Physician Assistant / Associate New Stories and Articles:Professional Medical Practitioners who diagnosis, perform medical procedures, and prescribe treatment as partners with physicians in all medical and surgical specialties, uniting medical expertise with compassion for exceptional patient care

                                     United States Surgeon General Richard H. Carmona, M.D., M.P.H., FACS, unknowingly helped
                                     lead the way as a decorated Viet Nam combat medic whose advanced medical training and medical
                                     expertise laid the foundation for what is now called the Physician Assistant profession.

                                     After having first served our country as a Special Forces medic in Vietnam, receiving the Bronze
                                     Star, a Purple Heart and a Combat Medical Badge, Dr. Carmona furthered his service to our nation
                                     by studying advanced medical training and developing medical expertise in the early formation of the
                                     Physician Assistant concept.

The Physician Assistant profession owes its formation to several physicians who proposed utilizing
the same fast track model that prepared doctors for deployment in World War II.

              Duke University felt that this new physician assistant concept could help alleviate the increasing shortage of primary care physicians
              in rural areas. Duke proved they were able to successfully train Viet Nam war corpsmen and medics using the fast track model for
              doctors, thereby, giving birth to the Physician Assistant [PA] profession.

              "Dr. Richard Carmona is a dynamic leader with a remarkable background who can help lead America through the wide-range of
              medical and health challenges they face in their everyday lives. His diverse experiences also make him uniquely qualified for the
              position." said, HHS SECRETARY TOMMY G. THOMPSON.

              Dr. Carmona is a hero to those he serves and we expect that he will be a hero to the cause of stronger public health in America as
              Surgeon General. Dr. Carmona dedicated himself to serving his patients, community and country in ways that few can match. He
              certainly embodies "Physician Assistant, for the love of medicine and patients."

              Dr. Richard H. Carmona was sworn in as the 17th Surgeon General of the United States Public Health Service on August 6, 2002.
              He now holds the rank of Vice Admiral and serves as the Commander of the United States Public Health Service’s Commissioned
              Corps, numbering around 6,000 officers.

              Born and raised in New York City, Dr. Carmona dropped out of high school and enlisted in the U.S. Army in 1967. While
              enlisted he received his Army General Equivalency Diploma, joined the Army's Special Forces, ultimately becoming a
              combat-decorated Vietnam veteran, and began his career in medicine. Dr. Carmona has worked in various positions in the medical
              field including paramedic, registered nurse, and a physician.

Sturgis and Fields are second year surgical First Assists who also provide direct patient care at Affinity's St. Elizabeth Hospital's clinic, in Appleton, WI.

"The Affinity Orthopaedic Symposium was held on Thursday, July 31, at Mercy Medical Center. 109 participants were registered for the event - an attendance level that rose well above expectation. Physicians, physical therapists, athletic trainers and other health care professionals heard presentations on a variety of topics related to the care and treatment of lower extremity injuries and sports medicine. Hands-on joint evaluation and casting skill stations were available throughout the day. Thanks to those who participated and to those who helped organize this very successful event!"
Source: AffinityHealth.org Intranet

National Coalition Founded to Represent Nurse Practitioners and Physician
Assistants. The American College of Clinicians is Born San Antonio, Texas

The American College of Clinicians is a new organization to represent and
promote physician assistants (PA¹s) and nurse practitioners (NP¹s)
nationally. This first of its kind organization was founded by leaders of
both professions and will utilize the combined strength and talents of both
groups.

Today NP¹s and PA¹s represent over 150,000 professionals providing care to
millions of patients throughout the United States. Both groups work in
collaboration with physicians providing care that is high quality,cost
effective, and up until 30 years ago only provided by doctors. NP's and PA's
are highly trained professionals who provide a full range of health care
including diagnostic treatment, prescription writing and hospital care. They
spend considerable time in patient counseling and education, patient
advocacy and preventative medicine. "We recognize the time has come for PA's
and NP's to have a group that represents the interests and goals that are
common to both groups" says Michael Champion, PA-C, Executive Director,ACC.
The ACC intends to build upon the long standing workplace collegiality
between PA¹s and NP¹s by transforming it into a nationwide alliance that can
improve patient care and advocate for changes in our healthcare system.
"PA's and NP's have the same educational needs, the same challenges in terms
of networking, health policy and a host of other issues. An umbrella
organization that can coordinate our efforts will enhance us all and improve
the care we deliver to our patients" says Champion.

For more information call:
Dave Mittman, PA
Director of Communication, ACC
973-954-9208
info@amcollege.org

Mindy Glivinski (left), a student at Oregon Health & Science University, scrubs up with Dr. Harris Waters before a surgical procedure Wednesday at Silverton Hospital. Glivinski is studying to be a physician assistant. Silverton Hospital is helping to teach Mindy Glivinski to be a physician assistant.

SILVERTON — When she graduates in August from Oregon Health & Science University, Mindy Glivinski will be ready for work as a physician assistant in the Mid-Willamette Valley.

As part of her studies, the 26-year-old from Carlton, in Yamhill County, has spent the past five weeks helping Dr. Harris Waters and Dr. James Nealon perform surgeries at Silverton Hospital. Her last day at the hospital will be Friday.

During her five weeks in Silverton, Glivinski has gained practical experience helping in the operating room during surgeries, including a double mastectomy and a carotid endarterectomy, a serious surgery done to reduce the risk of stroke by clearing plaque from the outer carotid artery.

She also has spent time talking with patients, learning to recognize symptoms and illnesses, and applying techniques she learned through classroom instruction.

“I’ve gotten to see a lot, and I’ve done a lot of suturing,” Glivinski said. “This has been a really helpful rotation. I’ve learned a ton.”

Surgical rotations are a mandatory part of the 26-month Master of Physician Assistant Studies program at OHSU, and they are a critical step in preparing students for a career as a physician assistant, Glivinski said.

Glivinski graduated from the University of Oregon in 1999 with a bachelor’s degree in general science, but she always wanted to work in medicine. She spent a few years working in medical offices before deciding to enroll at OHSU.

“I thought about the medical school route, but after doing some research, I determined it wasn’t for me,” said Glivinski, who lives with her husband in Aurora. “I want to have a family and time to enjoy it. That’s why I chose the PA profession.”

Besides helping doctors during surgeries and other procedures, physician assistants also diagnose illnesses and conduct tests on patients.

Pat Kenney-Moore, associate director of OHSU’s physician assistant program, said that demand for certified physician assistants in Oregon is high, with the majority working in primary care. She said that one-fourth of Oregon’s physician assistants specialize in surgery.

Glivinski said that working with Waters and Nealon at Silverton Hospital has been especially helpful.

“They’re both great teachers,” she said. “You can’t learn everything from a textbook. They’re very good at explaining the practical side of things.”

Glivinski’s rotation at Silverton Hospital is her fifth of 11 needed to complete OHSU’s master’s program. She has worked in offices and clinics specializing in orthopedic cases, obstetrics gynecology, community medicine and pediatrics. In January, she will begin working at a dermatology clinic in Salem to supplement her knowledge of skin-related problems.

Waters said he works with four or five physician-assistant students rotating through his office every year. He said that providing hands-on training for students also helps him keep his own skills sharp.

