John W. Kirklin, M.D. Award for Professional Excellence

The John W. Kirklin, M.D. Award for Professional Excellence was established in 1985 by the American Association of Surgeon’s Assistants, now the American Association of Surgical Physician Assistants. The award was established to honor John W. Kirklin, M.D. for his pioneering work in establishing the surgical physician profession. Dr. Kirklin is considered the founding father of the surgical physician assistant. He started the first surgical assistant program in 1967 at the University of Alabama with his wife Margaret Kirklin, M.D. two years after Eugene Stead founded the first physician associate program at Duke University. Dr. Kirklin was a world famous cardiovascular and thoracic surgeon recognized by over a dozen honorary memberships within prestigious national and international surgical associations, past president of the American Association for Thoracic Surgery and past editor of the Journal of Thoracic and Cardiovascular Surgery. As the chair of the Department of cardiovascular and thoracic surgery at UAB at the time when referring physicians were expected to first assist the surgeon. He recognized and envisioned an assistant to the surgeon not just in surgery, but also in all areas of clinical care of the surgical patient. Dr. Kirklin convinced not only UAB but also his surgical colleagues of the need for a highly specialized surgical assistant convincing the American College of Surgeons of the value and gaining their support.

The essentials for accreditation of surgeon’s assistants programs (similar to the primary care PA program essentials) were adopted by the ACS in 1973 and by the AMA in 1974. He had the foresight to have the UAB SA program involved with the AMA’s Committee on Allied Health Education and Accreditation (CAHEA) that is now the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). Dr. Kirklin was also a strong advocate for the NCCPA to include the graduates of what would become four SA programs to be included in the NCCPA examination process. If it had not been for his foresight, we very well may have followed the same path of the orthopedic physician assistants (OPAs).

John W. Kirklin, M.D. received an award of professional excellence in 1985 from the American Association of Surgeon’s Assistants recognizing him as the founding father of surgical physician assistants.  With his permission, his name has been added to the award.

This prestigious award has been reserved for those members of the surgical physician assistant profession or someone who has made a significant contribution to the surgical physician assistant profession. It has been awarded twelve times in the past nineteen years. The award is reserved only for those who have proven their devotion to the surgical physician assistant profession by service and sacrifice having contributed to promoting the profession over an extended period of time.

Nominees do not need to be members of the American Association of Surgical Physician Assistants or the Association of Physician Assistants in Cardiovascular surgery. However, candidates must be nominated by fellows of these organizations. To be considered as a nominee, one must be of irreproachable character, known to exhibit the highest standards of excellence in their professional life, and noted for contributions to the PA profession. Nomination is a significant honor from one’s peers.

Past Recipients of the John W. Kirklin, M.D. Award for Professional Excellence:
1986 Charles W. Watkins, PA-C
1987 Jacqueline B. Hall, PA-C
1988 Dana R. Gray, PA-C
1989 John F. Byrnes, PA-C
1990 Douglas D. Condit, PA-C
1991 David J. Bissonette, PA-C
1992 Joseph H. Cooper, PA-C
1993______________
1994______________
1995______________
1996______________
1997______________
1998 Gerald T. Simons, PA-C
1999 John Y. Lee, PA-C
2000 Clara E. Vanderbelt, PA-C
2001 Catherine I. Dunning, PA-C
2002 Susan E. Lusty
2003______________
2004______________
2005 Robert M. Blumm, MA, PA-C

Bob Blumm received this award at the AASPA Conference in San Francisco on Oct 15, 2005

US-style physician assistants (PA) are being championed as the latest solution to the medical and nursing manpower crisis. 

The Department of Health (DoH) is on the point of publishing a curriculum and competency framework with a view to producing a new breed of home-grown health care professional, based on the PA model. 

Doctors may have reservations about the role, but the DoH believes that a cohort of American PAs who have been working in the UK for two years have shown they can make a valuable contribution. 

PAs in the US undertake two years of training which focuses on general and acute first-contact medicine. Recruits are required to have either previous clinical experience or a first degree in life sciences. They work under medical supervision, performing duties similar to a UK junior doctor, operating at a level somewhere between an SHO and a registrar. 

There are currently more than 50,000 PAs practising throughout the US and they also work in Canada, India and in some parts of Europe. 

The 30-strong UK cohort, based in primary and secondary care in the West Midlands, has recently been evaluated by the University of Birmingham's Health Services Management Centre (HSMC) for the DoH. 

The HSMC report, published in May, says that PAs employed in A&E departments at Sandwell Hospital and City Hospital, Birmingham, were positively received, particularly by medical staff. 

Doctors commented on how hard they worked. One consultant said: 'I find them as a group very amenable, very flexible, very approachable. You know they are humble, considering they are very experienced,' he says. There has also been positive feedback from patients. 

Some problems 

The report did, however, highlight some problems. In one A&E department providing medical supervision proved difficult because of a shortage of senior medical staff. And because the American PAs are not regulated in the UK, they were unable to prescribe or order radiological investigations which also proved a drawback. 

On the whole, there were few problems and HSMC found no evidence that the introduction of the PAs resulted in any redefinition of professional boundaries or re-profiling of work between professions. 

The Royal College of Physicians of London (RCP) is very enthusiastic about the development of the new practitioners, who they believe have great potential to relieve doctors' relentlessly rising workload. 

The college has been working in partnership with the DoH and other stakeholders to develop the competencies and core curriculum framework for the new role. The first training course could be up and running as early as September 2006. 

The training will be rigorous, involving 3,150 hours of study, of which 1,600 hours will be clinical learning. Students will be taught to perform diagnostic and therapeutic procedures, prescribe medication, request and interpret diagnostic studies and undertake patient education, counselling and health promotion. 

Dr Mary Armitage, clinical vice-president of the RCP, foresees that the assistants could be usefully employed in A&E departments, medical admissions units or on general medical wards. 

One reason the college became involved in the project was because of concerns about the plethora of unregulated health care support workers. These roles have evolved across the country with no common standards or training. 

In addition, the terminology describing these posts has become confusing. What, asks Dr Armitage, is the difference between health care practitioners, medical assistants, physician assistants, doctors' assistants, medical support workers, medical technicians and emergency or surgical care practitioners? 

