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27. PA advocacy
149 Plays1 year ago
In this episode I bring on one of the new Directors at Large of the AAPA Ashton Ogle, PA-C where we talk about all things advocacy for the PA profession and how to get a start in professional leadership.
You can find her on instagram at: pashionate_pa
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Transcript
Introduction to PA Experience Podcast
00:00:15
Speaker
Welcome to the PA Experience Podcast. I'm your host, Sebring Sands, and as a PA, I take you behind the scenes to see what it takes to become a PA in all steps of the journey.
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Meet Ashton: From Connecticut to Kentucky
00:02:38
Speaker
Welcome everyone to another episode of the podcast. I got a very special guest for you. I guess I do see that every time, but I try. This is especially special because I think a lot of people will want to know her story and her successes in the AAPA world. So I want to introduce to you Ashton.
00:02:57
Speaker
Hi, thanks for having me. Yes, I'm Ashton. I am from Kentucky originally and moved up to Connecticut where our paths crossed and went to PA school at Sacred Heart. Practiced emergency medicine in Connecticut for a couple of years and then just a couple months ago moved back home to Kentucky and now I'm practicing pediatric emergency medicine.
Ashton's Role in the AAPA Board
00:03:22
Speaker
Awesome. Well, thank you so much for being willing to get on here. LinkedIn I found is a very awesome place to find people that you know, kind of know, and to ask them to come on the podcast. I'm glad that you responded because you have a very special take on things because you just got elected to set
00:03:40
Speaker
board of directors. Yeah. So I just ran for a board of directors position, a director at large with the American Academy of PAs. And fortunately I got elected. So I will be starting a two year term with the American Academy of PAs that starts next month. Awesome. And we'll just start with that. What does that do? What do you do in that position?
00:04:07
Speaker
Yeah, I think that's a great question because I think no one ever knows, like everyone knows that there's a board of directors. Everyone knows there's leadership with different academies, PAEA, RPA. We all know that there has to be leaders, but I think no one really knows how to get there or what you do when you are there. And so for the American Academy of PAs, we kind of represent the voice of our constituents. I think most people are familiar with the House of Delegates, which is the body that, you know, brings forth resolutions and things
00:04:37
Speaker
that, you know, ways we want our PA profession to move forward. And then it's kind of the role of the directors and the board to enact those changes that the body wants to see. So we're kind of a liaison to the membership. There's many different constituent organizations that will use different directors as their voice at the table. And that's exciting. That's really cool. And so the president now is Jason Privilege, correct?
00:05:06
Speaker
So Jason was elected to president elect. So Jason is also another Connecticut PA who I served with with the Connecticut Academy of PAs and he used to be my boss in the ER. So really special that we're going to get to serve together. But he was elected as president elect. So he will spend one year as president elect and then his second year he will be the president of the AAPA. And then I think even in his third year, he'll be the past president. So he's got quite a bit of work ahead of him.
00:05:36
Speaker
Yeah, that's really cool.
Ashton's Journey to Becoming a PA
00:05:40
Speaker
Let's start from the beginning. Why did you even want to become a PA? What brought you to the profession? I always, from a very young age, had an interest in medicine. I have no idea why. I was always very drawn to it. In a strange way, I loved my pediatrician growing up, which I think is why now I've ended up in pediatric emergency medicine. I just remember how special that person was to me. He was someone who believed in me.
00:06:06
Speaker
always asked me what I wanted to be when I grew up and of course at the age of like five I'm like I'm gonna be a doctor and he just like really empowered me and inspired me to continue that so I remember being like in college I guess I still saw my pediatrician my freshman year of college and he was like what are you doing like what are you studying and like biology is like you're still gonna go be a doctor right and I'm like yeah I'm gonna be a doctor and
00:06:30
Speaker
At one point, I remember him telling me that when I was like eight or nine, he like put a note in my chart at the pediatrics office. I was going to take his job one day. And that was just like, I think as a young kid, hearing like an adult and someone who you thought had like was so cool and so admirable, like believe in you and like think that you could be him one day was really special to me. I think that just kind of like fueled my desire and my passion for medicine.
00:06:57
Speaker
And then in college, my junior year, I was exposed to a PA in an emergency department here when I was shadowing for a course that I had to take. And I was like, wow, I really, really love this person. This is a cool job. I loved that they were able to have such a cool relationship with their patient. And I just felt they had a lot of time to spend with their patient. And that really inspired me. I looked into the PA profession. And ultimately, that's what I decided on.
00:07:25
Speaker
That's really cool. It's similar to what I did too, like junior year too. I was dead set on going to the MD route or at least trying to do it. I had some hiccups. I didn't end up taking the MCAT like I was planning on taking it.
00:07:40
Speaker
And then I went on vacation, and one of the guys that went on vacation with the friend group that we had was in PA school. And he was like, hey, you should be going to PA. And I said, I don't have to take the MCAT. I don't have to do residency. This is amazing. It's two years instead of four plus residencies. It's amazing.
00:07:59
Speaker
I think that's so cool what you just said because I don't think PAs realize the power that they have on other aspiring medical professionals. And I think that's so cool because you just don't know who you're around that you may inspire to kind of join your profession. And that's a really neat thing about the PA world is that we're, you know, young enough to where not everyone even knows that a PA is now, but we're gaining so much traction that it's a neat thing that we can kind of continue to spread and share. Yeah, and definitely,
00:08:28
Speaker
where I work, it's a cool summer internship. I was telling one of the people there, because I think they're wanting to go become a doctor. I said, you get to see the best of both worlds, what a PA does in this situation and what the MD does. And I keep every day, I'm thinking to myself, I definitely take the right profession because this would be super stressful.