“It keeps your mind going,” Waters said. “As surgeons, we do things almost routine, but when you have a PA around, it makes you think a little more about what you’re doing.”

Waters and Glivinski said that Silverton Hospital’s rural location makes it a strong learning ground for students looking for experience in a variety of medical cases.

“Part of the mission statement of OHSU’s (program) is to train PAs to work in rural, underserved areas,” Glivinski said. “Having grown up in Carlton … I’d prefer to work in a smaller area.”
source: http://news.statesmanjournal.com/article.cfm?i=72462

Physician assistant Bob Ross examines Jeffrey Bonin. Growing numbers of physician assistants treat patients with routine ailments like colds, sprains and earaches, allowing doctors to focus on more complex cases.

Dr. Paul Ehrmann, right, hired Ross in 2001 and says he doesn't know what he'd do without his help.

ROYAL OAK -- Patients with appointments at Dr. Paul Ehrmann's office often come and go without ever seeing the doctor.

Instead they see Bob Ross, who can usher most patients through an entire visit from diagnosis, to ordering tests, to writing prescriptions.

Ross is a physician assistant and part of a booming health care profession that's increasingly filling in for medical doctors. There are more than 52,000 physician assistants nationwide, including 2,000 in Michigan. That's up from 26,000 nationwide in 1996.

It's no wonder why. A shortage of doctors in urban areas, including Detroit, is driving up demand for health care providers. And in this era of skyrocketing health care costs, using physician assistants is a more economical way to treat patients with routine ailments.

The average physician assistant earns about $76,000 a year -- much less than the $132,000 average wage of a primary care doctor. And the cost of educating a physician assistant in a two-year graduate program is much less than educating a doctor, which can take up to 10 years.

"The practice of medicine is changing in America and physician assistants are leading the change," said Steven Crane, CEO of the American Academy of Physician Assistants.

Under Michigan law, physician assistants can take on whatever duties a doctor delegates to them. In a general practice, that usually means taking care of patients with colds, sprains and earaches and consulting with doctors on more complex cases that could require surgery or hospitalization.

In fact, some health care experts insist physician assistants are part of the antidote to Detroit's health care crisis, which has driven the city's hospitals into financial trouble and forced a government bailout for the particularly vulnerable Detroit Medical Center. The crisis stems from a lack of primary health care for the poor and uninsured, who often ignore symptoms until they're critically sick and then turn to hospital emergency rooms.

Architects of the proposed Wayne County Public Health Authority are considering using physician assistants in clinics to treat the county's poor and uninsured patients.

And private practice doctors are increasingly hiring physician assistants because they decrease waiting time for patients and free up doctors to spend more time on research and with patients who are critically ill.

The profession began in the late 1960s. Soldiers in the Korean War had been trained in triage to help field doctors who were overwhelmed with patients. But when they returned to the civilian world, there wasn't a place for them.

Today, physician assistants are trained in two-year graduate programs that require many of the same classes that medical students take including gross anatomy, where students dissect a human cadaver and take a class on pharmaceuticals, where they learn about prescription medications. They also must pass a national certification test and earn a license from a state board.

Despite their qualifications, expanding the profession would require an attitude shift from some doctors and patients, who often are skeptical because physician assistants don't attend medical school.

"I have to admit, initially I was a little apprehensive about hiring someone who's not a physician," said Ehrmann, who hired Ross in 2001 to help handle the increasing number of patients at his practice. But now Ehrmann says he doesn't know what he'd do without the extra help.

But for patient Jeffrey Bonin, who came to see Ehrmann Wednesday for a sinus infection, seeing a physician assistant seems like a fine idea.

Increasing Number of Physician Assistants Handle More than 190 Million
Patient Visits in 2003

(Alexandria, VA) - The number of physician assistants (PAs) in clinical
practice continues to increase, with more than 50,000 PAs in practice
accounting for almost 200 million patient visits and writing over 200 million
prescriptions.

The American Academy of Physician Assistants (AAPA) estimates there will be
approximately 50,121 people in clinical practice as PAs at the beginning of
2004, according to the newly released Information Update: Projected Number
of People in Clinical Practice as PAs as of January 1, 2004. This estimate more
than doubles the number of PAs in clinical practice ten years ago. AAPA
estimates there were 23,300 PAs in clinical practice at the beginning of 1994.

Approximately 192 million patient visits were made to physician assistants and
236 million medications prescribed or recommended by PAs in 2003, according
to the Information Update: Number of Patient Visits Made to Physician
Assistants and Number of Medications Prescribed or Recommended by
Physician Assistants in 2003.

"With almost 200 million patient visits this year, it's clear that physician
assistants have become a significant part of the health care system,
providing quality care in all medical specialties," said Stephen Crane,
executive vice president and chief executive officer of the American Academy
of Physician Assistants. "With the intensive training required for the
profession and focus on team practice with physicians, PAs have gained
widespread acceptance by the public as well as the medical community."

This year, more PAs (33%) practiced in family medicine than any other
specialty. These PAs accounted for approximately 38 percent of the patient
visits made to PAs during 2003 and approximately 44 percent of the total
number of medications prescribed or recommended by PAs during 2003.

"The number of individuals entering the physician assistant profession
continues to grow, driven by the fact that PAs are recognized as a solution
to expanding access to health care," said Crane. "PAs also prefer to stay in
clinical practice serving patients because they are incredibly satisfied with
their profession," he added.

In a separate survey taken at the AAPA's annual conference in May 2003, 86
percent of physician assistants surveyed said they would become a PA if they
had to choose their career over again, and 95 percent would recommend the
PA profession to a promising student.

PAs practicing general pediatrics, family practice medicine, and emergency
medicine reported more patient visits per week than did PAs practicing other
specialties. The most prevalent disorders treated by PAs in 2003 were
respiratory/ENT infections, muskuloskeletal disorders/injuries, allergic
disorders, hypertension, and pain management. A full listing of the estimated
number of visits to PAs in 2003 by specific disorders is available in the
Information Update: Number of Visits to Physician Assistants for Selected
Disorders in 2003. All information updates are posted on the AAPA Web site at
www.aapa.org/research. Reporters may access additional information on PAs
through the AAPA News Room at www.aapa.org/newsroom.

Physician assistants are licensed health professionals who practice medicine
as members of a team working with supervising physicians. PAs deliver a
broad range of medical and surgical services to diverse populations in rural
and urban settings. As part of their comprehensive responsibilities, PAs
conduct physical exams, diagnose and treat illnesses, order and interpret
tests, counsel on preventive health care, assist in surgery, and prescribe
medications.

AAPA is the only national organization to represent physician assistants in all
medical and surgical specialties. Founded in 1968, the Academy works to
promote quality, cost-effective health care, and the professional and
personal growth of PAs. For more information about the Academy and the PA
profession, visit the AAPA's Web site, www.aapa.org.

Your child is sick, and you call to make an appointment with the doctor. Just your luck - he's out for the day. The receptionist suggests you might want to see the physician assistant.

