.
And when folks were getting tothe hospital it was normally an
acute state, some advanced stageof disease, low health literacy
, just really few communityresources.
You know our closest specialtycenters were two to three hours
(05:11):
away.
It was often a hardship totravel.
You know this has a huge impacton outcomes for folks.
So I've always felt drawn to lowresource communities to be a
patient advocate.
But you know how could I bringspecialty services back to my
small community?
So that's sort of.
I've always known that I wasgoing to take care of people,
but I was especially invested inmaking sure that there was some
(05:32):
equality in the care.
So that is how I decided Iwanted to be in medicine.
But then from there, you know,I thought I would be a
veterinarian, but now I'm anindividual LGPA in Oregon.
So of course it makes perfectsense how I went from there to
here.
Ashley (05:47):
A little bit of a wild journey, absolutely, absolutely.
You know it's funny veterinarycare I spoke about this again.
I mean this is there's so manyconnections in medicine, but I
spoke about it with a pediatricresident physician recently and
caring for animals and caringfor people is still caring for
another living thing, you know,and she told me about how much
she had learned working as aveterinary technician and how a
(06:09):
lot of her patients as pediatricpatients.
She uses very similartechniques with them because
they don't speak.
Most of her animal patientsalso did not speak.
You know they have differentways of expressing themselves.
Carrie, you worked as a medicalsonographer before PA school.
Is that correct?
Carrie (06:25):
Tell us a little bit about that and what that
transition looked like yeah,that's so funny that you bring
up what you did, because while Ithought I was going to be a
veterinarian, I ended up workingwith a veterinary radiologist
group, two radiologists on theirown practice.
We were mobile, we went toveterinary hospitals and clinics
and did diagnostic andinterventional ultrasound and I
became obsessed with ultrasound,like, oh my gosh, you just put
(06:45):
this on their belly and oh mygosh, you could see all these
things.
So it was while I was doing thatthat I fell in love with
ultrasound.
And then I thought, okay, I cando this with animals, I want to
do this with people too.
So that's how I ended up goingto ultrasound school.
It's like, okay, I want to scanpeople.
And then while scanning peoplefrom 24 week preemies to 100
year old patients I hit thisglass ceiling of like, oh man,
(07:10):
like what happened to them?
How did that turn out?
Was my ultrasound correct?
You know, I really want to knowwhat happened.
That patient told me aboutsomething that was going on with
them personally.
How's she doing?
She was so sweet when I saw her, so that glass ceiling sort of
propelled me forward.
You know, okay, I want to havean established relationship with
patients.
(07:30):
I want to be part of alongitudinal care aspect.
So that's how PA schoolhappened.
I got into Duke's PA programand I hit the ground running.
The first, my first job was inHouston.
So that was an interestingtransition going from being a
sonographer to PA school to nowbeing an IRPA, where I'm not
(07:50):
only using ultrasound indiagnostic capacity but now I'm
doing using it in aninterventional capacity.
So yeah, it seemed like alogical step for me it's a very
interesting tract really.
Ashley (08:01):
You saw what you were interested in and then you've
really stayed close to thatfield at least.
But your responsibilities havechanged and what your abilities,
what you can do, has changed.
How has Duke's PA program thisis one of the best, if not the
best, pa programs in the countrysuper challenging, I would
(08:21):
imagine.
Carrie (08:21):
I think they tell you.
You know, I went into itthinking, yeah, I'll probably
still work part time.
No way, man.
And they made you sign a pieceof paper that said you wouldn't
work in any capacity more than15 hours a week or something.
It definitely became a fulltime job.
You know that we've all heardthis like drinking information
(08:43):
through a fire hydrant.
I mean it was really literally.
I mean, I think there was onemorning I had been studying, for
I mean I would go to go toschool.
Come home I'd study all night,I'd go to sleep, I'd get up, I'd
study, then I'd go to school.
I think there was one morningwhere I had studied so hard for
a test that I went out to my carand I could not remember how to
open the door to my car.
(09:05):
Like where is it?
I mean it was just my brain wasso full of other things Like I
had forgotten how to open my cardoor.
But I and I have like a corememory of that moment.
It's like Carrie, just breathe.
You know it was fine.
But you know, great program.
I mean we had patient contactreally early on.
I really feel like theyprepared us to be clinicians.
(09:27):
So I'm very proud of my timethere.
Ashley (09:29):
That's awesome.
No, it's so true.
You know our brains.
