12 LESSONS FOR PAs

I was privileged to be last week's keynote speaker for the MEDEX Northwest Tacoma Class 10 Graduation. Thirty newly minted PAs passed across the stage and received their diplomas.

I still remember my graduation, 40 years ago from the University of Oklahoma. I knew I was on the right path. I started in rural Oklahoma in family medicine. It was exciting to ply my trade finally. I spent 18 years in rural Oklahoma, the best years of my practice. It was challenging and rewarding. Some patients became friends and remain so today. They taught me how to be a competent PA. I shared the 12 lessons I learned along the way. 

1. Stay humble no matter how accomplished you become because humility keeps you honest. Share your knowledge. Don't be afraid to ask for help from your team or consultant. 

   
   

2. Listening is an art. Put down your stethoscope and Bring your ears, eyes, hands, and compassion into the room. It is a sacred space. Patients trust you by your very presence. They will share personal stories, and don't be shocked by their presence. Be prepared for the door knob comment, it might be the reason for their visit.

   
   

3. Fear is good. If the patient keeps you up at night, you're not done. So, develop a strong differential. If you don't think of the disease, you'll never find it. Follow up. 

   
   

4. Treat the patient, not the disease. (Who is this patient? Why are they here? What obstacles do they face in their daily lives? Can they read? Afford the medication? Understand English? Transportation?) 

   
   

5. Never take away hope, even in a terminal diagnosis. Assess what they want to know. My rule of thumb is never to give an initial diagnosis over the phone. Help your patients prepare for the worst and hope for the best because they can change what they hope for. Don't be afraid to share their sorrow. It shows you're human. 

   
   

6. Get out of your fraidy hole. Never be afraid to say, "I don't know." Then go find out. 

   
   

7. Always do the right thing. It's a late, long, busy day; your shift is almost over, and here comes your challenging diagnosis: dizziness in an elderly patient. They deserve your best, too. 

   
   

8. If the shoe doesn't fit, find a new shoe. Find the organization that will help you develop as a strong PA through mentorship and CME. On average, PAs change specialties twice before finding the one that fits. Be patient. 

   
   

9. Be kind. There will be times when you are challenged by a patient, physician, or organization. State your case without anger; you'll be heard. 

   
   

10. You can guide healing when there is no cure by providing a safe place built with empathy. You will meet courageous people, let them teach you how to live. 

    
    

11. You are the future of medicine. Remember, medicine is about finding our shared humanity in a world that constantly presses us to take shortcuts and rely on impersonal ways of managing very complex human problems. It takes a team. 

    
    

12. Join your state and national organization. We need your time and talent. We're here to help. 

Best of luck, and may the Force be with you.