You're a What?

So a Physician Assistant is Like a Paramedic...?

I often forget that PA's are not utilized in countries like Belize. Some patients ask who the student is sitting next to the doctor. Both of the doctors at the clinic introduce us as physician assistant students from New York. Immediately after the words "physician assistant" are out of their mouths, the patient's eyebrows furrows and a confused look sweeps over their face. They often nod, not sure what to say, and instead state how nice it is to have a doctor in training at the office who is from New York. 

When they ask, I have tried to explain what a PA is, but I can never seem to find the right words. Part of the confusion comes from a language barrier between English (me) and Spanish (them), but the majority of miscommunication comes from the patient never hearing of, or being exposed to a PA as their provider. I find myself saying, "a physician assistant (I cannot use PA, because this would cause a new level of confusion) is someone between a doctor and a nurse. We are able to have our own patients, prescribe medications, and do procedures like a doctor, but we need the doctor to be in the same building as us." If they don't understand, I end up saying I am just a type of doctor who is in training. That usually satisfies their curiosity. I know this is not the proper way to describe and advocate for the role of a PA, but I find it easier to simplify than go into a lengthy description. 

A younger guy kept insisting I was like a paramedic, despite how many different times I tried to explain what a PA was. At the time I was preforming an EKG on him and I think he was confused because I was doing a hands on procedure while the doctors were in their offices doing paperwork. He didn't understand how I would be a provider who could be hands on with patients (like a paramedic) and still be responsible for completing paperwork (like a doctor). 

I also tried to explain to a medical student, who came in for a check-up, that a PA finishes their training in approximately 36 months. When I told her this, she looked like she was going to jump off the table. She insisted I was mistaken and that I have 3 years of classes (instead of 4-5 years like medical students) before beginning my clinical rotations. I told her, again, I do it all in 3 years and I still learn all the necessary skills like a physician. I could see her doubt that statement and think that there is no way I could ever develop the same skills as a doctor. 

The doctors have never said anything about us being PA students or compared us to medical students and our ability to see and interact with patients. They have, however, said that it would be rare if a PA was to be hired in the country of Belize. The country itself is lacking enough physicians to serve all the citizens of Belize, yet hospitals still prefer a physician because they are able to be independent and have their own practice. The chance of being hired as a PA is slim to none around here. 

Everyday I am more and more thankful that I chose to become a PA and not attend medical school. I am so appreciative that I am finishing school in 5 years and able to work immediately after training. While it has not been easy (this rotation is a bit of an exception, however I am still doing a ton of work that I never blog about!) I have enjoyed every moment of this advanced program. I love that PA's get more opportunities to interact with the patient and form relationships rather than get caught up in endless paperwork required to run a medical practice. I have found that some physicians, with the exception of primary care and pediatricians, have little face time with their patients and they prefer it that way. I love being that "front-line" provider who makes the day to day efforts with patients. 

What I do not enjoy is constantly explaining my role as a provider. I find it difficult to verbalize what a PA is and how they are able to provide quality care just like a physician. This rotation, along with my psychiatry and surgery rotation, have made me realize the importance of finding a medical facility that utilizes a PA efficiently. PAs can do so much more than only write patient charts (what I found on surgery) and they can be utilized in essentially any field (not a single PA worked in the psychiatry department I was at). While I have been welcomed with open arms at the clinic, I know I would never be able to work there because the country of Belize, as a whole, does not utilize PA's. 

I love my career path and everything it encompasses. I have also enjoyed that each rotation teaches me more than the medicine specific to that area, it allows me figure out the type of environment and the type of facility I want to work in. I have learned that I need to work somewhere where my work is valued and appreciated equally by my superiors and patients. While I am always ready to try to educate the population about the PA profession, a PA, like any other professional, deserves to work in a place their skills are appropriately utilized.

#PAPower