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A Marriage with Medicineby Kimberlee Barbour
The profession has evolved in its short 40-year history. The PA and physician duo has been described as a partnership with give, take and sharing of ideas, also as a team with the physician as the clear leader, and even a marriage with constant, clear communication and compromise. During their 30-month training program PA students learn to interview and examine patients, identify health care risks and problems, transmit patient information in verbal and written form to physicians, obtain specimens for diagnostic testing, participate in surgeries and monitor programs of evaluation and therapy. Men, particularly former military corpsmen, dominated the profession during the early years, but with time and the spread of programs across the country, more women seeking to enter the healthcare workforce took an interest in the profession. "When the programs began in 1965, there was no established model for the curriculum so we built the program as we went," said Carl Fasser, founder and now director of the BCM PA program. Fasser, also a former military corpsman, enrolled in one of the first PA classes at Duke University when he was recruited from his post of running Duke's artificial kidney transplant unit. It wasn't until a series of conferences held at Duke in the late 1960s that a proposed model for the education of PAs would emerge. Fasser was recruited from Duke to BCM in 1971 to help build a PA program in Houston. The program began as a hospital-based certificate program of the Houston Veterans Affairs Medical Center under the auspices of the BCM Department of Medicine. Completion of the program now leads to a Master of Science degree.
"It has been a process of adaptation, but one constant is that the patients have always been welcoming," said Fasser, who is also a founding member of both the American Academy of Physician Assistants and Texas Academy of Physician Assistants. There is one standard of care and PAs are expected to provide services within that one standard of care as they work along side physicians. To keep with the evolving field of medicine and changing patient population the curriculum continues to be 'tweaked.' BCM PA students take part in a Spanish language enrichment program to meet the growing needs of the population. The program now incorporates attributes of the learning experiences offered both medical students and graduate students, requiring PA students to not only complete clinical rotations, but also conduct a research project, present the results in poster format and report the results though a Master's Paper. The program has focused for several years on community oriented primary care, which is a large blend of public health, prevention and disease management. Students focus not only on how to identify a problem, but also on how to sit and talk with a patient to modify their behaviors to manage their disease. BCM's program remains one of the most competitive in the country. Only 17 percent of the students who submitted applications to BCM in 2005 were admitted to the program and rankings of PA programs have consistently placed BCM's program among the top 10 in the nation. Perhaps most impressive is that since 1995 the BCM PA program has had a 100 percent passing rate on the national certifying examination. According to the US Bureau of Labor Statistics, the profession will be the third fastest-growing professional job in the nation through 2012, when the number of PAs is expected to increase to 94,000, up 49 percent from 2002. "We think that BCM has designed a curriculum that teaches the students to understand the sciences of medicine, how to apply them in a clinical setting, and teaches them how to take care of patients," said Fasser. "When they master that, their credentialing exam becomes just another stepping stone along their career path." Commitment, interpersonal skills, communication and motivation are top on the list when faculty siphon through the hundreds of applications the program receives each year for its 30 spots. The typical student is 26 years old, but they range in age from 22 to 41, all have bachelor's degrees and all have an interest in the medical sciences. According to the US Bureau of Labor Statistics, the profession will be the third fastest-growing professional job in the nation through 2012, when the number of PAs is expected to increase to 94,000, up 49 percent from 2002. J. David Holcomb, Ed.D., director of the School of Allied Health Sciences, sees the need to expand the School's programs and to add more programs along side its nationally ranked PA and Nurse Anesthesia Master of Science programs, and its new Child Psychology programs. New programs create greater opportunities for collaborative education and research with other BCM departments and help meet the need of the health care community. Karen Gunter - Class of 2005In February of 2003 as the seven astronauts onboard STS-107 Columbia made their way to land at the Kennedy Space Center in Florida, a piece of foam that broke off during launch smashed a hole in the left wing. During re-entry the damaged wing slowly overheated and came apart, eventually leading to loss of control and total disintegration of the shuttle. The tragedy was deeply personal for Karen Gunter, a class of 2005 PA graduate, who instructed the STS-107 crew for two and a half years and managed the in-flight procedures onboard from Mission Control. "At NASA I felt like I was taking on the frontier, but now I know that there's so much more to offer as a PA." "They were all very good friends, and when they didn't come back it was horrific," Gunter said. "The country lived it, but I felt like I'd lost family members." Gunter began working at NASA in their clinical laboratory in 1996 as a medical technologist, life sciences research procedure instructor and coordinator, but she says once she arrived her job began to take on a new life. She began instructing astronauts and cosmonauts on in-flight medical procedures for emergency contingencies. The accident was the turning point that brought Gunter to Baylor College of Medicine to pursue a career as a Physician Assistant. BCM was the only medical school that she applied to and she was accepted in 2003. "At NASA I felt like I was taking on the frontier, but now I know that there's so much more to offer as a PA," Gunter said. "I really feel like I need to take this opportunity to make a difference in people's lives." Gunter was nominated by the American Academy of Physician Assistants (AAPA) and appointed by the Secretary of the U.S. Department of Health and Human Services to the Representative to the Advisory Committee on Training in Primary Care Medicine and Dentistry of the U.S. Department of Health and Human Services to serve as a PA student advisor. The Advisory Committee advises the Secretary of the U.S. Department of Health and Human Services on policy and program development. As a recent PA graduate, Gunter says she's looking forward to stepping out into the real world and making a difference in the lives of those in underserved communities. "My work on the advisory committee has opened up my eyes to the medical needs of rural communities and vulnerable populations," Gunter said. "Not