00:08:51
Speaker
I think that all the time too. I'll see residents working alongside of me and I'm like, yeah, my 13 shifts a month. I can't complain about work around the people that are working so many more and training so much longer. Kudos to them. We can't do anything that we can do without them, but I am not envious.
00:09:08
Speaker
Yeah, and I think I brought this up with Rob because I had him on, he was the guy that introduced me to the PA world a couple of episodes ago. And we can really leverage our income. Yeah, yes, our income's significantly like half or less more than that compared to some specialties of doctors, but we have so much lead time on a full salary compared to them. They could really leverage that to live a life that's great without having to go through that extra
00:09:36
Speaker
you know, extra stuff and extra stress and all that other stuff, which is so true. And with those off days, you can pick up more work, which if you're looking for work life balance, I don't recommend, but like just last week I picked up per diem in Connecticut because I was going to be there anyway visiting and I picked up a couple shifts and I was like, well, that supplements well.
00:09:56
Speaker
Yeah, there's urgent cares everywhere. And they're always desperate for PAs. And if you have some experience, you can definitely per diem. Where I work, my base salary is kind of low because we have an urgent care and it incentivizes us to work at the urgent care. And it's so easy. And there's other PAs that per diem there. And everyone's looking for people to per diem at their place. So there's so much flexibility.
00:10:25
Speaker
this profession, which is really nice.
Leadership and Advocacy in PA School
00:10:27
Speaker
Even just a few extra hours, gaining an extra thousand or two a month is really awesome. Yeah. So let's move on. We're going to skip past PA schools. I think we've talked about PA school a lot in this podcast. We're going to get to, okay, what, I guess we're going to stay in PA school just a little bit. What were you doing in PA school to get you into leadership in PA school and after?
00:10:52
Speaker
Yeah, so I have always been one I've been known to take on challenges and leadership rules and I think some of that is just like innate and me my mom is like I mean, she's an incredible leader at home. She is a female in medicine that is a director at her hospital and has been for 30 years and
00:11:16
Speaker
is an awesome boss and advocate for her employees. She served on her state board of physical therapy. And I think seeing her do all of those things, it never was even like a question for me of like, it was always like, why wouldn't I do that? Like I saw my mom do that. I saw my mom go through her doctorate program when the PTs bridge to a DPT.
00:11:36
Speaker
And she did that when my little sister was an infant. And I remember just like always being like, wow, my mom's really cool. Not all moms are like this. And so I think for me, it never really was a question of like, if I was going to be involved, if I was going to be in leadership, but it was kind of more like a natural, well, if they need me, I'll sign up. I'll do it. And it kind of started PA week of my first year of PA school when we were doing class elections, class officer elections.
00:12:01
Speaker
And I was like, yeah, I'll run for the vice president of the class. That sounds like a job that I can do while in PA school and trying to maintain everything. So I got elected as our class vice president and got to plan PA week and plan some cool class events and do a lot of, you know, in PA school, it's a lot of like class bonding. And how can we get outside of this classroom together and just like forget about school because your wellbeing and your health is so important during PA school. And that's really the, our class officers took that stance of
00:12:31
Speaker
We want our role to be more outside of the classroom. How can we really focus on our mental health and our well-being? And that was something that was really cool to me was to do that. Then later in my didactic year, we had a professor, our program director at the time was all about
00:12:49
Speaker
PA advocacy and involvement and we had lectures about in our professional practice course like why do we need to be advocates for ourselves and I remember leaving that lecture like oh my gosh like if we all don't do something we're not going to be a profession and I took it very dramatically but it was also just really kind of sparked a fire that was like I want to do something and I don't want to be mediocre and I don't just want to do
00:13:15
Speaker
I get so much more satisfaction out of doing things and being busy and feeling like I'm doing something good for either society or a profession or even just the professional development for myself. And so that's kind of what sparked that. I looked into, I remember looking at the AAPA website and being like, oh, AAPA has student leaders and you can be on the student board of directors.
00:13:40
Speaker
interesting. I don't know much about that. And I kind of looked into it. I met with our program director and I was like, is this crazy? Like, is this crazy that I would consider one of these positions? And she was like, we support you. We'll sign the letter right now saying you have support from your program. Do it like you would be awesome at it. And I remember just being like, well, that was really cool. And so I kind of thought about a little bit more. And I ended up running for a student board of directors position, which was the Northeast regional director. Um, so that was kind of,
00:14:06
Speaker
a liaison over at the 60 programs in the Northeast at the time, now we have more. And it was kind of the representation to the AAPA. And then as AAPA student board, we would take any upcoming events, information, what's happening in the PA world, and we would meet with our constituents a couple times a year, four times a year, which was cool. And we would see them all at conference. So that was neat. So I got to work with the American Academy of PAs through their student board.
00:14:33
Speaker
in 2019 and then that's kind of how I got plugged in there and really enjoyed it. I worked a little bit with CONAPA with the Connecticut Academy of PAs. As a PA student, one of my colleagues and I planned PA student day and then COVID hit and we were so bummed so we weren't able to do like the Connecticut challenge bowl.
00:14:56
Speaker
So after graduating, he and I ran for the Connecticut Academy of PAs board because at that point we had kind of been in that role as a student and were well connected. And it took some professionals that said, you should consider being on the, I call it the adult board. Like when you're not a student anymore and you get to join the big boys at the big girl table, it was fun to kind of make that transition. So that, that was really neat for us. We both ran and were elected to their board of directors.
