:: eye of the storm ::


About Me

A 27-year-old PA student who wants to visit all seven continents, write a book, work at a pediatric clinic in Africa, and basically meet as many of the world's challenges as possible.

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current mood:
current mood

Life List

(already accomplished)

Become a PA

Visit all 7 continents

Take a SwimTrek trip

Bike through Western Europe

Raft the Grand Canyon

Improve my Spanish proficiency

Go on safari in Africa

Trace my roots at Ellis Island

Vacation in Hawaii

Work on a hospital ship in a Third World country

Celebrate New Year's in Times Square

Visit all 50 states (29 to go: AK, AZ, AR, CA, CO, HI, ID, IL, IN, IA, KS, MI, MN, MO, MT, NE, NV, NM, ND, OK, OR, RI, SD, TX, UT, VT, WA, WV, WI, WY)

See the ruins at Pompeii

Swim in Capri's Blue Grotto

Tour Mt. Vesuvius

Throw a coin in the Trevi Fountain

Tour the Colosseum

Visit the D-Day beaches

See the Mona Lisa

Visit the palace at Versailles

See the Acropolis and Parthenon

See the Egyptian pyramids

Hike the Inca Trail

Walk El Camino Santiago

Take an Alaskan cruise

View the Taj Mahal at sunrise

Hike Table Mountain in South Africa

Climb through the Amazon canopy

Walk at least part of the Great Wall of China

Get laser hair removal

Learn to surf, ski, and snowboard

Learn to drive a stick-shift

Learn to play the piano

Go on a tropical cruise

Ride horseback on the beach

Ride in a hot air balloon

Get tickets to the Olympics

Go to adult Space Camp

Witness a shuttle launch from up close

Build a full-sized snowman

Sew a quilt out of my old race T-shirts

Update and continue my Life Scrapbook

Become the oldest person to ever do the River Run

Live to be a happy, healthy 100 years old - at least!

(unlikely dreams)

vrijdag 5 maart 2010

So I still haven't found any financial aid for PA school whatsoever, and after a conversation with my mom today, I started thinking about how strange that is. With the current trend of MDs all wanting to be surgeons and dermatologists and make the big bucks, and PAs and NPs picking up all the primary care slack, you'd think there would be a lot more aid out there. As my mom put it, I'm "ahead of the curve, as usual." So I spent a large chunk of my day writing this letter. This version is tailored to North Carolina politicians, since that's who I'm sending it to, but feel free to tweak it and send it to anyone you want. The goal isn't necessarily to scrounge up money for myself (unless someone's offering, of course! :)), but rather to make those in power aware of the inequality we're dealing with and try to change things for students down the road.

Dear (insert name here),

My name is Jessica ______; I am a 26-year-old graduate student from North Carolina, and I will soon be entering the Physician Assistant (PA) program at Duke University. I am thrilled to have been accepted to such a wonderful program, and very excited to start school and embark on a rewarding medical career. However, the rising costs of education have recently led me to spend hours in front of my computer seeking out financial assistance. To my shock and disappointment, I have found virtually no aid whatsoever for PA students beyond loans. Given the rapidly changing model of medicine in favor of the mid-level practitioner, I feel that this is an unacceptable gap in the system.

Over the past few decades, we have seen how effective mid-level practitioners such as PAs and nurse practitioners (NPs) can be. As physicians increasingly turn away from primary care and toward higher-paying specialties, PAs and NPs are quietly filling in the resulting gaps, providing a nearly equivalent level of education and experience for a fraction of the cost. Physicians have communicated a high level of satisfaction with PAs, and patients often state that they feel that their PAs spend more time with them than their doctors and take their concerns more seriously. Simply put, not every patient needs to be seen by a doctor. A good percentage of daily care can be easily handled by mid-level practitioners, leaving the truly complex cases for the physicians. This fact is beginning to be recognized globally as well, with multiple PA education programs springing up in the Netherlands, Australia, Canada, the UK, and South Africa. In recognition of our success, American PAs are being heavily recruited overseas, both to teach in these new programs as well as simply to practice medicine, demonstrating firsthand the vital role of the PA and paving the way for new graduates to take over.

Though PAs are increasingly well-respected across the medical field by physicians and patients alike, there exists a blatant inequality in the educational system responsible for the training of these practitioners. While there are multiple programs in place for financial assistance for medical students, there is virtually nothing available for PAs. To use my own institution as an example, fifty percent of a Duke medical student’s demonstrated financial need is covered by internal scholarships and grants, which do not need to be repaid; the student only needs outside funding (loans, external scholarships, or help from family) for fifty percent of his or her costs. For the PA program, however, with an estimated total program cost of $116,000, the only internal aid available is that which is dispersed through the program itself, generally a pittance; current students report having received around one thousand dollars. Following this model, a medical student (who spends twice as long in school and graduates with three times the earning power) will incur the same amount of debt as a PA student, who spends a mere two years in school and receives a far lower salary with which to repay his or her debt.

This financial picture appears to hold true across the board, not only at Duke; moreover, this inequality extends beyond the institutions themselves and into the myriad of external scholarships. There are countless funds available for undergraduates, as well as for nurses, teachers, and doctors, but a graduate student pursuing any other path is often at a loss. Graduate students are commonly newly independent of their parents, living hand-to-mouth on their first real-world job while struggling to pay their bills; yet the vast majority of available financial help goes to undergraduates, who generally pay less tuition to begin with and are often still covered under their parents’ policies for cell phones, health insurance, car insurance, and the like.

There does exist the occasional loan forgiveness program for students entering the medical field, in which student loans are forgiven in exchange for a certain number of years of service in a medically underserved area. The competitive National Health Service Corps (NHSC) is a well-known example. However, should I choose to pursue it, the North Carolina version of this program (NC Health, Science, and Mathematics Student Loan Program) would cover barely 10% of my projected educational costs, yet requires the same amount of service as the NHSC, which covers the entire cost of education. In a state like ours, with such a strong medical reputation, this program seems a halfhearted effort at best.

North Carolina is home to several prestigious institutions of higher learning—more than most states can claim—as well as top-notch hospitals and pharmaceutical companies. In terms of medicine, our state is a clear national leader. As such, I feel that we should pave the way for the rest of the country in demonstrating the value we place on our mid-level practitioners, most notably PAs. Many more PA-specific scholarships and grants must be made available, both within our universities and outside them, and our loan forgiveness program needs to be improved—for if it were made more attractive to pre-PA students such as myself, North Carolina would gain much-needed practitioners where they are in the shortest supply.

There is no reason to think that the current trend away from primary care MDs will shift anytime soon. With the high levels of competence and dedication demonstrated by PAs and NPs across the world, as well as the degree of physician and patient satisfaction, it seems clear that PA education, training, and service should be recognized by helping these practitioners incur less debt. After all, we all need medical care from time to time. It seems a fair exchange to help those who might one day help you.

Thank you for your time.

2 Comments:

Blogger Raconteur said...

This is interesting. I am a student at WFU who is involved in some governmental affairs committees for PA advocacy and I would be interested in maybe using your letter as a spring board for getting more students to lobby our legislators.

11/3/10 14:02  
Blogger Jess said...

Raconteur - I can't access your profile or email address, but it would be fine with me if you wanted to use my letter for that purpose. Credit would be nice, but not necessarily a must. Let me know what you decide.

12/3/10 12:50  

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