The college hopes the new framework will standardise the role, thereby reducing any confusion for patients and any risk of patient safety. 

'I am very excited about this project,' says Dr Armitage. 'The college is very pleased to be taking part in this work because it feels it is very important. 

'Many employers in the UK have been trying to recruit American physician assistants and their numbers are increasing all the time because people are desperate to fill jobs. There is a lot of published literature showing that both patients and doctors welcome these practitioners in the States.' 

Lynn Tyrer, one of the West Midlands PAs, who has been involved in drawing up the new curriculum framework, believes potential employers will be supportive once they see how rigorous the training is. 

Slow process 

But getting the message out there could be a slow process, she warns. 'It is still a new profession and people are not familiar with it,' she says. 'We need to develop trust and understanding in the role and it has to be underpinned by good training.' 

Neil Erickson, chairman of the newly formed UK Association of Physician Assistants, says PAs provide a good quality service at an affordable price. 'This is where we really fit the bill very well. You can develop a team approach based on that and, because our education is primarily broad and general in nature, then we can just about fit any position that is needed.' 

Meanwhile, the name of the new UK-trained professional is proving to be a bone of contention. For the time being, the new role has been given the rather unwieldy working title of medical care practitioner (MCP), because 'physician assistant' is considered to be too American. 

But others say that the term 'assistant' is acceptable and that 'medical care practitioner' will give the impression the role equates with that of a doctor. At the moment, there is no obvious name that meets everybody's approval. 

Regulation is another issue. The problem is the PA profession's 'dependent practitioner' status does not fit well with UK professional culture. In the UK, professional status is partly determined by autonomy and the ability to practise independently. Talks are currently ongoing between PAs, the DoH and regulatory bodies to resolve this. 

The BMA has recognised the importance of a health care professional working at an intermediate level of care. Its seniors committee is currently considering a discussion paper which poses a number of queries, such as how the supervisory role is to be managed. It also asks how the role will affect the training and work of SHOs and whether professionals trapped in a house officer-style role could become dissatisfied. 

Mr Simon Eccles, immediate-past chairman of the BMA's Junior Doctors Committee, is enthusiastic about PAs. He believes they will be invaluable in helping to provide 24-hour cover and continuity of care when, in five to ten years' time, medical care may be provided in fewer larger centres and there may not be juniors in every hospital. 

Cautionary note 

He says they will also play an invaluable role in helping to reduce the non-essential workload of juniors. 

However, he sounds a note of caution: 'Some people think that physician assistants will be a cheaper alternative to doctors. This is short-sighted because studies show that they are more expensive per patient treated than junior doctors.' 

He says he is also concerned that the role should not confuse patients and that it should not be considered as a dumbed-down doctor's position. 

That said, he does think the new health care professional has a future in this country. 'The physician assistant is a very respected role and I think we have got a lot to learn about using people other than doctors in health care roles,' he says. 

CASE STUDY 

Kirsten Gipson, a physician assistant with 14 years' experience in America, came to the UK in June last year to work in the Accident and Emergency Department at Birmingham's City Hospital. 

'I am working virtually as a doctor and my experience is probably equivalent to that of a registrar. I see anything and everything that comes through the door, so I can work in resuscitation or see children, psychiatric illness or obstetric and gynaecology patients and so on. The only thing I am not allowed to do is major surgery on my own. 

'My supervising consultant is comfortable with my skills, so I don't need that much direct supervision. 

'I have had a very good reception here and have been accepted by my medical colleagues. I have a big name tag with my title on and patients often ask me what my role is. I always make it very clear that I am not a physician and they are happy to accept that. Even in America, where our profession is more established, you still run in to patients who have never heard of us. 

'All the doctors I work with here accept my role. There have been only a couple of receiving medical or surgical officers who have asked me whether the doctor has seen the patient. 

'Hospital medicine is certainly a very good niche for physician assistants. While the junior doctors are rotating through the department every six months, we are able to provide continuity of care. 

'We also help to teach the SHOs. I teach them things like suturing or pelvic examinations. They might have only done one and are a bit unsure of their skills. Because we are not part of the medical hierarchy they feel more able to ask us the questions they might have otherwise been afraid to ask. 

'The trust has benefited financially because, by employing us, it has been able to save money on hiring locums. But I am not cheap to employ - I earn just a little bit more than an SHO.' 

source: http://www.hospital-doctor.net/hd_news/hd_news_article.asp?ID=16311&Section=Feature
 
 

By Alison Dayani, Health Correspondent, Evening Mail
 

AMERICAN medics have been drafted in to help health bosses cope with a drastic shortage of doctors in Birmingham. 

The 12 physician assistants are working at GP surgeries in some of the most deprived areas of the city, from Aston to Handsworth. 

They are carrying out almost the same duties as a normal doctor - examining patients, diagnosing and treating illnesses and interpreting test results - despite less training. 

The Heart of Birmingham Teaching Primary Care Trust has resorted to the foreign physician assistants in an effort to meet patient demands. 

Jane Millard, the trust's head of teaching, said: "This area has historically had to deal with a shortage in the supply of doctors. 

"With many existing GPs approaching retirement age, we have to think of new ways of treating patients. The introduction of physician assistants, or PAs, is one of the ways."

Each of the PAs has studied at university, followed by two years of medical training, and years of experience in America. 

They have spent the summer in training practices before being placed in surgeries across the city, including one based at Birmingham Prison in Winson Green, under the watchful eye of a senior GP. 

The move comes after other Physician Assistants were sent from America to Sandwell last year. 

New recruit, Noel Genova, has worked as a PA for 25 years and is now attached to the Rotton Park Medical Centre, in Edgbaston. 

"Moving to Birmingham has been a really positive experience," said Mrs Genova. "My new colleagues at the practice and the patients have all been extremely supportive and welcoming. 

"I am confident that patients will see that the level of care they receive will not be diminished and should even be enhanced." 

The Evening Mail revealed earlier this year how the city faces a medical crisis with a quarter of Birmingham's 147 inner-city doctors retiring in the near future. 

Incentives to plug the growing shortage have included a £12,000 'golden hello' to new doctors and a £4.4 million Government grant to train an extra 400 GPs in the West Midlands. 

