August 18, 2025 • 33 mins
Pete Breitinger's journey to respected PA educator spans more than three decades and reveals the profound human connections at the heart of healthcare. What begins as a candid reflection on his unexpected path into medicine transforms into a masterclass on resilience, advocacy, and equity in patient care.
When Pete shares stories from his years in pediatric cardiology, his voice brightens with genuine affection for the families he's followed, some from infancy through adulthood. "These kids are resilient," he says, "you talk about a definition of resilience? Go to Peds Cardiology." This perspective on patient strength becomes a thread woven throughout our conversation, reappearing as he describes the qualities that make successful PA students and practitioners.
The most powerful moment comes when Pete redefines his profession's very acronym. "What does PA stand for?" he asks his students each year. Beyond the official "Physician Assistant," Pete insists it means "Patient Advocate," a conviction forged while navigating the healthcare system with his wife during her cancer diagnosis. Seeing patients struggle without guidance crystallized his belief that advocacy isn't just political action but happens in every exam room, with every prescription, with every referral.
His work with UF's Mobile Outreach Clinic brings this philosophy to life, providing care to underserved communities from a converted bus. "If you want to be a true patient advocate, go work in underserved areas," Pete advises, noting how this experience forces practitioners to find creative solutions without "all the bells and whistles" of well-equipped facilities. The geographical distribution of healthcare resources, with standalone ERs concentrated in affluent areas, becomes a stark visual reminder of persistent inequities.
Through three decades of evolution in healthcare education, Pete has witnessed growing awareness of these systemic issues. Today's students arrive more community-aware and ready to address social determinants of health, giving him hope for medicine's future. His parting wisdom? Simply "be kind," a reminder that seeing patients as complete human beings rather than medical cases is perhaps the most fundamental form of advocacy.
Join us for this illuminating conversation about what it truly means to care for patients in all their complexity. Subscribe now and follow @shadowmenext on social media for more insights into the human side of medicine.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ashley (00:00):
Hello and welcome to Shadow Me Next, 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.
I've had the privilege ofknowing today's guests for over
(01:06):
a decade as a colleague, mentorand friend.
Mr Pete Breitinger has spentmore than 30 years shaping the
PA profession, not only throughhis work in pediatric cardiology
in the UF Mobile OutreachClinic, but also by guiding
generations of students as anassistant professor at the
University of Florida School ofPhysician Assistant Studies.
(01:28):
In this conversation, peteshares how a career that began
with a love for wildlifeconservation led him to medicine
.
He talks about the unexpectedjoy he found in pediatric
cardiology and the lessons he'slearned about resilience, both
in the clinic, in the classroomand in his personal life.
(01:48):
We talk about patient advocacyin its truest form, the
realities of healthcare,inequity and how some of the
most important moments inmedicine happen outside the exam
room.
At its heart, this is aconversation about the human
side of healthcare, the partthat shapes who we are as
(02:09):
clinicians.
Please keep in mind that thecontent of this podcast is
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,
(02:31):
employer or company.
This is Shadow Me Next with PeteBreitinger.
Hey Pete, thank you so much forjoining us today on Shadow Me
Next.
This is such a gift to mebecause Pete is not only
somebody that I've known andadmired for such a gift to me,
because Pete is not onlysomebody that I've known and
admired for such a long time, heis my mentor and was my mentor
throughout PA school.
So it's a treat for me to haveyou on the show.
(02:52):
Thank you so much for joiningus.
Pete Breitinger (02:53):
Thank you.
I'm so honored to be here andI'm so proud of you for doing
this, but not only that.
I mean kudos for yourgraduation speech.
That was so inspiring.
It really was, and you knowthat's what makes me so happy as
well to see people who you knowPAs right, who have been
(03:15):
through the program and theirsuccess, you know I mean that's
really fulfilling.
So so proud of you.
Ashley (03:22):
I appreciate it.
You know it was a group effortfrom the people I've spoken with
on the podcast, who are justyou know.
I invite them, expecting themto be your typical average
healthcare provider, and then wehave this conversation and
every single one of them is justmind-blowingly incredible and
awesome.
What we're doing is not justending when we step out of those
(03:42):
exam rooms.
These people are doingincredible things and they
contributed to but, it's just.
It's a mark of what anincredible educator you are the
fact that you do follow yourstudents and you've been in PA
education for a while, so youhave seen a lot of students come
through and really seen howthey've shaped the landscape of
this incredible profession thatwe have.
(04:03):
You have had a long career asboth a PA and a PA educator.
How long have you been doingthis, tell us?
Pete Breitinger (04:10):
So my LinkedIn profile said hey,
congratulations for being at UFfor 32 years.
I'm like whoa, that's amazing.
It's been an amazing journey,amazing ride, amazing career and
you hear this from PAs all thetime.
It's like I picked the bestprofession to be in and we most
(04:30):
definitely have.
It's been really cool to reallykind of see students grow
throughout the program, you know, becoming PAs but, more
importantly, following themthrough their careers to see the
amazing stuff that people do,right.
We have PAs who've inventedstuff.
We have PAs who are doingpodcasts outside of the
profession but yet still kind ofpromoting the profession, which
(04:51):
is really cool.
I had a faculty member kind oftell me, not too long ago
actually, which really kind ofresonated with me.
It's like you know, you spendthis time educating students and
if you add up the amount ofstudents that you've touched
through education, right, andthen you multiply that by the
amount of patients they haveseen, that's literally the
(05:13):
amount of patients that you haveindirectly kind of helped
affect or at least kind ofunderstand and know about the PA
profession, and it gets youknow, when you've been in the
profession for a while, it getsup in the millions, right.
Ashley (05:26):
I imagine a tree, you know, and I imagine all the
branches of that tree.
You know, we've talked a lotabout mentors on this show and
having a mentor is so importantand a lot of times it's not.
I mean, good Lord knows, I donot work in pediatric cardiology
, I couldn't.
I'm amazed with what you dowith these sweet tiniest
littlest of hearts.
But you still mentor me, youknow, and I still ask you
(05:49):
questions about all sorts ofthings related to the profession
, not necessarily related to themedicine, and I think that's
what is so interesting ismentorship can look so vastly
different as a PA.
Pete.
Go back, go back more than 30years.
How did you know about the PAprofession?
It was rather new when youfirst entered it, wasn't it?
Pete Breitinger (06:10):
So it was.
You know, it's funny.
I look back at my career kindof, where I went into medicine.
I originally wanted to go intowildlife management.
Okay, I was going to be likeyou know, I'm going to save the
wolves, think, whatever.
You know, somehow along the wayI figured out there's really no
(06:31):
career in wildlife managementand just kind of fell into
actually going to santa fe forcardiovascular technology.
I was a cardiovascular tech andworked cath lab, worked, did
ultrasound, that kind of stuff.
And then through there Iactually had some exposure to a
couple PAs that I knew, one whoactually was part of the program
(06:51):
at the time and she kind ofencouraged me because you know,
at the time, looking atcardiovascular techs and you
know, great profession, greatpeople, but it's really about
lateral movement.
It wasn't really much in thevariety and I like variety so
anyway, so I kind of fell intoPA and you know, been there ever
since.
