Physician Assistants for Change!

The best way to raise awareness of our profession is to reach out to our community.

Physician Assistants for Change was created to do just this. Using our unique skills as PA's to make the world a better place!

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When I was in college all I could think about was providing healthcare to those in need.

I am not sure where this came from, but it was something inside of me since I was quite young.

I remember the excitement I would have when I had the chance to go to my pediatricians office for a physical or to have my ears checked.

He had these anatomy books in the waiting room that I just loved to read.

Even at the age of five years old the body inspired me, mesmerized me!

I wanted to practice medicine so bad that from that young age I made a commitment to do whatever it would take to get to that point. I also made a commitment to do right by my patients. Not just do it because it was a job but do it because I could make the world a better place.

The Journey – Your Burning Desire

It really began in high school. Like everyone I love to goof off.  When I see and treat teenagers today and they tell me “I am just so bored” I try to empathize, but boredom in my opinion is just a lack of imagination, and a lack of belief in yourself… That you have the chops to do what truly excites you.

I understand where they are coming from. Many kids don’t have the emotional and family support that I had growing up. My parents instilled a belief in me that I could do whatever it was that was in my heart. This is the main reason I made it to where I am today.

Many kids will never get this, it is our job to help those kids, help them to attain their true potential.

But I digress…

For me the sciences were inspirational, they were my passion. Math was a hurdle I had to overcome and it was the one thing I wished I could just side-step, but you can’t.  And this is life you have to do things you don’t like to do to make it to where you want to be. So I pushed hard, worked hard, and yes I played hard. But in the end I had a burning desire. Something inside of me that was established at a very young age.

Not Listening to What People Tell You

I tell my kids everyday that they need to be better listeners. Especially to their mom and dad.

But when I made it from high school to college I met a guidance counselor who told me that I would never have what it takes to establish a career in medicine.

How she accumulated this “data” and came to this conclusion is beyond me. But it was demoralizing for me. Came sometime around my sophomore year. I remember it like it was yesterday.

It was as if somebody snuffed  my burning desire. Crushed my dreams and in a way a part of who I was. It would take a spark to start it again.

Igniting Your Passion

I was working as a student in “Hall Health” at the time as a phelobotomist. Demoralized by what the guidance counselor told me, convinced that I was on a nowhere path, I somehow found it into the office of an Orthopedic Physician Assistant.

It was at this moment, talking with this man learning about the Physician Assistant profession that the spark was re-ignited. And from that moment onward I knew what I wanted to become.

Redirecting your Passion

I was pre-med. I spoke to a different guidance counselor who steered me into Zoology…. Yes Zoology. It was not a major as many people belive focused around “animals” or working in a zoo but it is a major focussed around nature, life,  physiology and the essence of all the sciences. For me the spark turned into a fire. I found a love again in what I was doing.

Upon graduation I was now on the deans list, I had made connections in the campus clinic that led to a job as a mobile phlebotomist for Seattle’s Blood Center. From here I established grounding in my work, moved up the ranks to a mobile supervisor, made more connections, took night classes to get my EMS certification and began applying for PA School.

Reaching your Goals:

From acceptance to practice was a long road. Heck from high school to practice is a long road. You will reach many obstacles along the way. If you didn’t you would never learn to be grateful for what you have, these struggles make you appreciate what you have, to value it and later to do good with it.

Every day that I get to wake up and help a patient reach their health potential is a day I am thankful for.

Every day that I get to throw on my stethoscope and do what I dreamed of as a child is a reminder that in life anything is possible.

But you must work hard, never give up (you know all the normal platitudes) but most of all start believing in yourself… Enough to do what you know you NEED to do to reach your goals. Otherwise you will quit when the going gets tough and make the mistake of settling for less.

Post image for My first Day as a Physician Assistant: Faking it 101 (Part One)

I remember my first day on the job like it was yesterday.

I was petrified. When I ask other PA’s about their first day they often proclaim having had a certain sense of calm. For me, it was pure fear.

Possibly it was due to my situation at the time. I was working pretty much solo, in a walk in clinic, in the middle of a rural community with patients who spoke mostly Spanish. I spoke little to none.

The fear had compounded in my my mind based on a variety of predicted scenarios. These of course were bad scenarios that often ended in my patient either dying or coming close to it. I had conceived of millions of different scenarios in my head mostly based on my college obsession with the TV show ER.

I didn’t have enough pediatric experience, my orthopedic skills were shoddy, I had never actually written my own prescription. For the first time in my life I was going to have to stand by my own diagnostic skills.

Doctors don’t have to overcome this fear in the same way PA’s do. They have a residency to ease into it. As PA’s it is just one day you are a student then the next day you’re a prescribing midlevel practitioner.

