Harding Magazine

First physician assistants chart their own course

By Jennifer L. Marcussen

July 28 marked a milestone in Harding history as 16 individuals received the master of science degree in physician assistant studies. In addition to being the University's first PA graduates, they are also the first in the state of Arkansas.

And they are needed.

Two weeks before graduation, 11 students had accepted job offers in cardiology, psychiatry, neurosurgery, family practice/primary care, mental health, internal medicine, dermatology and orthopedics - all in Arkansas. Many had interviews scheduled.

Clinical director Gary Hill is not surprised at their success. "The students who have applied here have applied because they wanted a Christian-based medical education," he says. "I think that means a lot.

"From the time they came back from their first rotations, it was amazing listening to them talk. They were talking to one another like medical professionals, not like the young students we had seen just a year earlier."

The PA profession is one of the 10 fastest growing employment areas in the United States. Students who complete the 26-month program may provide medical care to patients by working with a supervising physician, relieving overworked doctors and allowing more patients to be treated.

PAs will be particularly beneficial in Arkansas, which ranks 47th in availability of primary care physicians per capita. And with more than half of the 2007 graduates planning to work in state, they are taking a critical step toward alleviating these shortages.

According to Dr. Mike Murphy, program director, these PAs desire to serve. "Within the next few years, these students will impact the lives of hundreds of thousands of patients for whom they will provide care ... not only to physical needs ... but to spiritual needs as well."

They are well on their way to making a difference. Meet three of our new physician assistants dedicated to improving others' quality of life.

Sarah Kate Epperson - the transplant

Sarah Kate Epperson, a 2005 graduate of Freed-Hardeman University, initially wanted to attend PA school in Texas or North Alabama. About to accept a place at Texas Tech, she learned about the University's startup and applied for a position here instead. Part of her decision was based on a desire for a Christian environment; she also liked the smaller class size.

"I just felt like I would get a lot more one-on-one attention from the faculty," she says. "Other schools have about 50 students in each class."

She did, however, have a few qualms about being in the first class and knew she would face obstacles. "I wasn't worried that I would get less of an education," she says. "It was more like not knowing what we were going to do next. The first year was kind of experimental. But Dr. Mike [Murphy] did lots and lots of work. He's a great director."

Facing the unknown brought the students together during the year-one summer semester of eight-hour classroom days spent poring over anatomy and physiology. That closeness endured, so that upon return from clinical rotations during year two - in which each works exclusively with a physician for a six-week period - they felt as if they had never been apart.

"We go out to eat a lot when we get back together," she says. "We're all friends. We're the loudest 16 people you've ever been with. I'm pretty sure we've almost gotten kicked out of Pizza Hut a lot of different times."

Epperson, who got married two weeks before starting the program, says her greatest personal challenge was learning to juggle both family and school. One word emerged as key to survival for her and her classmates: flexibility. "That was our class motto," she says.

Stress aside, she feels prepared to enter her field. "I was very pleased with the quality of education," she says. "I also think it's getting a lot better."

Much of her confidence stems from extensive clinical rotations that comprise the second year. Each student works eight: two in family practice; one each in geriatrics, psychiatry, emergency room and general surgery; and two electives. The physician assistant earns more than 2,000 clinical hours — more than twice the amount of a nurse practitioner. "PA school is more like medical school," Epperson explains. "We're certified to do a lot more procedures."

The Vicksburg, Miss., native never planned to stay in Searcy after completing her degree. But during her six-week rotation with cardiologist Dr. John Henderson at Searcy Medical Center, she began to think otherwise while performing EKGs, treadmill stress tests and pacemaker interrogations. "I thought, 'Man, he would be awesome to work for.'"

But before Epperson could work up the nerve to ask for a job, he offered one. She didn't have to think twice. As for her husband? "He's pretty happy," she says. "We were looking for a way to stay here."

Chris Casey - the local

Chris Casey likes to fix things. To take an injury, locate and alleviate the problem, and see someone able to live pain free gives him great satisfaction. Thus it is no surprise to learn he is working as a PA for orthopedist Dr. Bill Helfley of Martin, Bowen and Hefley Knee and Sports in Little Rock, Ark.