We become so focused on whatwe're studying and trying to not
just pass our tests but reallyretain this knowledge.
So it sticks.
Carrie (09:41):
Yeah, and I remember them saying you know, the goal
is not to remember everything,it's to remember that that thing
exists and to know where to goget that information.
And that was super helpful tome.
But you know, it's also put mein a unique position now for new
PA students, when they aremessaging me saying, oh my gosh,
I'm studying for blah blah,blah test, it's like you know
what.
Ashley (10:00):
It's going to be a blip.
Yeah, ask us in 10 years.
And and what we're doing?
And, if we remember, you knowany of those, any of those exams
.
So, carrie, when you were, whenyou were on rotation, when you
were doing rotations in PAschool, did you have access to
an interventional radiologyrotation or did you just know
that you were interested in that?
Carrie (10:19):
Well, you know, I leveraged my network at Duke
hospital because I was asonographer there and so I went
to and a lot of the physiciansthat I worked with, a lot of the
radiologists, they were verysupportive of me going to PA
school.
And so with my program youcould pick two rotations and you
could create one.
So I went back to my IR youknow folks at Duke and said, hey
(10:42):
, can I create an IR rotationwhere I can come and be an IRPA
student?
And they said, oh yeah, great.
So I set that up actually, andso I got to go and spend, you
know, that rotation there.
So I got to actually do somethyroid biopsies and and do some
other things.
You know, be more hands on.
But the trick was that they hadto continue to offer that to
(11:02):
other students, right?
So once you created it, it hasto be maintained.
So, yeah, that was how I solvedthat riddle.
Not everybody has thatopportunity, not all PA programs
allow that.
And then you know I would also.
You know, even when I was a PA,when I was in my first job,
sometimes the PA students thatwere on surgery rotations would
(11:24):
come hang out with me, comespend time with me.
But I think there are more ofthem now than there used to be
where you can have a rotation.
But as far as fellowships go, Ithink there are maybe one or
two maybe, but when you Googlethat it's not, it doesn't just
pop up.
So I think in general you'renot really getting a lot of IR
(11:44):
exposure.
I think you're going to getsome radiology lectures, but
you're not going to get a lot ofIR exposure.
Ashley (11:50):
Which I'm sure is where your background and, like you
said, your network came in suchhandy.
It's the cool thing about beinga PA.
You know we have access to allof these different fields that
we can jump into and andinterventional radiology is one
of them that we can jump intoand interventional radiology is
one of them.
You mentioned a thyroid biopsy,and the medical nerd in me is
freaking out now, so excited totalk about a day in your life.
(12:13):
Keri, walk us through what itlooks like to be an
interventional radiology PA.
Now we know you do thyroidbiopsies and I'm sure that, just
like just the beginning, justto kind, of start it off.
Carrie (12:31):
We're image guided interventions, image guided
procedures, so we're clinicaland procedural.
So we're either intervening ina clinical capacity, meaning
we're trying to find an answer,so maybe like a targeted biopsy
of the liver with a mass in itthat was a common procedure I
might do, where that's answeringa question.
The oncologists need to knowwhat kind of cancer they're
treating to go to the next steps, right?
So it's a unique intersectionfor you to build a relationship
(12:54):
with a patient because they'reoften scared to death.
We often become sort of alanding pad for a lot of
questions because they getpretty hurried and rushed
through this process.
It may be that their primarycare did some lab work, get
pretty hurried and rushedthrough this process.
It may be that their primarycare did some lab work.
It was abnormal.
They messaged them on theportal and said, hey, I'm
sending you for this liverbiopsy.
By the time they get to methey're like what is happening
to me?
So it's a unique intersectionthere.
(13:15):
So it allows us to be advocatesfor the patients and to sort of
normalize what's happening andsay, hey, I'm here rooting for
you.
This is what comes next.
Let me make sure all theconnections are in place for you
.
So there's a lot of that.
We offer treatments that allowpeople to walk in feeling badly
and then leave feeling better Ajoint injection for someone who
(13:39):
has osteoarthritis and they justcan't lose the weight they need
for their knee replacement orwhatever it may be.
Or cancer patients who've hadradiation, who have pain.
You know, just this year I'vehad the pleasure of taking care
of two women who are metastatic,like stage four cancer, that
(14:00):
their biggest complaint wasshoulder pain, just their
shoulders hurt, just thetenseness in their body.
And they said no one's beenable to make this feel better.