      What do you do? What is a physician assistant - sometimes called a PA - and why should you see one?
      Rhonda C. Rotert, a physician assistant at McFarland Clinic in pulmonary medicine, said she used to get those questions, along with a lot of concern from patients. But as the field has expanded, patients are becoming accustomed to see non-physicians, especially in clinic settings. As a result, she said more patients are feeling comfortable with her role.
      "I am an extension of my supervising physician," Rotert said. "I practice medicine just like he does."
      Rotert said one of the biggest differences between her position and that of the nurse practitioner is that by law, the physician assistant must be under the guidance of a supervising physician.      She said as a physician assistant she was formally trained to provide diagnostic, therapeutic and preventive healthcare services, as delegated by a physician.
      She has been at McFarland Clinic four years now, specializing in pulmonary medicine under the guidance of Steven Wanzek, a doctor of pulmonary and critical care medicine.
      "I confer with him, and we work as a team," she said. "I see this as a plus for patients because we work very closely together."
      Rotert's training was an intense couple of years at Des Moines University. She said becoming a doctor did not seem an option for her as she looked at ways to increase her skills in medicine. She said the physician assistant program appealed to her because it is a shorter, faster curriculum than that of physicians or nurse practitioners.
      Prior to going back to school, she worked as a nurse and a respiratory therapist at Methodist Hospital in Des Moines.
      "I went to PA school, and pulmonary was my calling," Rotert said. "It was very intense, and I had no life. But I get to do everything I hoped I would as a mid-level provider. I can use my old skills, and it has been a good fit."
      Rotert likes her ability to spend a little more time with patient than the doctor may be able to. She does quite a bit of consulting with patients and educating them in aspects of their medical needs.
      "I try to have a good bedside manner," she said. "I put myself in their place. I think most PAs have a compassion for people and relate well to everyone. I treat my patients like I would like to be treated. And every day is a new adventure."
      Wanzek said he sees both the physician assistant and the nurse practitioner as important roles in the medical setting. It's something that has worked well for him.
      He said Rotert's role has made it cost effective for the patient because she is a recognized service provider for Medicare insurance. In addition, he said Rotert takes his place as a consultant during the day when he may be called to the hospital for emergencies or daily rounds.
      "She is an important part of my practice," he said. "And she makes life a lot easier. It's a win-win situation."

A credentialed physician assistant ...
Ì provides health care services with supervision by physicians. PAs may provide care in rural or inner city clinics where a physician is present for only one or two days each week, conferring with the supervising physician and other medical professionals as needed or required by law.
Ì takes medical histories, examines and treat patients, orders and interprets laboratory tests and X-rays, makes diagnoses, and prescribes medications.
Ì can provide treatment of minor injuries by suturing, splinting and casting procedures.
Ì records patient progress notes and instructs and counsels patients.
Ì may order or carry out therapy.
Ì orders medical and laboratory
supplies and equipment and may supervise technicians and assistants in some states.
Ì works in either primary care areas such as general internal medicine, pediatrics and family medicine or in specialty areas, such as general and thoracic surgery, emergency medicine, orthopedics and geriatrics.
Ì has taken advanced classes and clinical training. Most physician assistant programs are provided through medical schools.
Ì obtain supervised clinical training in several areas, including primary care, inpatient medicine, surgery, obstetrics and gynecology, geriatrics, emergency medicine, psychiatry and pediatrics. They must pass recertification every six years.
Ì should not be confused with medical assistants who perform routine clinical and clerical tasks.

source:http://www.amestrib.com/site/news.cfm?BRD=2035&dept_id=490351&newsid=10518723&PAG=461&rfi=9

Within a few days you will see an ad in Clinician Reviews, announcing a new
national association, The American College of Clinicians (ACC). This
organization is being formed to represent two professions with common
interests; nurse practitioners and physician assistants. It is clear to
many PAs and NPs, including the founders, that there is much that can be
achieved and learned from each other by working together on issues of common
interest. Both professions have always shown a commitment to improving
healthcare. The goals of the ACC are consistent with those commitments.

The ACC is not an alternative to profession-specific organizations already
in existence. We encourage you to continue to support those associations as
you always have. But, we are asking you to support the ACC as well. The
richness of the concept, possible size of its constituency, and potential to
greatly improve healthcare in this country all underscore the fact that the
American College of Clinicians is an idea whose time has come. As you can
see on our site and in our membership ad, some of the best known leaders of
both the NP and PA professions have endorsed this new association. We all
ask that you do also. We have also promised measurable benefits that will
help both professions, benefits that we will accomplish and that all will
gain from.

Please accept my invitation to join this new association and help us grow.
You've always shown a deep commitment and interest in improving healthcare.
I hope you consider sharing that commitment with the ACC by joining and/or
getting involved. We need all of the help we can get.

As you all are special friends, I wanted you to hear it from me, before it
is officially announced next week. I will be away from tomorrow at the
Family Practice PA meeting in San Antonio, speaking on the future of PAs. If
you are there please stop and say hello. My Forum friends are very close to
me. When I return I'll be happy to answer any questions to be best of my
ability as will anyone else associated with the organization.
For more info and a membership application click
here.......

Arterial health is only a scan away
By Gary Mitchell gary_mitchell@link.freedom.com

Although his new business, Clinical Diagnostic Services, is only a couple of weeks old, owner/manager Troy Eden is setting up branch offices in three states.
Clients come to his centers to get a computerized scan, similar to a sonogram used to take pictures of a baby in a mother’s womb, of a blood vessel in the neck or a blood vessel in the leg.

“It’s our goal for the business in Clovis to be the central analysis site for the acquisition centers in other areas,” said Eden, who is a physician assistant, a registered vascular technologist and a registered diagnostic cardiac sonographer.

“The technicians send it to me here via our telephone hookups, and I send a report back the next day,” Eden said. “We have office sites in Billings, Mont., Salt Lake City, Utah, and we’ll soon have one in Las Vegas, Nev.”

“My belief is that we typically deal on the wrong side of heart disease,” he said. “We wait until people have already had a heart attack or stroke. People need to have this kind of testing prior to any symptoms occurring because there’s something we can do about it, especially with the medications we have now.”
Taking these tests have been proven scientifically to reduce people’s risks up to 60 percent, Eden said.

“But people say, ‘Why would I want to know that (I have high risk factors)?’ That’s based on the assumption there’s nothing you can do about it,” he said. “But that’s not true. You can do something about it. This test is by far the earliest indicator of arteriosclerosis. We try to find people in their 30s or 40s to let them know how their cardiovascular health is progressing. Then they have more opportunity to get back on a right road. We offer them the opportunity for greater information they can share with their doctors.”

Eden said 25 to 30 percent of people who have heart attacks have normal cholesterol levels, so it’s the other factors that make the difference.
“People say, ‘It’s just a man’s disease,’ but it’s the number one killer of women,” he said. “Everybody preaches early detection. Well, this is a way of early detection.”

Eden’s sister, Tuni Theonnes, is a registered nurse who operates a satellite site in Billings, Mont.
“The public is really receptive, and people want the test,” she said. “We’ve been getting a lot of calls, and we have a lot of scans scheduled. We’ve been open a little more than a week. We don’t have an office yet, so we take the test to where the people are. They love the idea of a technician coming to their home.”
Theonnes said she needed a change after serving for 29 years in critical care.

“It’s time for people to get proactive — and not reactive — about health care,” she said. “It may take a while for the medical community to accept the idea of it. It’ll just take time.”

