September 29, 2025 • 28 mins
What drives someone to leave a successful career as a Physician Assistant and return to medical school? For Dr. Joanne Amos, it was discovering her true calling in one of medicine's most demanding specialties: the Neonatal Intensive Care Unit.
Dr. Amos takes us behind the scenes of her level three NICU, where she cares for babies as young as 22 weeks gestation. Her vivid descriptions bring to life both the technical challenges (placing catheters "the width of a spaghetti noodle" in babies who sometimes weigh less than a pound) and the profound emotional landscape of working with families experiencing their worst nightmares. The balance she strikes between adrenaline-fueled medicine and deep compassion offers a masterclass in what makes a truly exceptional physician.
Her unconventional path from PA school to medical school truly took off after she discovered her passion for neonatal intensive care. This journey gives Dr. Amos unique perspective on the differences between PA and physician education, addressing common misconceptions and offering invaluable guidance for students navigating their own healthcare career decisions.
Beyond clinical expertise, Dr. Amos discusses the realities of NICU schedules, the challenges facing PAs seeking leadership positions, and how her perspective as both a physician and parent influences her practice. Her story reminds us that finding your place in medicine sometimes means taking the road less traveled and that the courage to change course can lead to our most meaningful work.
Follow Dr. Amos on TikTok, Instagram, or YouTube to learn more about her journey and gain insights into the world of neonatal medicine. Her story will inspire anyone considering a career in healthcare to pursue the path that allows them to make their greatest contribution, regardless of conventional wisdom.
Instagram: @pa.c_to_doctor
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ashley (01:04):
Today on Shadow Me Next, I am excited to introduce you
to Dr.
Joanne Amos, whose journeythrough medicine is as
interesting as it is unique.
She began her career as a PA,only to discover her true
calling as a physician in theNICU, a world of both delicate
precision and profound emotion.
From managing life-savingprocedures on babies no bigger
(01:28):
than your hand, to walkingalongside families on some of
their hardest days, Dr.
Amos has learned what it meantto balance adrenaline with deep
compassion.
Her story is also one ofcourage, leaving a thriving PA
career to return to medicalschool, fueled by a love for her
patients and a desire to standfully in the work she knew she
(01:51):
was meant to do.
In this episode, we talk aboutthe reality of NICU medicine,
the differences in PA andphysician training, and the
trust that underlines everyclinical encounter.
So Dr.
(03:16):
Amos and I did not get a chanceto discuss a quality question,
but something that she saidreminded me of something that
you might hear on your owninterviews.
How do you see the role of PAsor other APPs in leadership
evolving in the next decade?
And what would it take for PAsto fully step into those
(03:36):
positions?
Dr.
Annis, thank you so much forjoining us on Shadow Me Next.
You are an expert in somethingthat I can give my my one-sided
opinion on things.
And to have your voice as theother side of steps is going to
be absolutely incredible.
I'm excited to learn.
And I know that this is goingto be so great for so many
people.
So thank you so much forjoining us.
(03:56):
Thank you for having me.
So, Dr.
Amos, we're going to do thingsa little bit backwards today.
I'd like to hear about whatyou're doing now.
What does your medicalpractice, a day in your life
right now, look like?
Dr.Amos (04:09):
Okay, so I am in a what's considered a level three
NICU.
So the highest security islevel four, and level three is
the next step down.
Um so we just have fewersubspecialties for the baby.
So if something complex comesin, we'll have to send them to
the subspecialists.
So my schedule looks likeessentially one week on, one
(04:29):
week off.
And how that works is there'seither an NP or PA that's
in-house 24-7.
And then I am also on 24-7 forthat week.
So I will, if it's a good day,I will go in for rounds around 8
30, work in the hospital, bethere all day, and then leave in
the evening, um, afternoon,evening, and then I'm on call
(04:51):
overnight.
So if I have something happens,they need me there, I will have
to go back in.
So there have been a few timeswhere I'll get called in at like
2:45, get home at 6:45, geteveryone off to school, then go
back to the hospital at 8, andthen keep going.
So it can be pretty exhaustingwhen you're on, um, or you can
(05:11):
have a good week and you get tosleep in your own bed the whole
week.
So it really depends.
Ashley (05:16):
Amazing.
And then when you're in thehospital, what does that look
like?
Is it, I mean, surely you roundon patients, you you chat with
your NPs and your PAs aboutmanagement and care procedures,
are there procedures as well?
I would imagine so.
Yep.
So NICU is nice because it isprocedure, I would say, heavy
and it's more unpredictable.
So if you're kind of anadrenaline person like the ER,
(05:37):
uh NICU is similar, we'll go toany high-risk deliveries.
So if there is a complicationin labor, then you do a
C-section, all that stuff willgo.
So you don't always know what'scoming down the pipeline for
you.
And then procedure-wise, we doall of our own lines.
So you do umbilical lines,intubations, LPs, um, pick
lines, so art sticks, all sortsof procedures.
(06:00):
Wow, that is that's incredible.
And those procedures are allincredibly difficult and
complicated on adults.
I um I can't imagine.
Everything's doing on it.
Yeah, it's so small.
Dr.Amos (06:12):
It's too tiny.
Yeah.
So we have like the catheterswe use for the belly button are
probably about as wide as thespaghetti noodle on the tiniest
of babies.
So it takes a little, uh, youhave to have some good vision.
Ashley (06:25):
I would imagine, yeah, really tiny microscopic vision
and very steady hands.
Yeah.
Um, which is interestingconsidering the fact, like you
mentioned, that it is veryadrenaline heavy and um you're
moving quickly, and yet youstill have to really center
yourself and find that calmnessin the moment, just the briefest
moment while you're placingthese lines.
I would imagine.
Tell me about the age of yourpatients.
Dr.Amos (06:48):
So we have anywhere from 22 weeks all the way to
full term.
Um, NICU is predominantly likelate preterm term babies that
you know come to us.
Most people don't realize thatthere's a lot of term babies
that end up in the NICU.
Um, but we do take care ofbabies as young as 22 weeks.
Ashley (07:06):
Wow, that um there's a lot of emotions there, of
course.
I mean, I think bringing a lifeinto the world anyway carries
its fair share of emotions.
And then the absolute lastthing a parent wants to hear is
that their baby is having to goto the NICU.
Is that something that you aredirectly involved with, managing
the emotions of those patients?
And what does that number one,as a as a as a physician, what
(07:28):
does that look like?