00:15:26
Speaker
and then served as I was really passionate about getting PA students involved because it did so much good for my life. I learned and met so many people. I learned so much about the profession and where we are and kind of the challenges that we face. And I just wanted every student to understand that they have a responsibility to the profession to be more than just
00:15:50
Speaker
a PA because we really need advocates and it's as simple as just advocating for yourself in your clinic. You don't have to do anything crazy, but just helping and teaching and explaining what is a PA goes so far for our profession and being a good representation, right? So if you're a really good PA and you're a kind PA and you're compassionate and good to your patients,
00:16:11
Speaker
That is the best branding and marketing that we can do for ourselves. So that became my passion was showing students why we need, why we need to stand up for ourselves and advocate for ourselves and be a good team member on the healthcare team.
00:16:25
Speaker
And that was all introduced as a student to me, which is why I feel passionately that students should know about it. So they know when they graduate, here's your options for involvement, leadership if you want it, or just staying connected to your profession via your state organization or your national organization because your dues pay for your representation. It's kind of my, you owe it to your profession and to yourself to pay your membership dues of your state and national organizations because they're the ones that are
00:16:53
Speaker
advocating for you and for your job. Um, and that to me is, um, kind of, it's, it's become what is important to me along with the student aspect of everything. And, um, I worked with Con Appa for two years. My term with Con Appa is ending now. And I was making the move back home to Kentucky and I was like, what am I going to do now?
00:17:12
Speaker
And all along, my friend Jason Prevelich, our AABA president-elect, everything that he has done, and this is what's really special and really cool to me, is that he's always gone and done something really cool leadership-wise, and he has grabbed someone and said, come with me, do this with me. Or he's moving up, take this position that I had. I want you to have this experience. It's really great. And he hired me as a new grad in the emergency department and believed in me with that.
00:17:40
Speaker
He encouraged me to join CONAPA and to be on the board of directors. And I was like, you're crazy. I'm a new grad. He's like, we need a new grad voice. We need your fresh ideas, your perspectives. And I said, okay, sign me up. And I ran. I got elected. And now with AAPA, he called me back in March or April when applications were out for the AAPA board.
00:17:59
Speaker
And he was like, am I crazy? I'm thinking about running for president-elect. And I said, Jason, this is awesome. Do it. And he was like, really? And I'm like, yes. And he's like, well, what if I don't win? And I said, Jason, you're already not the AAPA president. You can't be anymore not the president. Do it. You would be so awesome at that. This is right down your alley. I support you. Do it. And that very quickly turned into, well, that brings me to my next point. I was hoping you would consider running for a director at large position.
00:18:29
Speaker
And I said, Jason, hey, PA Director-at-Large. I'm moving home to Kentucky. I just got a new job. My term with Con Appas, and he's like, exactly. Your term with Con Appa is going to be ending. You're really great at what you do. You'd be an awesome early career PA voice on the board. That's really important for us to have. Like, I really think you should consider it. I'm like, Jason, I'm not going to win a national election. And he goes, you're already not the Director-at-Large. You can't be any more. You're not the Director-at-Large.
00:18:57
Speaker
I was like, okay, that backfired on me. I'll think about it. We'll consider. And I didn't even know if I would be, if I had the requirements to even run and I went home and I looked into it and I was like, oh, I want to do this so badly. And so for me, it's always been important because I've had incredible, incredible PA mentors that have said, come with me.
Encouraging Future PA Leaders
00:19:19
Speaker
And that's kind of why I think I'm so passionate now about the next generation of leaders. It's
00:19:24
Speaker
Okay. Now I've had this experience. It's really cool. We need more people come with me. And, um, that's kind of become my little mantra of bringing people with you where you go. And, um, it's been, it's been very beneficial. We have a student that just got elected to the American Academy of PAs student board as the chief delegate. And he was one of our PA students, um, at Quinnipiac. And he was one of our Grand Appa representatives. And so that was really, really special too.
00:19:53
Speaker
Nick Bettino and I who are the student reps because we really encouraged these students and Alec would have done it on his own. I think he has the self motivation to do it on his own. But for us, it was really cool because he was at conference with us in Nashville last month and he got he won his election. So we're super, super proud of our Connecticut PA students. And it's been a great
00:20:15
Speaker
testament to what you feed into in your state is what grows and our student engagement and involvement has been really impressive and it's because we have leaders in the state that really value their involvement and groom them as leaders. So it's been really cool. It's kind of how I got into it and how we're trying to continue all of that.
00:20:36
Speaker
That's that's really awesome that Jason did that for you and was that mentor. That's I really believe in mentors, too, because they really make a break someone's path to where you're at. So, yeah, let's unpack this a little bit. So applying that's well and good. How do you get elected? Is it just the more friends you know and harping on them to vote for me or how are you? How do you get so successful at getting elected?
00:21:06
Speaker
So the really sad truth is that there's not much competition in terms of people who will sign up and say, I want to run. That's sad. Especially with Nash, even state elections, we usually have very few people that want to run and be involved. It's worse at the, I think it's about the same to the national level. So as a PA student,
00:21:35
Speaker
For Northeast Regional Director representing the entire Northeast of 60 PA programs at the time, there were only two of us running for the Northeast Regional Director.