Birmingham University became the first in the country to train US-style Physician Assistants to remove pressures from GPs and cut waiting times last year. 

The medical school is producing medical experts capable of working, unsupervised, alongside family doctors through an intensive two-year course. 

The 24 graduates with a science or health background are due to qualify next year and will work in GP surgeries, A&E departments and out-of-hours GP and emergency care. 

Rachel Catanzaro, one of the first assistants to come to the Black Country last year, said: "We are not here to replace GPs but to complement them and help to reduce waiting times, by holding surgeries, diagnosing, treating or referring patients on. 

"We know our limits and discuss the more complex issues with the doctors but we have helped to free up GP time." 

source:  http://icbirmingham.icnetwork.co.uk/0100news/0100localnews/tm_objectid=16148722&method=full&siteid=50002-name_page.html

By Charlene M. Morris
Special to the Daily Times

GLASGOW — 
To the Daily Times:

Six years ago, my brilliant, talented and athletic 15-year-old niece killed herself. Suicide is what I have learned is the tidal wave that destroys much more than one life. My sister and her family have changed; there are bad days and those that are not as terrible. She can now laugh as we recall Tori’s antics and her daughter’s incredible sense of humor. Our own county has recently experienced this sadness; the victim was a young man.

Over 500 Kentuckians have died of suicide—more than from homicide (murder) and AIDs combined! It is the second leading cause of death for teens and young adults in our state. Nearly half of gay and lesbian youth have considered killing themselves, due to harassment in theirs schools and community. Death from suicide involves firearms over 70 percent of the time although alcohol and drug abuse are often involved. Prescription medications can be misused as well as the well-known street drugs. Although a scary discussion, talking about suicide does not make someone attempt it. Suicide occurs in all areas of society—young, old, wealthy and poor and all religions. 

The basics are these: 

• If someone you know has talked of suicide, take it seriously! Call 1-800-273-TALK
• Advise the person to seek medical help and go with them. 
• Call the police or Emergency Medical Services if danger to them or you is about to happen. These trained professionals can help.
• Remember: it is not a dishonor to be depressed or suicidal! Killing yourself is a permanent solution to a temporary problem!
• If someone you know has committed suicide, please see a counselor. Support groups can be helpful. Realize it will get better. 
• If you know a suicide victim’s family and friends, please do not desert them! Call, write, visit and do not be afraid to mention their loved one’s name. It is always on their lips, their minds and their hearts!

Kentucky will soon have an opportunity to show support for suicide awareness and prevention. Governor Fletcher recently conducted a press conference concerning the tragic problem of suicide deaths in Kentucky. He announced the existing awareness media campaign by Kentucky Suicide Prevention Group and asked that Kentucky media play the new 30-second public service announcements that was shown at the press conference. 

Governor Fletcher also announced the signing of a proclamation declaring Sept. 4-10 as Suicide Prevention Week in Kentucky in conjunction with National Suicide Prevention Week and the Suicide Prevention: “It’s Everybody’s Business” Conference to take place in Louisville at the Galt House, Sept. 5 - 6 with a two-day Grief Conference to follow. 

For more information or updates, go to this web address: http://mhmr.ky.gov/ mhsas/suicidepreventiongroup.asp or contact Jason Padgett at jason.padgett@ ky.gov. or call 502-564-4456.

Suicide is everyone’s business! Please become aware, if not involved.

Charlene M. Morris, MPAS, PA-C
Family Medicine Physician Assistant
source http://www.glasgowdailytimes.com/

Lieutenant Randy Scott, a Physician Assistant here at the Naval Branch Health Clinic at Corry Station, returned in June from a recovery mission to the Central Highlands of Vietnam. He was among five teams of personnel selected with specialized skills that were searching for Americans missing from war.

Scott was the medical officer on one the five Joint POW/MIA Accounting Command (JPAC) teams that returned in June after recovering remains believed to be U.S. service members and helping to identify six future excavation sites.

The Navy physician's assistant, raised in a rural farming community in North Carolina, volunteered for the mission because he felt strongly about it. "As long as there are service members (that remain) missing in Vietnam, we should continue to search in order to bring them home to their families," he said.

The JPAC teams scoured four provinces within the Central Highlands - from the jungles to the remote mountainous regions where "likely none of the locals had ever been." It was the area during war time that had been known as the demilitarized zone or 'DMZ.'

The recovery teams go to sites previously identified by investigational teams as having a high likelihood of American service member remains present. Sites are selected on "real-time" Search and Rescue log entries, witness accounts from either U.S. forces in the area at the time of the crash or locals through subsequent interviews, Scott said.

After surveying the area with metal detectors and combing through vegetation, materials found would be delivered to an Air Force Life Support Equipment expert who would "try to determine if the equipment correlated with the reported incident, and if any of the material supported the possibility of American remains being present," he continued.

"From a medical perspective, my role was to provide medical advice and care to the team, which fortunately mostly consisted of monitoring individuals for heat injuries, encouraging hydration and taking care of the occasional bump, bruise or case of diarrhea.

"Most of my time was spent digging into the sides of the mountains with a small hand tool, searching the areas in which metallic objects were detected," the physician assistant said.

The search areas were in the mountains and often required helicopter transport to a prepared landing zone which would be placed as close to the site as possible. More often than not, "we were required to hike our gear up the mountain or mountains to get to our site.

"We logged a lot of hours trekking up and down the mountains with 40-to-60 pounds of gear on our backs in 100-plus degree heat," Scott said. "When packs got heavy and the terrain got tough, I would simply remind myself that the members that we were searching for fought a war in (similar) conditions and for a much longer time than we were in country. That split-second reminder had a way of putting things into perspective and making it much easier to press on," he said.

"This was one of the most rewarding experiences of my 25-plus years of service. Just to know that our country, deep in the throws of a war at this time, is still making a tremendous effort to bring our fallen heroes home makes me proud.

"When I think of how our Vietnam veterans were often overlooked, mistreated and sometimes forgotten, I get a sick feeling in the pit of my stomach. I am saddened and humbled by the sacrifices that they made for our great nation, but am extremely proud to have been able to contribute in a small way toward bringing them home to rest. But the job still isn't done. Teams are in country right now, pressing on with these searches. To honor these heroes and bring closure to their families, I hope the search continues until they are home."