Eden said his office offers four tests to people — all based on research and scientific literature.

Digital sonography offers the best way of identifying risk factors for the least money, Eden said. The primary screening — known as quantitative intima media thickness — measures the average thickness of a portion of the carotid artery, a vessel that supplies blood to the brain. Numerous studies show thicker blood vessel walls mean higher risk for heart attacks. The images also show buildup of plaque on the wall of the artery, which increases the risk for stroke.

“It may sound complex, but everything we do is simple, inexpensive and backed up by tons of literature,” he said. “We want to work with people’s doctors to institute a primary cardiovascular (heart and stroke) prevention program. That’s what we do.”

In 2000, the American Heart Association endorsed the procedure as part of a complete cardiovascular diagnostic evaluation. Clients at risk will be urged to talk to a doctor about possible treatment options, Eden said.

Patients are given a copy of an image of their blood vessel along with a chart comparing the thickness of their carotid artery to ideal thickness, Eden said.
“We look at the sum of all your risk factors, and how those risk factors are affecting your arterial health today,” he said.

Eden stressed that Clinical Diagnostic Services of Clovis will not provide patient care or treatment recommendations. Only a doctor’s office should provide that, he said.
Eden came to the Clovis-Portales area not long ago.

“My wife, Dr. Kirin Madden, is a doctor, a family physician at Cannon Air Force Base,” he said. “She just finished her residency at the University of Utah, and Cannon was her first duty assignment. I started my business there in Salt Lake City.”

Eden said Clovis has been enjoyable so far. “It hasn’t been that bad,” he said. “I love the people of Clovis. Right now, I’m doing all the cardiovascular diagnostics out of Roosevelt General Hospital, and I’m also doing the cardiac diagnostics in Tucumcari. I go there once a month. My business here in Clovis is just getting started. I still want to meet with the doctors in the area. I’ve been doing what I do for 20-plus years.”

source:http://cnjonline.com/engine.pl?station=clovis&template=storyfull.html&id=2285

On a recent day, a white Jeep pulled up at a Pensacola apartment complex. Spencer Campbell, a certified physician's assistant, jumped out and opened the back hatch. Inside was an array of medical supplies, from which he filled a small black bag.

Albert Spratt, right, a Parkinson's disease patient, receives medical treatment at his home from Physician's Assistant Spencer Campbell. At left is Albert's wife, Barbara.

Campbell, a partner in the Comfort Care Medical Group, was making his first house call of the day.

He will listen to the vital signs of 84-year-old Albert Spratt, a Parkinson's disease sufferer, check his blood pressure and review his medication schedule, then provide flu shots for Spratt and his wife, Barbara, 82, before zooming off on his next visit.

"People are saying, `Where've you been?' We're seeing people who haven't been seen in years. They've been treated over the phone - when what they need is someone to listen to their chest."

With 22 years as a general internal medicine practitioner, Gary Gotthelf, a board-certified physician who initiated the service locally, said the increasing number of aging and disabled patients served by his busy practice demanded the home visits. Many, like Spratt, had great difficulty in getting to his office, with no transportation and severe physical disabilities.

"Three years ago, we started with one afternoon a week. Then it became a backlog of patients, so we added Spence, who wanted to get into primary care. More and more people are in need. He sees about eight to 10 patients a day."

"All over the country - you can get home visits in every other metropolitan area of the state and everywhere. But nobody else besides me offers this in Pensacola."

Spratt and his wife said if Campbell didn't come to them, they'd have to ask their daughter, Pace resident Gail Ward, to take time to help them out.

"She already buys my groceries for me," Barbara Spratt said, "so I hate to ask her for more."

It's cost-effective patient management, compared to an emergency room visit, which is the only other alternative for some homebound patients.

Medicare pays for the visits, when required by necessity, and some insurance also covers them, which most people don't know, Gotthelf said. The service operates weekdays from 8 a.m. to 8 p.m., and some weekend appointments are available.

Campbell can provide basic care to chronically ill patients, Gotthelf said, including performing a physical examination, taking vital signs and other comfort and preventive measures.

He discusses treatment needs with family members and can explain how to manage tube feedings, wound care and prevention of bedsores, as well as making sure all immunizations are up-to-date and medications are being taken as ordered. He can also order lab work, X-rays and diagnostic tests and call in specialists, if needed.

"It's the way to fly if you have someone who's had a stroke. It's better than a home health care nurse, because he is a board certified primary care provider, trained in assessment, who can legally prescribe medications. We work together with the agencies on therapy," Gotthelf said.

"We've already added another physician and a nurse practitioner. I see us adding another physician within the next year. Now everybody's wanting it."

Another "side effect" - tourists visiting on the beach can access the service through their hotels and condos, Gotthelf said. Severe sunburns, tourist tummy aches and more are treated on the spot, without the strss of trying to find a doctor's office in a strange town.

"The hotels are excited about it, and it's very marketable - and much cheaper than an ER visit," Gotthelf said.

Physician Assistant: A newer position filling age-old demand
By Mary Le Arneal/Tribune Correspondent

On this day in 1967, the first physician assistants graduated from Duke University. For more than 35 years, the physician assistant (PA) profession has provided quality medical care in this country and has had an important impact on patient access to care.

The profession has grown from the first handful of graduates in 1967 to more than 46,000 clinically practicing PAs in 2003.

They practice with Drs. Milo Anderson and Monty Sellon in their family practices. Exstrom and Stenger each arrived at the profession via different routes.

Exstrom followed the route for which the PA program originally was planned. He graduated from high school in Holdredge in 1971 and attended college for one year before being drafted into the United States Army. In the Army, Exstrom was first exposed to physician assistants, where he worked with them in a medical clinic. When his tour was up, Exstrom returned to college. After completing his second year of prerequisites, he applied to the physical therapy and physician assistant programs at University of Nebraska Medical Center since they had basically identical requirements.

"I was an orderly in high school," Exstrom said. "I was a lab tech in the Army. In college, I worked in home health in the summertime at a nursing home, so I was always in the medical field, and wanted to stay in the medical field."

Exstrom graduated with a bachelor of science in physician assistant studies in May 1979. He was in the fifth class to graduate from UNMC.

"Back then, people were either asking for PAs or else you had to go out to sell yourself," Exstrom said. "There were a lot of places where you went for a preceptorship for three to four months to a rural family practice. Those preceptorships showed the doctors what the PA could do and that led to jobs."

Exstrom's first job was in Fairbury, with a family practice group. One of the partners had retired and the group replaced him with two PAs.

"The story goes that one of the doctors had been to a CME (continuing medical education) course," Exstrom said. "They had to take a test every morning over the previous day's material, and the first or second highest score was by a PA who was already out practicing. That is what caught his attention, that the PA was learning right along with them."

In April 1990, Exstrom moved to Fremont to work with an anaesthesiologist. Drs. Anderson and Sellon asked if he was interested in helping them part-time, so Exstrom started working for them on their afternoons off. In February 1997, he started working full time for Anderson and Sellon.

Katy Stenger came to the PA profession via a different path. She worked as a licensed practical nurse for 16 years before deciding to restart her schooling.