(07:11):
Obviously, as far as Pete'scardiology that was kind of the
similar I initially started kindof going to work at the student
infirmary, which is a great gig, and then came into education
from there and then I actuallykind of have a good friend of
mine who is a pediatriccardiologist here, who's a
genius, kind of convinced me hey, come on down, come on into
(07:34):
Pete's Cardiology.
And it was such a great movebecause I never realized that
that was actually kind of mypassion as a PA, you know,
getting to know these patients,the families.
But more importantly it wasprobably my relationship with my
supervising physician, who ismy mentor and was fantastic with
(07:54):
helping to kind of, you know,really get me into the
profession, you know, intoPete's cardiology as well.
So, and you know, it really ledto a lot of wonderful
experiences that as a PA I neverthought that I could have, you
know.
I mean I was really brought into help with the echo lab, to
help with the exercise program,but became so much more
(08:18):
developing those relationshipswith the supervising physician
and those patients and such itwas great.
Ashley (08:24):
Pete.
What?
Because I'm sure well, numberone, I'm interested.
It's a question I've neverasked you, but I'm sure many
people would be interested.
What does a day look like foryou?
Just a typical regular day withthese pediatric patients?
I'm sure they're rather sick.
If they're seeing you, is italways quite sad or it seems
like you enjoyed it.
So I would imagine it's notalways a hard day.
Pete Breitinger (08:45):
No, not necessarily.
I was really more on theoutpatient side of things.
I never really kind of had thehospital responsibilities, which
was fine because my comfort andmy forte is really more
clinic-based medicine.
A typical day over there wouldbe, you know, we'd have
conference in the morning, youknow kind of go through surgical
cases and patients, just likethat, and then pretty much just
(09:06):
kind of looking over yourpatients of the day.
You know kind of go throughsurgical cases in patients, just
like that, and then pretty muchjust kind of looking over your
patients of the day.
You know kind of seeing ifthere's any labs that are going
to need to be done or anyfollow-ups and such like that,
reading last notes, et cetera.
And then of course you knowclinic and just kind of running
the patients with yoursupervising physician.
Now I also had the uniqueopportunity of helping develop
their exercise program.
So you know, scattered in thereI'd either be doing MBO2 stress
(09:29):
tests or we'd be doing regularstress tests on patients.
That kind of depended on theday.
But you know, getting to knownot only the patients but the
families themselves is one ofthe most fulfilling
opportunities you can have as aprovider and making those
connections with those familiesand there's still some families
today that I'm still kind ofconnected to and watching the
(09:50):
kids grow.
You know seeing them from whenthey were first kind of a baby,
having their surgeries and such,but yet following them, you
know, as teenagers andeventually into kind of adults
or helping them transition intothat.
That was big with us too istransitioning our kids into.
You know adult medicine as welland you know kind of following
the adults over time too Werethere the sad moments and such,
(10:13):
because you do get incrediblyclose with these people.
I've had several of adults who,or even some of our teenagers
who have grown into adulthoodand then passed away arrhythmias
, whatever, and that's hard,that's so tough.
You know just the joy.
I mean these kids are resilient.
You talk about a definition ofresilience.
Go to Pete's Cardiology, seethese kids and the families
(10:35):
themselves.
I'm always impressed with youknow, since we're kind of a
regional center families fromall walks of life and I'm always
impressed with those familieswho probably don't have two
nickels to rub together but yettheir priority is their kid.
They're still bringing them toclinics.
They're still doing what theyneed to do, but not only that.
(10:55):
The psychological side ofcoming to clinic is is this the
time they're going to tell me mydaughter needs surgery?
Or, as an adult, is this thetime when they're going to tell
me my daughter needs surgery,you know?
Or, as an adult, is this thetime when they're going to tell
me no, your heart's not gettingany better.
We're probably going to have tolist you for transplant.
You just kind of go throughthat, you know, wondering when's
the shoe going to drop, right?
Ashley (11:16):
It just.
That's a great example of howyou know you can have these
great relationships with thesepatients and their families and
usually things are really reallygood in your exam room but, for
whatever reason, one day theywalk in and they're just upset
or angry or sour, not actinglike they normally would, and
there's just so many other fearsthat are underlying these
(11:37):
conversations that we're havingthe preconceived notions and the
things that they'reexperiencing at home.
And when you have theserelationships with these
patients, you will run intothose things.
It is a gift, I think, inmedicine to be able to say and
it really is one of my favoritethings to be able to say hey,
what's going on?
(11:57):
This is not like you, this isnot you know you weren't like
this.
The last four or five visits Iseverything okay, and then they
will say no, and then they'lltalk about something completely
unrelated to your visit, but itcontributes to their care.
It's one more element that Idon't think we talk about enough
in clinical medicine that it'sso much more than looking at
their diagnoses, than reviewingtheir medications and coming up
(12:20):
with their plan.
It's factoring in the rest oftheir life, sometimes as well.
Pete Breitinger (12:30):
But that's we are in medicine to do, right, I
mean, that is the holistic sideof medicine and a lot of times
that can actually be more thehealing side of medicine, right,
I mean just the fact thatyou're listening and you're
talking to them.
They put so much trust in us.
You know, that is the otherside of medicine that I would
hate for see people kind oftaking for granted, because that
to me is kind of the fulfillingside as well that you talk to a
(13:06):
lot of students about too,because you can read a textbook
and you can learn about all ofthese conditions.
Ashley (13:08):
but it is some of these human moments in medicine that
it is nice to give students aglimpse into.
You are a PA educator.
You work for a university PAprogram.
You have for a while we'vealready mentioned you've seen a
number of students come throughFor you.
What is the most rewardingthing about working in PA
(13:32):
education?
If you had to pick one?
Pete Breitinger (13:34):
I would say graduation, you know, because if
you think about it, it's aculmination of what they
originally dreamed they wantedto do, you know, until they got
in there and realized, holy cow,this is tough, right, but to
watch our students starting, youknow, first in the summer, I
have no clue.
Yeah, you know no clue.
(13:56):
But to watch their growth intobecoming a provider in two short
years is amazing and it justfills me so much.
I mean, I tell my advisees, forbetter or for worse, I said you
know, look, I expect you guysto really grow through this and
(14:16):
you're going to, and there'sgoing to be some trials and
tribulations, but you are goingto come out the other end being
a strong, beautiful, wonderfulprovider.
Ashley (14:25):
It's incredible, pete.
So we've talked about your rolein clinic as a in Pete's
cardiology.
What about as a PA educator?
I would imagine it is a very,very different day for you,
probably multifactorial lots ofthings in the air that you're
balancing Still exciting thoughI would imagine.
Pete Breitinger (14:41):
Exactly what you said Multiple balls in the
air at any time, what studentsdon't see and they don't need to
.
It's like behind the curtain,wizard of Oz kind of stuff.
But there's a whole lot ofadministrative stuff that goes
on that we all have to deal with.
We are blessed with having agreat faculty, great staff who
are dedicated to the mission ofthe program but, more
(15:02):
importantly, the mission of thestudents and ensuring that we're
giving a good quality education.
But yeah, from day to day youjust never know what fires are
going to come up and what youneed to kind of do.
The best days are when you're inthe classroom and you're not
dealing with the emails that arecoming in.