And then number two, you're aparent as well.
You know, do those emotionskind of play into it too?
Dr.Amos (07:33):
Yeah, it's um definitely challenging at times.
I think obviously for anyone,the hardest babies are those
full-term babies that somethinggoes awry with.
Um, you know, pregnancy's beenperfect, labor's been perfect,
and then something happens justat the very end.
Um and it's pretty devastating.
And I think it's hard to, itcan be hard to separate
yourself, especially as aparent, from those emotions.
(07:54):
Um, I would say being pregnantin the NICU is not for the faint
of heart.
You just you know too much andof all the things that can go
wrong.
Obviously, it's a smallpercentage of patients that end
up with us, but it's hard not tolet your head go there.
Um, but yeah, so when we admitpatients, you know, I'll be
there with the team.
And a lot of times the dadswill have to come because the
moms are still in the C-sectionor they have an epidural and
(08:17):
can't walk yet.
Um, so it's that, you know,going over and updating the mom.
And I think trying to giveparents the best hope that they
have.
So I think they're terrified alot of the times if they see
that the team is calm and thisis more of a, you know, we're
used to doing this thing,everything's gonna be okay.
Um, it helps because they trulyhave, they're so out of their
(08:39):
wheelhouse when they end up inthe NICU, it's just not
something most parents expect.
Ashley (08:43):
I I really love the way that you put that because this
is, as we've talked aboutalready, this is a lot of
people's worst days.
It's not something I wouldimagine in a perfect world, if
you didn't have to do your jobanymore, it would be a beautiful
world, right?
If you did not have to come inand do these things every single
day.
But yet, because you do,because you have, because you
(09:04):
you have experience and you'veseen these things, you can then
offer that reassurance.
Say, hey, you know, I've beenhere, I've seen this, I've done
this, this is the right thing todo.
I would imagine that that wouldbe really, really comforting
for your parents of yourpatients.
Let's go back for a second.
Um, there's a couple of thingsthat I wanted to touch on.
First, let's talk about theteam.
So you mentioned you come inwith the team usually.
(09:25):
What does the team involve?
What does that look like?
Dr.Amos (09:28):
So I think depending on the delivery room, it can be
overwhelming.
So you have a nice quiet berth,and then all of a sudden this
team shows up of people you haveno idea.
So typically NP or PA, myself,depending on the scenario.
Um PAs and MPs have a lot ofautonomy in the NICU.
So if it's kind of a regular,we go to all C sections.
(09:49):
So the MP or PA will go there.
If there's something that goeswrong or they need me, they'll
call me for that.
Um, or if we have a complicatedcomplicated patient, I'll just
go with them.
Um, so it's, you know, NPPA,myself, respiratory therapist,
and then a nurse, a NICU nurseat the bedside at a minimum.
Now, if things get complex, wehave a very small baby, there's
typically more people.
(10:10):
Um, so the care really startsfrom the beginning.
And it's hard.
And I, you know, somescenarios, it's easier than
others.
If we know they're gonna gointo labor early or the baby's
gonna come to NICU, we candiscuss with them beforehand.
Otherwise, they're hitting thestep button and we come running
in, and it's really hard becausethe parents are just panicked.
Um, for us to kind of introduceourselves, we're just focused
(10:30):
on the baby.
Um, and then I think fromthere, we'll take the baby,
always we want them, the parentsto see the baby before we go to
the NICU.
And then you use that chance.
I mean, there's so much goingon to kind of just say
everything is okay, the baby'sdoing as we expect.
We're gonna take them to theNICU, dad can come, grandma can
come, whoever.
Um, and then we kind of justmove to the NICU and then take
(10:51):
care of everything that needs tobe done as quickly as we can.
So typically within an hour fora small baby, we want
everything done.
So the lines in, fluid hung,uh, sugar checks, all that.
So the first hour is reallyjust kind of like this high
pressure, high intensity time,even though we're all calm
because you need to be calmaround the babies.
Um, and then once the baby'ssettled, it's just typical like
(11:14):
management.
Um, so everything else, fluids,labs, all that jazz get done
quickly.
And then it's a lot of justtrying to tuck the baby in
because they're not supposed tobe here.
Um, so you want to leave themalone as much as you can.
Ashley (11:26):
Yeah, that's really, really interesting.
And it's so funny you mentionedthat.
I've had a C-section andliterally I don't think I knew
who half the people in the roomwere.
You know, I think it's just asa patient, at least speaking on
the patient side of things,there really is so much trust
that goes into these things.
And there's this is a reallyhot topic, and I don't want to
step too much into it right now.
But mistrust in medicine, Ithink right now is is so
(11:48):
prevalent.
And when you're in a situationlike this, speaking as a
patient, and of course you seethis as a clinician, really
sometimes it it's just it's justtrust.
That's all there is, you know.
And and I'm a clinician and Iknew what was going on.
And I still like I like I said,I didn't know who half the
people were.
If my baby was taken, I wouldjust trust that they were taken
care of.
And I think the people thatwork in the NICU are some of the
(12:10):
most compassionate,intelligent, um,
success-oriented people inmedicine, really.
I mean, you guys, your end jobis to make sure that these
babies are okay.
And um, yeah, I'm so gratefulfor you guys and what you do.
Uh, let's go back a little bit.
What are some of the things?
I think knowledge is power, um,but I also think, like you
said, being pregnant in theNICU, knowledge can also be very
(12:32):
overwhelming.
Okay, so for a second, let'sjust talk about some of the
things that um that you might becalled in for, some of the
diagnoses that you might see.
And if this is something that'sgoing to stress you out, I
would recommend fast-forwardinga couple of seconds until we get
through this.
But tell us about some of thesediagnoses that you're making
and managing.
Dr.Amos (12:50):
Yep.
So any baby that's born before28 weeks, we are called in um
just because they are high riskfor complications.
So we have to put lines inthem.
They are usually intubated, etcetera.
So they will always be therefor those.
Um, there are certain thingslike hydrops fatalis that we
will be there for.
If there's a cardiac,congenital cardiac abnormality
(13:12):
or anything else, they'll callus in.
Some of these diagnoses wedon't always know about
beforehand.
Most people do get theiranatomy scanned, but there are
some things that you just aresurprised.
And unfortunately, more peopleare going away from modern
medicine while they're pregnant.
So there are a lot moresurprises than there used to be.
Um, so any congenital defects.
So you can have anything from,you know, valve pushing through
(13:34):
your belly button to not havingan anus.