"I was encouraged to go on by some good nurturers," Stenger said. "So I went back to school, taking prerequisites at Metro to get my feet wet, then finishing at UNO."

Stenger started taking her prerequisites in 1992, continuing to work part time. She graduated with a master's in physician assistant studies degree from UNMC in December 1996 and started at her present position in February 1997.

Exstrom and Stenger have compared their time at UNMC and agree it was pretty much the same program.

"It has always been physician-based," Stenger said. "I became a PA rather than a nurse practitioner because I liked the practicum program with the preceptorship where you actually get the hands-on experience versus just a book-based, nursing-based program."

"The program has changed very little," Exstrom said. "It's a little longer with the master's program. When I was a student, they did a good job getting the student out into rural Nebraska. That has changed in that a lot of the students stick around the Metro area now. The other thing I noticed is that the gender balance has changed. The classes ahead of me were mostly male. My class was 50/50. Now I would say that the classes are strongly female-dominated, probably 80 percent."

Val Harms of rural Dodge will graduate in December 2003 from the UNMC PA program. She said there are only eight males in her class of 39. She will have seven months of rotations in rural Nebraska by the time she graduates. "Rural" areas she worked in include Fremont, Pender, West Point, Wahoo and Sidney.

Stenger said the acceptance of PAs has greatly increased with the overall understanding of the profession.

"People used to say, ‘What do you do, clean up after the doctor or what?' I would say there are very few people — in Nebraska at least — who have not had contact with a PA."

Harms also said the job market is somewhat tight. Available positions are learned about through "word-of-mouth" through clinical rotations, active PAs or classmates.

"A few of my classmates have positions by this time," Harms said, "several others have been actively interviewing and the rest are currently finishing résumés and working on applications."

Exstrom and Stenger said the concept of the PA program is to be in a general or family practice, but PAs are becoming much more specialized: orthopedics, vascular surgery, pediatrics, dermatology — just about every specialty. To keep up to date, every two years PAs must earn 100 CMAs and take a recertification exam every six years.

When asked what they like best about their job, the two PAs had similar answers.

"What I like," Exstrom said, "is the variety — everyone from babies to grandmas. It is something different, every time, every day."

"I like that too," Stenger said. "It's the constant learning process. You're always seeing something new, the constant changing process. You're learning something new every day. Nothing is stagnant."

Dr. Eugene Stead of the Duke University Medical Center is given credit for establishing the first Physician Assistant program in 1965.

Physicians and educators recognized there was a shortage and uneven distribution of primary care physicians and the PA was seen as a way to expand the delivery of quality medical care. Military men with considerable medical training during their service and in the Vietnam War made up the first class. Stead based the PA curriculum on the fast-track training of doctors done during World War II.

The definition of a PA by their own organization, the American Academy of Physician Assistants (AAPA), is that they are health care professionals licensed to practice medicine with physician supervision. PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery and in most states can write prescriptions.

The scope of a PA's practice corresponds to the supervising physician's practice. PAs are taught to know their limits and refer to physicians appropriately. The physician is ultimately responsible for coordinating and managing the care of patients, and with the appropriate input of the PA, ensure the quality of health care provided to patients.

Information from the 2002 AAPA Physician Assistant Census report, with almost 20,000 PAs responding showed:

*58 percent were female;
*41 was the median age;
They practiced in 61 specialty fields with family/general practice employing 32 percent.
The median income was $70,000.

In Nebraska there are two schools providing PA education. The UNMC PA Program was established in 1971 with the stated purpose to provide primary care providers for rural and underserved areas of Nebraska. Bachelor degrees were awarded to the first class in 1975, and in 1993 the program began awarding master's degrees. The program runs 28 months.

Since 1972 the UNMC Program has awarded bachelor's degrees to military personnel through the Interservice Physician Assistant Program.

The second program is at Union College in Lincoln. They award a baccalaureate degree, but are developing a master's program to begin with the 2004 class. Their program is in a 27-month curriculum.

PAs are educated in the medical model designed to complement physicians' training. One of the main differences between the PA education and physician education is not the core content of the curriculum, but the amount of time spent in formal education.

For more information, contact the individual schools or visit Web sites: http://www.aapa.org , http://www.unmc.edu/student/colleges/physasst.htm , paprog@ucollege.edu .
source:http://www.fremontneb.com/articles/2003/10/06/news/news7.txt

The new doctor is in
Able to do about 85% of the tasks doctors perform, physician assistants are helping fill a medical void

By ANGELA MULLINS
Times Herald

Times Herald photos by TONY PITTS

REVIEWING THE CASE: Physician assistants Amy Collins and Michelle Zimmer examine an X-ray before going into surgery at Port Huron Hospital. They were assisting Dr. Rajesh Makim with the surgery. Collins and Zimmer, who work with Orthopedic Associates, are two of about 20 physician assistants practicing in the Blue Water Area.

When Amy Collins graduated from college six years ago, she became a pioneer.

Newly trained in the relatively new field of physician assistants, Collins was immediately thrown into a world of challenges.

Local hospitals had no rules and procedures established for the job, and most doctors -- the professionals Collins' was expected to assist -- were in the dark about what she had to offer.

Today, there are about 46,000 physician assistants practicing in the United States, according to the American Association of Physician Assistants. In 1996, the first year of the group's survey, there were 26,600.

Michigan is the third-leading state with 1,928 physician assistants practicing as of January 2003.

CHECKING: Physician assistants Michelle Zimmer, left, and Amy Collins check on Wanda White of Port Huron after White's hip surgery.

Estimates put the number of physician assistants in the area at less than 20.

Monday was National Physician Assistant Day, a way to honor professionals and promote the field that has the right to do 85% of what doctors do, including administering patient care.

"Health care is changing, and physicians are realizing that," said Collins, who works for Port Huron's Orthopedic Associates and has privileges at Port Huron and Mercy hospitals.

A physician's assistant could well be the first person a patient sees before surgery and the first person a patient sees when they come out.

Certified to do 85% of the work medical doctors do, including writing prescriptions in Michigan and most other states, physician assistants often spend more time with patients than doctors.

The assistants -- who work with indirect supervision from doctors -- often are seen making hospital rounds when doctors are too busy, answering patient questions and taking a hands-on role in many surgeries.

The only true difference between a physician assistant and a doctor is the assistants can't open practices and must work under the direct or indirect supervision of a doctor.

Physician assistants -- most of whom have earned a master's degree before becoming certified -- receive much of the same medical school-type training as doctors and can specialize in any medical field from general medicine to pediatrics. The field is gaining popularity, local physician assistants said, because becoming fully licensed takes fewer years than becoming a full doctor, which requires a residency and a more time in medical school.

On average, the physician assistant curriculum takes about 26 months to complete.

Locally, starting salaries for assistants with no experience range from about $60,000 to $70,000 a year, Collins said.

Michelle Zimmer, a physician assistant who works with Collins, said the reason the profession is popular in Michigan is because five universities and colleges in the state offer physician assistant degrees.

Plus, she said, more doctors are educating themselves about the field, and the assistants are doing more community education work themselves.

"It used to be the average age was 43 to 45 and it was all men," said Zimmer, who has been in the field for about one year.