00:21:45
Speaker
And I was like, that is so sad that out of 60 programs, there's only two programs that are sending someone for this election. And I think it's just because people don't know that it's there. And that's really why I came back. And I was like, you guys have to know about this. And I told, it was so easy to get elected. So I went to conference. I'll give you that story. And then I'll tell you what I did when I came back. I went to conference. The Student Academy representative. So every program, if they're registered with the American Academy of PAs,
00:22:14
Speaker
sends a student academy representative to conference to be their representation. So each program, so each student academy representative, SAR, they get to vote on who is going to be their Northeast Regional Director. So the idea is that they're the voice of their class. They came up with who they wanted to represent them and they vote for us.
00:22:36
Speaker
So those are the students that get to vote. Now, what happens sometimes is people don't always get to go to conference, which is okay because the American Academy PAs has you do a video submission on who you are, introducing yourself to everybody, what you're passionate about, what you want to do if you're elected, that sort of thing. So all of that is always on the AAPA elections website.
00:23:00
Speaker
which is really nice so that everyone knows who you are, what your stance is, and why you want to be a student leader. Then we have elections, and you find out very quickly after elections, always following conference, who wins. And then you're on the board, and you kind of have board meetings. You travel, which is really nice. AAPA will pay you to travel. So you'll go to DC for a meeting, usually around the time of leadership and advocacy summit. And then you travel to the conference the following year.
00:23:30
Speaker
which I kind of got cheated out of because of COVID. So I never got my, I never got to go to conference as a student leader when I was on the board because COVID hit and that conference got canceled. But typically that's the way that that goes. So I got elected, it was incredibly easy. I came back to Connecticut and I went to Conappa and I said,
00:23:51
Speaker
There is no reason we are not sending PA students to this conference every year for elections. And it's really expensive to go and I'm afraid that that's a barrier to students. And it was amazing because at the time,
00:24:04
Speaker
the Turchak brothers, Andy and Mark were kind of running things. And I emailed both of them and they're like, here, let's do this. So what they decided, literally like the week I came back from conference was in the future, they're going to set aside funds and they're going to pay the conference registration rate for up to two Connecticut PA student leaders.
00:24:25
Speaker
that are going to pursue national leadership. And I was thrilled by that. I was like, that's amazing. At least they know it exists, we can advertise it, and we can help offset some of that cost burden of going, because that's such a barrier to leadership at the national level.
00:24:42
Speaker
So that was amazing. That's what they did. The next year when I got off of the board, I think we had four or five Connecticut PA student leaders on the national board of like 10 or 12 people. So I mean, it was, it was incredible. Um, it actually has become such a problem that now we're like, okay, we're going to have to put more funds in the budget for PA student leadership at the national level. So we can send more than two people to conference and
00:25:07
Speaker
That's been just an absolutely awesome thing. This year we had three students that were interested, and I think only two ended up running. But nonetheless, we're trying to break the barriers of getting involved. And that was a really cool thing. And also shows that your state engagement and leadership really does affect your students. So if states are hands-off with students, guess what? The students are hands-off. And guess what? They don't ever get plugged in, so then they become hands-off professionals because they just don't know.
Challenges in PA Leadership Elections
00:25:33
Speaker
It's to no fault of their own. It really comes down to having
00:25:36
Speaker
a program that believes in advocacy and PA education and leadership. And they have to value that. Some programs say you're here for your academics and what you do outside of this doesn't matter. And that's not my opinion at all. I really think what you do outside is the most important. Yeah, because peace goes only a little bit of time and then you got the whole rest of your life to really work and advocate for the profession. That's really awesome. And that's good to know, especially the people listening to this that
00:26:06
Speaker
Just go for it. You might end up winning. You might, you may. Which is a good chance, good chance. Also, I so encourage any PA student that is interested, I am one that I'm like, I'll talk to anybody. I'll tell you what to do. Maybe I'll even sponsor your trip, you know, whatever. But I am so adamantly, like, ask for it. If there's something that you want, you ask. I asked our program director. We went to our dean. The dean of health professions was so supportive in these education roles that I was pursuing.
00:26:35
Speaker
They were willing to offset costs, which once I was elected, AAPA did that. But there are so many resources that we don't know of. Go to your state society and say, this is what I want to do. Is there any way you can help fund this trip or pay for my registration? Or is there a mentor in the state society that's had one of these elected roles that I could talk to and get some input from? There are so many resources. And just asking really will get you a long way.
00:27:03
Speaker
That's really cool. So we're going to switch gears a little bit. So what is the platform that you ran on with Jason and everyone kind of together in that group? For the most recent AAPA election? Yes. So for my director at large position, so I think it's important to note that kind of the process of what happens. So you
00:27:27
Speaker
There's the call out for applicants. I think I don't recall how many we had this year, but you go through that process. You have to turn in a platform statement. You have to answer questions about why you want this, what it is that you intend to do, what you're passionate about. And then you meet with the commission and what they essentially do is they interview you and you respond to questions that they ask.