So there's lots of surprisinglylarge number of things that can
go wrong in pregnancy.
And luckily they don't happenthat often.
But anytime there's anythinglike that, we're always
involved.
Ashley (13:47):
The medicine is just mind-blowing.
I mean, it really is mindblowing.
And then you step over to theparent side of your life and you
it's just terrifying.
You know, it's just all thethings that can go wrong.
Yes, there's there's a lot ofemotions there.
Well, thank you so much forsharing your career with us and
and what you do right now.
Well, this is the mostincredible thing to me.
(14:08):
So you began as a PA.
Actually, perhaps you began assomething even before that.
I would I would love to hearbriefly walk us through how you
first realized you wanted to bein medicine and then this
incredible journey that you havetaken to where you're at right
now.
Dr.Amos (14:23):
So I, so my mom worked as a medical assistant in a
doctor's office.
Um, but I wasn't really thatgung ho on medicine in the
beginning.
So in high school, I think Iwas trying to sort out what I
wanted to do.
And one of my neighbors waslike, Oh, I'm an EMT at the
firehouse.
You can take free classes atthe fire station.
So I was like, all right, I'lldo that.
Um, so I did a couple ofride-alongs, hung out at the
(14:45):
fire station.
I was like, this is fun.
Like I liked, you don't knowwhat you're kind of walking into
with when you're an EMT.
Um, but I knew I likedmedicine.
I was good at biology in myscience classes.
So I was thinking medicine,some variety.
At some point, I was like,maybe a biomedical engineer, but
I definitely don't have theengineer brain.
Um, so then when I was looking,I was going to do some sort of
(15:08):
like science undergrad.
Um, and my mom was like, oh,what about a PA?
Which I didn't really know toomuch about, but they the office
she worked at had just hiredone.
So I shadowed a bunch of PAs,shadowed some doctors in high
school, and then decided on PAschool.
I was still torn between, and Ithink most students are,
(15:28):
pre-med, uh med school or PAschool.
It's a hard decision to make at18.
And the program I applied towas actually a three plus two,
so a five-year program.
And my 18-year-old brain, I waslike, this is great.
I'll get my undergrad done inthree years.
And if I want to do med school,I can do that afterwards, or I
(15:50):
can continue and stay into gradschool.
So I just went with thatbecause I was like, this is
seems like a pretty good,surefire way to have a job out
off after college.
And that was, I think, my majorreassurance was either way I
could go to med school or Icould continue in the grad
program.
So finished my three years, wasstill kind of thinking medical
(16:11):
school.
But one thing that I found themost daunting was like, there's
really nothing guaranteed in medschool.
Get in, pay all that money andloans, and not match.
It's rare that that happens,but it can happen.
You could fail your step one,you could fail your step two.
So those are all, or you canmatch into something that you
hate and you're for the rest ofyour life.
So all of those to me were likea huge deterrent.
(16:33):
I was like, um, I like PAbecause if I don't like the
fields, I can just switch intosomething else.
Um, so I think that was a hugedriver for me to continue with
PA school.
And then as I was gettingthrough PA school, I realized
perhaps I don't like medicine atall.
I remember being on myrotations, being like, I don't
(16:54):
like this one, I don't like thisone.
And I think it was on like myeighth or ninth rotation.
I was like, oh God, I what haveI done?
Yeah, like I didn't don't likeany of this.
And I happened to do the adultICU.
And I liked the medicine, Iliked managing ventilators, I
liked the procedures.
So I was like, this is great,except I find it really
depressing.
It's a lot of people towardsthe end of their life or young
(17:17):
people that something horrifichappened.
And I was like, this is notgood for your mental health.
So then I still was like, Idon't know what I'm gonna do.
And I happened to get anelective in the NICU, and that
was when I realized, okay, samemedicine, same concepts, but
with a population that iscompletely different,
pathophysiology-wise, andthere's just a lot more hope in
(17:37):
the NICU, I found.
So then I realized I liked theNICU.
So I was like, great.
But of course, some of thecaveat being there wasn't at the
time, I think there was one ortwo uh NICU residencies.
And I didn't find out that Iliked the NICU till it was too
late to apply anyway.
So the place I did my electivein was like, we'll hire you and
kind of train you for six monthsto get catch up to speed.
(17:59):
So I did that and thenrealized, oh, gee, like I'm
still in over my head in termsof knowledge base, just because
it is a very specific field.
And I think a lot of the timeyou can gain experience the
longer you do something.
So if I'm in it for 20 years,sure.
But there was a level of, I'mnot studying Krebs cycle and
(18:22):
gluconeogenesis on my own, andI'm not studying embryology that
we come from and mesoderm andectoderm and endoderm.
And so those are things likeyou can look at and you can
read, but nothing sticks.
So I felt that in order formyself to feel confident and
comfortable and treat thepatients how I wanted to, my my
(18:43):
next best step was going back tomed school.
Ashley (18:47):
What did that look like?
I mean, did were you just didyou ever stop and think, am I
out of my mind?
Dr.Amos (18:54):
Yeah, I think most people, when I told them,
they're like, you're nuts.
Um I was like, Yes, I am.
Because most doctors, if youtalk to them even now, they'd be
like, oh, I should have done PAschool.
Right.
PAs and PAs are like, oh, Ishould have just gone to med
school.
Uh so it's a very everyone'slike on the opposite page.
But I finished PA school and Ifigured I kind of still had that
in the back of my head and Iknew I needed some prereqs.
(19:16):
So I'm like, I'll startworking, gonna take these
prereqs, see how I feel after Istart working.
Took my prereqs and kind ofjust decided, look, I'm just
gonna go for it.
I'd rather regret not getting,like, I'd rather just try
getting in and then notregretting for the rest of my
life, not even trying.
So I took the MCAT and then Iapplied the following.
(19:38):
So I worked for a full year,applied that fall-ish, I guess,
the timeline for med school.
So worked for two years fulltime before I had gone back.
So it kind of was like as I wasfinishing PA school, I was
still kind of like this knowingwhat I wanted to do, I needed
more education.
Had I gone into something likeprimary care or something
(20:01):
outpatient, would I have been asmotivated to go back to medical
school?
Probably not.
I think just because I was insuch a specific field, and if I
liked everything too, like if Iloved ortho and I loved surgery
and I loved internal medicine, Idon't know if I would have gone
back because I didn't want topigeon, I wouldn't want to
pigeonhole myself into like onefield.