By having physician assistants on staff, officials at local hospitals and doctor's offices said they are able to see patients faster and more efficiently.

Since the assistants began working in Port Huron Hospital's emergency room in May 2002, Dr. Thabit Ba**ur, the hospital's director of emergency services, said his waiting room is rarely busy, if it's occupied at all.

Patients with less serious injuries or complaints often are evaluated by an assistant while doctors are dealing with more serious emergencies, Ba**ur said.

With the assistants evaluating the patient in advance and consulting with a physician sooner, Ba**ur said, any needed X-rays or diagnostic testing can be completed before a doctor sets foot near the patient's bed.

Often, the assistants can handle the patient without a doctor needing to give treatment, Ba**ur said.

"We've seen an overall steady improvement in patient satisfaction," said Ba**ur, who has two physician assistants in the emergency room from 10 a.m. to 2 a.m. daily.

In addition to seeing patients faster, physician assistants are trained to talk about patient concerns in lay terms.

Overall, offices where assistants are on staff said patients feel more comfortable asking question and get more comprehensive answers.

"People feel like we have the time and are there to talk," Collins said. "People often feel less intimidated by us."

source:http://www.thetimesherald.com/news/stories/20031007/localnews/405211.html

By Sgt. Matthew B. Roberson, Combined Joint Task Force - Horn of Africa Public Affairs

DJIBOUTI, Africa (NNS) -- Service members from Combined Joint Task Force - Horn of Africa (HOA) performed the first Medical Civil Action Program (MEDCAP) in Djibouti City Sept. 29, treating more than 550 patients over a two-day period.

This was the first time the 478th Civil Affairs Battalion (Special Operations) Army Reserve unit worked with the Navy's Expeditionary Medical Unit (EMU) to complete a humanitarian mission in the region.

"This was the first MEDCAP we've actually done in the city of Djibouti," said Army Capt. James McGinnis, physician assistant with the Miami based 478th CA Bn. "The closest one to this that we've done was in Balabala, but it's on the outskirts of Djibouti City. This was a more central location and allowed us to see more patients."

McGinnis said that this MEDCAP was unique compared to other MEDCAPS, because it took place over a two-day period and served as the first training exercise of this kind for personnel from the Navy's EMU, based out of Jacksonville, Fla.

"We've had a big shift in our medical assets with the addition of the Navy's first Expeditionary Medical Unit," said McGinnis. "It was a good way for the new personnel to get their feet wet and introduced into operations in the Horn-of-Africa region."

Since McGinnis is the only licensed medical officer with Civil Affairs, he relies on other assets from the camp to complete humanitarian missions.

"It's physically impossible for me to do a MEDCAP by myself," said McGinnis. "I can do the coordination and liason work, but I'm very limited on what I can do from a medical standpoint, so I rely very heavily on Marine Central Command (MARCENT) and HOA to supply us with additional manpower and assist with our medical needs."

Thirteen members of the Navy's EMU, including two naval doctors, six officers that served as nurses to diagnose illnesses, and five enlisted personnel, assisted in the mission.

"It was very challenging but extremely gratifying," said Navy Cmdr. Sharron Miller, EMU emergency room physician. "Because of the cultural differences, it was difficult to understand what the exact symptoms and complaints were. Many were chronic symptoms and were hard to treat, but with the immeasurable assistance of the interpreters, we were able to give them outstanding care."

"I did have the 'warm, fuzzy feeling' at the end of the day," said Navy Lt. j.g. Lesa Roth, EMU medical/surgical nurse. "The simplest little things that we as Americans take for granted were tremendously appreciated by the Djiboutians, even children's Flintstone's Vitamins. To see the children smile with gratitude was unforgettable for me."

During the exercise, Lt. Richard Schulz, EMU critical care nurse, said the naval team experienced a wide range of illnesses, including breast cancer in the final stages, liver and skin diseases, and ear infections.

Most of the ear infections and skin diseases the children suffered from were due to lack of food, malnutrition and poor living conditions, said Schulz. They were given basic medicines, like antibiotics, Tylenol and vitamins, they would otherwise never receive.

"These are a very poor people, and they are receiving medicine and care they would normally never get," said Djiboutian Capt. Moad Mohamed Seif, host nation doctor. "A lot of these people have already been checked out by doctors, but they can't afford the medicine that was prescribed to them. Since they have been getting free medication, they seem very open and friendly toward the American people."

"I think the majority of the people we saw were very happy with the services they received," said McGinnis. "We made contact with the doctor who runs this hospital several weeks prior and arranged to see 200 people per day."

Four hundred tickets were given to the main doctor, so they could be distributed out to the smaller clinics in the area.

"The smaller clinics know the patients in their community that need the most immediate care," said McGinnis. "By doing it this way, the people who needed the most care were able to receive it."

Many people showed up at the main gate of the hospital without tickets, and because of sheer numbers, they were unable to be seen. "What this tells us, is that we need to go back," said McGinnis.

The woman who runs the hospital has assisted the CA team on the past two Djibouti MEDCAPs they have conducted.

"This was a nice way for us to: A. Get into the city, and B. pay the lady who runs the hospital back for her hard work.

"We have other projects nominated for this area, so I think we'll end up back down here again," said McGinnis.

For more news from around the fleet, visit the Navy NewsStand at www.news.navy.mil.

MARINE CORPS AIR STATION IWAKUNI, Japan(Oct. 3, 2003) -- The American Red Cross was one of the first humanitarian organizations in the United States, established in Washington, D.C., on May 21, 1881.

Its foundation was based on the benevolence of the American people, donating their money, blood, support and time to those in need.

Through the American Red Cross, creditable work is available for volunteers willing to aid the Red Cross here, in order to support service members and their families, said Lynne S. Hammonds, American Red Cross Station manager.

The volunteers receive not only their choice of work, but also a variety of health and safety courses, which they can get certified for, said Hammonds.

Some of the classes include a babysitting course that gives babysitters knowledge in leadership, basic care, first-aid and professionalism, a cardiopulmonary resuscitation course, and an HIV/AIDS education course. The American Red Cross also offers a basic lifeguard course, said Hammonds.

There are also volunteer jobs available at Marine Corps Air Station Iwakuni clinics through the Red Cross as a pharmacist, physician assistant, receptionist, records clerk and screening room assistant.

"Volunteering is something someone does for themselves. You won't feel like an extension of your husband or the Marine Corps. This is something you can do for yourself," said Hammond.

All are welcome to volunteer. Service members that volunteer for 300 hours receive the volunteer ribbon. Spouses that volunteer will be provided with eight hours a week of day care for their children.
"The reward for volunteering is a reward in itself," said Cpl. Damerice J. Pierre, a Red Cross volunteer.
"The feeling that you get when you look into the eyes of someone you helped is unexplainable," said Pierre.
He also feels that the experience of volunteering has helped him to grow as a person. It has taught him respect and to be more tactful, said Pierre.
"Volunteers are the backbone of the Red Cross. Volunteers run the American Red Cross. They make up for 90 percent of the organization. We need volunteers. Without them there is no Red Cross," said Hammond.

source:http://www.usmc.mil/marinelink/mcn2000.nsf/main5/455FD468E9C84B1685256DB30082842E?opendocument

Narberth - In 1995, Jim Gallagher was a New York-based consultant who helped businesses meet their computer needs. These days, the 38-year-old Narberth resident is still helping others, but for a different reason.

