Physician Assistant

Shani Fleming is a physician assistant at Total Health Care in Baltimore.

How long have you been a physician assistant?

I have been a practicing physician assistant for 11 years. My career has included adolescent and women's health care, infectious disease, health care administration, research and education. Currently, I am employed full time as the research and scholarly work coordinator and instructor for the Anne Arundel Community College Physician Assistant program and provide primary care services part-time at Total Health Care in Baltimore City.

What does your job entail?

Physician assistants work in a variety of settings and the scope of practice will look different depending on that clinical setting. I work as a clinician in an outpatient primary care clinical setting. My job consists of collecting the details of a patient's history and medical complaint, performing a physical exam, ordering any necessary laboratory or diagnostic tests, interpreting these tests, and in collaboration with the patient, determining the best treatment plan. I focus a great deal on prevention and health maintenance services. I provide a tremendous amount of patient education, always remaining mindful of the health literacy of the patient population. All physician assistants practice under a supervising physician where supervision can range from telephone consultation as needed to on site supervision.

What kind of schooling or training did you go through?

I attended George Washington University and graduated with dual master's degrees in health science and public health. Physician assistants are trained in a similar medical model as our supervising physicians. PA programs average two years, with one year of didactic training and one year of clinical training. Many of the students entering PA school have a significant clinical background with over 5000 hours of health care experience. Physician assistant training is currently transitioning to a masters level for all programs. This will require all entering students to hold a baccalaureate degree. All programs have pre-requisites and requirements for entry and PA programs are very competitive, often receiving several hundred applications for 40-50 seats in the program.

What inspired you to this career?

I have always wanted to serve in low socio-economic populations. The PA profession was created to provide medical care to the underserved population. There are significant health disparities that exist in the underserved population and I aspire to be part of the solution. I am a National Health Corps Scholar and received Loan Repayment for serving the medically underserved communities. The mission of this federal program is to encourage providers to serve in underserved communities. All eleven years of my career have been working in Federally Qualified Health Centers working with patients from primarily low socio-economic populations. I also provide training and education in cultural competence, bringing to light the existing health disparities and I encourage other providers to take an active role in health policy and address social determinants of health while concurrently self-assessing implicit and explicit bias which may play a role in health care delivery.

What do you like best about your job?

I love the fact that I change lives as an educator and a clinician! People come to see me and often feel better after a service I provide. As a PA, I educate my patients, treat them for any urgent or immediate concerns, and encourage prevention of future illness. I advocate to policy makers on behalf of the care of my patients. I also teach and train future physician assistants. There continues to be low numbers of minorities entering into the profession. I have the opportunity to go into schools and promote the profession to hopefully increase interest and application into PA programs. I also try to be an inspiring role model to the patients I serve as a possible future career choice for them as well. It is an incredibly fulfilling job!

What are the challenges?

Our health care environment is rapidly changing. The Affordable Care Act is providing health care to millions of new patients. There is a dramatic shift in the number of primary care providers needed to provide services and health care and consequently health disparities continue to rise. I believe physician assistants will be integral to address many of these concerns. We must continue to advocate on behalf of our profession, overcome reimbursement barriers that limit employment opportunities for PAs, educate the public on the services we provide and the benefit of having us on the medical team, and promote culturally competent primary care education to our PA students.

Median salary?

The 2010 median salary for physician assistants was $86,410 per year, according to the Bureau of Labor Statistics.

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