But because NICU was what I sawmyself doing for the rest of my
(20:25):
life, I was like, I think Ineed to make this decision.
Ashley (20:28):
So I did.
I think it's a really, reallygreat example of how versatile
medicine can be.
Even when we think we are atthe end of our career decision
making, and we realize, but inessence, you fell in love with a
specialty.
You fell in love with medicinethat is incredibly complicated.
(20:49):
And because you loved it somuch, you literally went back to
school and did tell me, howmany more additional years of
schooling was it?
A decade later.
So that's how much you lovethis, but all of that knowledge,
every time you walk into aroom, the presence that you can
give these patients and theirparents, knowing that this is
(21:09):
absolutely where you belong andwhat you love doing, and this is
how hard you've worked to getto where you're at.
I mean, it's just theconfidence in that that you must
feel and that they must feel isabsolutely incredible.
Okay, let's let's talk a littlebit about PA school versus
medical school very briefly.
Yep.
Because as we know, it was umjust a little bit of time ago
that you're doing these things.
(21:30):
Generally speaking, both areextremely difficult.
One is a little bit longer.
Um, is there in your opinion,is there any like a major, major
thing that you would like totell a pre-health student
perhaps that is trying to decideone or the other, really just
based on the schooling alone?
Dr.Amos (21:47):
I would not go under the assumption that PA school is
easier because it's shorter.
So it was, I mean, theintensity of PA school was
unreal.
And I think I blacked out a lotof my uh my schooling at this
point, um, just out of purestress.
But I really we would havetests three times a week in PA
(22:08):
school.
We were in class eight to fiveevery day, like there was no
stopping it.
Um, and then med school wasstill a lot of information, but
it was more spaced out.
And I would really truly recallwe'd have like didactics in the
morning from like eight to oneor eight to two with like a
lunch break.
And then some days we wouldhave lab, but like to me, I
didn't count lab, I guess, aseducation because everyone's
(22:30):
like, we were in class every dayin med school too.
And I'm like, yeah, but like wewould have physical diagnosis
lab, but like I would have thatin PA school, but that would be
like after my five o'clocklectures.
So I felt the intensity was alot more in PA school.
You're just trying to cover somuch information in one year.
Um, so it was veryoverwhelming.
(22:51):
Medical school, I think I hadmore time to kind of digest
things before or tested on it,or I could like really study,
process it, and then kind ofmove on to the next day.
PA school, there was none.
Like you were just, it wasgoing full speed for a whole
year.
Ashley (23:06):
When you made the transition from PA to physician
and now you've been working init for a while, are there any
gaps that you've seen that youdidn't expect?
So things like clinicalknowledge, which we've talked
about a little bit.
You know, you just did NICU isa really special case too.
There's so much that you haveto know.
So we we talked about that, butum, what about like maybe
leadership opportunities orresearch opportunities or just
the system and in general?
(23:28):
You've seen things from bothsides now and you've experienced
things from both sides workingas a P and as a physician.
Um, anything glaring thatyou've noticed that you just
think we should be aware of?
Dr.Amos (23:38):
I think which I find frustrating, especially in this
current environment, um the forPAs, there's definitely kind of
like a glass ceiling at somepoint, right?
Clinically, you can doeverything, you can take on
patients, you can do some likelow-level managerial work in the
office or whatever.
But like true leadershippositions really, you don't see
(24:01):
that many PAs in them.
And I don't think that's for alack of ability.
I think it's just lack ofunderstanding the role.
There's more NPs getting intothose positions just because
they they have a great lobbythat pushes for those types of
things.
Um, but there's certainly thatkind of not that you want to sit
in meetings all day, but likeadministratively, I think PAs
(24:22):
are a huge value and they'rejust can be very underutilized
in certain situations.
Ashley (24:27):
Yeah, I would agree with that.
So on your social channels, youhave a really incredible online
presence, and I'll tag it inthe in the show notes for sure.
Um, but you get a lot ofquestions, and you are so kind
and so amazing to answer thesequestions and really mentor some
of these students.
What are some of the mostcommon questions or
misunderstandings that maybe apre-health student or even even
current clinicians have aboutthe PA to physician, switch, or
(24:51):
transition?
Dr.Amos (24:52):
Uh most common question is definitely people that are
torn between PA and MD.
The highest misconception Isee, and I think it gets like
torn apart in comments, is just,and I think some of them are,
you know, they could all just betrolls and bots, but people
really not understanding theeducation of a PA.
(25:14):
So in comparison, when you havethe whole NPPA mid-level role
or APP role, you get a lot ofheat, no matter how you post it.
PAs, I think, though trainingis not like medical school, I
think you have the broadesttraining in comparison.
(25:36):
So you're the closest that youcan get to medical school
without the biocellular,molecular basis of medicine.
So we get a lot of commentslike, oh, PAs are just like
doctors, or PAs are they have noidea what they're doing.
They're not like doctors atall.
They shouldn't have, you know,independent practice.
It goes like both ways.
So, like, there's a middleground, which I think we should
(25:57):
all come to, but your training,you're getting education in all
of those areas.
So you're getting rotations,which I try and highlight.
You're doing OBG way in.
Yes, maybe it's a shortrotation, but same with med
school, it's a short rotationuntil you do residency.
Um, so your rotations and youreducation mirror that of medical
school without the nitty-grittyscience to some degree.
(26:19):
Um, but there is obviouslynitty-gritty science in PA
school, it's just not asintense.
And compare that to NP school,which I think people have a hard
time with.
You pick a specialty as an NP.
So you're you're not like ifyou are a pediatric NP, you can
only prescribe medicine for Ppatients.
As a PA, I can run the gamut.
I can write meds for an80-year-old, I can write meds
(26:41):
for a six-month-old.
Um, and you have training inall of that, though it's more
brief.
Whereas an MP are kind of thespecialists in whatever field
they so choose in that regard.
So I think the confusion is theeducation.
And in PAs to me, and MPs arenot necessarily comparable in
(27:01):
some regard.
Sure, they have the same role,but the education is so
different.
Um, and I think that is where alot of the questions,
controversy, comments come from.
Ashley (27:12):
That is a really, really great example.
And I'm so glad that youhighlighted that.
I think in practice, oftentimesthey appear the same, but
you're absolutely right.
You have to look back and youhave to see how we were trained.
And um, and that's whatstudents really need to
investigate and see because ofthe the the training that you
get and the specialties that youyou can work in afterwards are
(27:34):
very, very different.