Honestly, as I write this looking back at 7 years of experience no wonder I was scared senseless.

There is an understandable and probably protective fear that every medical provider should have. That is the fear of doing harm to someone. But there is another fear and that is less protective, it is the fear of looking like a beginner, having to ask for help, letting your patients down.

For me this was difficult. I like feeling in control. I hate doubt. I pride myself on my expertise. But there I stood, vulnerable and scared down to my bones.

I arrived at the clinic early this day of course, which only added fuel to my anxiety. I cleaned my workspace (which of course already was clean because I didn’t have any patients or charting yet) and I sat there in my chair. Living my dream that I had prepared for for so many years. Why did I want to run out of there home to my mom?

I cleaned my stethoscope, made small talk with my medical assistant, I re-cleaned my stethoscope and sat nervously awaiting the clinic doors to open.

And as the front doors of the clinic did finally open there I stood, exposed, nervous for my patients mostly.

In fear that people would discover that I really had no clue what I was doing.

Post image for Why Religion and Health Care Shouldn’t Mix–A Contraceptive Conundrum

A good portion of what I do as a family practice Physician Assistant involves counseling women and men about birth control. I have also gone to public schools and counseled junior high school students about puberty and sex.

One thing is for certain… the answer to solving America’s health care problems is definitely not placing restrictions or further boundaries on access to safe, effective contraception.

Of course right now in the news a big debate is raging over weather or not religious institutions should be required to provide family planning services. These are often the same religious institutions that aim to curb the ever rising rates of abortion. To me this seems backwards.

If I don’t believe in smoking is the best way to curb the rising rates really by denying my patients a prescription for Chantix?

The Contraceptive Conundrum

Of the six million pregnancies that occur among American women each year, nearly half are unintended. As a result, American women experience 1.4 million unplanned births and 1.3 million abortions annually.

In 2007 The Alan Guttmacher Institute, which specializes in reproductive health issues, released a massive study showing that abortion rates rise and fall in synch with the availability of family planning services.

From the Guttmacher Institute’s news release, its study, and the Washington Post report, we learn that states which fund programs to make family planning services widely accessible had lower rates of unplanned pregnancies — and women having abortions.

In recent years, many states cut back on these programs, making poor women and girls more likely to have unintended pregnancies. Meanwhile, the religious right is aggressively campaigning both to end the availability of abortion and to limit access to contraception.

The United States has sky-high rates of unplanned pregnancies and abortions. As Guttmacher President Sharon L. Camp told the Washington Post, “Unintended pregnancy in the United States is twice as high as in most of Western Europe. As a direct result, abortion rates are twice or three times as high as European countries.

There is no reason why abortion rates need to be as high as they are.

At What Cost?

The direct medical costs of unintended pregnancies were US$5 billion in 2002. Direct medical cost savings due to contraceptive use were US $19 billion.

National Cost of Teen Childbearing

Teen childbearing in the United States cost taxpayers (federal, state, and local) at least $10.9 billion in 2008, according to an updated analysis by The National Campaign to Prevent Teen and Unplanned Pregnancy. Most of the costs of teen childbearing are associated with negative consequences for the children of teen mothers, including increased costs for health care, foster care, incarceration, and lost tax revenue.

Contraception, unsafe abortions and complicated pregnancies

The risk of a woman dying from pregnancy-related causes during her lifetime is about 1 in 4,800 in the USA and 1 in 17,400 in Sweden as compared to 1 in 7 in Niger.

Worldwide some 200 million women of childbearing age want to delay or avoid pregnancy, but 137 million use no method of contraception at all.

Every year, 190 million women become pregnant, at least a third of them unintentionally.

Nearly 50 million women resort to abortion every year, and 19 million are done under unsafe conditions. An estimated 68,000 women die each year as a result. Millions more suffer infections and other complications, such as infertility.

Family planning can prevent the serious health consequences of becoming pregnant
within six months of an abortion (anemia, membrane rupture, low-birth weight, preterm delivery).

Contraceptive use drastically reduces the chances of unintended pregnancy. Over the course of a year, only 8% of women using the pill will become pregnant, compared with 85% of sexually active women not using contraceptives.

This fact alone helps explain why the 7% of U.S. women at risk of unintended pregnancy who do not practice contraception account for almost half of the country’s unintended pregnancies.