00:27:51
Speaker
then they come up with an endorsed slate and they decide who of the applicants they are going to endorse. And that changes every year based on what the board needs. So if the board is needing an early career PA, maybe they would favor the early career candidate. If they're needing someone aging into retirement and they need to have that perspective, then they may change their guidelines to where they really need and are focused on what the board needs in terms of being sure to represent
00:28:21
Speaker
the PA population. And so I think that's important to recognize is that there are people deciding who is going to be endorsed and it's usually based on recommendations from the current board on what voice that they need. So I went through the endorsement process. I was fortunate to be endorsed. It was a really cool moment for me to find out that I was endorsed because certainly after you go through these things, you start having
00:28:46
Speaker
imposter syndrome, right? Anything you do, you graduate school, you get your new job and you're like, do I know anything? I've had all this really cool leadership experience and suddenly I'm like, can I do this? And so I think it was really cool for me to get that endorsement and see that there were people that believed in me, professionals, like leaders that believed in me was really cool. And then it was neat to, after that, to see
00:29:08
Speaker
my former student board colleagues reach out to me and say things like, you're going to be an awesome early career PA voice. And that was also really special and really kind of kept me going and recognize that the early career PAs, we are growing so exponentially that we have a huge, huge early career PA group. And it is important that the board of directors have an early career PA that
00:29:34
Speaker
can be their voice and be their representation. So that was really neat. So that was kind of like the process. I had to create, we had to create a website and then Canada's website stating what our platform was. And I kind of ran on the platform, kind of what I've talked to you about with my passion, like what I'm passionate about, which is
00:29:55
Speaker
advocacy it's student engagement and leadership and really really investing in that next generation because if you don't get them while they're students when they have to listen to lectures and they have to be there and they have to get community service hours and they have to have all this stuff you lose them and it's really really sad the programs and the states that just lose their PAs without introducing them to leadership and engagement and so that's something that
00:30:21
Speaker
I'm still very passionate about and something that I do believe in is investing in our next group of leaders. And I think the AAPA is actually doing a very good job of that. And it's something that I hope that we continue to do with investing in them.
00:30:35
Speaker
And so that, that was kind of my, my platform was my early career PA platform and my, you know, within five years I've been in PA school. So I really still relate to those students and recognize the barriers that they face to getting involved and also just recognize that they don't know and that we have to teach them and show them. So I think that's kind of the, the, the, um, the, um, Roth that I took in, in my, um, campaign.
00:31:02
Speaker
okay awesome that's good to know student engagement because i well as a student i had a family which i was one of a very few with children so i wasn't really engaged in space school at all i was just past my classes
00:31:17
Speaker
get out of here, get a job so I can start making money. What's great that emphasizing this when students do really want to have that drive, especially a lot of my classmates were in their mid 20s, like right out of college a lot of times. So they still have a lot of downtime they can do to do things. And that's one awesome way to do is get into that leadership.
00:31:41
Speaker
Young and early so that you have time when you do have the time to do it Rather than trying to fit fit in time when you can't do it later life later in life I also say like and I hear you like you You had a family which I don't know how people go through that with a family I will also say like look at you now, right? Like now you're doing the good work. You're like doing the hard work of like, okay, I
00:32:07
Speaker
Maybe I wasn't able to give back in those moments when I was in school and I had a family, but what can I do now to help the next generation? And you've started a podcast. You're inspiring these new PAs who are in PA school who want to hear about everyone's experience.
00:32:25
Speaker
Because quite honestly, some of these PA students are miserable and they're like, am I going to get through this? And it's just really, really helpful to hear you're going to get through this, you're going to thrive. It feels really awful right now and take care of yourself, right? Like make sure you're doing things to take care of yourself and listen to these other people's journeys and experiences because they're very similar to what you're going through. My
00:32:50
Speaker
Brother's girlfriend is in PA school right now. We have many talks throughout the week. Hang in there at second trimester. It's hard. Second trimester is hard. Go do something for yourself today. Go for a walk. Go for a run. You know what? If your hot shower is what you have to convince yourself that you're doing for yourself that day, do it. Whatever it is, give yourself some time. Give yourself some grace. It's hard, but we get through it.
00:33:17
Speaker
Awesome. That's, that's some good encouragement. That's really exciting to have someone so close to you and basically like, I just did this. Let me help you. That's awesome. So what we're going to switch gears
Legislative Challenges and State Differences
00:33:29
Speaker
a little bit too. So what are the biggest challenges facing the profession today in your opinion nationwide? Oh man. That's a, that's a good question because I think you could ask a hundred PAs this question and you can get a hundred different responses.
00:33:46
Speaker
Um, personally something that I am, so I think the, first of all, I think the absolute biggest challenge is that every state is different and that it is really hard to be a cohesive, unified group of PAs when every state can practice so differently and the legislative climate in every state is so different. Example, I was a PA in Connecticut for over two years.
00:34:12
Speaker
Connecticut is a very PA friendly state. I just moved home to Kentucky and suddenly I'm in a state that isn't PA friendly and it's different, right? So my prescriptive authority changed. I can no longer prescribe some of the things that I was able to prescribe in Connecticut. And so having that is, it's a challenge and it's also hard as a PA to say, wait a second, the education that I had,
00:34:41
Speaker
prepared me to practice at my full authority and ability in Connecticut. I had that same education, nothing has changed. I moved to a different state and suddenly my practice is limited in a way. And I think that's very challenging as a national organization and for national leaders to navigate, how do we make decisions when it's going to affect states so differently? And I think that ultimately is our greatest challenge. So things like PA title change, right?
00:35:11
Speaker
Connecticut CONAPA was the first state constituent organization to change their name to the Academy of Decision Associates.
00:35:22
Speaker
And it was an easy, easy change. All we had to do is change some tax documents, change a few things. We got a vote from our membership to see their thoughts and perspectives of that. And if it was going to impact them negatively, then certainly we weren't going to pursue that. But as a leadership team, we said, we got to be united. And this is the way that we're transitioning and what we're going into, then that's what we have to do.