Scott was the second staff member from the Naval Hospital Pensacola command to go on an MIA mission within the last year. Capt. Tom Kersch, head of the family practice department, took an excursion into Cambodia in the summer of 2004 and returned with remains. JPAC has not confirmed any identities from either of these two missions.

The Fairmont, NC, native - a statewide vice president of the Future Farmers of America while attending Fairmont High school -- got his first taste of medicine from the town's now-retired veterinarian, Dr. Milton Jordan. In his 25 years in the Navy, he spent 12 as a preventive medicine technician.

The Pensacola clinic's Officer in Charge, Cmdr. Holly Bennett, said that when Scott returned in late June that the look on his face told it all ..."showing so much satisfaction" for the job accomplished.

Prior to reporting to the Corry Station clinic 23 months ago, Scott was with the Marine's Chemical Biological Incident Response Force at Indian Head, Md., and was intimately involved with the response teams to the anthrax scares that rocked senate offices in Washington, DC.

"He was the first Navy lieutenant I'd ever seen - in over 17 years of service - to be awarded a Meritorious Service Medal (for duty at Indian Head) from the Marine Corps," said Bennett.

"His love, and devotion, is for the Marines," said Bennett, "and he even speaks their language."

source:http://www.gulf1.com/medicine/navy/0822a.htm

By Ian Thompson

TRAVIS AFB - Her success in teaching members of the Iraq Army how to provide better care to wounded soldiers has earned Capt. Beverly West the Bronze Star.

The David Grant Medical Center physician assistant's received the award Tuesday from 60th Medical Group commander Col. Byron Hepburn for meritorious service during her tour in Iraq, which ended June 4.

West, a member of the 60th Medical Operations Squadron, went to Iraq early this year to serve with the Army Reserve's New England-based 98th Division.

The 98th Division was the first training division sent overseas to form 39 advisory support teams to mentor, coach and advise units of the new Iraqi Army and make it more self-sufficient.

West served as a senior medical adviser for Iraqi medical staff and worked with them on how to handle mass casualties, medical evacuations and medical practices such as sick call, according to a Travis Air Force Base news item. 
 

"When I first got there, it took them 45 minutes to medically evacuate a patient," West said in the news item. "We finally got it down to 15 minutes. I helped them with everything it takes to run a clinic."

West also helped the Iraqis treat soldiers wounded while fighting insurgents and those who were killed in action from around northern Iraq.

The base West was stationed at was divided into two halves, one part for Americans and one part for Iraqi soldiers. West lived and worked on the Iraqi side as their only medical provider.

West worked in two clinics, the news item said, one for the 2,000 Americans stationed there and one for the 14,000 Iraqis.

"They were my co-workers," West said of the Iraqis she worked with. "We had a great working relationship, which helped us excel in everything we did. They didn't need me to teach them medicine. They needed me to teach them other stuff like medical evacuations."

West is at least the third David Grant member to earn a Bronze Star for service in Iraq.

source: dailyrepublic.net

Recruitment has started on the first UK course to train medical care practitioners to manage some of the caseload of GPs, thus improving patient access to treatment. 

The Postgraduate Diploma in Medical Care Practice, the first of its kind to be offered by a British university, is to be run by the University of Hertfordshire in collaboration with East and North Hertfordshire NHS Trust. It has been designed to fit the curriculum framework developed under the leadership of the Royal College of Physicians and the Royal College of General Practitioners as part of the NHS national workforce modernisation programme. 

Modelled on the US Physician Assistant (PA) programme, which, over the last 40 years, has demonstrated the value of having practitioners who undertake a close support role in the delivery of medical care, the Hertfordshire course will provide opportunities for life science graduates to develop a rewarding career within the NHS. 

The aim of the course, which will begin in September and run for two years, is to train life science graduates as Medical Care Practitioners (MCP) so that they develop the attitudes, skills and knowledge base to enable them to deliver care and treatment within the general medical and/or general practice team under defined lines of supervision. 

Dr Barry Hunt, Associate Dean of the University’s Faculty of Health & Human Sciences, commented: “A Medical Care Practitioner is not a doctor, but a new healthcare professional working to the medical model. This role will bring a new team of people into the NHS and take the pressure off GPs, thus improving patient access to treatment.” 

An MCP will be trained to take a patient’s history, undertake a physical examination and having identified a diagnosis, develop a comprehensive patient management plan. They will also be able to perform many diagnostic and therapeutic procedures, prescribe medications, request and interpret diagnostic studies and undertake patient education, counselling and health promotion. All of these tasks will be undertaken under the overall supervision of a general practitioner or medical consultant, who will be professionally accountable for the work of the MCP. 

Course Co-ordinator, Guy Dean commented: “This new breed of health professionals could help alleviate the current national GP shortage crisis. The MCP will also be able to work in secondary care taking pressure off hospital doctors and helping trusts meet the European working time directives for junior doctors.”

King’s College first- and second-year master’s degree students in the Physician Assistant Program were recognized at a pinning-and-white-coat ceremony at the King’s College J. Carroll McCormick Campus Ministry Center.

The ceremony honors the clinical-phase students with a pin and a copy of the Physician Assistant Oath as they complete all specialty rotations and begin their primary-care preceptorships.

Students who have completed classroom work are welcomed to rotations and presented with white coats by members of the clinical class.

The ceremony included opening remarks by Dr. Frances Feudale, director of the Physician Assistant Program, and an address to the students by the Rev. Donald J. Grimes, CSC, vice president for academic affairs.

King’s College first-year master’s degree students in the Physician Assistant Program presented with white coats, are: Mark Abel, Kelly Baker, Alexa Beretski, Kelly Bevilaqua, Sarah Brody, Nicole Buak, Deborah Buechner, Jessica Clark, Meghan DeRosa, Jennifer DiLungo, Melissa Donbroski, Jamie Durchin, Lindsay Fedor, Matt Gordon, Nick Grande, Chris Gregorich, Amy Gregory, Kristin Hosak, Mike Kelly, James Kincel, Emily Kluck, Margaux Lovell, Amy Maguschak, Kyle Maza, Michelle McGee, Kyle Mummy, Nick Popchak, Jennifer Porta, Derek Rachelli, Erich Salch, Sarah Siano, Catherine Sylvernal and Leann Watkins.