I think that the other sidethat I really love about being
(15:22):
here obviously is the variety,but it's also the creativity
that it kind of can bring out inyou putting together lectures,
putting together labs.
It's a lot of work up front,but when you're up there and
you're delivering content andyou're seeing students are just
kind of like, yeah, the lightbulbs are going on or you're
throwing candy at them andthey're happy.
It's a highlight of educationin a sense.
(15:44):
But yeah, the behind the scenesstuff, it's a lot of
administrative stuff really is.
Ashley (15:49):
It's almost like wearing two hats.
You know, which I mean I thinkmedicine's the same way.
You're in the room with thepatient, you're wearing your
patient, your patient I call itthe customer service hat, and
then you step back and you startcharting and it's all the
clerical work and it's just alittle bit less.
Well, I smile less when I'msitting at my computer as
opposed to when I'm in front ofmy patients.
I'd imagine the same studentsyou mentioned getting to really
(16:12):
interact with these students andgetting to see them pick up
some of these incredibleconcepts that you have really
worked so hard to present tothem.
In your opinion, when it comesto the, let's talk about the
students for a second.
For PA students specifically,what are some of the qualities
that you consistently see insome of your most successful
(16:32):
students?
Let's not just talk didactic,let's do didactic and clinical
students.
So, just generally speaking,when you think about the most
successful ones, what do theyhave?
What's that thing?
Pete Breitinger (16:45):
I think the number one thing that I see in
the most successful students,but really would love to see
develop more so in all ourstudents, is resilience.
Ashley (16:58):
Now.
Pete and I did not get a chanceto discuss a quality question,
but this brings up an excellentopportunity to review a question
that you might hear on apre-health professional school
interview Describe a time inyour life that helped you forge
the most resilience.
Listen in as Pete describes whythis is so important in both
(17:19):
our pre-health students and alsoour healthcare professionals.
Keep in mind that there's moreinterview prep, such as mock
interviews and personalstatement review over on
shadowmenextcom.
There, you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Pete Breitinger (17:36):
You know, knowing when you get to a tough
point it's going to be okay.
I just have to power throughthis, you know, and then take
that time to look back and go,okay, what was it that was
giving me so much angst that Ineed to kind of improve in
myself that it's less and lessnext time.
These things kind of come up.
And I guess you know, primeexample, regardless of whether
(17:59):
it's clinical or didactic, isyou know, our students are
highly motivated, highlysuccessful, but yet they've
never really felt the pain ofmaybe failing a test, you know.
So when that happens, it'salmost world-ending for them you
know, and you know, not thatwe're going to kick you out, but
(18:21):
you know, I would hope thatyou're going to go back and go,
okay, what was it that I didn'tknow?
So that now I know it for mypatients later.
Right, because we're notstudying for the exams.
Well, I mean, you got to getthe grades, but we're studying
for our patients ultimately, youknow, but having that
resilience to realize, okay,we're still marching on, we're
(18:41):
still doing what we want, stillrealizing our goals and our
dream, you know, and realizingalso and I think you know the
the trust is a big thing, youknow.
Trust the process, trust theprogram, trust where you're
going and how we're taking youthere, but, more importantly,
trust we're here to support you,you know, because, like I said,
come graduation, I can't waitto call you colleague.
Ashley (19:04):
It's a special moment, and that's actually a perfect
segue into another question thatI wanted to ask, which was for
students consideringspecifically for PAs.
What is it that they should bedoing now to best prepare?
And, of course, we know aboutthe studying.
They should be getting goodgrades, they should be getting
clinical shadowing experience,but I'm wondering if what you
might say in this case is putyourself in positions where you
(19:27):
can develop resiliency and youcan at least be able to speak on
that a little bit.
Is that what you would say?
And if so, how could we do that?
Pete Breitinger (19:37):
That's a great question.
I think it's kind of hard toreally say here's a cut plan for
how you need to go about this,because everyone has a different
makeup of how they study andinterpret things.
But I would probably say, ifyou are looking to get into PA
school, start taking some harderclasses, classes that are going
to challenge you when you getinto PA school.
(19:59):
It's nonstop, right.
We've all experienced it, We'veall lived it.
Right.
It is tiring, It'll wear youdown.
We used to have a director whowould say well, you all are in
PA school.
However, the cracks you mayhave bringing in, we didn't
create them, but we're going tohelp widen them.
So it's like wow, but to somedegree, unfortunately, it really
(20:26):
challenges our mental health ofwho we are when you're going
through this incredible stresstime and time again.
So I think the other thing thatI usually kind of also tell at
least my advising students isyou know what?
Yes, you guys are going to beunder a lot of stress here.
Don't forget who you are andpractice your wellness.
(20:46):
You know.
Get back to who you were beforethis and know that again, we're
here to support you.
You're going to get throughthis.
Ashley (20:54):
And really, I guess, again leads to a really
interesting question.
And you've been doing this fora long time and I'm sure you've
seen, you know, plenty ofdifficult moments for students.
But have you experienced anydifficult moments in your career
whether it's in clinic andpractice or perhaps in education
where you had to say, okay,let's get that putty out and
(21:16):
let's fill up this crack realfast, because this is rough
right now?
Pete Breitinger (21:22):
You know, I think we've all kind of gone
through our periods of burnoutand you know it can be a
cyclical event, right, I knowthat through education yes,
being in a PA education I've hadthose moments of going through
the burnout and questioningmyself Am I really cut out to be
an educator?
Am I really developing thesestudents the way that they need
(21:42):
to be developed?
Because I mean, you know,students obviously come in with
their own expectations, right,of how things should be and how
they are, you know, and there'sbeen times when I felt like I
just don't feel like I'm livingup to those expectations and
it's bothered me.
Challenges, clinically, I'mgoing to know what to do.
Throughout the course of whatshe was going through, I was
(22:21):
fortunate that, yes, I havebackground in certain areas, but
I don't have backgrounds in theareas where it's going to count
the most for her right now,where it's going to count the
most for her right now and to me, that kind of left me feeling I
don't want to say less as a PA,but it did kind of motivate and
inspire me to make sure thatyou know what.
I am here to care for patientsand I need to do the best that I
(22:43):
can, no matter what situationI'm in.
Ashley (22:47):
Thank you so much for sharing that, because I think
it's something that we don'ttalk about a lot is when we are
put in those social situations,whether it's a spouse or a child
, or even a good friend.
So many people will reach outto us in our private life and
say, hey, what's your opinion onthis?
And it might not be yourspecific field, but because
(23:07):
you've been trained medically,they just want to know your
opinion on that and I think,gosh, especially something that
is so intimate as having a closefamily member walk through a
long-term diagnosis like that,it can be eye-opening, I think,
and it gives you an opportunityto be.
You were definitely an advocatefor your wife, of course, but I
(23:29):
think it really reframespatient advocacy when you are
the one that is so motivated toadvocate for your spouse, for
your child.
How did that?
Well, let me take a step back,and we mentioned of course it's
a buzzword we mentioned patientadvocacy.
What does that mean?
Pete Breitinger (23:48):
first of all, I'm so happy you brought that up
because that is somethingthat's very important and near
and dear to my heart andactually kind of form my opinion
of what that looks like andwhat it should be, while going
through with my wife what shewas going through, seeing her
strengths, seeing her resiliency, but, more importantly,
realizing our system's broken.