00:35:44
Speaker
So we valued the title change, but you look at other states and they're very hesitant to do so in some states. It's because they're having really great legislative victories right now that are affecting practice positively. And the last thing they want to do is change their title to associate to where some group may misconstrue that as them wanting full practice authority or something else. And then, you know, lose all these legislative battles that they've really worked hard to, um, to, um, progress. And so I think.
00:36:14
Speaker
That's just the overall biggest challenge that we have. I'm in my doctorate program right now and I'm doing my research project on PA title change and what that looks like state to state. And truly my belief is, okay, the academy came up with in the house, right? It's not just the academy. It was the house that decided this is what we are going to do. We're going to change our names to a physician associate. And now it's all of a sudden we have to kind of take a step back because
00:36:44
Speaker
of legislation and different things, but there's no reason that organizations can't change their title. And I think for me, one of the things is we have a very short window to do that. And I think it's important that within the next five years, we're all physician associates, but that requires that every state constituent organization get on board.
00:36:59
Speaker
also requires us getting some guidance from PAEA. What do we do about these PA programs? We all know that Yale has a physician associate program and they've had that for years. So they have nothing to change. They're kind of like, you know, hanging out out there like, we told you guys, we've always been associates. They graduate as associates. So, you know, it's not that unheard of, but it's just the concept of changing all of that and going through that process.
00:37:24
Speaker
And each state having to decide for their state, is this what's best for us right now? The AAPA can only push so hard, can only make so many statements that we want you to adopt this change. But I think what's also frustrating for many states is some conflicting information of the AAPA getting legal advice saying, you can make this title change, but you can't use the title in practice.
00:37:46
Speaker
There's a lot, lot to unpack with all of that. And what it does is it makes every state have to really be engaged and understand what AAPA is recommending. And also they have to hear those recommendations, but then make the best decisions for their state and where they're at legislatively, what battles they're trying to fight with optimal team practice and their own scope of practice. So I think that is ultimately a very hard thing to do on the national level is to
00:38:14
Speaker
make all of these changes and decisions coming out of the House of Delegates and then how does that translate state to state is a whole different complicated process because of the different legislative climate state to state.
00:38:30
Speaker
Okay, great. That's, that's a great overview. Yeah, it's kind of the things that we've been just hearing in PA school, those types of things. So I know APA is OTP, but
00:38:46
Speaker
In my, my understanding, like Utah just passed something in the last couple of years, basically giving independence after so many hours. Is that, is that something that's correct or. So I don't want to speak on behalf of AAPA, but, um, so it is, there's been a lot of different legislative victories and I will be completely honest that I am very familiar with my States and the States around me just because that's my practice environment.
00:39:13
Speaker
I think that's a problem with our profession too, right? We have all these PAs that have all this knowledge about things, but they forget that it doesn't translate to every state. And so it's really difficult to know nationally, like who struggles with what. And, you know, so in Kentucky, it's been prescriptive authority. That's always been our thing. And just in the last five years, we finally got, you know, we're able to prescribe drugs. And so it's like one of those things just unbelievable how different it is state to state. So I cannot speak on
00:39:43
Speaker
what's happening in other states. But certainly, yes, everyone has different elements that they're trying to pass. And the concept is we're trying to create this ideal practice environment for PAs. What is it that we need to have to be a PA-friendly state and to be able to practice that, our full authority? And I think legislatively,
00:40:07
Speaker
you know, the PA profession, we say we don't want independent practice. That's not what we're after from a national standpoint. We're not after that. We're after being able to practice to our full ability in a healthcare team. We value our team. The PA profession values having a healthcare team. So I think that gets misconstrued as well because, you know, if you have a state that's going after independence or, you know, what, what not, it kind of, um,
00:40:35
Speaker
negatively impacts all the other states that are trying to say, no, we want to work as a team. But very similar thing happened with the nurse practitioners, right? And many of these legislators feel that we're after the same thing where they went for collaboration into full practice authority. And so I think these legislators are kind of like, why not just go for full practice authority? If you're going to come back to us in 10 years and say, now we want full practice authority, why aren't you just saying it right now?
00:41:04
Speaker
And so I think that's another legislative battle that we're facing. And that's what we've heard in Connecticut is why are you trying to pretend or act like this is all that you want when in a few years you may come back to us and say, we want full practice authority now. So I can't speak to other states. I'm really only familiar mostly with Connecticut and I'm becoming familiar with Kentucky now that I'm back home.
00:41:27
Speaker
Yeah, these different states have had really awesome victories recently and it's a huge, huge undertaking to pass these through legislatively. They're legislative teams in these states. I give them all the credit in the world because nothing moves quickly legislatively and these people are doing an awesome job and they're collaborating with their right people. And they've also had really, really positive collaborations with other people in the medical team, right? So they have great relationships with their
00:41:57
Speaker
nurse practitioner friends and their physician friends and they all see that we're trying to practice together with the same goal right like at the end of the day if we're not motivated by what is best for our patient what gives more patients access to equitable health care and what is um in you know fighting these health disparities then you know i think sometimes we have to refocus that
00:42:17
Speaker
I don't care how independent as a PAI can be. I really care that my patients are able to get the care that they need. And I want to do whatever I am trained to do to help them have that care. So for example, I can prescribe, you know, intranasal, you know, anti-seizure medications in Connecticut for a pediatric patient, but I can't do that in Kentucky now.