Little things, you know, doinga suprascapular nerve steroid
injection or trigger pointinjections.
These women were in tears whenthey left because they felt
better after a year.
So it's that right.
It's answering the question butalso making it more manageable.
(14:24):
So I like that.
You know, in one day a patientcan arrive.
We don't know what's wrong withthem.
I can do an ultrasound.
I can say, hey, there's a livermass.
All right, I'm going to do abiopsy of that liver mass.
This is all in the same day,right?
You don't even have to reallybe fasting in some settings I
get that answer it's off topathology.
(14:45):
Within a day or two we have ananswer about what that is and
then maybe two weeks from nowyou come back to me for your
port placement because you needchemotherapy.
And then maybe, farther downthe road, you've got, you know,
refractory ascites that I cannow take off for you
palliatively to make you morecomfortable.
So being able to intervene atthese places where this
specialty care is really neededis pretty exciting for me.
(15:07):
I like making people feelbetter and I like solving the
puzzle.
Ashley (15:10):
That's the coolest thing about working procedurally and
also clinically as well.
You know you get to do, you getto use your hands, you get to
fix the problem, but also youhave that, that interaction with
the patient.
That is so wonderful andarguably one of the reasons why
we became PAs, right?
Oh, carrie, there are so manydifferent ways.
I want to go based oneverything you just said.
(15:32):
First, I want to talk aboutyour autonomy, and this is
probably going to lead into aquestion about how you work in a
group setting right, how youcollaborate with radiologists
and technologists and otherhealthcare professionals.
You mentioned even primary caredoctors sitting patients in
that sort of thing.
What does your autonomy looklike in interventional radiology
and how do you collaborate withother members of the healthcare
(15:55):
field?
Carrie (15:56):
You know it's different.
I mean I think you ask you, askPAs nationally that are in IR.
They're going to tell you, hey,I'm only clinical.
One's going to say I'm onlyprocedural, internationally that
are in IR, they're going totell you, hey, I'm only clinical
.
One's going to say I'm onlyprocedural.
One's going to say I'm amixture One.
You know we use these terms, youknow, like a physician
surrogate versus a replacement.
You know, I think in my role,in my years of experience, you
(16:18):
know I enjoy working in that.
The outpatient setting, so Ioutpatient based labs, I like
that setting.
It can be very, very fluid.
You can get a lot done.
But for me I can be prettyindependent.
I mean I have that.
I have that support that I knowmy attendings in the other room
or he's a phone call away, butfor the most part they trust me
(16:39):
and I also know that if I needthem they're going to be there.
So they do allow me to practicewithin my full scope, which I
feel very lucky about.
I work in the state of Oregonright now and it's very PANP
friendly, so there are not a lotof limitations in that
standpoint.
But you know, one of the uniquethings about my practice is
that we have diagnosticradiologists those are the folks
(17:00):
who are spending time in frontof the computer screen reading
CTs, mrs etc.
And you have interventionalradiologists and in the last
several years it used to just beradiology and they've separated
.
So for a private practice it'smore, you know, from that
standpoint of generating RVUsand keeping the doors open for
patients.
I can see, you know, theparacentesis, the thoracentesis,
(17:22):
the consultations for cancertreatment, the women's health
consultations, the problemvisits, the catheter exchanges.
I can see all of that.
While he's able to read thesehigh-level acute CTs and MRs and
x-rays and get people answers,like keeping the wheels turning.
So if he were to be pulled awayfrom that reading, then someone
(17:42):
like you or me is waiting tofind out what mom CT said, or
waiting to get that answer, sowe know what to do next.
Or or that patient who's youknow now finished chemo and we
want to know did it respond?
Is the cancer still there?
It allows them to keepanswering those questions.
Right, we're keeping the otherpart going.
So I've been fortunate enoughin practice to be to be very
(18:05):
autonomous, but also likeknowing what my limits are.
So if I, if I call and ask forhelp.
They're like, okay, something'sup right and they've learned to
trust me in that way.
It's definitely, I think, canbe a little bit harder to build
that in a procedural specialtybecause of the liability.
Ashley (18:25):
I absolutely agree with you and Carrie.
You just beautifully describedhow a PA working at the top of
their license in conjunctionwith an attending who trusts
that PA is so efficient.
Once you've developed thattrust and that relationship with
your attending physician oryour supervising physician, when
(18:46):
you call on them for theiropinion or for advice or for
help, they respond.