(24:08):
Our system is rough, you know.
So I, when I'm with thestudents, you know, especially
now, that they're new and suchone of my lectures is on the
biopsychosocial Okay, so it'skind of the whole, you know
putting it all together, but yetyou know kind of empathy, all
that stuff, right, but one ofthe things that I asked them and
(24:30):
I ask every class, this and Ihave for a while.
So what does PA stand for?
And we get, oh, physicianassistant or associate, now
Right, and I go, well, yeah,that's our title, but what does
(24:51):
it stand for?
And they're like, oh, patientadvocate, because that is first
and foremost your job as a PA isto help and make sure that that
patient is getting through thesystem and they have the support
they need, and that is yourcure.
That is what you are as a PA,because I mean going through our
own experience.
I mean, we had some wonderfulnurse navigators I mean, oh my
gosh, fantastic.
But looking at some of thesepeople who are going through
(25:13):
this alone and not realizing,you know, how do I need to kind
of get you know over here, orhow do I need to kind of get
into this office?
Or you know what do I do ifthis happens?
Right, I don't know how thosepeople do it without someone
kind of being there to kind ofadvocate for them.
You know, now, granted,advocacy takes on many forms,
(25:33):
right, with the governmentpolitical side of advocacy Super
important, right, you know.
And if you're a person who isinto that kind of grassroots
kind of stuff, then yes, be apatient.
Advocate in that direction, weneed that as well, right.
Advocate in that direction, weneed that as well, right.
But most importantly, when youare in clinic, when you are with
your patients, you are theiradvocate first and foremost.
(25:53):
So I'm hoping that that kind ofimpresses on the students as
they go out and we start to seethis kind of building more and
more.
Ashley (26:01):
It's true.
Thank you for defining that forus, because I think it's a word
that we so often hear thrownaround.
Nobody really quite knows, ofcourse, like you said, the
political, grassroots efforts,things like that.
But politics sometimes feel sofar away from some people and
they think, well, I'm not cutout for patient advocacy, I
don't want to lobby on CapitolHill, that's not me.
But that's not all it is.
(26:21):
It's so much more intimate thanthat in certain situations.
So thank you for defining that.
Pete, as you have worked in PAeducation, you also had the
opportunity to work on a mobileoutreach clinic, which I'm sure
gave you the opportunity toreally see some of these
biopsychosocial issues firsthand.
Tell me about this outreach andtell me about why it is so
(26:44):
important for PAs to seek outsome of these opportunities that
maybe are a little bit outsideof their wheelhouse.
Pete Breitinger (26:50):
So if you want to be a true patient advocate,
go work in underserved areas orrural health.
Ashley (26:56):
There you go.
Pete Breitinger (26:58):
That is, I mean , to me that's just so inspiring
.
And the mobile outreach clinicis basically a bus that goes
through Gainesville to providecare for underserved,
non-insured patients.
They have such a wonderful crewbetween the nurses, the NPs
that are there and the PAs.
It's a really kind of coolinterdisciplinary model as far
(27:21):
as everyone kind of workingtogether for the same shared
goal.
You know, but they do it withsuch compassion, such love for
the patients.
And you know, but they do itwith such compassion, such love
for the patients and, and youknow, it's very much inspiring.
I'm so grateful that we can haveour students kind of going
through that and in fact, if wecould, I would say every single
student should go through this,you know, because not only does
it kind of open your eyes to thehealth inequities that are out
(27:45):
there, but it also opens youreyes and kind of helps influence
you with social determinants ofhealth and how powerful that
plays within communities as faras determining population health
and such, but also kind ofhelping students recognize
(28:07):
resources within communities tohelp their patients, in addition
to the fact that you're reallypracticing medicine without the
benefit of having all the bellsand whistles right.
Needs an MRI?
(28:32):
I can't just put the order into say, schedule an MRI.
I've got to find some othercreative solutions to either try
and get this person an MRI orat least get them to a point to
where they're feeling morecomfortable.
Right, until we can, you know.
So you really have to kind ofthink about what you're, what
you're doing and what you'reable to do.
Ashley (28:48):
I remember I did a rotation on the bus and I 100%
agree with you it absolutelyshould be a required rotation
for everybody, because you walkinto this situation this is my
experience but you walk into thesituation knowing that you're
going to be providing care tounderserved, providing care to
people with less.
But, pete, I tell you, at nopoint while I was on the bus did
(29:09):
I ever think, oh, this personis less, they just have less and
they have access to less.
And I had to be moreintentional with the care that I
was giving and theprescriptions that I was writing
, because it was just our accessand their access and social
determinants of health.
These are things liketransportation.
It's a big one.
(29:30):
You know a lot of these peoplecan't get to the other side of
town to come see the doctor, sothe bus does that, things like
that.
I think it is just.
It is incredible.
You've been working on the busfor a while.
Go back to when you firststarted being a PA.
How has your understanding ofhealthcare equity changed?
Pete Breitinger (29:50):
Oh, immensely, you know, and.
But I think, though, that thatthat has also been in general
for everyone, right?
I mean, I look back to when Istarted.
Yes, you knew the inequitieswere out there, but there
weren't kind of programs inplace to say, oh, you know what,
let's start putting someclinics on the east side of town
to get more people into thesystem per se.
(30:12):
You know, it's been a slowlykind of evolving process,
obviously, and it's still notthere.
Show this to the students ifyou look at where the majority
of ER and the standalone ERs are, they're all on the side of
(30:33):
town, where the money is,insurance is.
Ashley (30:38):
Wild.
Pete Breitinger (30:39):
So I mean, just looking at a map alone, you see
where the inequities lie,unfortunately.
Being in education, though,it's also helped to better
inform me as well, trueThroughout In that respect.
Better informed students too, Imean our students are coming in
more community aware andcommunity responsive to what the
needs are and being thoseadvocates for that as well.
(31:02):
So it's really cool to see.
Ashley (31:05):
That's incredible, you know.
It feels like the problems seembigger, but the awareness is
also bigger now, I think, and itis, it's great, cool to see.
That's incredible, you know, itfeels like the problems seem
bigger, but the awareness isalso bigger now, I think, and
it's great.
And I also think it's important, regardless of where you're
practicing in medicine or howspecialized your field is, or if
you're ordering MRIs all thetime or if you're shopping off
of the Walmart $7 list forprescriptions with your patients
, I think everybody needs tohave a general understanding of
(31:27):
these things and of theseproblems, and I think that is
something that we are doing somuch better, at least recently,
in education and healthcareeducation.
So, working our way there,what's one piece of advice that
you like to give your studentsoutside of medicine?
Something that speaks to lifeor their character, not
(31:47):
necessarily something that youwould find in a textbook.
Pete Breitinger (31:51):
Oh, I'm not that wise.
Ashley (31:52):
I disagree.
Pete Breitinger (31:54):
Yeah, that's the golden rule right, just be
kind, right, be kind.
You mentioned something beforethat resonated with me with the
bus is, when you see thesepatients, you don't see them as
patients, right?
Nor should you see anybody as apatient, right, because they do
.
They have lives, you know,behind what we're seeing, you
(32:15):
know and they're going back to.