King’s College second-year master’s degree students in the Physician Assistant Program honored with pins and a copy of the Physician Assistant Oath, are: Michelle Burke, Mei Mei Chan, Rachel Chango, Amanda Galloway, Rebecca Geoffroy, Ryan Geoffroy, Sarah Halbert, Shelly Hendrick, Jamie Henniger, Jared Henniger, Molly Van Horn, Beth Jenny, Kerry Larkin, Chris Lawyer, Mike Lemly, Mushtaq Mahmood, Mary Mazaleski, Megan McCormack, Dante Palumbo, Alex Piczon, Kelly Pietrouchie, Kim Purta, Nancy Rowlands, Bob Shumaker, Tracey Stacker, Tamara Sullivan, Frank Tippett, Matt Walk, Lindsay Weist, Stephanie Wilks and Elizabeth Wist.

Father of the Physician Assistant Profession  Passes June 12, 2005 at 97 years old

Eugene Stead was born in Atlanta in 1908 as one of six children to Eugene Anson and Emily White Stead.  He received his BS and MD degrees from Emory University and completed internship and residency in Internal Medicine and Surgery at the Peter Bent Brigham Hospital in Boston, Cincinnati General Hospital and Boston City Hospital.  After serving on the faculty of Harvard University under the tutelage of Soma Weiss, he returned to Emory University as Chairman of the Department of Medicine (1942-46) and Dean of the School of Medicine (1945-46).  In 1947 he came to Duke University as Chairman of Medicine.  He served in that capacity until 1967, when he stepped down to spend the next 24 years helping younger faculty start innovative programs.  Thereafter, faculty and medical students often went to Kerr Lake to visit him and seek his wisdom on matters medical! and non-medical.

 No other single individual had more impact on how medicine was taught and practiced in the mid 20th century America than Dr. Eugene Stead.  At Emory and Duke, his research teams described the physiologic basis of shock and congestive heart failure.  Later, he was one of the first to see the potential for computers to change the practice of medicine.  He coached the team that developed the Duke Cardiovascular Disease Research Databank, a successful experiment using the computer as a time-lapse camera to tie clinical outcome of individual patients to their initial findings and using this process to figure out which treatment might be best for new patients. 

 In addition to his innovations as a researcher, Dr Stead was widely recognized as an outstanding medical educator.  He attracted students from many other universities who then went on to leading posts in other schools.  Thirty-three Stead trainees became Chairs of departments of medicine.  Secondly, he changed the structure of medical education itself by spearheading the 1966 revision of the Duke Medical School curriculum that cut in half the required basic sciences and thereby provided room for a full year of research without extending the overall duration of time spent as a student.  This change reflected his belief that most facts need not be memorized because they are quickly forgotten.  Instead he argued that students need to learn how to learn what they need when they need it.  And finally, he established the Duke Physician Assistant Program ! and is recognized nationally as the "father" of the PAs.    The PA profession itself is a reflection of his belief that it is possible to meet many patient needs without all the time and cost overhead of a traditional medical education.

 Eugene Stead served as President of the American Society for Clinical Investigation and the Association of American Physicians.  He was a founding member of the Institute of Medicine of the National Academies.  He was editor-in-chief of Medical Times, Circulation, and the North Carolina Medical Journal.  He received many awards including the American College of Physicians Distinguished Teacher Award, The Association of American Medical Colleges' Abraham Flexner Award for Distinguished Service to Medical Education, the Kober Medal from the Association of American Physicians, Durham North Carolinas' City of Medicine Award and the William G Anlyan, MD Lifetime Achievement Award from Duke University.

 Eugene Stead and his late wife Evelyn raised three children.  He protected time for the family from his busy professional life.  He turned building the house at Kerr Lake into a family project that took twenty-five years of weekends and summer vacations.  He is survived by son and daughter-in-law, William Wallace and Janet Stead, daughters and sons-in-laws, Nancy and Alan Atwood, and Lucy and Curt Barnhill; three grandchildren, Elizabeth Stead, Christina Auch and family, and Patrick LaVarre and family. 

 In lieu of flowers, memorial contributions may be sent to Vanderbilt University for the Evelyn Selby Stead Fund for Innovation, at Gift Records, Vanderbilt University, VU Station B 35772! 7, Nashville, TN 37235-7727.
 

43-year-old shows skills to younger generation 

By Benjamin Wideman 
Post-Crescent staff writer 

NEENAH — With surgical precision, Theresa Cheng dissected the defense for one layup after another at the Neenah StreetBall Challenge.

Then again, what else would you expect from a neurosurgeon?

Cheng, a doctor with Affinity Health System who specializes in operating on the brain and spine, was among the nearly 1,900 participants on 470 teams at the 14th annual three-on-three basketball tournament held downtown this weekend.

Cheng, who at age 43 is the oldest female in the event, guarded girls half her age and hung with them. Her opponents likely had no idea she’s a well-respected doctor, and that was just fine with Cheng.

“I may be 43, but I don’t feel 43,” she said after scraping her knee on the pavement during Affinity Neurosurgery’s first game Saturday morning. 

“I’ve always enjoyed sports, so this is something I enjoy doing. Just like operating on a patient, they’re both something I like.”

The tournament is a homecoming of sorts for Cheng, who played basketball softball and track at Neenah High School before graduating in 1979.

Cheng served her neurological surgery residency and fellowship in neurosurgery at the Mayo Graduate School of Medicine in Rochester, Minn., and returned to the Fox Valley in October 2002. Her mother still lives in the same house in Neenah, and living in Oshkosh gave Cheng the opportunity to renew old acquaintances, even if she doesn’t have much free time.

She usually works 6 a.m. to 10 p.m. Monday through Saturday, and is on call 24 hours a day. While playing Saturday, she wore a pager in case of an emergency. She does the same thing while competing in her Neenah softball league, too.

“Patients have the utmost respect for her, because she’s very skilled and she does so much for people in the community,” said Menasha’s Karen Fields, 28, a board-certified physician assistant who works with Cheng and is playing on the same team with her this weekend. 