They know that you know whatyou know and they're also aware
of the fact that you know whatyou don.
They know that you know whatyou know and they're also aware
of the fact that you know whatyou don't know as well.
And that's equally disappointed, right?
No?
Carrie (19:04):
it's true.
It's true, something as simpleas a paracentesis.
You know we'll take that fluidin the belly.
We need to take it off.
That's something I was doing 25of those a day at a prior
practice and I had a patientcome in really complex history
cholangia, car carcinoma we'reseeing frequently for various
drains, catheters, tubes that hehad.
But when he came down forparasitesis I thought you know,
(19:26):
this just looks funny, like thefluid doesn't look normal,
something's not right about it.
It just bothered me and I thinkas PAs we have that little voice
that says something's not righthere, I need to go get somebody
.
And that's the beauty of beinga PA, right Is that you always
have that person that you can gograb and say look at this with
me.
I love that and that's how Ibecame a PA.
I mean I think there aremisconceptions about, well, you
(19:47):
couldn't go to medical school oryou weren't smart enough.
No, absolutely not.
It was just not that at all.
I just I like the team, like Iwant to have a group of people.
I'll be better having thatsupport.
But yeah, I went and grabbed oneof my attendings.
Now, keeping in mind, I've beendoing these for years and years
, thousands and thousands ofthese procedures.
And I went and grabbed him andsaid, hey, this does not look
(20:08):
right.
So he kind of rushed in and waslooking around.
He's like, oh, wait a second.
Yeah, what had turned out isthat this patient had a gastric
outlet of he had a gastricoutlet obstruction, and so that
what, what I was actually, whatwas like funny looking fluid was
actually his stomach, becausethey had two stairs.
(20:28):
So he was in trouble and youknow, and afterwards the
radiologist went to the side andhe said you know, I gotta be
honest, I probably wouldn't havecaught that, I probably would
have just done it, and then thatwould have been a whole other,
a whole other situation.
But it's in that moment where Itook the chance that he was
gonna go oh, it's fine, wouldhave just done it, and then that
would have been a whole other,a whole other situation.
But it's in that moment where Itook the chance that he was
going to go oh, it's fine,carrie, like she should have
been able to do that, butinstead it was a winning moment
in his eyes because she's goingto come get me and I don't worry
(20:51):
about it.
So, yeah, I think that's what Ihope for every advanced practice
provider, you know.
But I think we ultimately are aproduct of the investment of
our collaborative physicians.
Right, if you invest time in us, we're going to be great.
If you don't, we're not goingto be great, we'll have our own
way.
But we were created to helpextend them, to help make their
(21:14):
day easier and to just havebetter access for patients.
So, with physician shortages,especially in radiology, I am a
product of a lot of greatradiologists and mentors.
Ashley (21:26):
That's incredible.
Some of us work very, veryclosely with our attendings,
with our supervising physicians,and others don't have that
opportunity and, while I thinkthey can still be incredible PAs
, they will also tell you thatperhaps their road to where
they're at was a lot steeper, alot scarier and a lot less
(21:49):
supportive period.
I think the confidence that Ihave in my practice has largely
come from the fact that I havesignificant access to my
supervising physician.
Something you mentioned, Carrie, that I would love to go back
to just because it's interesting, is when you have patients come
in.
You mentioned some of them comein incredibly fearful because
they're there.
Somebody told them there issomething wrong with their body
(22:11):
and they are there to find outwhat it is and how, how wrong,
how bad it is.
And then other patients come inand they're so hopeful because
they found out maybe you canhelp them with chronic pain or
with a chronic disease orchronic issue.
How do you manage that?
How do you address thepatient's emotions?
Going into this, I think?
Carrie (22:30):
that's probably one of my favorite parts, you know,
because you have patients thatare afraid.
Of course.
You have patients who've beenin chronic pain for a long time,
and that changes people.
And then you have people whohave just sort of given up.
You've people who haven'treally been heard, that feel
sort of hopeless.
And then you have the peoplethat you walk in the room and
they're very skeptical.
(22:51):
They're very skeptical of you.
They've had bad experiences andmaybe they're skeptical of you
because you're a PA or an NP hadbad experiences, and maybe
they're skeptical of you becauseyou're a PA or an NP, not a
physician.
So, being able to walk in theroom, establish a rapport and
win them over, where at the endthey're saying, oh, can I, can I
get your card, I like that.