WOMEN IN NEED OF CONTRACEPTION, 2000
State Overall, # in 000s With public support
% of all # in 000s
U.S. Total 33,983 48.2 16,396
Alabama 496 55.6 276
Alaska 72 44.4 32
Arizona 606 52.0 315
Arkansas 280 58.9 165
California 4,281 49.3 2,111
Colorado 537 42.6 229
Connecticut 438 36.8 161
Delaware 93 43.0 40
District of Columbia 85 48.2 41
Florida 1,699 49.9 848
Georgia 988 47.8 472
Hawaii 138 44.2 61
Idaho 141 56.7 80
Illinois 1,568 44.3 694
Indiana 735 48.6 357
Iowa 325 52.0 169
Kansas 309 50.8 157
Kentucky 442 54.3 240
Louisiana 520 59.4 309
Maine 152 52.0 79
Maryland 637 38.1 243
Massachusetts 880 38.0 334
Michigan 1,215 46.3 562
Minnesota 598 42.3 253
Mississippi 310 62.6 194
Missouri 665 51.4 342
Montana 89 61.8 55
Nebraska 197 51.8 102
Nevada 239 46.0 110
New Hampshire 158 39.9 63
New Jersey 1,101 35.9 395
New Mexico 207 61.4 127
New York 2,557 46.7 1,195
North Carolina 924 49.2 455
North Dakota 72 58.3 42
Ohio 1,369 48.1 658
Oklahoma 372 58.3 217
Oregon 390 50.5 197
Pennsylvania 1,528 46.8 715
Rhode Island 143 46.2 66
South Carolina 458 53.3 244
South Dakota 82 57.3 47
Tennessee 646 51.2 331
Texas 2,469 52.8 1,304
Utah 292 50.3 147
Vermont 72 52.8 38
Virginia 835 43.8 366
Washington 708 45.1 319
West Virginia 182 60.4 110
Wisconsin 634 46.4 294
Wyoming 51 56.9 29
Source: The Alan Guttmacher Institute (AGI), Women in Need of Contraceptive Services and Supplies, 2000, AGI, 2003, <www.guttmacher.org/pubs/win/index.html>.

Some Final thoughts

I know there is a ton of data here. But I think it comes down to this. If the goal of the religious right is to save lives then they need to preserve access to contraception.

If conservatives want to save money and reduce taxes then they need to preserve access to contraception.

If conservatives want to protect the constitution then they need to remove a biased religious based judgment from medical decision making.

And this is why religion and health care shouldn’t mix!

The Physician Assistant / Physician Relationship: 5 Must haves!

by Stephen Pasquini 0 comments

I have had the unique joy of working with some great physicians during my career. Physicians who get what I do, treat me like a colleague and understand my utility: Both to my patients and to the medical practice.
I have always worked as part of a large hospital and thus my relationship with my supervisor [...]

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How Much Does it Cost to go to Physician Assistant (PA) School?

by Stephen Pasquini 0 comments
Thumbnail image for How Much Does it Cost to go to Physician Assistant (PA) School?

 
When I was attending PA School in 2001 the annual tuition was in the range of $9000 per year.
As we know most college costs have nearly doubled or tripled since that time. So I decided to take a look and so some math. Here is the breakdown of my school (UMDNJ) and the projected annual [...]

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The Best Treatment For Your Patients: Your Time and Attention

by Stephen Pasquini 0 comments
Thumbnail image for The Best Treatment For Your Patients: Your Time and Attention

Sometimes what your patient really needs is your time and attention.
This of course is not just true in your medical practice but applies to your life in general.
We get so caught up with things that can be measured, we look to our prescriptions pads for the answer.
But I will tell you this: What people really [...]

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Physician Assistant Sample Resume

by Stephen Pasquini 0 comments

When I was first applying for a job I searched all over to find a good sample of a Physician Assistant Resume. I was reluctant to share mine here, but in the name of helping other PA’s here your go.
Of course this is my resume, I am sure yours will be much more interesting and [...]

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My PA School Interview: The Journey of a Lifetime

by Stephen Pasquini 0 comments
Thumbnail image for My PA School Interview: The Journey of a Lifetime

I am turning back the clock 10 years to 2001. I can’t believe that. It seems like just yesterday I was holding that small rain-soaked letter in my hand. The one that said: You have been accepted for an interview.
I was living in Seattle at the time… I was two years removed from my undergraduate [...]

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The Best Medical iPhone Apps for Physician Assistants

by Stephen Pasquini 0 comments

For years I used a palm handheld device. This was before the days of iPhones and Android devices.
This year I upgraded my life and my practice when I purchased my very first iPhone. I will never look back!
Here is my list of the current medical apps I have installed on my iPhone.  These are the [...]

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How to Study for and Pass The Physician Assistant Recertification Exam (PANRE)

by Stephen Pasquini 0 comments
Thumbnail image for How to Study for and Pass The Physician Assistant Recertification Exam (PANRE)

First of all let me give you a few truisms:

Pass Rate Overall: 97%
Pass Rate Guaranteed by those costly Exam Review Courses: 97%
No matter how hard you study for the PANRE the consensus is this: When you leave the exam room you will feel like you failed.
Don’t worry about if you have been in a specialty [...]

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