So I'm really glad youhighlighted that.
Dr.
Amos, you are incredible.
Um, tell us where we can findyou so that we can, you
mentioned uh independentpractices PAs, and that is
another big hot topic.
So I would love for you toshare where we can maybe learn a
little bit more about some ofthese other topics that you are
very well versed in.
Dr.Amos (27:52):
Well, I am I'm on TikTok and Instagram, and I have
some of the same videos reuseon YouTube.
So whatever not my YouTube isnot anywhere near up to speed,
but I do have some videos there.
Um, I would say TikTok orInstagram is my spot.
Ashley (28:10):
Very good.
Awesome.
Dr.
Amos, thank you so much forspending the time with us on
Shadow Me Next.
I really, really appreciate it.
Thank you for having me.
Today on Shadow Me Next, I am excited to introduce you
to Dr.
Joanne Amos, whose journeythrough medicine is as
interesting as it is unique.
She began her career as a PA,only to discover her true
calling as a physician in theNICU, a world of both delicate
precision and profound emotion.
From managing life-savingprocedures on babies no bigger
(01:28):
than your hand, to walkingalongside families on some of
their hardest days, Dr.
Amos has learned what it meantto balance adrenaline with deep
compassion.
Her story is also one ofcourage, leaving a thriving PA
career to return to medicalschool, fueled by a love for her
patients and a desire to standfully in the work she knew she
(01:51):
was meant to do.
In this episode, we talk aboutthe reality of NICU medicine,
the differences in PA andphysician training, and the
trust that underlines everyclinical encounter.
So Dr.
(03:16):
Amos and I did not get a chanceto discuss a quality question,
but something that she saidreminded me of something that
you might hear on your owninterviews.
How do you see the role of PAsor other APPs in leadership
evolving in the next decade?
And what would it take for PAsto fully step into those
(03:36):
positions?
Dr.
Annis, thank you so much forjoining us on Shadow Me Next.
You are an expert in somethingthat I can give my my one-sided
opinion on things.
And to have your voice as theother side of steps is going to
be absolutely incredible.
I'm excited to learn.
And I know that this is goingto be so great for so many
people.
So thank you so much forjoining us.
(03:56):
Thank you for having me.
So, Dr.
Amos, we're going to do thingsa little bit backwards today.
I'd like to hear about whatyou're doing now.
What does your medicalpractice, a day in your life
right now, look like?
Dr.Amos (04:09):
Okay, so I am in a what's considered a level three
NICU.
So the highest security islevel four, and level three is
the next step down.
Um so we just have fewersubspecialties for the baby.
So if something complex comesin, we'll have to send them to
the subspecialists.
So my schedule looks likeessentially one week on, one
(04:29):
week off.
And how that works is there'seither an NP or PA that's
in-house 24-7.
And then I am also on 24-7 forthat week.
So I will, if it's a good day,I will go in for rounds around 8
30, work in the hospital, bethere all day, and then leave in
the evening, um, afternoon,evening, and then I'm on call
(04:51):
overnight.
So if I have something happens,they need me there, I will have
to go back in.
So there have been a few timeswhere I'll get called in at like
2:45, get home at 6:45, geteveryone off to school, then go
back to the hospital at 8, andthen keep going.
So it can be pretty exhaustingwhen you're on, um, or you can
(05:11):
have a good week and you get tosleep in your own bed the whole
week.
So it really depends.
Ashley (05:16):
Amazing.
And then when you're in thehospital, what does that look
like?
Is it, I mean, surely you roundon patients, you you chat with
your NPs and your PAs aboutmanagement and care procedures,
are there procedures as well?
I would imagine so.
Yep.
So NICU is nice because it isprocedure, I would say, heavy
and it's more unpredictable.
So if you're kind of anadrenaline person like the ER,
(05:37):
uh NICU is similar, we'll go toany high-risk deliveries.
So if there is a complicationin labor, then you do a
C-section, all that stuff willgo.
So you don't always know what'scoming down the pipeline for
you.
And then procedure-wise, we doall of our own lines.
So you do umbilical lines,intubations, LPs, um, pick
lines, so art sticks, all sortsof procedures.
(06:00):
Wow, that is that's incredible.
And those procedures are allincredibly difficult and
complicated on adults.
I um I can't imagine.
Everything's doing on it.
Yeah, it's so small.
Dr.Amos (06:12):
It's too tiny.
Yeah.
So we have like the catheterswe use for the belly button are
probably about as wide as thespaghetti noodle on the tiniest
of babies.
So it takes a little, uh, youhave to have some good vision.
Ashley (06:25):
I would imagine, yeah, really tiny microscopic vision
and very steady hands.
Yeah.
Um, which is interestingconsidering the fact, like you
mentioned, that it is veryadrenaline heavy and um you're
moving quickly, and yet youstill have to really center
yourself and find that calmnessin the moment, just the briefest
moment while you're placingthese lines.
I would imagine.
Tell me about the age of yourpatients.
Dr.Amos (06:48):
So we have anywhere from 22 weeks all the way to
full term.
Um, NICU is predominantly likelate preterm term babies that
you know come to us.
Most people don't realize thatthere's a lot of term babies
that end up in the NICU.
Um, but we do take care ofbabies as young as 22 weeks.
Ashley (07:06):
Wow, that um there's a lot of emotions there, of
course.
I mean, I think bringing a lifeinto the world anyway carries
its fair share of emotions.
And then the absolute lastthing a parent wants to hear is
that their baby is having to goto the NICU.
Is that something that you aredirectly involved with, managing
the emotions of those patients?
And what does that number one,as a as a as a physician, what
(07:28):
does that look like?
And then number two, you're aparent as well.
You know, do those emotionskind of play into it too?
Dr.Amos (07:33):
Yeah, it's um definitely challenging at times.
I think obviously for anyone,the hardest babies are those
full-term babies that somethinggoes awry with.
Um, you know, pregnancy's beenperfect, labor's been perfect,
and then something happens justat the very end.
Um and it's pretty devastating.
And I think it's hard to, itcan be hard to separate
yourself, especially as aparent, from those emotions.
(07:54):
Um, I would say being pregnantin the NICU is not for the faint
of heart.
You just you know too much andof all the things that can go
wrong.
Obviously, it's a smallpercentage of patients that end
up with us, but it's hard not tolet your head go there.
Um, but yeah, so when we admitpatients, you know, I'll be
there with the team.
