Zionsville physician assistant takes pride in growth of profession
Tom Cartmel, an urgent care patient in his 70s, has been plagued with multiple medical problems, from diabetes to chronic kidney disease, but he perseveres without complaining. He and his wife, who live in Westfield, visit me at Witham Health Services at Anson in Zionsville, and she’s convinced he should no longer drive. It’s my responsibility to evaluate him and complete the form for the state.
Tom’s intellect and resolve to remain independent are steadfast, but he requires a walker to get around. Blockages in his legs impair circulation, and he’s developing ulcers. For reasons involving health and safety, I ultimately recommend that Tom not be able to drive. I like and respect Tom very much and feel the weight of this difficult recommendation. But I am humbled and thankful for the trust he and his wife place in me.
Even when I have to make a difficult decision, practicing as a physician assistant gratifies me with a deep sense of purpose and privilege. As the field continues to grow, I share that opportunity to make a difference in patients’ lives with many others. About 880 physician assistants currently practice in Indiana, up more than 25 percent from 2000, according to the latest figures from the Bureau of Labor Statistics.
I remember entering the profession in 1977. I had a young family, and the time and financial commitment related to medical school and residency seemed overwhelming. But I knew I wanted to practice medicine. At the time physician assistants were largely unknown and misunderstood by the medical community and patients alike. On the orthopedic ward of a small hospital in Pennsylvania in the early years, I can remember a nurse telling me she’s not going to take my order off the chart until the doctor co-signs it. Another wants to know if I’m allowed to dictate the admitting history and physical of a patient. I confirm the hospital bylaws and that state legislation enable me to perform these tasks, but they remain uncomfortable with it.
Now, 35 years later, I’m thankful patients and the medical community, as well as legislators, have responded to the steadfast competence and professionalism of PAs over the years. Despite some residual “turf” guarding, we now have privileges consistent with our training and expertise. That includes being able to perform physical examinations, formulate diagnoses, order and interpret lab and imaging studies, assist in surgery, and place splints and casts. PAs can also prescribe medications with a few exceptions, such as general anesthetics.
The balance of seeing patients, teaching PA students at Butler University and maintaining a personal life can prove a juggling act, but I have peace in my heart knowing this is my calling in life and where God wants me. Being a PA was really hard many years ago, not because of the challenging skill set, but for the battle to exist as a profession and be understood.
Now the pendulum has swung and the challenge comes from the right place: Being the best PA I can be for my patients and handing the “baton” of medical competence and compassion to the next generation of health care providers.