"As an athlete myself, I was always kind of interested in sports medicine," he says. "I love surgery, and you get to do a lot of that. And there are very tangible results from your work."

What is surprising is the fact that less than three years ago, he did not even know what a physician assistant did, much less desire to become one.

Growing up in Searcy, Casey doesn't remember ever visiting a PA; they were relatively unknown and unutilized. That was of no consequence, however, as he was going to attend medical school — or so he thought.

But during his junior year at the University, the biology major reconsidered this plan, overwhelmed by the additional years of study required. When he learned about the PA profession, he liked what he saw.

"It really appealed to me," he says. "I could get out there and practice medicine and enjoy a lot of the perks that physicians get and undergo some of the same training as physicians, but with less schooling."

He entered the program energized but realistic, expecting bumps along the way. An easy-going person, Casey wasn't phased by the need for constant flexibility. "That didn't bother me one bit," he says. "I can roll with the punches as well as the next guy."

His clinical rotations took him all over Arkansas. As he gained the experience needed to be a proficient physician assistant, he also faced one of life's toughest lessons: not every problem can be fixed.

"On my ER rotation, we had a lot of tragedies that kind of came in a wave," Casey says. One particular incident that sticks with him occurred at night, near the end of his shift. A woman about 37 came in with her young daughter. "She seemed like she was doing fine in the waiting room," he remembers.

Upon examination, her vitals were normal, and doctors couldn't find anything wrong. They stepped into the nurses station to check test results for another patient when the woman suddenly stopped breathing. "

We ran back and rushed her into a trauma room and did CPR on her for 45 minutes," he says. "And we lost her. ... We did everything we could to bring her back, but we lost her. It was one of the saddest things I have seen." Doctors later suspected a pulmonary embolism took the young mother's life.

Yet despite the hardships that come with the job, Casey sees no turning back. "I really do love this profession," he says. "I love what I get to do. I'm very satisfied."

Nicole Reece - the traveler

As a senior exercise science major at the University, Nicole Reece was well on her way to a career as a physical therapist. But while shadowing one, she realized that profession did not suit her.

Unsure of her next move, Reece, from Glen Allen, Va., investigated the PA Program. She says, "I heard about it, researched it and thought, 'That sounds great.' I was excited about being part of a new program and getting it started and up on its feet."

Knowing that both faculty and students would delve into the unknown together, she also admits to feeling less pressure. But she says she felt very prepared for her second year. "I was always scared at the beginning of my clinical rotations, but once I got in there, I was like, 'OK, I can do this.'"

Many students chose to perform clinical rotations in Searcy and Little Rock; others went as far as Texas. But for Reece, even Texas was too close. Instead, she and classmate Mary Madill chose to practice developing-world medicine in the mountains of Guatemala.

She learned about the opportunity when Health Talents International made a presentation to the class during the first year. At that time, 10 students signed up, but only Reece and Madill were able to raise the funds to go.

There she lived with a host family of eight in an adobe house with dirt floors. "My family cooked all their meals over an open fire in a room with no chimney," says Reece. "It was very primitive. There were holes between the ceiling and the tops of the walls."

But they insisted she have a room of her own. "It was very humbling. They wanted to give me everything that they could."

Each morning she and Madill would hike down a mountain, where they would be picked up by Health Talent's medical team to go to a local village and set up a clinic in its church. For a small fee, they treated such illnesses as muscular pain, worms in children and tumors. Then the team and members of each church would pray with the patient.

At one point in the rotation, the team drove to a larger, more modern clinic a couple of hours away. There a plastic surgeon and gynecologist treated more serious problems, such as fixing cleft lip deformities and performing hysterectomies.

New experiences abounded during her global adventure. "The first surgery I was in on was in Guatemala," she says. "I remember the doctor telling me to stand back. He didn't want me passing out on him."

She handled it well. "In that situation ... you almost detach yourself a little bit. You don't think of it as a person; you think of it as a problem that you are solving."

For now, she is working at a women's correctional facility in Newport, Ark., for Correctional Medical Services. Would she ever go back to Guatemala? Says Reece, "I've already been asked to."

Let's just say she's not ruling it out.