I like that opportunity to getin there and reshape the way
(23:13):
they're seeing it, you know, asa more of a victory and less of
a setback, that we're going tomake that better.
We're going to work on makingit better and if we can't, we're
going to get you connected tothe next step, because sometimes
that's what I'm doing.
Hey, I can't fix this or makethis better, but I know who can
and I'll take thatresponsibility of getting you to
the next step.
(23:34):
You know, when patients come inthe room, they trust you.
They're very vulnerable to youto share this sort of problem,
so I think we take that forgranted as providers.
You know they're our seventhpatient today, but this is their
unique situation.
So it's very important for methat I walk in the room
knowledgeable about that patient, especially the skeptical ones,
(23:57):
and you never know when you'regoing to hit the skeptical ones.
But when they start sharingpast experiences, when they
start sharing other things thathave happened, you need to be
able to say, yeah, I read aboutthat.
That must have been reallydifficult.
Or you know what about this?
You know I had a patient whoneeded a biopsy, a lung biopsy
done, but he kept canceling, hewouldn't get the biopsy done and
(24:19):
I said you know, let's, let'sbring him in.
I want to sit and talk to him.
This guy was in his 70s, sweetguy, but was very, was very
withdrawn, very shielded.
I could just tell I was like,hey, you know, it's really
important that we get this donefor you.
So I want you to talk to me.
What's happening, tell me andyou could tell, as an older man
(24:42):
from a generation of not reallycomplaining or being upset.
It was hard for him to talk tome about it, and I said you know
, are you afraid it's going tohurt?
Are you afraid that you knowyou're going to pass away?
Like what?
Tell me, talk to me.
And so he shared an experiencewhen he was a kid.
This was many, many years ago.
It was probably eight, nineyears old maybe, and it sounds
like he had pneumonia and he hadpleural effusions, and so he
(25:04):
said that daily someone wouldcome in the room hold his arms
and they would drain his chest,and they did that for days.
And so he has trauma.
He has trauma as a man in his70s, and that trauma is
preventing him from getting hislung biopsy.
So I needed to create a spacewhere we could talk about that
(25:24):
before we could even get to therisks and benefits of a lung
biopsy, and so what I was ableto zero in on is OK, he needs to
feel like he has some controland he needs to know that it's
not going to hurt, and we needto deal with his anxiety
surrounding having the proceduredone, and so we laid out a plan
that he felt good about, and wegot it done and we're able to
move on to the next step.
(25:45):
But sometimes you think you'regoing to go in and talk about a
pneumothorax as a risk, butinstead you've got to hear them
and say that's awful, thatshould have never happened to
you and nothing like that ishappening on my watch.
So it's awful, that should havenever happened to you and
nothing like that has happenedon my watch.
So it's interesting how I thinkyou do have to be prepared for
(26:06):
whatever you're going to walkinto.
But I love when patients can bethat way with me.
I love when they come in afraidand feel overwhelmed by it and
we make it more manageabletogether.
I like that.
Ashley (26:20):
That is such a great story and those stories believe
it or not, those stories usuallydo have happy endings.
I have found, at least in mypractice.
It's inevitably the patientswhen you walk in the room and
the temperature literally drops.
They're so reserved and they'reso protected and guarded.
And being able to disarm apatient like that with your
(26:41):
words and your questions andmaybe a physical touch if it's
required, is so rewarding.
Carrie (26:49):
It can be exhausting if you have to do that multiple
times a day.
Yes, there is a cost to that tobecome that fully effective
right.
Especially in IR, we deal witha lot of palliative patients.
So you know, sometimes you'regoing to get asked those tough
questions.
You know, why is this happeningto me?
I've accepted what's happeningto me and I'm ready to go, but I
(27:10):
don't know how to let go, likeI don't know how to die Carrie,
like how do I even do that?
My husband isn't ready to letme go.
You got to talk to him.
So sometimes you could askthese questions, especially
around procedures andinterventions of you know, is my
mom going to make it throughthis?
They'll bring daughter andgranddaughter and sons, and so
(27:32):
you're not just treating thepatient, you're often treating
the families too.
I think it's just being reallyclear about you know how we're
going to help and how we'regoing to address all the other
things too, because maybethey're coming to me for liver
directed therapy for a tumor intheir liver, but they also
really need a nephrologistbecause their renal function is
(27:52):
not great but they don't have anephrologist.
So now, okay, I got to get themsafely to that next destination
, because it's more than just Ido IR, and I think that's
different.