I think, if anything, that forall of us is, we need to
recognize and maybe look beyondsome of the biases that we have,
because, you know, working onthe MSE is not for everybody.
Some people have those biasesthey can't get over.
It's like, well, that's notyour issue right now.
(32:36):
Your issue is taking care ofthis person and looking beyond
that to be able to objectivelydo that right.
So be kind, let's be kind.
Ashley (32:46):
That's fabulous, pete.
Thank you so much for takingthe time to join us on shadow me
next and just share yourincredible journey and all of
the people that you've impactedand the patients that you've
impacted, and I'm grateful foryou and it's a pleasure, of
course, as always.
Pete Breitinger (33:01):
Well, I thank you as well, and I'm so proud of
you.
I'm very grateful of you andfor what you're doing as well,
so you are amazing.
Ashley (33:09):
Thank you so very much for listening to this episode of
Shadow Me Next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday, as always.
If you have any questions, letme know on Facebook or Instagram
Access.
You want stories you need?
You're always invited to shadowme next.
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-health student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
(00:44):
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.
I've had the privilege ofknowing today's guests for over
(01:06):
a decade as a colleague, mentorand friend.
Mr Pete Breitinger has spentmore than 30 years shaping the
PA profession, not only throughhis work in pediatric cardiology
in the UF Mobile OutreachClinic, but also by guiding
generations of students as anassistant professor at the
University of Florida School ofPhysician Assistant Studies.
(01:28):
In this conversation, peteshares how a career that began
with a love for wildlifeconservation led him to medicine
.
He talks about the unexpectedjoy he found in pediatric
cardiology and the lessons he'slearned about resilience, both
in the clinic, in the classroomand in his personal life.
(01:48):
We talk about patient advocacyin its truest form, the
realities of healthcare,inequity and how some of the
most important moments inmedicine happen outside the exam
room.
At its heart, this is aconversation about the human
side of healthcare, the partthat shapes who we are as
(02:09):
clinicians.
Please keep in mind that thecontent of this podcast is
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,
(02:31):
employer or company.
This is Shadow Me Next with PeteBreitinger.
Hey Pete, thank you so much forjoining us today on Shadow Me
Next.
This is such a gift to mebecause Pete is not only
somebody that I've known andadmired for such a gift to me,
because Pete is not onlysomebody that I've known and
admired for such a long time, heis my mentor and was my mentor
throughout PA school.
So it's a treat for me to haveyou on the show.
(02:52):
Thank you so much for joiningus.
Pete Breitinger (02:53):
Thank you.
I'm so honored to be here andI'm so proud of you for doing
this, but not only that.
I mean kudos for yourgraduation speech.
That was so inspiring.
It really was, and you knowthat's what makes me so happy as
well to see people who you knowPAs right, who have been
(03:15):
through the program and theirsuccess, you know I mean that's
really fulfilling.
So so proud of you.
Ashley (03:22):
I appreciate it.
You know it was a group effortfrom the people I've spoken with
on the podcast, who are justyou know.
I invite them, expecting themto be your typical average
healthcare provider, and then wehave this conversation and
every single one of them is justmind-blowingly incredible and
awesome.
What we're doing is not justending when we step out of those
(03:42):
exam rooms.
These people are doingincredible things and they
contributed to but, it's just.
It's a mark of what anincredible educator you are the
fact that you do follow yourstudents and you've been in PA
education for a while, so youhave seen a lot of students come
through and really seen howthey've shaped the landscape of
this incredible profession thatwe have.
(04:03):
You have had a long career asboth a PA and a PA educator.
How long have you been doingthis, tell us?
Pete Breitinger (04:10):
So my LinkedIn profile said hey,
congratulations for being at UFfor 32 years.
I'm like whoa, that's amazing.
It's been an amazing journey,amazing ride, amazing career and
you hear this from PAs all thetime.
It's like I picked the bestprofession to be in and we most
(04:30):
definitely have.
It's been really cool to reallykind of see students grow
throughout the program, you know, becoming PAs but, more
importantly, following themthrough their careers to see the
amazing stuff that people do,right.
We have PAs who've inventedstuff.
We have PAs who are doingpodcasts outside of the
profession but yet still kind ofpromoting the profession, which
(04:51):
is really cool.
I had a faculty member kind oftell me, not too long ago
actually, which really kind ofresonated with me.
It's like you know, you spendthis time educating students and
if you add up the amount ofstudents that you've touched
through education, right, andthen you multiply that by the
amount of patients they haveseen, that's literally the
(05:13):
amount of patients that you haveindirectly kind of helped
affect or at least kind ofunderstand and know about the PA
profession, and it gets youknow, when you've been in the
profession for a while, it getsup in the millions, right.
Ashley (05:26):
I imagine a tree, you know, and I imagine all the
branches of that tree.
You know, we've talked a lotabout mentors on this show and
having a mentor is so importantand a lot of times it's not.
I mean, good Lord knows, I donot work in pediatric cardiology
, I couldn't.
I'm amazed with what you dowith these sweet tiniest
littlest of hearts.
But you still mentor me, youknow, and I still ask you
(05:49):
questions about all sorts ofthings related to the profession
, not necessarily related to themedicine, and I think that's
what is so interesting ismentorship can look so vastly
different as a PA.
Pete.
Go back, go back more than 30years.
How did you know about the PAprofession?
It was rather new when youfirst entered it, wasn't it?
Pete Breitinger (06:10):
So it was.
You know, it's funny.
I look back at my career kindof, where I went into medicine.
I originally wanted to go intowildlife management.
Okay, I was going to be likeyou know, I'm going to save the
wolves, think, whatever.
You know, somehow along the wayI figured out there's really no
(06:31):
career in wildlife managementand just kind of fell into
actually going to santa fe forcardiovascular technology.
I was a cardiovascular tech andworked cath lab, worked, did
ultrasound, that kind of stuff.
And then through there Iactually had some exposure to a
couple PAs that I knew, one whoactually was part of the program
(06:51):
at the time and she kind ofencouraged me because you know,
at the time, looking atcardiovascular techs and you
know, great profession, greatpeople, but it's really about
lateral movement.
It wasn't really much in thevariety and I like variety so
anyway, so I kind of fell intoPA and you know, been there ever
since.
(07:11):
Obviously, as far as Pete'scardiology that was kind of the
similar I initially started kindof going to work at the student
infirmary, which is a great gig, and then came into education
from there and then I actuallykind of have a good friend of
mine who is a pediatriccardiologist here, who's a
genius, kind of convinced me hey, come on down, come on into
(07:34):
Pete's Cardiology.
And it was such a great movebecause I never realized that
that was actually kind of mypassion as a PA, you know,
getting to know these patients,the families.
But more importantly it wasprobably my relationship with my
supervising physician, who ismy mentor and was fantastic with
(07:54):
helping to kind of, you know,really get me into the
profession, you know, intoPete's cardiology as well.
So, and you know, it really ledto a lot of wonderful
experiences that as a PA I neverthought that I could have, you
know.
I mean I was really brought into help with the echo lab, to
help with the exercise program,but became so much more
(08:18):
developing those relationshipswith the supervising physician
and those patients and such itwas great.
Ashley (08:24):
Pete.
What?
Because I'm sure well, numberone, I'm interested.
