[NPInfo] Nice story of a PA student

[David Mittman]

Like that she is doing 10 weeks in a rural practice.

So many of the new students are interested in money and increasingly  
are going into derm, the surgical specialties, etc and not family  
medicine and geriatrics or psych.
Again, nice story..........






WEDNESDAY JUNE 11, 2008 Last modified: Tuesday, June 10, 2008 10:11  
AM PDT



Physician assistant Carly Hammer examines Sandra Pittmann Monday in  
Vale at Valley Family Health Center. Hammer, a student at Oregon  
Health & Science University in Portland, has come to Vale for 10  
weeks to practice family medicine.
A rural focus

By Johna Strickland
Argus Observer

VALE — Carly Hammer gets around in the world of medicine.

For nearly a year now, she has been something of a gypsy doctor,  
flitting from one practice to another as she hones her physician  
assistant skills.

Hammer, a student at Oregon Health and Science University, recently  
landed in Vale at Valley Family Health Center. Under the direction of  
Bob Davis, PA-C, Hammer will spend the next 10 weeks practicing  
family medicine. It is the capstone project of a 26-month physician  
assistant program at OHSU. The first year, Hammer — a Kimberly,  
Idaho, native — spent in a classroom furthering her knowledge of  
medicine. The next found her cycling through a set of nine, five-week  
rotations in various Oregon and Idaho practices. She studied  
inpatient medicine, orthopedics, obstetrics/gynecology, emergency  
medicine, general surgery, pediatrics, women’s health and  
dermatology. Then her 10-week preceptorship in family medicine.

“They send us out to do a little bit of everything so we get a  
little experience in every area of medicine,” Hammer said. “We  
typically do every other rotation outside of Portland.”

During each rotation, Hammer works under the supervision of a  
licensed doctor or physician assistant called a preceptor.

Her duties have varied from doctor to doctor, she said. Each  
preceptor first learned where she was in the program to determine how  
much supervision Hammer needed.

Under Davis’ supervision, Hammer meets with patients alone first,  
then she and Davis reevaluate the patient together.

“You take the history, do the physical exam, then kinda formulate a  
plan. Then you come out and discuss it with your preceptor,” Hammer  
said of her duties.

After they decide on a diagnosis and plan, they return to the  
patient “and do it all over again,” Davis said, referencing the  
history and physical.

In the months of her practical training, Hammer has learned how to  
insert a chest tube, do a spinal tap, and two months ago she  
participated in her first birth.

There have been challenges though. One came during a rotation at  
OHSU. The patient had severe liver disease and didn’t speak English.

Hammer had to explain his condition and treatment procedures through  
an interpreter.

Another hard moment arrived when Hammer met a patient who thought she  
had some food caught in her throat.

Hammer discovered a tumor in her esophagus and early testing didn’t  
show if was malignant or not. Hammer had to break the news to a  
surprised patient, she said.

“I think it’s really challenging as a provider to decide what to  
tell them to not scare them more than you have to,” Hammer said.

Still, Hammer said she likes the field she picked while completing  
her undergraduate degree in health science services at Boise State  
University.

“I decided in college that I really enjoyed biology and the other  
sciences ... then I chose PA because there’s a lot of flexibility.  
You can go into family medicine, then 10 years later go into  
cardiology,” Hammer said. “Being a PA is great because you still  
get to make the decisions ... you have your own patients. You just  
work under the supervision of a doctor.”

The flexibility in switching areas comes from Hammer’s broad  
training rather than the specific, specialized training an M.D.  
undergoes, she said.

As her August graduation draws closer, Hammer has begun to interview  
for a job in family or emergency medicine in the Boise area.

But for now, she’s busy practicing in Vale.

“I love the feel of community clinics,” she said.