It's different for everybody,but for me it's all encompassing
.
In my current practice I'mworking with advanced vascular
centers in Portland and we do alot of women's health but a lot
(28:15):
of limb salvage, like preventingamputation.
And these people come in afraid, someone going from being able
to walk to not being able towalk.
What an equalizer right.
The morbidity and mortalityassociated with patients after
that happens.
We got to fight really hard forthem.
So you know how do we interveneat these acute and scary times
(28:38):
in a you do, Carrie.
Ashley (28:45):
You've talked about some really mind-blowing things that
you get to do and ways that youget to help these patients.
Thinking back when you firststarted PA school, or maybe
right after you graduated, isthis what you thought your life
was going to look like?
I mean, do you take a step backevery now and then and go oh my
goodness, look at what I amdoing right now, Look at how
(29:07):
amazing this is?
Carrie (29:09):
You know, like I said, I think I knew I always want to
take care of people, but Ididn't know that this is where I
would end up or how it wouldend up when I knew I wanted to
be in radiology as a PA.
I only knew one other one, youknow I was in North Carolina.
I had never lived outside ofNorth Carolina so I didn't know
any other ones.
But I thought, oh my gosh, weneed more of these.
(29:31):
So I kind of set out in thisunfamiliar territory and thought
if I can at least land safelyin some of these spots, then
there'll be a place for othersto land safely.
And so it's been really coolseeing more and more and more of
us, you know.
And then there were peopledoing it before me, but more and
(29:52):
more and more of us, you know.
And then there were peopledoing it before me but I didn't
know how to reach them orconnect with them.
So now, going from being theonly one I know to being in a
room with 200 of us, it's prettyamazing that they you can say,
hey, this happened or thathappened.
They're like, yeah, I knowexactly what you're talking
about.
So that feels pretty awesome.
And then, you know, increasingaccess to patients, because,
especially from the smallcommunity I came from, there's
no one like me.
I also have become sort of thatcenter hub for a lot of people
(30:17):
that know I'm in the medicalfield that will reach out like
with a question or a concern.
I don't always have the answer,but I can at least point them
in a direction.
So, yeah, it's, it's beenreally cool.
And then when I have someonemessage me on LinkedIn and be
like hey, you look, you looksreally cool what you're doing.
How did you do that?
(30:39):
I mean this, this mentorshipidea, any chance I get, any
chance I get.
If someone says, oh, like wehad an equipment vendor said my
son's thinking about going to PAschool, hey, give him my, give
him my cell number, have himcall me.
Or I'm working on my letter forPA school, send it to me, let
me look at it with you.
Can I do a workshop for the PAclass?
This is when I was at Stanford.
Yeah, okay, let me do that.
I can't wait.
Make a workshop, any chance Iget, like what you're doing.
Ashley (31:01):
You know I love this, being able to talk about it, not
just as an IRPA but as a PA ingeneral, because I wish this
resource had been available tome or I knew how to access it
when I was coming through RightExactly, and you know, speaking
on professional development,what you do is amazing and the
fact that you realize that it isgrowing but it has so much
(31:22):
farther to go is pivotal, andthis is a perfect segue.
You know I've I talked about abunch of the other things that
you're involved with in theintroduction, but this is a
perfect segue into talking aboutsomething that is so
interesting that you areinvolved with, and it is
creating a certificate of addedqualification for interventional
(31:42):
radiology.
This is through the NCCPA,which maybe we can talk a little
bit about.
Caqs.
I have one in dermatology.
They're specific to our fieldin medicine.
Tell me about how that processis going for you.
Before we hear about thisincredible experience that Keri
is having creating the CAQ, Iwant to talk to you about
quality questions.
(32:03):
This is a segment on our showwhere we ask these leaders in
medicine that we are talking toif they have ever had an
interview question.
That has been extremelymemorable.
Now, Carrie and I did not havethe opportunity to discuss a
quality question.
However, her conversation hereabout CAQs brings up a fantastic
(32:24):
opportunity opportunity.
This is directed at pre-PAstudents, but if you're a
pre-health student that'sinterested in a different field
of medicine, this can bedirectly applicable to you as
well.
A CAQ, or certificate of addedqualification, is a certificate
that you get after you achieveyour degree.
So in this case, my qualityquestion would be do you believe
(32:46):
specialty certifications arebeneficial for the future of the
PA profession or insert yourprofession here, or do they
create unnecessary barriers?