“I’m an extra pair of hands in case she needs it in the operating room, and I guess you could say I’m also an extra pair of hands if she needs to pass it to me on the basketball court.”

Despite losing the first game, Cheng wasn’t rattled. She’s used to painstakingly delicate operations, some lasting around 10 or 12 hours, in which millimeters mean the difference.

“I never really feel any pressure,” said Cheng, who quickly added with a smile, “I get to operate on a brain tumor Tuesday, so I’m looking forward to that.”

Aimee Goodwin's Team In Training Page 
Racing to Save Lives 

Welcome to my Team In Training home page. 
I am training to participate in an endurance event as a member of The Leukemia & Lymphoma Society's Team In Training. I am running the Rock N Roll marathon in San Diego on 6/5/05. All of us on Team In Training are raising funds to help stop leukemia, lymphoma, Hodgkin lymphoma and myeloma from taking more lives. I'm completing this marathon in honor of all individuals who are battling blood cancers. These people are the real heroes on our team, and we need your support to cross the ultimate finish line - a cure! 

Please make a donation   to support my participation in Team In Training and help advance the Society's mission. 
I hope you'll visit my web site often. Be sure to check back frequently to see my progress. Thanks for your support!  Aimee

Published: Wednesday, May. 4, 2005 

 Staff photo by Bob Hammerstrom 

With bandages on the healing area of her legs, Maria Kiely of Nashua gets some he! lp with her stockings from Dr. Maureen Knepp during a visit to the Dartmouth Hitchcock Clinic in Nashua on Friday. A longtime patient of Knepp’s, Kiely suffers from recurring vasculitis, which has created ulcer-like sores on her legs. Order this photo 
NASHUA – About 10 years ago, when Dartmouth Hitchcock physician assistant Maureen Knepp was asked to take over wound care for a retiring physician and his medical assistant who was also leaving the practice, she realized how little she knew about the specialty.

“I didn’t know what I was doing,” Knepp says. “I thought, ‘I have to get rid of these patients or I have to learn.’ ”

She chose to learn.

After searching the Internet, Knepp discovered the American Academy of Wound Management and the Association for Advancement Wound Care. She also learned she could apply for certification as a wound care specialist if she had five years experience, three letters of recommendation and passed a test.

When she earned her certification, Knepp became the first certified wound care specialist in the Nashua area and one of the first in the state. Since, the number has slowly grown: Currently, there are ! only 16 certified wound specialists in New Hampshire, including several at the city’s two hospitals.Medical experts say the specialty, which is relatively new and often unfamiliar to physicians, is slow, messy, and sometimes malodorous.

“Wound care is not very exciting, and most people don’t like it,” says Dartmouth Hitchock surgeon Michael Barr. “Patients are shuffled around.”

Barr says before Knepp took over most of the clinic’s wound care services, he and other physicians did much of the work themselves – albeit, without the science-based knowledge or the passion Knepp has brought to the specialty.

“A lot of what she does is old stuff, but there’s science behind it,” says Barr. “We did it. It worked, but having a dedicated person brings quality and consistency of care.”

 Staff photo by BOB HAMMERSTROM
Dr. Maureen Knepp is one of 16 certified wound specialists in the state. Order this photo 
Wound care is a slow process, and once a chronic wound is healed it often recurs. As a result, a wound-care specialist sees patients on a regular basis: many visit Knepp on a weekly basic for weeks or even months for treatment and follow-up on conditions caused by diabetes, vascular problems, trauma, lymphedema, and other, less common conditions.

“Maureen’s position is a good fit for her,” says Barr. “She really does a wonderful job, and patients under her care are helped very much.”

Patients attest to that.

Nashua resident Maria Kiely, for example, says Knepp’s success in healing ulcers on her leg relieved excruciating pain and inspired confidence in her clinician after the condition reoccurred.

“From the first day I saw! her, I trusted her,” says the 80-year-old Kiely, who saw Knepp twice a week to have her wound drained and bandaged.

Likewise Thomas LeBlanc, 44, says he is grateful for Knepp’s persistence and caring – traits she demonstrated during a long course of treatment that led to diagnosis of an aneurysm and surgery.

“She tried different remedies and found a combination that worked well,” says LeBlanc, who suffered for a year with a wound that would not heal before he sought medical attention.

He says he enjoyed the frequent visits to Knepp’s office.

“It was like going over to someone’s house for tea,” he remembers.

Indeed, Knepp’s success has attracted attention across the community. At least half of her patients are referred from physicians outside the Dartmouth Hitchcock Clinic.

“She’s incredibly helpful (in treating) chronic wounds,” says Dr. John Watson, a dermatologist at Dartmouth Hitchcock. “She’s a single point of referral for all of our p! atients with chronic wounds, she’s extremely helpful, and she takes the time to photograph and follow (patients).”

Knepp photographs her patients’ wounds at intervals, takes her film to KMart for developing, and orders two copies – one for the patient’s chart, the other for the referring physician. She also keeps the images to use for teaching purposes.

Her area of expertise is venous ulcers, a condition related to poor blood return to the heart, and it was the focus of her master’s degree thesis, written two years ago to compare her treatment outcomes with national and international standards. What she found was heartening: her results matched the best outcomes in nine studies, showing that during a 12-week period, 65 percent of wounds were healed using standard treatments.

But Knepp says her work as a wound specialist entails far more than treating painful ulcers. What drives her is “etiology,” a word she uses often. What she aspires to is nothing short of fi! nding out why wounds develop and how they can be prevented.

“There’s so much more to wound care than what you put on the wound,” she says. “You have to look at the whole patient, not just the hole.”

To that end, Knepp has developed her sleuthing skills.

For example, after failing to heal a wound a young man told her came from a spider bite, she pressed further to discover a genetic disorder with a high incidence of clotting abnormality.

“He got the spider bite in January, and you don’t see many spiders in January,” Knepp says.

She says the patient did not improve after she prescribed an antibiotic and was still showing no progress after she switched him to another medication.

“While I’m here, can you look at the other leg?” the patient asked during another office visit.