everyone can live in a metroplex. Many surrounding areas and especially those underserved, are in need of healthcare and access to healthcare providers. I hope to focus time with this population and to also increase awareness in my colleagues of the need to volunteer their time." Granville Collins - Class of 1974Granville Collins, a member of the second graduating PA class in 1974, was the first African-American to graduate from Baylor College of Medicine's program. "My first job wasn't as a Physicians Assistant, because, at that time, being an African-American made it hard for me to find a job," Collins said. "I ended up getting a job at St. Elizabeth's Hospital as an evening administrator for all non-nursing activities." "People used to pick on me because I was so slow, but I'm a firm believer that the more you talk, the less medicine you have to prescribe." When the hospital budget fell through, Collins was left without a job after working there for seven months. In 1975 he landed the job that he was looking for. He got his first job as a PA working at the West End Community Health Center, and was also trained by the City Health Department to treat STDs. "In 1993, I started doing some part-time work with Dr. John Clemmons, a gastroenterologist who has a private practice," Collins said. "When I worked with him I felt like I was in training all over, because the more confident he became in me, the more he gave me to do." While working with Dr. Clemmons, Collins also held a position with Baylor as coordinator of physician services in the department of community and family medicine. Collins says that while doing hospital rounds for Dr. Clemmons he started having trouble walking. He had a drag in his right foot and began tripping over things that weren't there. He went in for X-rays and MRIs, but they were unable to figure out what was wrong. In 1999, Collins was diagnosed with Multiple Sclerosis (MS). "I finally had a diagnosis, but now I had to decide if I was going to continue to work," Collins said. "As much as I loved my job, I knew that it was time for me to give up the reigns." Despite all odds, Collins hasn't let MS slow him down a bit. He is an active participant in the PA admissions selection process as an interviewer, a guest lecturer and he recently helped as a research assistant with a grant proposal. "I miss being able to help and educate people," Collins says. "People used to pick on me because I was so slow, but I'm a firm believer that the more you talk, the less medicine you have to prescribe." In 2000, Collins received the Distinguished Alumnus Award, which is presented to Baylor alumni who have made outstanding contributions to humanitarian causes, the medical community and for service to Baylor College of Medicine. "He never says there's something that he can't do, he just plows ahead and does it," said Carl Fasser, Physicians Assistant Program Director at Baylor College of Medicine. "He's been with the Baylor family for years and he's just an all around good guy." Dwight Deter - Class of 1976For Dwight Deter, growing up in a family of physicians meant that by genetic predisposition he would end up working in the medical field. "Growing up I saw how much my father worked to provide us with a good life, and how rewarding it was for him to be able to help and heal people," said Deter, P.A.-C, '76. "I knew that I wanted to go into the medical field, but I also wanted to be able to spend more time with my family." "It feels really rewarding to know that my patients and even the doctors that I work with appreciate the work that I do...There hasn't been a day that I have gotten up and dreaded going to work." While studying at The University of Texas at El Paso, Deter held summer jobs at Baylor College of Medicine's surgical research labs and the Arizona Heart Institute where his interest in becoming a PA was sparked. "During this time the world of PA's was in its infancy," Deter said. "The more that I learned about Baylor College of Medicine's PA program, the more convinced I was that this was the career for me." Upon graduating from Baylor, Deter returned to his grassroots in El Paso and began working for Southwest Endocrine Consultants as one of the city's first physician assistants and also the first PA to practice in the field of endocrinology. In 1985, Deter was elected to serve as president of the Texas Academy of Physician Assistants. Deter became the first Chairman of the Texas Physician Assistant Board in 1994, and is currently waiting to be re-appointed to the Board. "I take this responsibility on the licensing board very seriously as an obligation to serve the State of Texas, protect the public, and ensure the highest standards of my profession that I have seen evolve from its early days," says Deter. "It has been a totally different, yet rewarding challenge in my career as a PA." The Texas Physician Assistant Board consists of nine members, who determine physician assistants' eligibility for licensure, regulate physician assistants in Texas through registration and conduct investigations of allegations against physician assistants to determine if they should cancel, revoke, restrict, suspend, or otherwise limit the license of any physician assistant upon proof of violation of the Texas Occupations Code. In 2002, Deter became the first PA to be appointed to the BCM Alumni Executive Committee. Deter is approaching 30 years of service at Southwest Endocrine Consultants, and he has truly enjoyed every day on the job. "It feels really rewarding to know that my patients and even the doctors that I work with appreciate the work that I do," Deter said. "There hasn't been a day that I have gotten up and dreaded going to work." Now Deter is instilling the same work ethics that his father taught him into his two daughters, Stephanie and Kim. Stephanie is currently in her second year of medical school at The University of Texas Health Science Center at San Antonio and Kim is a junior marketing major at St. Edwards University. "I've been giving them the advice that my father told me growing up," Deter said. "You have the smarts and the personality, but when you decide on a career make sure it's something that you have fun doing. I get so much satisfaction from helping others; I couldn't see myself doing anything else." |
Patient CareA New Medical School for Botswana ResearchStars and Workhorses: A Varied Future for Stem Cells Unfolding the Tiniest Problems EducationCommunity ServiceAlumni & DevelopmentThe Story Behind the Jewish Building From a One-Room School to Medical Research College News
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Volume 2, Issue 1, Spring 2006 |
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| Last modified: October 10, 2008 |
The need in the early 1960s for another pair of eyes, ears and hands in the nation's emergency rooms, operating rooms and clinics set the stage for the emergence of the physician assistant profession.
In 2005 the College's Division of Allied Health Sciences converted to the School of Allied Health Sciences. The new school is a central part of the College's education mission of preparing top quality health professionals. Elevating the status to a school aligned Baylor's Allied Health programs with those of other leading academic health centers.