It's a question I've neverasked you, but I'm sure many
people would be interested.
What does a day look like foryou?
Just a typical regular day withthese pediatric patients?
I'm sure they're rather sick.
If they're seeing you, is italways quite sad or it seems
like you enjoyed it.
So I would imagine it's notalways a hard day.
Pete Breitinger (08:45):
No, not necessarily.
I was really more on theoutpatient side of things.
I never really kind of had thehospital responsibilities, which
was fine because my comfort andmy forte is really more
clinic-based medicine.
A typical day over there wouldbe, you know, we'd have
conference in the morning, youknow kind of go through surgical
cases and patients, just likethat, and then pretty much just
(09:06):
kind of looking over yourpatients of the day.
You know kind of go throughsurgical cases in patients, just
like that, and then pretty muchjust kind of looking over your
patients of the day.
You know kind of seeing ifthere's any labs that are going
to need to be done or anyfollow-ups and such like that,
reading last notes, et cetera.
And then of course you knowclinic and just kind of running
the patients with yoursupervising physician.
Now I also had the uniqueopportunity of helping develop
their exercise program.
So you know, scattered in thereI'd either be doing MBO2 stress
(09:29):
tests or we'd be doing regularstress tests on patients.
That kind of depended on theday.
But you know, getting to knownot only the patients but the
families themselves is one ofthe most fulfilling
opportunities you can have as aprovider and making those
connections with those familiesand there's still some families
today that I'm still kind ofconnected to and watching the
(09:50):
kids grow.
You know seeing them from whenthey were first kind of a baby,
having their surgeries and such,but yet following them, you
know, as teenagers andeventually into kind of adults
or helping them transition intothat.
That was big with us too istransitioning our kids into.
You know adult medicine as welland you know kind of following
the adults over time too Werethere the sad moments and such,
(10:13):
because you do get incrediblyclose with these people.
I've had several of adults who,or even some of our teenagers
who have grown into adulthoodand then passed away arrhythmias
, whatever, and that's hard,that's so tough.
You know just the joy.
I mean these kids are resilient.
You talk about a definition ofresilience.
Go to Pete's Cardiology, seethese kids and the families
(10:35):
themselves.
I'm always impressed with youknow, since we're kind of a
regional center families fromall walks of life and I'm always
impressed with those familieswho probably don't have two
nickels to rub together but yettheir priority is their kid.
They're still bringing them toclinics.
They're still doing what theyneed to do, but not only that.
(10:55):
The psychological side ofcoming to clinic is is this the
time they're going to tell me mydaughter needs surgery?
Or, as an adult, is this thetime when they're going to tell
me my daughter needs surgery,you know?
Or, as an adult, is this thetime when they're going to tell
me no, your heart's not gettingany better.
We're probably going to have tolist you for transplant.
You just kind of go throughthat, you know, wondering when's
the shoe going to drop, right?
Ashley (11:16):
It just.
That's a great example of howyou know you can have these
great relationships with thesepatients and their families and
usually things are really reallygood in your exam room but, for
whatever reason, one day theywalk in and they're just upset
or angry or sour, not actinglike they normally would, and
there's just so many other fearsthat are underlying these
(11:37):
conversations that we're havingthe preconceived notions and the
things that they'reexperiencing at home.
And when you have theserelationships with these
patients, you will run intothose things.
It is a gift, I think, inmedicine to be able to say and
it really is one of my favoritethings to be able to say hey,
what's going on?
(11:57):
This is not like you, this isnot you know you weren't like
this.
The last four or five visits Iseverything okay, and then they
will say no, and then they'lltalk about something completely
unrelated to your visit, but itcontributes to their care.
It's one more element that Idon't think we talk about enough
in clinical medicine that it'sso much more than looking at
their diagnoses, than reviewingtheir medications and coming up
(12:20):
with their plan.
It's factoring in the rest oftheir life, sometimes as well.
Pete Breitinger (12:30):
But that's we are in medicine to do, right, I
mean, that is the holistic sideof medicine and a lot of times
that can actually be more thehealing side of medicine, right,
I mean just the fact thatyou're listening and you're
talking to them.
They put so much trust in us.
You know, that is the otherside of medicine that I would
hate for see people kind oftaking for granted, because that
to me is kind of the fulfillingside as well that you talk to a
(13:06):
lot of students about too,because you can read a textbook
and you can learn about all ofthese conditions.
Ashley (13:08):
but it is some of these human moments in medicine that
it is nice to give students aglimpse into.
You are a PA educator.
You work for a university PAprogram.
You have for a while we'vealready mentioned you've seen a
number of students come throughFor you.
What is the most rewardingthing about working in PA
(13:32):
education?
If you had to pick one?
Pete Breitinger (13:34):
I would say graduation, you know, because if
you think about it, it's aculmination of what they
originally dreamed they wantedto do, you know, until they got
in there and realized, holy cow,this is tough, right, but to
watch our students starting, youknow, first in the summer, I
have no clue.
Yeah, you know no clue.
(13:56):
But to watch their growth intobecoming a provider in two short
years is amazing and it justfills me so much.
I mean, I tell my advisees, forbetter or for worse, I said you
know, look, I expect you guysto really grow through this and
(14:16):
you're going to, and there'sgoing to be some trials and
tribulations, but you are goingto come out the other end being
a strong, beautiful, wonderfulprovider.
Ashley (14:25):
It's incredible, pete.
So we've talked about your rolein clinic as a in Pete's
cardiology.
What about as a PA educator?
I would imagine it is a very,very different day for you,
probably multifactorial lots ofthings in the air that you're
balancing Still exciting thoughI would imagine.
Pete Breitinger (14:41):
Exactly what you said Multiple balls in the
air at any time, what studentsdon't see and they don't need to
.
It's like behind the curtain,wizard of Oz kind of stuff.
But there's a whole lot ofadministrative stuff that goes
on that we all have to deal with.
We are blessed with having agreat faculty, great staff who
are dedicated to the mission ofthe program but, more
(15:02):
importantly, the mission of thestudents and ensuring that we're
giving a good quality education.
But yeah, from day to day youjust never know what fires are
going to come up and what youneed to kind of do.
The best days are when you're inthe classroom and you're not
dealing with the emails that arecoming in.
I think that the other sidethat I really love about being
(15:22):
here obviously is the variety,but it's also the creativity
that it kind of can bring out inyou putting together lectures,
putting together labs.
It's a lot of work up front,but when you're up there and
you're delivering content andyou're seeing students are just
kind of like, yeah, the lightbulbs are going on or you're
throwing candy at them andthey're happy.
It's a highlight of educationin a sense.
(15:44):
But yeah, the behind the scenesstuff, it's a lot of
administrative stuff really is.
Ashley (15:49):
It's almost like wearing two hats.
You know, which I mean I thinkmedicine's the same way.
You're in the room with thepatient, you're wearing your
patient, your patient I call itthe customer service hat, and
then you step back and you startcharting and it's all the
clerical work and it's just alittle bit less.
Well, I smile less when I'msitting at my computer as
opposed to when I'm in front ofmy patients.
I'd imagine the same studentsyou mentioned getting to really
(16:12):
interact with these students andgetting to see them pick up
some of these incredibleconcepts that you have really
worked so hard to present tothem.