After, Knepp took a biopsy, identified a culture resistant to antibiotics, and also learned about the genetic abnormality. As a result, she treated the wound with a top! ical antibiotic and a synthetic, non-surgical skin graft.

“Two weeks later, it was healing,” she says.

On March 4, CPT Sean Grimes of Southfield, Michigan, was one of four soldiers assigned to the 1st Infantry Battalion, 9th Infantry Regiment, 2nd Brigade Combat Team who were killed when a roadside bomb exploded near their patrol in Ar Ramadi, Iraq. Grimes, 31, is the first Army PA to be killed in combat during Operation Iraqi Freedom.

“The Army PAs are clinically stronger and more knowledgeable because Sean was one of them,” COL Bonnie DeMars, Chief, Army Medical Specialist Corps, said at Grimes’ funeral on March 15. “You will be missed, Sean, but not forgotten. You truly exemplify the Corps’ motto, ‘Soldiers First, Professionals Always.’”

COL William L. Tozier, Chief, Physician Assistant Section, also delivered a eulogy at the funeral. “CPT Grimes epitomized the model PA,” he said. “No, he was the perfect example of an Army PA. For that I thank you, Sean.… You have brought great honor to your family, your profession, and the Army.”

“[Sean] was a soldier because he firmly believed that was the best way he could make a difference in the world,” Grimes’ family said in a statement. “He died fighting for what he believed in, and our entire family is extremely proud of his service. Sean will always be a hero to us, and he will be sorely missed by his family and many friends.”

Eulogies written by Grimes’ older brother, Donald Grimes, Jr, and his sister, Mary, outlined a career built on hard work, sacrifice, and dedication. Grimes joined the Army Reserve as a medic right out of high school, then later attended Michigan State University on an ROTC scholarship. He earned a Bachelor of Science in Nursing and was commissioned as a Second Lieutenant.

During a three-and-a-half year stint at an Army hospital in Germany, Grimes spent six months with the United Nations peacekeeping force in Kosovo. He ran the emergency field hospital and went on patrol. While stationed in Germany, he was promoted to Captain.

Following his tour of duty in Germany, Grimes decided to become a PA. He was in the first class of officers admitted to the Interservice PA Program in Fort Sam Houston, Texas—a move that required Grimes to lower his rank from Captain to Lieutenant. “But this was not a problem for him,” Grimes’ brother said in his eulogy. “He joined the Army to practice medicine and be with the troops.”

After completing his PA studies, Grimes was again promoted to Captain and volunteered to serve in Korea. When Operation Iraqi Freedom began, Grimes repeatedly volunteered to go to the combat zone. But the units he worked with in Korea did not want to lose him. Finally, though, Grimes’ unit was transferred to Iraq, where they worked with the 1st Marine Division near Fallujah and Ar Ramadi, two of the most dangerous areas in Iraq.

“He was shot at, mortared, rocketed, and had bombs go off as his vehicle passed,” Donald Grimes recalled. “Yet he repeatedly volunteered to be the medic on recon missions and night raids.… [Sean] had gone out on 80 combat missions in just six months.”

On the day of his death, Grimes again volunteered for a patrol mission. He was one of four passengers in a Humvee that was destroyed by an improvised explosive device. At his funeral, Grimes’ brother recalled one of the last phone conversations they had: “[S]ome days before [his death], I had asked Sean to hang back a little since his R and R leave was so close. He answered, ‘Can’t do that, Bro. The troops can’t hang back, so neither can I.’”

Grimes will be posthumously awarded the Combat Medic Badge, the Bronze Star, and the Purple Heart. Besides his brother and sister, he is survived by his mother, Mary T. Grimes, and his father, Donald Grimes.

The Veterans Caucus of the American Academy of Physician Assistants (AAPA) plans to award one of their scholarships in CPT Grimes’ honor. “Speaking for both myself and for all the members of the Veterans Caucus, we are very saddened by the loss of any soldier in any circumstance,” Tim Egan, President, told Clinician News. “But it certainly brings it even closer to home when it’s a fellow PA.” The scholarship will be presented at a reception immediately following the organization’s annual memorial service during the AAPA conference in Orlando (May 30, 6 to 7:30 pm, at the Peabody Orlando Hotel). 

"Clinician News, Vol 9, No 4. Copyright 2005 Jobson Publishing LLC."

Capt. Kevin Eastep hugs his daughter Carolina at his Springdale home on Sunday. Eastep served for one year in the National Guard 39th Brigade and returned home Sunday to a party thrown by family members and friends.
ZAC LEHR , THE MORNING NEWS 

FAYETTEVILLE -- Thunderstorms and lightning have Army Capt. Kevin Eastep jumping a little, but he says it's nothing compared to the sounds in Iraq.

Eastep of the National Guard 39th Brigade was honored Sunday by family members, friends and neighbors with a welcome home barbecue at his home in Springdale. Balloons and flags marked the entrance to Eastep's street, and a large tent was set up in the front yard with a barbecue buffet for many family members and friends.

Eastep came back a few weeks ago to his wife, Sheila, and daughters, Claire, 2, Emma, 5, and Caroline, 6.

Kevin Eastep, a reserve member since 1988, served about 18 months in Iraq and was a battalion surgeon stationed about 15 miles from Baghdad.
 

He is a physician's assistant at the Fayetteville Diagnostic Clinic but his medical service in war was a bit different.

"The Army prepares you for what you have to deal with but it's still an adjustment," Eastep said. "We saw 3,700 patients (many casualties). There were some that I'm sorry to say couldn't be identified."

Eastep said he only knew two or three men over there while he served, but he did lose a friend -- a medic during an ambush.

"We could go for weeks without an ambush but other times there were ambushes every day, he said. "We were hit quite a bit."

Eastep wasn't wounded during his stint. He did receive the Bronze Star, a medal for meritorious service and two others for the global war on terrorism, a Combat Medic Badge and an Arkansas Federal Service ribbon.

He's happy to be home but finding it difficult to adjust back to this life, Eastep said. He can't sleep yet and is a little jumpy during thunderstorms. They remind him of the sounds of war.

The most difficult thing has been connecting with his daughters again.

"Our youngest, Claire, wasn't even a year old when I left," he said. "Sometimes she looks at me like 'Who are you?'"