It's a great question to thinkabout before you go for your own
interview.
Keep in mind that there's moreinterview prep, such as mock
interviews and personalstatement review over on
(33:09):
shadowmenextcom.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Carrie (33:17):
You know it's interesting, I think, first off
figuring out why it makes sense,why we'd want to do it.
You know, wanting to be, Ithink, because radiology for so
many years was just considered aprocedural specialty.
We are a heavily clinicalspecialty as well.
You know we're more.
You send a consult our way foran intervention.
Then we've got to look at thepatient holistically and say
(33:39):
this is a good idea or not agood idea for them.
So we're a part of thatmultidisciplinary care team,
right.
So we are a heavily clinicalspecialty, but I think we're
still viewed for those of us,for those that even know what we
are, as a procedural field.
So this is a way to demonstrateclinical proficiency in this
specialty as a PA.
(34:00):
So this certificate of addedqualification, as you know, is
created within the specialtythrough NCCPA and it's basically
a way for you to say I havetaken extra time and paid extra
attention and put extra effortstowards demonstrating my
proficiency in this specialtyand I think that it's time for
us to do that.
(34:20):
I mean, we are still a smallnumber.
I don't know.
Do you know what percentage ofPAs and MPs are in dermatology?
Do you have ways to get thosenumbers, do you?
Ashley (34:28):
know.
I'm sure we could figure it out.
I don't know off the top of myhead, but it's a larger
percentage than PAs ininterventional radiology.
Can I tell you that?
Carrie (34:37):
We're in that probably 1%, 1% to 2% of PAs nationally
that are in IR Very small numberbut growing, growing.
There's more and more interest.
We have folks leaving otherspecialties to come to us, you
know, et cetera.
So the CAQ is a way for us toshow others, hey, ir is my thing
, it's important to me.
(34:58):
It also demonstrates to others.
You know, I think if you're aperson who says, well, what does
an IRPA do, then you've gotthis blueprint that says these
are the things from aknowledge-based standpoint.
This is what they are expectedto know and be familiar with.
You know, it's not saying thatI'm proficient at placing a port
(35:18):
.
It just says that I haveknowledge of this and I know
what it's about and I know thepertinent key things to do.
It's not a certification.
So I think we have to be reallymindful about that.
There's some concern that thesesay that we can do things that
we can't do.
I can place ports, but that'smore than a CAQ.
(35:38):
That's mentorship, that's yearsof training.
So I think it's a way and alsoto demonstrate to other
providers like, say, you're anIR physician or radiologist has
a private practice and you'vegot a list of candidates you
know like, hey, okay, great,this person, you know, has a
dedication to this field, so itmight give you the upper hand as
(36:00):
a, as a PA or an MP as you'relike, fighting for that, that
role I.
But interestingly, I need anendorsement from sort of our
governing body or our, our, ourspecialty organization, that
society of interventionalradiology.
So I'm still in the process ofgetting their endorsement.
It's just taking longer than Ithought it would, but we're just
(36:21):
wanting to make sure that we wethink of all the things um, and
the place I'm at currently isobtaining physician champions to
be collaborative and support mein it, and we're probably going
to be meeting for a SWOTanalysis.
So it gets very it's important,though we want to do it the
right way.
So I mean, this is down theroad, but it'll be really
(36:44):
valuable once it's done.
Ashley (36:47):
And I'm not giving up.
Carrie (36:48):
I'm not giving up.
Ashley (36:48):
You've already done so much for the field of's done and
I'm not giving up.
I'm not giving up.
You've already done so much forthe field of medicine alone and
then for the field of medicinefor PAs.
The fact that you're working onthis number one, after talking
with you and now knowing so muchmore about interventional
radiology than I did before, itis absolutely needed to have a
CAQ in interventional radiology.
Really, like you said, it'sjust.
(37:09):
It's just proof that you knowwhat you know.
You know this isn't thisdoesn't train you any better.
I mean, really this is going tosound silly, but really getting
my CAQ and DERM was quite easybecause it was all this stuff I
already knew how to do.
Right, the test questions werequestions I knew the answers to
because I've done this for 10years, you know.
(37:31):
So it's just a proof.
Carrie (37:34):
Yeah, and I think for us , because IR is very specialized
.
We have folks that just do neuroIR, we have folks that do
interventional IR, we havewomen's health, we have men's
health, we have diagnostic.
We have so many different areasthat it may be that a PA or an
MP may just be practicing in acertain one.