And a lot of times the dadswill have to come because the
moms are still in the C-sectionor they have an epidural and
(08:17):
can't walk yet.
Um, so it's that, you know,going over and updating the mom.
And I think trying to giveparents the best hope that they
have.
So I think they're terrified alot of the times if they see
that the team is calm and thisis more of a, you know, we're
used to doing this thing,everything's gonna be okay.
Um, it helps because they trulyhave, they're so out of their
(08:39):
wheelhouse when they end up inthe NICU, it's just not
something most parents expect.
Ashley (08:43):
I I really love the way that you put that because this
is, as we've talked aboutalready, this is a lot of
people's worst days.
It's not something I wouldimagine in a perfect world, if
you didn't have to do your jobanymore, it would be a beautiful
world, right?
If you did not have to come inand do these things every single
day.
But yet, because you do,because you have, because you
(09:04):
you have experience and you'veseen these things, you can then
offer that reassurance.
Say, hey, you know, I've beenhere, I've seen this, I've done
this, this is the right thing todo.
I would imagine that that wouldbe really, really comforting
for your parents of yourpatients.
Let's go back for a second.
Um, there's a couple of thingsthat I wanted to touch on.
First, let's talk about theteam.
So you mentioned you come inwith the team usually.
(09:25):
What does the team involve?
What does that look like?
Dr.Amos (09:28):
So I think depending on the delivery room, it can be
overwhelming.
So you have a nice quiet berth,and then all of a sudden this
team shows up of people you haveno idea.
So typically NP or PA, myself,depending on the scenario.
Um PAs and MPs have a lot ofautonomy in the NICU.
So if it's kind of a regular,we go to all C sections.
(09:49):
So the MP or PA will go there.
If there's something that goeswrong or they need me, they'll
call me for that.
Um, or if we have a complicatedcomplicated patient, I'll just
go with them.
Um, so it's, you know, NPPA,myself, respiratory therapist,
and then a nurse, a NICU nurseat the bedside at a minimum.
Now, if things get complex, wehave a very small baby, there's
typically more people.
(10:10):
Um, so the care really startsfrom the beginning.
And it's hard.
And I, you know, somescenarios, it's easier than
others.
If we know they're gonna gointo labor early or the baby's
gonna come to NICU, we candiscuss with them beforehand.
Otherwise, they're hitting thestep button and we come running
in, and it's really hard becausethe parents are just panicked.
Um, for us to kind of introduceourselves, we're just focused
(10:30):
on the baby.
Um, and then I think fromthere, we'll take the baby,
always we want them, the parentsto see the baby before we go to
the NICU.
And then you use that chance.
I mean, there's so much goingon to kind of just say
everything is okay, the baby'sdoing as we expect.
We're gonna take them to theNICU, dad can come, grandma can
come, whoever.
Um, and then we kind of justmove to the NICU and then take
(10:51):
care of everything that needs tobe done as quickly as we can.
So typically within an hour fora small baby, we want
everything done.
So the lines in, fluid hung,uh, sugar checks, all that.
So the first hour is reallyjust kind of like this high
pressure, high intensity time,even though we're all calm
because you need to be calmaround the babies.
Um, and then once the baby'ssettled, it's just typical like
(11:14):
management.
Um, so everything else, fluids,labs, all that jazz get done
quickly.
And then it's a lot of justtrying to tuck the baby in
because they're not supposed tobe here.
Um, so you want to leave themalone as much as you can.
Ashley (11:26):
Yeah, that's really, really interesting.
And it's so funny you mentionedthat.
I've had a C-section andliterally I don't think I knew
who half the people in the roomwere.
You know, I think it's just asa patient, at least speaking on
the patient side of things,there really is so much trust
that goes into these things.
And there's this is a reallyhot topic, and I don't want to
step too much into it right now.
But mistrust in medicine, Ithink right now is is so
(11:48):
prevalent.
And when you're in a situationlike this, speaking as a
patient, and of course you seethis as a clinician, really
sometimes it it's just it's justtrust.
That's all there is, you know.
And and I'm a clinician and Iknew what was going on.
And I still like I like I said,I didn't know who half the
people were.
If my baby was taken, I wouldjust trust that they were taken
care of.
And I think the people thatwork in the NICU are some of the
(12:10):
most compassionate,intelligent, um,
success-oriented people inmedicine, really.
I mean, you guys, your end jobis to make sure that these
babies are okay.
And um, yeah, I'm so gratefulfor you guys and what you do.
Uh, let's go back a little bit.
What are some of the things?
I think knowledge is power, um,but I also think, like you
said, being pregnant in theNICU, knowledge can also be very
(12:32):
overwhelming.
Okay, so for a second, let'sjust talk about some of the
things that um that you might becalled in for, some of the
diagnoses that you might see.
And if this is something that'sgoing to stress you out, I
would recommend fast-forwardinga couple of seconds until we get
through this.
But tell us about some of thesediagnoses that you're making
and managing.
Dr.Amos (12:50):
Yep.
So any baby that's born before28 weeks, we are called in um
just because they are high riskfor complications.
So we have to put lines inthem.
They are usually intubated, etcetera.
So they will always be therefor those.
Um, there are certain thingslike hydrops fatalis that we
will be there for.
If there's a cardiac,congenital cardiac abnormality
(13:12):
or anything else, they'll callus in.
Some of these diagnoses wedon't always know about
beforehand.
Most people do get theiranatomy scanned, but there are
some things that you just aresurprised.
And unfortunately, more peopleare going away from modern
medicine while they're pregnant.
So there are a lot moresurprises than there used to be.
Um, so any congenital defects.
So you can have anything from,you know, valve pushing through
(13:34):
your belly button to not havingan anus.
So there's lots of surprisinglylarge number of things that can
go wrong in pregnancy.
And luckily they don't happenthat often.
But anytime there's anythinglike that, we're always
involved.
Ashley (13:47):
The medicine is just mind-blowing.
I mean, it really is mindblowing.
And then you step over to theparent side of your life and you
it's just terrifying.
You know, it's just all thethings that can go wrong.
Yes, there's there's a lot ofemotions there.
Well, thank you so much forsharing your career with us and
and what you do right now.
Well, this is the mostincredible thing to me.
(14:08):
So you began as a PA.
Actually, perhaps you began assomething even before that.
I would I would love to hearbriefly walk us through how you
first realized you wanted to bein medicine and then this
incredible journey that you havetaken to where you're at right
now.