It's hard to imagine anything much worse than a doctor telling you that you have a brain tumor. But for Gallagher, learning of his diagnosis several years ago gave him a new outlook on life. And a new mission.

In the mid-1990s, Gallagher began having constant minor seizures. Early on, the seizures weren't severe, so Gallagher ignored them thinking it probably wasn't anything too serious. As time passed, the attacks began getting worse until one day he passed out while jogging. A passer-by called for an ambulance, and Gallagher was rushed to the hospital.

Days later, his doctor told him the news: He had a tumor on the right side of his brain.
Quickly the questions came to mind. His first question was obvious: Is this life threatening? But soon other questions followed. Just what is a brain tumor, how do they work?

Soon he began learning as much as he could about tumors and what having one means.

"This doesn't have to be a death sentence," Gallagher said. Over time he began meeting with other patients who had also been diagnosed with brain tumors.
While at New York University Hospital, he helped form a support group for others.

"Often people are looking for emotional support," Gallagher said. So he tells them what he has learned and, perhaps more important, he listens to what they have to say.

Now, whenever he has the opportunity, he talks with others who have been diagnosed with a brain tumor.

In Gallagher's case he was lucky. The tumor was in an area of the brain that it could be removed successfully with only minimal damage and a scar that runs along the right side of his head.

He discovered that the tumor had likely been with him for nearly 15 years but it was growing at a very slow rate.

After this ordeal Gallagher, at the age of 35, decided to leave business world behind and follow a new calling: medicine. In 2001 he began studying to be a physician's assistant at Drexel University.

Gallagher said mostly he is looking forward to the one-on-one communication he plans on developing with his patients. This will give him the opportunity to talk with and perhaps help other patients with the fears of being diagnosed with a disease they may not understand.

He doesn't graduate from the program until next summer, but he is already thinking about where to go next.

Ideally he would like to work with a neurosurgeon specializing in brain tumors. But this is a small field, so he says he is also considering working in the fast paced environment of an emergency department or cardiac-care center.

source:http://www.zwire.com/site/news.cfm?BRD=1676&dept_id=43786&newsid=9971998&PAG=461&rfi=9

Accustomed to treating patients in the modern confines of a modern city, a WNY Branch Medical Clinic (BMC) physicians assistant recently took care of the sick and injured in a much different environment.

Physician Assistant Lt. Lorenzo Tarpley, Jr., M.S.C., returned to Washington last month after a five month stay in Iraq in support of Operation Iraqi Freedom.

Tarpley, a Dallas native, was chosen to provide medical support for the members of the Office of Reconstruction and Humanitarian Assistance (ORHA), now referred to as the Coalition Provisional Authority (CPA).

Physician Assistant Lt. Lorenzo Tarpley Jr., M.S.C., performs an eye examination at the Washington Navy Yard's Branch Medical Clinic. Tarpley recently returned from a five-month deployment to Iraq.

Tarpley, married and a father of four, began his naval career 23 years ago as a hospital corpsman at age 21. After he made chief, Tarpley was selected for physician assistant school.

Tarpley, commissioned in 1998, has been seeing patients at WNY BMC for two years.

His last duty station was USS Tranquility, Recruit Training Command (RTC) Great Lakes, Illinois.

With a specialty in family practice and dermatology, Tarpley was going about his normal daily routine when he received the call that he would be leaving for Iraq.

Tarpley and his co-workers spent the next two weeks getting ORHA's 200 personnel ready to be deployed.

"Initially, we worked to help the Iraqi's form a government and reconstruct their country and provide humanitarian assistance," stated Tarpley. "My part along with the other medical staff was providing medical support to ORHA.

"We saw a wide variety of things there from lacerations to upper respiratory infections to traveler's diarrhea. We did have some emergencies pop up, but our team handled it pretty well."

Tarpley said most of the problems they encountered stemmed from dehydration. "We had to emphasize fluids."

Tarpley and shipmates worked seven days a week, 18 hours a day through the heat, dust storms and one brief rain shower that, according to Tarpley, seemed to rain more mud than anything else.

Tarpley, who served in Iraq from February to July, also treated some Iraqi nationals, most of who worked in the area to which ORHA was assigned.

"Every now and then we would get some civilian Iraqi nationals who needed medical attention and we would triage them and get them on their way.

"It was seldom that that happened, but if it did, we would take care of them," he stated.

Upon their arrival in Iraq, conditions were less than favorable for the medical team.

"Initially we were roughing it a bit," Tarpley remembered. "But once the civilian contractors got in, things improved. We had three hot meals a day and we had showers that were set up in a trailer type of thing."

According to Tarpley, the weather in Baghdad was hot, even for someone accustomed to the Texas heat.

"Some days before 8 a.m. it would be over 100 degrees. I've never experienced that type of heat before," Tarpley stated.

Even in the middle of some precarious situations, Tarpley wasn't worried about his safety.

"We were well trained and we had significant support available to keep us safe where we were," he stated.

"Every now and then I had to go out in town, into Baghdad, to take care of situations or transport a patient or pick up supplies.

"When you're riding around the streets of Baghdad, you have more sense of awareness of what is going on around you. During that time frame, we had a heightened sense of security," Tarpley added.

The former enlisted Sailor said, for the most part, the people of Iraq were very welcoming. "Overall, the people were really friendly, they appreciated us being there," he said.

Tarpley, who would like to re-visit Iraq in about 10 years to see first-hand how the country has grown, came home with positive memories and a renewed sense of gratitude for his homeland.

"It was a good experience to see the people being so joyful and good to see them (the Iraqi's) take initiative.

"It (being in Iraq) also makes you appreciate what we have in the U.S. compared to other countries."

Days later, his doctor told him the news: He had a tumor on the right side of his brain.

Quickly the questions came to mind. His first question was obvious: Is this life threatening? But soon other questions followed. Just what is a brain tumor, how do they work?

Soon he began learning as much as he could about tumors and what having one means.

"Often people are looking for emotional support," Gallagher said. So he tells them what he has learned and, perhaps more important, he listens to what they have to say.

Now, whenever he has the opportunity, he talks with others who have been diagnosed with a brain tumor.

In Gallagher's case he was lucky. The tumor was in an area of the brain that it could be removed successfully with only minimal damage and a scar that runs along the right side of his head.

He discovered that the tumor had likely been with him for nearly 15 years but it was growing at a very slow rate.

After this ordeal Gallagher, at the age of 35, decided to leave business world behind and follow a new calling: medicine. In 2001 he began studying to be a physician's assistant at Drexel University.

He doesn't graduate from the program until next summer, but he is already thinking about where to go next.

Shane Pierce
A physician’s assistant at McCook Clinic for the past four years, Shane Pierce, is leaving Aug. 22 to join the U.S. State Department as a foreign service medical officer.

Pierce, 31, will be assigned to Guinea in West Africa. After receiving orientation in Washington, Pierce and his family will move to Guinea in mid-October. Guinea is north of Liberia, the African nation now in conflict.