00:42:42
Speaker
but I had the same education and I was doing it three months ago. So I think those are the kind of barriers that we face to making sure that we all have a practice environment that is up to date with what we can do, what we're trained to do. And really many of these legislative pieces that we're trying to fix, it's just modernizing it. The terminology is so old and so outdated that we're really just trying to modernize the language
00:43:09
Speaker
And I think oftentimes that's seen as a threat to us trying to increase our scope. And I don't think that that's always the case. I very much value the healthcare team. I sleep very well at night knowing that there is a team that is helping me take care of patients. And I think that that's important and that's something that we don't want to lose as the PA profession.
Doctorates for PAs: Pros and Cons
00:43:30
Speaker
But again, certain things that we have to modernize just for our practice.
00:43:35
Speaker
Okay, okay. I'll give you that. You're super tactful. I'm here to store stuff. That's all right. I had to ask it. So, okay. So this is the last thing I really want to talk about. And I don't think it's really well known in PE school, but we kind of heard about it.
00:43:55
Speaker
It's the push for doctorate degrees. In my opinion, I don't like this trend because I don't want to have to go to a bridge program in order to be competitive with my peers in order to get jobs I want in the future. I went to preschool just to do two years. And that's it of education. I want I don't have to go to more school and I really don't want to see this inflation. And also another concern I have is are we to see our salaries increase dramatically?
00:44:25
Speaker
If I have a doctorate degree, I want double the salary or even more. Is that even gonna be a thing? I understand like using it as a tool to get into like hospital administration and things like that. But for the, I just worry that this is gonna, because it's happened in the whole, first as a certificate program, then a bachelor's, then a master's, it's gonna be a doctorate if everyone keeps pushing it. And I've been looking on LinkedIn
00:44:52
Speaker
and everyone's high fighting each other like yes get your doctorate everyone should every ph you get their doctor and i want to so what are your thoughts on i know you're you're in a doctorate program so you probably have a lot of things to say about which is great because i don't really know a whole lot about it all i know is right now i do not want to to be a thing so
00:45:14
Speaker
I think you echo the concerns of every single PA in the nation, even the ones of us that are in our doctorate programs or did get our doctorate. I think we all thought the same thing. Here is my take on the doctorate. Again, my opinion is not the opinion of anybody else. I think that the doctoral degree can be used and should be used for
00:45:39
Speaker
something outside of practicing clinically. So if you graduate from PA school and you are a PA and you have your master's degree and you only want to practice clinically and that's the only thing, all you want to do is practice clinically, that's great, that's fantastic. That's what your degree trains you for. If I want to go into healthcare administration, my degree did not train me for that. If I want to be a lead APP at a national renowned
00:46:07
Speaker
Center, my degree did not really give me much leadership exposure other than a professional practice course that I took where I learned what other professionals do and I learned that there are CEOs and CMOs and CFOs and I learned the structure of those systems. I never was taught how to manage a business. I never was taught how to manage people for that in the healthcare realm.
00:46:34
Speaker
I pursued my doctoral degree, one because I felt if I'm, if I, I feel the program, the PA profession is going to go into a doctoral level degree at some point. So, right. So here we have this degree inflation of, Oh, everyone else is doing it. You know, get on in the water is fine. I fell for it. Right. I wanted to do that. And I did it for the sole purpose of I
00:47:00
Speaker
I value leadership. I want to be a national leader. I want to be a leader in my hospital system and I want to be able to be qualified for that role and not just be that I have been there the longest at my hospital. So my reasoning in pursuing my doctoral degree, one, was because I don't have a family and this is the best time for me to do it. In three years, five years, whenever that may be, I recognize that I'm not going to have a lot of time for that.
00:47:30
Speaker
So I did it now because it was good life timing. And I did it now because I found a program where you choose your your pathway. So I could have chosen to go down an educational pathway. Those are really cool courses. Are my colleagues in the educational path?
00:47:46
Speaker
who are in education and just learning how to be good educators are taking like the science of learning and teaching and all of these really cool courses that are teaching them how to teach, which I think is very valuable and it's not something that we learn. So I really value that. I chose the clinical leadership, healthcare leadership administration route because I wanted to learn more
00:48:08
Speaker
what goes into that. I'm taking a business of healthcare course right now. That course is kicking my butt because I don't know anything about business, nothing. And I think that's, it's like halfway embarrassing, right? Cause now I'm in one of the most, the largest industries in the world is in one of the health, you know, being in healthcare and I don't know how it works. So it's been really great learning the different players in the healthcare industry, learning
00:48:32
Speaker
what business looks like in healthcare and marketing and advertising. So I'm learning all of these new skills that I never got from my degree in PA school. I'm also in a course with health disparities and really understanding what that looks like. Next semester, I get to take an elective. I can choose from like global health and learning even more about what our health looks like on a global perspective and the different disparities that those countries face. And so,
00:48:58
Speaker
I am getting a very well-rounded education to help me with future endeavors. Nothing that I am doing right now is going to help me in my clinical practice. I am not relearning medicine. Nothing about it is medical. I'm learning the social factors of medicine and the business factors. And that has been very, very good for me to understand and develop a more well-rounded approach to patient care. I think it translates in that way. But I am not going to graduate and get a pay raise.
00:49:28
Speaker
That's not happening. I'm not going to graduate and have more medical knowledge. So nothing that I'm doing is financially driven. It's more based on what my ultimate goal is. Do I want to see that the table at my hospital? Yes. If I have my doctoral degree, my doctorate of medical science, I'm going to have a better chance of getting a position like that because of the courses that I had to take than a colleague who's just been there for a few years and may want that and see it as well.