Dr.Amos (14:23):
So I, so my mom worked as a medical assistant in a
doctor's office.
Um, but I wasn't really thatgung ho on medicine in the
beginning.
So in high school, I think Iwas trying to sort out what I
wanted to do.
And one of my neighbors waslike, Oh, I'm an EMT at the
firehouse.
You can take free classes atthe fire station.
So I was like, all right, I'lldo that.
Um, so I did a couple ofride-alongs, hung out at the
(14:45):
fire station.
I was like, this is fun.
Like I liked, you don't knowwhat you're kind of walking into
with when you're an EMT.
Um, but I knew I likedmedicine.
I was good at biology in myscience classes.
So I was thinking medicine,some variety.
At some point, I was like,maybe a biomedical engineer, but
I definitely don't have theengineer brain.
Um, so then when I was looking,I was going to do some sort of
(15:08):
like science undergrad.
Um, and my mom was like, oh,what about a PA?
Which I didn't really know toomuch about, but they the office
she worked at had just hiredone.
So I shadowed a bunch of PAs,shadowed some doctors in high
school, and then decided on PAschool.
I was still torn between, and Ithink most students are,
(15:28):
pre-med, uh med school or PAschool.
It's a hard decision to make at18.
And the program I applied towas actually a three plus two,
so a five-year program.
And my 18-year-old brain, I waslike, this is great.
I'll get my undergrad done inthree years.
And if I want to do med school,I can do that afterwards, or I
(15:50):
can continue and stay into gradschool.
So I just went with thatbecause I was like, this is
seems like a pretty good,surefire way to have a job out
off after college.
And that was, I think, my majorreassurance was either way I
could go to med school or Icould continue in the grad
program.
So finished my three years, wasstill kind of thinking medical
(16:11):
school.
But one thing that I found themost daunting was like, there's
really nothing guaranteed in medschool.
Get in, pay all that money andloans, and not match.
It's rare that that happens,but it can happen.
You could fail your step one,you could fail your step two.
So those are all, or you canmatch into something that you
hate and you're for the rest ofyour life.
So all of those to me were likea huge deterrent.
(16:33):
I was like, um, I like PAbecause if I don't like the
fields, I can just switch intosomething else.
Um, so I think that was a hugedriver for me to continue with
PA school.
And then as I was gettingthrough PA school, I realized
perhaps I don't like medicine atall.
I remember being on myrotations, being like, I don't
(16:54):
like this one, I don't like thisone.
And I think it was on like myeighth or ninth rotation.
I was like, oh God, I what haveI done?
Yeah, like I didn't don't likeany of this.
And I happened to do the adultICU.
And I liked the medicine, Iliked managing ventilators, I
liked the procedures.
So I was like, this is great,except I find it really
depressing.
It's a lot of people towardsthe end of their life or young
(17:17):
people that something horrifichappened.
And I was like, this is notgood for your mental health.
So then I still was like, Idon't know what I'm gonna do.
And I happened to get anelective in the NICU, and that
was when I realized, okay, samemedicine, same concepts, but
with a population that iscompletely different,
pathophysiology-wise, andthere's just a lot more hope in
(17:37):
the NICU, I found.
So then I realized I liked theNICU.
So I was like, great.
But of course, some of thecaveat being there wasn't at the
time, I think there was one ortwo uh NICU residencies.
And I didn't find out that Iliked the NICU till it was too
late to apply anyway.
So the place I did my electivein was like, we'll hire you and
kind of train you for six monthsto get catch up to speed.
(17:59):
So I did that and thenrealized, oh, gee, like I'm
still in over my head in termsof knowledge base, just because
it is a very specific field.
And I think a lot of the timeyou can gain experience the
longer you do something.
So if I'm in it for 20 years,sure.
But there was a level of, I'mnot studying Krebs cycle and
(18:22):
gluconeogenesis on my own, andI'm not studying embryology that
we come from and mesoderm andectoderm and endoderm.
And so those are things likeyou can look at and you can
read, but nothing sticks.
So I felt that in order formyself to feel confident and
comfortable and treat thepatients how I wanted to, my my
(18:43):
next best step was going back tomed school.
Ashley (18:47):
What did that look like?
I mean, did were you just didyou ever stop and think, am I
out of my mind?
Dr.Amos (18:54):
Yeah, I think most people, when I told them,
they're like, you're nuts.
Um I was like, Yes, I am.
Because most doctors, if youtalk to them even now, they'd be
like, oh, I should have done PAschool.
Right.
PAs and PAs are like, oh, Ishould have just gone to med
school.
Uh so it's a very everyone'slike on the opposite page.
But I finished PA school and Ifigured I kind of still had that
in the back of my head and Iknew I needed some prereqs.
(19:16):
So I'm like, I'll startworking, gonna take these
prereqs, see how I feel after Istart working.
Took my prereqs and kind ofjust decided, look, I'm just
gonna go for it.
I'd rather regret not getting,like, I'd rather just try
getting in and then notregretting for the rest of my
life, not even trying.
So I took the MCAT and then Iapplied the following.
(19:38):
So I worked for a full year,applied that fall-ish, I guess,
the timeline for med school.
So worked for two years fulltime before I had gone back.
So it kind of was like as I wasfinishing PA school, I was
still kind of like this knowingwhat I wanted to do, I needed
more education.
Had I gone into something likeprimary care or something
(20:01):
outpatient, would I have been asmotivated to go back to medical
school?
Probably not.
I think just because I was insuch a specific field, and if I
liked everything too, like if Iloved ortho and I loved surgery
and I loved internal medicine, Idon't know if I would have gone
back because I didn't want topigeon, I wouldn't want to
pigeonhole myself into like onefield.
But because NICU was what I sawmyself doing for the rest of my
(20:25):
life, I was like, I think Ineed to make this decision.
Ashley (20:28):
So I did.
I think it's a really, reallygreat example of how versatile
medicine can be.
Even when we think we are atthe end of our career decision
making, and we realize, but inessence, you fell in love with a
specialty.
You fell in love with medicinethat is incredibly complicated.
(20:49):
And because you loved it somuch, you literally went back to
school and did tell me, howmany more additional years of
schooling was it?
A decade later.
So that's how much you lovethis, but all of that knowledge,
every time you walk into aroom, the presence that you can
give these patients and theirparents, knowing that this is
(21:09):
absolutely where you belong andwhat you love doing, and this is
how hard you've worked to getto where you're at.