Pierce will work out of Conakry, a city of more than 1.5 million residents. As the foreign service medical officer, he will be caring for U.S. Aid personnel, Peace Corps volunteers and U.S. State Department employees in Guinea.

Pierce will be accompanied to Guinea by his wife, Diane, and their two children: Chloe, 8, and Tristan, 4. While in McCook, Diane served as an EMT and firefighter. She speaks French, which is the language of Guinea. Shane studied French in school, and will take brush-up classes before beginning his assignment.

As a state department employee, Pierce will be on rotating assignments. After two years in Guinea, he will move to another U.S. State Department location.

Shane is a native of Oregon and his wife is from Hastings. “It’s a career opportunity,” Pierce said of the position with the state department. “Openings are rare, but I applied at an opportune time as several long-time employees were retiring. It worked out well, because I’m joining the department at a time when Colin Powell (the Secretary of State) is putting renewed emphasis on foreign service.”

Hamilton Boone, P.A.-C. has been elected to the Board of Directors for the Brevard Heart Foundation. The Brevard Heart Foundation is a not for profit corporation established in 1958 to provide financial support where appropriate in the form of loans and direct aid to persons suffering from circulatory diseases. The Foundation also awards several scholarships to medical students and nurses on an annual basis, is active in disseminating information to the public regarding the heart and circulation, provides educational support to hospitals within the county in specialized training of nurses and technicians in the fields related to the heart and circulation, and acquires and places within the hospitals the equipment necessary to develop outstanding cardiac care centers.

Mr. Boone, a physician assistant for over 23 years, is the owner and founder of Physician Assistant Services in Melbourne, Florida. His company provides NCCPA certified surgical Physician Assistants to surgeons on a 24 hour, 7 day a week, on-call basis. Mr. Boone is excited about his new position and says, "With a history of heart disease in my family, I saw a chance to be a part of a wonderful organization. I look forward to being a positive asset to the Brevard Heart Foundation in any way I can and to helping move the Foundation's philanthropic vision forward."

For more information call (321)409-8941 or the Brevard Heart Foundation at (321)725-2292.

Governor Gray Davis today announced the appointments of Dr. Mary Molina Bernadett, Dr. Michael V. Drake, Dr. Jimmy Hara, Dr. David Hayes-Bautista, Dr. Craig Lenz, Dr. Dennis Mull, and Conrad Rios as members of the Health Manpower Policy Commission.

Dr. Bernadett, 39, of Long Beach, has been the Executive Vice President of Molina Healthcare, Inc. and board member of Molina Healthcare of California and Molina Medical Centers (a Medicaid H.M.O) for more than 10 years. She also serves as a Family Physician for Molina Medical Centers. Dr. Bernadett serves as consultant of 21 Medi-Cal H.M.O primary care offices around California. She is a Trustee of St. Mary Medical Center and a board member of the Healthy Kids Coalition. Dr. Bernadett also has been District President of the L.A. County Medical Association since 2001 and a member of the California Academy of Family Physicians' Legislative Affairs Committee since 1997. She earned a bachelor of arts degree from California State University, Long Beach, a doctor of medicine from the University of California, Irvine, and a masters in business administration from Pepperdine University.

Dr. Drake, 52, of San Francisco, has been the Vice President of Health Affairs, Office of the President since 2000 and a University Professor since 1976. Prior to becoming Vice President of Health Affairs, Dr. Drake was the Senior Associate Dean for Admissions and Extramural Academic Programs at the University of California, San Francisco School of Medicine. He serves as co-chair for the University of California's California-Mexico Health Initiative. Dr. Drake is President of Alpha Omega Alpha Honor Medical Society, and serves on the Board of Trustees of the Association of Academic Health Centers. He has been the recipient of several awards for public service, mentoring and research. Dr. Drake earned a bachelor of arts degree from Stanford University, and a doctor of medicine from the University of California, San Francisco.

Dr. Hara, 57, of Woodland Hills, has been the Family Practice Residency Director at Kaiser Permanente Los Angeles since 1984, the Regional Director of Graduate Medical Education for Southern California Kaiser since 1992, and the Associate Clinical Professor at the University of California, Los Angeles since 1976. He is a member of the American Academy of Family Physicians and the President of the Los Angeles chapter of California Academy of Family Physicians. Dr. Hara is a board member and volunteer physician for the Venice Family Clinic and a current national board member of the Physicians for Social Responsibility. He earned a bachelor of arts degree from UCLA and a doctor of medicine degree from the University of California, San Francisco.

Dr. Hayes-Bautista, 57, of Los Angeles, has spent nearly 15 years as a Professor of Medicine at the University of California, Los Angeles School of Medicine. He is the founder and Director of the Center for the Study of Latino Health and Culture at the University of California, Los Angeles Department of Medicine since 1992. Dr. Hayes-Bautista has conducted extensive research and published materials and books on public health issues for the Latino population. He is a member of the American Association of Medical Colleges and the California Latino Medical Association. Dr. Hayes-Bautista earned a bachelor of arts degree from the University of California, Berkeley, master of arts and doctor of philosophy degrees from the University of California, San Francisco.

Dr. Lenz, 54, of Upland, has been the Dean of the College of Osteopathic Medicine of the Pacific (COMP) at Western University of Health Sciences since 2000. Previously, he was the Assistant Dean of Clinical Affairs at COMP. Dr. Lenz is a member of the American Osteopathic Association, Los Angeles County Medical Association and National Youth Leadership Forum. He is also a board member of the National Board of Osteopathic Medical Examiners and Faculty Advisor to the Emergency Medicine Club at Western University. Dr. Lenz earned a bachelor of science degree from Princeton University, and a doctor of osteopath degree from Philadelphia College of Osteopathic Medicine.

Dr. Mull, 65, of Irvine, is a Professor for the Department of Family Medicine at University of Southern California, a Professor Emeritus of Family Medicine at the University of California, Irvine and a Physician for the South Central Family Health Center. He is a Vietnam Veteran who received the Bronze Star and the Vietnamese Service Award. Dr. Mull also received the Humanism in Medicine Award from the Health Care Foundation of New Jersey in 1999. He has been a member of the American Academy of Family Physicians and the Society of Teachers of Family Medicine since 1976. Dr. Mull is the founder and board member of the International Health Medical Education Consortium and founder of the University of Southern California Summer Medical Spanish Program in Mexico. He earned a bachelor of arts degree from Harvard College, a doctor of medicine from the Medical College of Virginia, and a masters of public health from Harvard School of Public Health.

Mr. Rios, 47, of Fresno, has been a Lecturer for the University of California, Davis at the Teaching Center in Fresno, a Family Nurse Practitioner for the Fresno Community Emergency Medical Group and Long Term Medical Group Inc., and a physician assistant for Central California Faculty Medical Group since 1997. He is a member of the University of California, Davis Family Nurse Practitioner/Physician Assistant Program's Academic Committee and Admissions Committee. Mr. Rios earned a bachelor of arts degree from California State University, Fresno, and a masters of science degree from the University of California, San Francisco.

The Commission has responsibility for adopting standards to determine funding eligibility under the Song-Brown Act and establishing criteria to be used by the Office of Statewide Health Planning and Development (OSHPD) for executing contracts with training institutions. Members do not receive a salary. These positions do not require Senate confirmation.
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