In your opinion, when it comesto the, let's talk about the
students for a second.
For PA students specifically,what are some of the qualities
that you consistently see insome of your most successful
(16:32):
students?
Let's not just talk didactic,let's do didactic and clinical
students.
So, just generally speaking,when you think about the most
successful ones, what do theyhave?
What's that thing?
Pete Breitinger (16:45):
I think the number one thing that I see in
the most successful students,but really would love to see
develop more so in all ourstudents, is resilience.
Ashley (16:58):
Now.
Pete and I did not get a chanceto discuss a quality question,
but this brings up an excellentopportunity to review a question
that you might hear on apre-health professional school
interview Describe a time inyour life that helped you forge
the most resilience.
Listen in as Pete describes whythis is so important in both
(17:19):
our pre-health students and alsoour healthcare professionals.
Keep in mind that there's moreinterview prep, such as mock
interviews and personalstatement review over on
shadowmenextcom.
There, you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Pete Breitinger (17:36):
You know, knowing when you get to a tough
point it's going to be okay.
I just have to power throughthis, you know, and then take
that time to look back and go,okay, what was it that was
giving me so much angst that Ineed to kind of improve in
myself that it's less and lessnext time.
These things kind of come up.
And I guess you know, primeexample, regardless of whether
(17:59):
it's clinical or didactic, isyou know, our students are
highly motivated, highlysuccessful, but yet they've
never really felt the pain ofmaybe failing a test, you know.
So when that happens, it'salmost world-ending for them you
know, and you know, not thatwe're going to kick you out, but
(18:21):
you know, I would hope thatyou're going to go back and go,
okay, what was it that I didn'tknow?
So that now I know it for mypatients later.
Right, because we're notstudying for the exams.
Well, I mean, you got to getthe grades, but we're studying
for our patients ultimately, youknow, but having that
resilience to realize, okay,we're still marching on, we're
(18:41):
still doing what we want, stillrealizing our goals and our
dream, you know, and realizingalso and I think you know the
the trust is a big thing, youknow.
Trust the process, trust theprogram, trust where you're
going and how we're taking youthere, but, more importantly,
trust we're here to support you,you know, because, like I said,
come graduation, I can't waitto call you colleague.
Ashley (19:04):
It's a special moment, and that's actually a perfect
segue into another question thatI wanted to ask, which was for
students consideringspecifically for PAs.
What is it that they should bedoing now to best prepare?
And, of course, we know aboutthe studying.
They should be getting goodgrades, they should be getting
clinical shadowing experience,but I'm wondering if what you
might say in this case is putyourself in positions where you
(19:27):
can develop resiliency and youcan at least be able to speak on
that a little bit.
Is that what you would say?
And if so, how could we do that?
Pete Breitinger (19:37):
That's a great question.
I think it's kind of hard toreally say here's a cut plan for
how you need to go about this,because everyone has a different
makeup of how they study andinterpret things.
But I would probably say, ifyou are looking to get into PA
school, start taking some harderclasses, classes that are going
to challenge you when you getinto PA school.
(19:59):
It's nonstop, right.
We've all experienced it, We'veall lived it.
Right.
It is tiring, It'll wear youdown.
We used to have a director whowould say well, you all are in
PA school.
However, the cracks you mayhave bringing in, we didn't
create them, but we're going tohelp widen them.
So it's like wow, but to somedegree, unfortunately, it really
(20:26):
challenges our mental health ofwho we are when you're going
through this incredible stresstime and time again.
So I think the other thing thatI usually kind of also tell at
least my advising students isyou know what?
Yes, you guys are going to beunder a lot of stress here.
Don't forget who you are andpractice your wellness.
(20:46):
You know.
Get back to who you were beforethis and know that again, we're
here to support you.
You're going to get throughthis.
Ashley (20:54):
And really, I guess, again leads to a really
interesting question.
And you've been doing this fora long time and I'm sure you've
seen, you know, plenty ofdifficult moments for students.
But have you experienced anydifficult moments in your career
whether it's in clinic andpractice or perhaps in education
where you had to say, okay,let's get that putty out and
(21:16):
let's fill up this crack realfast, because this is rough
right now?
Pete Breitinger (21:22):
You know, I think we've all kind of gone
through our periods of burnoutand you know it can be a
cyclical event, right, I knowthat through education yes,
being in a PA education I've hadthose moments of going through
the burnout and questioningmyself Am I really cut out to be
an educator?
Am I really developing thesestudents the way that they need
(21:42):
to be developed?
Because I mean, you know,students obviously come in with
their own expectations, right,of how things should be and how
they are, you know, and there'sbeen times when I felt like I
just don't feel like I'm livingup to those expectations and
it's bothered me.
Challenges, clinically, I'mgoing to know what to do.
Throughout the course of whatshe was going through, I was
(22:21):
fortunate that, yes, I havebackground in certain areas, but
I don't have backgrounds in theareas where it's going to count
the most for her right now,where it's going to count the
most for her right now and to me, that kind of left me feeling I
don't want to say less as a PA,but it did kind of motivate and
inspire me to make sure thatyou know what.
I am here to care for patientsand I need to do the best that I
(22:43):
can, no matter what situationI'm in.
Ashley (22:47):
Thank you so much for sharing that, because I think
it's something that we don'ttalk about a lot is when we are
put in those social situations,whether it's a spouse or a child
, or even a good friend.
So many people will reach outto us in our private life and
say, hey, what's your opinion onthis?
And it might not be yourspecific field, but because
(23:07):
you've been trained medically,they just want to know your
opinion on that and I think,gosh, especially something that
is so intimate as having a closefamily member walk through a
long-term diagnosis like that,it can be eye-opening, I think,
and it gives you an opportunityto be.
You were definitely an advocatefor your wife, of course, but I
(23:29):
think it really reframespatient advocacy when you are
the one that is so motivated toadvocate for your spouse, for
your child.
How did that?
Well, let me take a step back,and we mentioned of course it's
a buzzword we mentioned patientadvocacy.
What does that mean?
Pete Breitinger (23:48):
first of all, I'm so happy you brought that up
because that is somethingthat's very important and near
and dear to my heart andactually kind of form my opinion
of what that looks like andwhat it should be, while going
through with my wife what shewas going through, seeing her
strengths, seeing her resiliency, but, more importantly,
realizing our system's broken.
(24:08):
Our system is rough, you know.
So I, when I'm with thestudents, you know, especially
now, that they're new and suchone of my lectures is on the
biopsychosocial Okay, so it'skind of the whole, you know
putting it all together, but yetyou know kind of empathy, all
that stuff, right, but one ofthe things that I asked them and
(24:30):
I ask every class, this and Ihave for a while.
So what does PA stand for?
And we get, oh, physicianassistant or associate, now
Right, and I go, well, yeah,that's our title, but what does
(24:51):
it stand for?
And they're like, oh, patientadvocate, because that is first
and foremost your job as a PA isto help and make sure that that
patient is getting through thesystem and they have the support
they need, and that is yourcure.
That is what you are as a PA,because I mean going through our
own experience.
I mean, we had some wonderfulnurse navigators I mean, oh my
gosh, fantastic.