I mean, it's just theconfidence in that that you must
feel and that they must feel isabsolutely incredible.
Okay, let's let's talk a littlebit about PA school versus
medical school very briefly.
Yep.
Because as we know, it was umjust a little bit of time ago
that you're doing these things.
(21:30):
Generally speaking, both areextremely difficult.
One is a little bit longer.
Um, is there in your opinion,is there any like a major, major
thing that you would like totell a pre-health student
perhaps that is trying to decideone or the other, really just
based on the schooling alone?
Dr.Amos (21:47):
I would not go under the assumption that PA school is
easier because it's shorter.
So it was, I mean, theintensity of PA school was
unreal.
And I think I blacked out a lotof my uh my schooling at this
point, um, just out of purestress.
But I really we would havetests three times a week in PA
(22:08):
school.
We were in class eight to fiveevery day, like there was no
stopping it.
Um, and then med school wasstill a lot of information, but
it was more spaced out.
And I would really truly recallwe'd have like didactics in the
morning from like eight to oneor eight to two with like a
lunch break.
And then some days we wouldhave lab, but like to me, I
didn't count lab, I guess, aseducation because everyone's
(22:30):
like, we were in class every dayin med school too.
And I'm like, yeah, but like wewould have physical diagnosis
lab, but like I would have thatin PA school, but that would be
like after my five o'clocklectures.
So I felt the intensity was alot more in PA school.
You're just trying to cover somuch information in one year.
Um, so it was veryoverwhelming.
(22:51):
Medical school, I think I hadmore time to kind of digest
things before or tested on it,or I could like really study,
process it, and then kind ofmove on to the next day.
PA school, there was none.
Like you were just, it wasgoing full speed for a whole
year.
Ashley (23:06):
When you made the transition from PA to physician
and now you've been working init for a while, are there any
gaps that you've seen that youdidn't expect?
So things like clinicalknowledge, which we've talked
about a little bit.
You know, you just did NICU isa really special case too.
There's so much that you haveto know.
So we we talked about that, butum, what about like maybe
leadership opportunities orresearch opportunities or just
the system and in general?
(23:28):
You've seen things from bothsides now and you've experienced
things from both sides workingas a P and as a physician.
Um, anything glaring thatyou've noticed that you just
think we should be aware of?
Dr.Amos (23:38):
I think which I find frustrating, especially in this
current environment, um the forPAs, there's definitely kind of
like a glass ceiling at somepoint, right?
Clinically, you can doeverything, you can take on
patients, you can do some likelow-level managerial work in the
office or whatever.
But like true leadershippositions really, you don't see
(24:01):
that many PAs in them.
And I don't think that's for alack of ability.
I think it's just lack ofunderstanding the role.
There's more NPs getting intothose positions just because
they they have a great lobbythat pushes for those types of
things.
Um, but there's certainly thatkind of not that you want to sit
in meetings all day, but likeadministratively, I think PAs
(24:22):
are a huge value and they'rejust can be very underutilized
in certain situations.
Ashley (24:27):
Yeah, I would agree with that.
So on your social channels, youhave a really incredible online
presence, and I'll tag it inthe in the show notes for sure.
Um, but you get a lot ofquestions, and you are so kind
and so amazing to answer thesequestions and really mentor some
of these students.
What are some of the mostcommon questions or
misunderstandings that maybe apre-health student or even even
current clinicians have aboutthe PA to physician, switch, or
(24:51):
transition?
Dr.Amos (24:52):
Uh most common question is definitely people that are
torn between PA and MD.
The highest misconception Isee, and I think it gets like
torn apart in comments, is just,and I think some of them are,
you know, they could all just betrolls and bots, but people
really not understanding theeducation of a PA.
(25:14):
So in comparison, when you havethe whole NPPA mid-level role
or APP role, you get a lot ofheat, no matter how you post it.
PAs, I think, though trainingis not like medical school, I
think you have the broadesttraining in comparison.
(25:36):
So you're the closest that youcan get to medical school
without the biocellular,molecular basis of medicine.
So we get a lot of commentslike, oh, PAs are just like
doctors, or PAs are they have noidea what they're doing.
They're not like doctors atall.
They shouldn't have, you know,independent practice.
It goes like both ways.
So, like, there's a middleground, which I think we should
(25:57):
all come to, but your training,you're getting education in all
of those areas.
So you're getting rotations,which I try and highlight.
You're doing OBG way in.
Yes, maybe it's a shortrotation, but same with med
school, it's a short rotationuntil you do residency.
Um, so your rotations and youreducation mirror that of medical
school without the nitty-grittyscience to some degree.
(26:19):
Um, but there is obviouslynitty-gritty science in PA
school, it's just not asintense.
And compare that to NP school,which I think people have a hard
time with.
You pick a specialty as an NP.
So you're you're not like ifyou are a pediatric NP, you can
only prescribe medicine for Ppatients.
As a PA, I can run the gamut.
I can write meds for an80-year-old, I can write meds
(26:41):
for a six-month-old.
Um, and you have training inall of that, though it's more
brief.
Whereas an MP are kind of thespecialists in whatever field
they so choose in that regard.
So I think the confusion is theeducation.
And in PAs to me, and MPs arenot necessarily comparable in
(27:01):
some regard.
Sure, they have the same role,but the education is so
different.
Um, and I think that is where alot of the questions,
controversy, comments come from.
Ashley (27:12):
That is a really, really great example.
And I'm so glad that youhighlighted that.
I think in practice, oftentimesthey appear the same, but
you're absolutely right.
You have to look back and youhave to see how we were trained.
And um, and that's whatstudents really need to
investigate and see because ofthe the the training that you
get and the specialties that youyou can work in afterwards are
(27:34):
very, very different.
So I'm really glad youhighlighted that.
Dr.
Amos, you are incredible.
Um, tell us where we can findyou so that we can, you
mentioned uh independentpractices PAs, and that is
another big hot topic.
So I would love for you toshare where we can maybe learn a
little bit more about some ofthese other topics that you are
very well versed in.
Dr.Amos (27:52):
Well, I am I'm on TikTok and Instagram, and I have
some of the same videos reuseon YouTube.
So whatever not my YouTube isnot anywhere near up to speed,
but I do have some videos there.
Um, I would say TikTok orInstagram is my spot.
Ashley (28:10):
Very good.
Awesome.
Dr.
Amos, thank you so much forspending the time with us on
Shadow Me Next.
I really, really appreciate it.
Thank you for having me.
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