Reaching Out to Serve
Spring 2011 Issue
ISU PHYSICIAN ASSISTANT PROGRAM PROVIDES CRUCIAL ROLE IN DELIVERING IDAHO'S HEALTH CARE
When she was a young girl, Heather Schaper had a vision of being a "black-bag" doctor similar to the character she witnessed on the popular television show, "Dr. Quinn Medicine Woman."
The fictional Dr. Michaela Quinn, who practiced medicine in Colorado in the 1860s, had strong bonds with her community and showed great care toward her patients. Schaper wanted to be like her.
"I always knew I wanted to work in rural medicine, " said the 32-year-old Schaper, a 2007 graduate from the Idaho State University Physician Assistant program. "But I wasn't sure about the details."
She credits the ISU physician assistant program for helping her achieve her childhood dream, and for giving her the skill set and flexibility to practice medicine in a manner in which she believes.
"The physician assistant profession has opened up and recaptured a niche that might have been lost in many cases, on people heading to eight years of medical school, who faced the draw of moving to the city," Schaper said. "I just wanted to be a black-bag doctor who has long-term relationships to patients, connecting with them on a personal and professional level. I feel the PA profession draws people to that side of medicine."
Schaper now is a physician assistant for Health West medical clinics in American Falls and Aberdeen. She provides care for a wide variety of patients, and her fluency in Spanish facilitates the medicine she practices and the relationships she builds.
DEFINITION OF A PA:
Physician assistants (PAs) are highly skilled health practitioners who work under physician supervision and deliver care to a broad range of patients. They now work in most medical fields, including specialties ranging from pediatrics to neurosurgery. In Idaho, PAs can prescribe medication, complete physical exams, order and interpret diagnostic tests, and assist in surgery.
"I love it, particularly working with the Hispanic patient population and the rural population," Schaper said. "In small towns like this PAs fulfill an important role."
Physician assistants like Schaper are playing a crucial role in delivering health care to Idaho.
Idaho has a dubious distinction: it ranks 49th in the United States in the rate of physicians in primary care to patients. Idaho has 67 physicians per 100,000 residents, compared to the national average of 99 per 100,000, according to Laura Rowen, program manager with the State Office of Rural Health and Primary Care in Boise. She quoted this statistic from the publication, " Health Care State Rankings" (2010 edition, the most recent available). Other reports rank Idaho last among the states in the ratio of primary care providers to patients.
A silver lining to this, for which ISU can take a measure of credit, is that the report also states Idaho ranks 16th in the nation for the rate of PAs in clinical practice. It has a rate of 34 clinical care providers per 100,000 population compared to the national rate of 24 per 100,000. ISU' s PA program is providing a significant number of those clinical care providers.
"Our mission is to provide access to primary health care to the underserved and rural populations of Idaho," said Paula Phelps, ISU PA program director and coordinator for the ISU Office of Medical and Oral Health. "Idaho does have a low population-to-primary provider ratio, and we're working hard to address that problem."
The ISU Physician Program, the only PA program in the state, was started in 1995 with a class of 20 and it has steadily grown. It now has accepts 60 students annually, 30 at the ISU's Pocatello campus and 30 at the ISU-Meridian Health Sciences Center.
The ISU PA program has produced about 400 graduates and about 270 of them are now practicing in Idaho, according to Phelps' estimates. ISU PAs are in clinics and hospitals in larger Idaho cities and towns from Coeur d'Alene to Boise, and in rural communities as diverse as Glenns Ferry, Salmon, Mackay and Stanley. The fabric of health care in the entire state is directly affected by ISU's PA program.
And the cost for the ISU PA program to taxpayers is zero dollars. The ISU PA program is 100-percent self-funded through student fees. The annual fee for the six-consecutive semester program is $54,000 for in-state residents and $90,000 out-of-state residents.
Despite the program's fees, competition is high to get into the ISU's PA program: last year, the program had 550 applicants for 60 spots.
"Our physician assistant program is in high demand," said Linda Hatzenbuehler, Interim Associate Vice President and Executive Dean of the ISU Division of Health Sciences. "Our physician assistant program has helped the state of Idaho by providing access to health care in areas that couldn't support a physician."
Physician assistant Heather Schaper offers medical care for patients in American Falls and Aberdeen.
Photos by ISU Photographic Services/Julie Hillebrant
The demand for PAs will grow. Because of the growth of an aging population requiring more medical services and the number of older physicians approaching retirement, there will be more than 200,000 physician openings by 2014, predicts the U.S. Bureau of Labor Statistics. PAs will help address this tremendous shortage.
"ISU has a great PA program," Rowen said. " I believe it is important to have a program in the state that our students can grow towards and reach for, as opposed to sending them away for their higher education and hope they come back, which is the case with our medical students. There is a much higher tendency for students to live, work and practice close to where they go to school, and the ISU PA program demonstrates this."
A key to the ISU PA program's past success, and to its future, is participation by preceptors, who are medical doctors who give practical experience and clinical training to PA students.
"Our program cannot function without the generous volunteer preceptors who provide crucial and invaluable training and education to our students during their mandatory clinical rotations," Phelps said. "We cannot thank our preceptors enough, and, at the same time, we need more of them to help our program continue to flourish."
The ISU PA program has about 480 participating preceptors, with about 80 percent of them located in Idaho, 90 percent in the Pacific Northwest or northern Rocky Mountain regions, with a few further away.
"ISU has a great PA program and we would like to find ways to encourage rural communities to make our program even more robust by participating as preceptor sites," Phelps said. "There are state programs and resources available to help support a community's ability to bring students in, and hosting preceptors is a great recruitment tool for a community to attract PAs and other health care providers."