But looking at some of thesepeople who are going through
(25:13):
this alone and not realizing,you know, how do I need to kind
of get you know over here, orhow do I need to kind of get
into this office?
Or you know what do I do ifthis happens?
Right, I don't know how thosepeople do it without someone
kind of being there to kind ofadvocate for them.
You know, now, granted,advocacy takes on many forms,
(25:33):
right, with the governmentpolitical side of advocacy Super
important, right, you know.
And if you're a person who isinto that kind of grassroots
kind of stuff, then yes, be apatient.
Advocate in that direction, weneed that as well, right.
Advocate in that direction, weneed that as well, right.
But most importantly, when youare in clinic, when you are with
your patients, you are theiradvocate first and foremost.
(25:53):
So I'm hoping that that kind ofimpresses on the students as
they go out and we start to seethis kind of building more and
more.
Ashley (26:01):
It's true.
Thank you for defining that forus, because I think it's a word
that we so often hear thrownaround.
Nobody really quite knows, ofcourse, like you said, the
political, grassroots efforts,things like that.
But politics sometimes feel sofar away from some people and
they think, well, I'm not cutout for patient advocacy, I
don't want to lobby on CapitolHill, that's not me.
But that's not all it is.
(26:21):
It's so much more intimate thanthat in certain situations.
So thank you for defining that.
Pete, as you have worked in PAeducation, you also had the
opportunity to work on a mobileoutreach clinic, which I'm sure
gave you the opportunity toreally see some of these
biopsychosocial issues firsthand.
Tell me about this outreach andtell me about why it is so
(26:44):
important for PAs to seek outsome of these opportunities that
maybe are a little bit outsideof their wheelhouse.
Pete Breitinger (26:50):
So if you want to be a true patient advocate,
go work in underserved areas orrural health.
Ashley (26:56):
There you go.
Pete Breitinger (26:58):
That is, I mean , to me that's just so inspiring
.
And the mobile outreach clinicis basically a bus that goes
through Gainesville to providecare for underserved,
non-insured patients.
They have such a wonderful crewbetween the nurses, the NPs
that are there and the PAs.
It's a really kind of coolinterdisciplinary model as far
(27:21):
as everyone kind of workingtogether for the same shared
goal.
You know, but they do it withsuch compassion, such love for
the patients.
And you know, but they do itwith such compassion, such love
for the patients and, and youknow, it's very much inspiring.
I'm so grateful that we can haveour students kind of going
through that and in fact, if wecould, I would say every single
student should go through this,you know, because not only does
it kind of open your eyes to thehealth inequities that are out
(27:45):
there, but it also opens youreyes and kind of helps influence
you with social determinants ofhealth and how powerful that
plays within communities as faras determining population health
and such, but also kind ofhelping students recognize
(28:07):
resources within communities tohelp their patients, in addition
to the fact that you're reallypracticing medicine without the
benefit of having all the bellsand whistles right.
Needs an MRI?
(28:32):
I can't just put the order into say, schedule an MRI.
I've got to find some othercreative solutions to either try
and get this person an MRI orat least get them to a point to
where they're feeling morecomfortable.
Right, until we can, you know.
So you really have to kind ofthink about what you're, what
you're doing and what you'reable to do.
Ashley (28:48):
I remember I did a rotation on the bus and I 100%
agree with you it absolutelyshould be a required rotation
for everybody, because you walkinto this situation this is my
experience but you walk into thesituation knowing that you're
going to be providing care tounderserved, providing care to
people with less.
But, pete, I tell you, at nopoint while I was on the bus did
(29:09):
I ever think, oh, this personis less, they just have less and
they have access to less.
And I had to be moreintentional with the care that I
was giving and theprescriptions that I was writing
, because it was just our accessand their access and social
determinants of health.
These are things liketransportation.
It's a big one.
(29:30):
You know a lot of these peoplecan't get to the other side of
town to come see the doctor, sothe bus does that, things like
that.
I think it is just.
It is incredible.
You've been working on the busfor a while.
Go back to when you firststarted being a PA.
How has your understanding ofhealthcare equity changed?
Pete Breitinger (29:50):
Oh, immensely, you know, and.
But I think, though, that thatthat has also been in general
for everyone, right?
I mean, I look back to when Istarted.
Yes, you knew the inequitieswere out there, but there
weren't kind of programs inplace to say, oh, you know what,
let's start putting someclinics on the east side of town
to get more people into thesystem per se.
(30:12):
You know, it's been a slowlykind of evolving process,
obviously, and it's still notthere.
Show this to the students ifyou look at where the majority
of ER and the standalone ERs are, they're all on the side of
(30:33):
town, where the money is,insurance is.
Ashley (30:38):
Wild.
Pete Breitinger (30:39):
So I mean, just looking at a map alone, you see
where the inequities lie,unfortunately.
Being in education, though,it's also helped to better
inform me as well, trueThroughout In that respect.
Better informed students too, Imean our students are coming in
more community aware andcommunity responsive to what the
needs are and being thoseadvocates for that as well.
(31:02):
So it's really cool to see.
Ashley (31:05):
That's incredible, you know.
It feels like the problems seembigger, but the awareness is
also bigger now, I think, and itis, it's great, cool to see.
That's incredible, you know, itfeels like the problems seem
bigger, but the awareness isalso bigger now, I think, and
it's great.
And I also think it's important, regardless of where you're
practicing in medicine or howspecialized your field is, or if
you're ordering MRIs all thetime or if you're shopping off
of the Walmart $7 list forprescriptions with your patients
, I think everybody needs tohave a general understanding of
(31:27):
these things and of theseproblems, and I think that is
something that we are doing somuch better, at least recently,
in education and healthcareeducation.
So, working our way there,what's one piece of advice that
you like to give your studentsoutside of medicine?
Something that speaks to lifeor their character, not
(31:47):
necessarily something that youwould find in a textbook.
Pete Breitinger (31:51):
Oh, I'm not that wise.
Ashley (31:52):
I disagree.
Pete Breitinger (31:54):
Yeah, that's the golden rule right, just be
kind, right, be kind.
You mentioned something beforethat resonated with me with the
bus is, when you see thesepatients, you don't see them as
patients, right?
Nor should you see anybody as apatient, right, because they do
.
They have lives, you know,behind what we're seeing, you
(32:15):
know and they're going back to.
I think, if anything, that forall of us is, we need to
recognize and maybe look beyondsome of the biases that we have,
because, you know, working onthe MSE is not for everybody.
Some people have those biasesthey can't get over.
It's like, well, that's notyour issue right now.
(32:36):
Your issue is taking care ofthis person and looking beyond
that to be able to objectivelydo that right.
So be kind, let's be kind.
Ashley (32:46):
That's fabulous, pete.
Thank you so much for takingthe time to join us on shadow me
next and just share yourincredible journey and all of
the people that you've impactedand the patients that you've
impacted, and I'm grateful foryou and it's a pleasure, of
course, as always.
Pete Breitinger (33:01):
Well, I thank you as well, and I'm so proud of
you.
I'm very grateful of you andfor what you're doing as well,
so you are amazing.
Ashley (33:09):
Thank you so very much for listening to this episode of
Shadow Me Next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday, as always.
If you have any questions, letme know on Facebook or Instagram
Access.
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You're always invited to shadowme next.
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