00:49:56
Speaker
Programs that are clinical doctorates, I think differently of because I think that's what's pushing for the doctoral degree being the terminal degree. We do know that PA school requires just as many credits and more to graduate a master's than many doctoral programs do graduating a doctorate.
00:50:16
Speaker
So I think that's something that we should look at in the future is should we be graduating as doctors, doctorates, having doctorates, maybe. I think the reservation is that we then go into a clinic and say, hi, I'm Dr. Ogle, I'm taking care of you today. And my doctorate is not a doctorate. Well, I will ever announce myself to a patient as Dr. So-and-so, because we don't want our patients to be misguided on our medical education.
00:50:43
Speaker
And I think that I am very firm in that boundary. Many people will say, well, you got your doctorate, you earned it. And I totally agree with that in the setting outside of patient care, because I think that's confusing to patients. I think it's very, very important that we maintain transparency. I'm a PA. I can be a doctor and be a PA, but I have a doctorate in medical science. I don't have a medical doctorate. And I think that that is something we have to be respectful of our physician colleagues about. And yes, you worked hard for your doctorate.
00:51:13
Speaker
But we didn't go through medical school. We didn't do a residency. Most of us have not done residencies, three or four year residencies rather. And we are not medical doctors. And I think if every patient was educated about that and knew that you could have a doctorate as a PA, fine, we can use it. But that's not the case. And I feel strongly about that with all of our colleagues. The physical therapists shouldn't be going in introducing themselves as a doctor.
00:51:40
Speaker
You know, you have to go in and state your title, not your, not your degree, right? Hi, I'm Ashton. I'm a PA. Hi, I'm Ashton. I'm a physical therapist. I'm a nurse practitioner, whatever it is. That is how we have to be. I think we really have to watch that line of introducing ourselves as doctors. And I think that's likely why it's not a terminal degree right now because of those reasons. And I think that's why we're not graduating as doctors right now.
00:52:05
Speaker
But yes, lots of bridge programs. There's a lot of bridge programs that make you take one trimester of school and then you got your doctorate. So I think it does kind of just help some of what we're doing with our clinical education. But I think if you're pursuing that and you want to go into education and you want to learn about how do I be an educator or how can I be a healthcare leader and understand that realm of the world, I think it's important for those situations.
00:52:31
Speaker
But if you have no desire to do that, I absolutely agree that it should not be, you should not feel that you have to get a doctorate to keep up. Degree inflation is horrible. It's bad at the university at the undergrad level and it's bad at the graduate level and now at the doctoral level because all it does is it divides us more. It's more barriers to being able to attain education. It's expensive and it's driving up the cost of education. And that's the last thing that we need to do because when we do that,
00:52:59
Speaker
we're gonna lose diversity in our profession.
00:53:03
Speaker
Awesome. Yeah, I didn't know a lot of those different things. I was in my mind, it's like crap. I have to go to school again. Like, that's my thought. Like, no, I didn't be a school. I'm not doing it again. No, like a part time thing. How many? Like, is it rigorous like a school? Yes. My program is a year. So I was able to because I was so close from my graduation date from school.
00:53:30
Speaker
many of the like evidence-based practice courses that were required in the doctorate I had just taken. So I kind of was able to like test out of those intro to research courses, which was fantastic. And so now my program goes from January to December. So I'm about halfway through and it is three courses a trimester. So I'll graduate with nine courses. And I think it's like 27 credits or whatnot.
00:54:00
Speaker
And it is designed to be for the full-time working person. And I will say there are weeks that I'm like, how do people with families and whatever else do this? But I also recognize that I spread myself then as well. And I have different obligations and leadership calls and things like that. So there are weeks that I am like, how am I doing this? And there are weeks that are like, I'm glad I'm just getting it over with.
00:54:29
Speaker
But they typically, my program, my courses, they tell you each course should take you about three hours a week because they're three credits. So you spend about nine hours a week is ideally what you do. So it's cool because my program is interprofessional. So some of us are getting our doctorate in medical science and others in healthcare science. So I'm in a program with PTs, OTs, SLPs, social work, case managers,
00:54:55
Speaker
And that is really, really cool because we work as a team and it's really important to see what the team does together and how we work together and the challenges that they face. So some of our social work friends will say things about, you know, something that I could have fixed in the ER and be like, oh, I should have just called you then and had you, you know. So it's really neat to learn from our colleagues in that way. I don't know that many programs are interprofessional, but I really value the setup of my program because
00:55:24
Speaker
It, it just is, it's medicine, right? Medicine is a team sport. If you aren't well on a team, you're not going to work well in medicine because to coordinate care for your patient, it takes a lot of communication with specialists and social work and case managers and physical therapists and SLPs and OTs. So, um, something that's something I really do value about my course, but that kind of shows we all put in different, um, things in our work weeks. Some of us work eight to five. Some of us have work in the ER and work three 12. So.
Podcast Conclusion
00:55:52
Speaker
I think it kind of depends on where you're at in your life and if you can kind of handle that workload. For me, it was just great timing. If I was ever going to do it, I needed to do it now.
00:56:03
Speaker
Okay, awesome. So it gives me some hope for the future. Awesome. It's been an amazing time talking with you. It's been informative. It's been great to just understand more. It's more for me than for all the listeners, but they're going to get a lot out of this too. So I'm very grateful for you to spend an hour with me and to chat about the PA profession. It's been, it's been amazing. Thanks so much for coming on. Thanks so much for having me.
00:56:31
Speaker
Anytime and if you everyone come back Feel free. I'm more than happy Okay, everyone I'm gonna this is gonna be a wrap but talk to you on the next episode