So when you look at getting theCAQ, it's like, well, hey,
(37:55):
you're going to have to knowsome things about neuro IR and
you're going to have some thingsabout all the different
sections.
So the beauty of being able tocreate it you know, having an
expert panel convene, physiciansincluded, to come up with the
blueprint, the questions, all ofthat stuff will make it, you
know, difficult or challenging,but fair right, and it gives
(38:20):
some people a betterunderstanding of well, how does
Carrie know how to do that?
Or how do I know Carrie can gosit and have that conversation?
Well, you know, here's anadditional demonstration of that
.
I would be super proud to haveit.
It's definitely not, it's aninvestment in me, but it also
demonstrates my commitment to myspecialty, carrie as we wrap up
(38:40):
, let's speak directly tosomeone who's interested in
pre-health, right?
Ashley (38:45):
I mean, you've seen healthcare from a variety of
different standpoints.
Right now, what advice wouldyou give them as they're looking
towards their future,considering a career in medicine
?
They're hearing all of thechallenges and everything about
burnout that everybody's talkingabout.
I, in my opinion, I, I itsounds like you are still super
passionate about clinicalmedicine.
(39:07):
So tell me, tell me what youwould tell them, what you would
tell those students.
Carrie (39:11):
You're either going to feel drawn to it, have a calling
to it.
I mean I think that's importantFirst off, I mean just saying,
oh well, I could be a PA.
I mean I think, starting from aplace that I really want to
make a difference and I want tomake things better, you know
that that's an important place.
I mean I think there needs tobe something about it that
speaks to you or drives you justfrom the beginning.
(39:31):
But I think medicine is justfor me, it's been very rewarding
.
I mean I wouldn't I wouldn'tchange a thing.
It changed me.
It changed the way I see theworld.
The relationships that I havemade with you know other
providers, relationships I'vemade with patients I mean it's
(39:55):
part of who I am now and it wasfinding an outlet for that part
of me that wanted to care forpeople.
So I think it needs to bemeaningful to you If you're
thinking about being a PA.
It needs to be meaningful, itneeds to come from a meaningful
place and you know I think we asPAs have a responsibility to
mentor and support those peoplewhen they're talking about it.
(40:18):
You know there are verytraditional ways to mentor.
We know preceptorships you knowI've done that.
But they're also really likenon-traditional ways to mentor
and that could be again, just aphone call or responding on
LinkedIn or talking to thatvendor's son, you know, talk to
them on your way home from work,send them an email, you know,
(40:40):
anytime you get a chance to dothat.
But I would say if you want toget into medicine, it needs to
come from a place of meaning foryou.
And with the burnout stuff,gosh, I'm so much better at
giving advice about that than Iam taking advice about it.
You know what I mean.
(41:01):
Like, oh man, you really needto have some self care.
Like you really should, gosh.
Like, forget it.
I'm like terrible at it.
I'm terrible at that.
I'm terrible at being a patient.
Like, I'm just terrible.
So I cannot.
I have no credibility, but Iknow it's real.
I mean I would say I probablyfailed it the most and hardest
during COVID and then afterCOVID, and I don't know that
(41:22):
I've gotten back to where I waspre-COVID and I don't know why
exactly that is.
We were still doing the samemedicine.
I mean, I was still, you know,frontline, still taking care of
patients.
I think it's because in myspecialty we didn't get to take
a break.
You know, we just still had tobe there, so I never really had
a mental break from it.
But yeah, it definitely hasimpacted me as a person and a
(41:44):
provider and it caused me to say, you know, oh, I'll have that
house in the mountains one day.
Or oh, I'm going to get thatJeep gladiator that I really
wanted.
I got my house in the mountainsand I got my Jeep gladiator.
So, like, don't, don't wait onthose things, for you know, when
it's less busy at work, youknow, go, go do those things,
take the time off Right.
Ashley (42:13):
It's great advice for for pre-health students, but
that's also really really greatadvice for current clinicians
too.
You know, I think that'sincredible.
Thank you so much for takingyour time your valuable time to
join us on shadow me next, aspromised.
You are just a wealth ofinformation and I'm so motivated
by what you're doing for PAsnow and what you will continue
to do that CAQ is going to begreat.
I know it's going to happen.
So thank you, thank you forwhat you do and thank you for
joining us today.
Yeah, thank you for your time.
(42:34):
It was awesome.
Thank you so very much forlistening 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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