Sheila Eastep said it was difficult for her to watch her children being without a father during his absence.

"It's hard for them to adjust to him being at home," she said. "We're going to spend a lot of family time together."

Kevin Eastep said he has about 90 days before he has to return to his job at the diagnostic clinic.

Sheila Eastep said the uncertainty of her husband's well-being was a struggle for her. They kept in contact via e-mail, but phone calls were limited. He did get to come home for two weeks in November.

"It was hard and lonely," she said. "I have a newfound respect for single parents ... I had my parents and his parents, and the neighbors have taken care of us."

Family members said they helped Sheila Eastep out and supported her husband.

Ada Beaver of Compton, Kevin's great-aunt, said she prayed for him every night, as well as for the other soldiers in Iraq.

"He's a fine son-in-law and he has done a great job," Wanda Self of Springdale said. "She (Sheila) held up okay. We were here for her."

Kevin Eastep said he believed things were improving in Iraq.

"What you read (newspapers, magazines) in the states isn't reflective of what's going on over there," he said. "The majority of the Iraqi people want us there. There's still others (countries) who don't. Things improved after the elections. I think they now realize they can depend on their internal security force."

Eastep said he's positive about the future for the country and sees it standing alone without America's support some day soon.

"There were good days and bad days and it was rough sometimes," he said.

source http://www.nwaonline.net/articles/2005/04/11/front/03soldier.txt

MONTREAL - Physician assistants may become a more familiar sight at hospitals across the country, as the health-care professionals sometimes called the best-kept medical secret in the Canadian Forces seek a greater role in the public health system. 

The 127 physician assistants treating Canadian soldiers on relief operations and peacekeeping missions the world over act as a second set of eyes and hands for doctors. They are trained to take a medical history, perform physical exams, make basic diagnoses, order lab tests or X-rays, and prescribe some treatments. 

The military's physician assistants aim to bridge Canada's shortage of health-care professionals. 
Some 60,000 physician assistants work in the United States, but in Canada, only the military uses their services. Although there is no civilian equivalent, their job description resembles that of a nurse practitioner. 

Though the military was the only place that accredited them in Canada, this week the Canadian Medical Association granted them recognition them as well. 

CMA certification means the standard of care physician assistants give to soldiers is considered equivalent to that afforded civilians by physicians. 

In Manitoba, the only province that regulates them, the health-care professionals are known as clinical assistants. 

The Canadian Forces have used physician assistants as part of their medical teams for about 50 years – since the Korean War. Doctors supervise physician assistants, although the physicians may not always be present. 

"Sometimes the physician is with the PA," said Dr. Pierre Ozon, a former military physician who now acts as medical director for physician assistant training at the Canadian Forces Medical Services School. "However, sometimes the physician's only way of communicating with the PA is through things like satellite phones." 
 

Medical training

Soldiers with at least 10 years of military experience and a background as a medical assistant or paramedic are eligible to take physician assistant training in Canada. 

Up to 24 Canadian Forces officers are trained each year. Their training consists of one year of medical theory at CFB Borden in Ontario, then another year of clinical rotations at eight civilian hospitals across Canada. 

During rounds at civilian hospitals, trainees learn about trauma, family medicine, ear, nose and throat specializations, general surgery, internal medicine, sports medicine and orthopedics. 

Ozon said the physician assistant model has worked well in the military but one hurdle to expanding their role in health care is there is no civilian equivalent to compare their training to. The legal liability for physicians supervising them also needs to be resolved. 

Physician assistants aim to be recognized by civilians so they can help to fill the country's gap of health-care staff, said Chief Warrant Officer Robert Sylvestre, medical branch officer for the Canadian Forces. 

A group of physician assistants is now in training at Montreal General Hospital, where the officers say they're often mistaken for doctors wearing scrubs. 

Dr. Jim Smith, an emergency physician at Great Plains Regional Medical Center, was named “Supervising Physician of the Year” at the Nebraska Academy of Physician Assistants’ conference in Kearney on April 14. 
Smith, who assisted in rescue efforts at the World Trade Center in September 2001, was commended for his commitment to community emergency activities, by J.R. Durbin, a physician assistant and friend from Papillion. 

Smith serves as a medical manager for the Federal Emergency Management Agency Urban Search and Rescue Nebraska Task Force-1 and was a founding member of the Department of Homeland Security in 2003. 

Durbin said Smith was “influential and instrumental in the education of physician assistants and resident physicians within his practice areas.” 

Smith has also been involved as a medical director for fire and rescue units. He personally responded to nearly 100 calls in 2003 and was a voluntary director and advisor for many pre-hospital care organizations, including Irvington, Omaha, and Gretna fire departments, as well as being an advisor for the SKYMED Aeromedical Program. 

Smith received his medical degree from the University of Nebraska Medical Center in 1988 and completed his residency at Akron General Medical Center, Akron, Ohio. He became board certified in emergency medicine in 1992. 

During his career, he has worked as a staff emergency physician at UNMC, Alegent Health, Immanuel Medical Center and BryanLGH Medical Center. 

He and his wife, Glee, with their four children, came to North Platte in 2004. 

The award was kept a secret from Dr. Smith. He was told that he would be presenting an award today to his friend, Durbin. 

At the last minute, his wife told him she could not go with him to Kearney. 

However, after he left for Kearney, she picked up their children from school and the family was on hand to surprise him at the noon presentation. 
 

The North Platte Bulletin - Published 4/14/2005 

(PAworld.net "Mike Roscoe is a PA that brought this child over." Dave Mittman)

KABUL, Afghanistan (AP) -- An Afghan toddler taken to the United States for surgery to fix a life-threatening heart ailment died Friday, two days after
returning home to a muddy refugee camp from the trip arranged with the help of U.S. soldiers.

Army medical officers said 16-month-old Qudratullah Wardak's repaired heart had likely given out as his father tried to comfort him in the family's
drafty tent near an American base outside the Afghan capital. The cause of death could not be determined because the Afghan tradition of burying the
dead quickly made an autopsy impossible.

The boy had been treated at a children's hospital in Indianapolis after Indiana National Guard soldiers and the Rotary Club learned of his condition
and the family's inability to find care in impoverished Afghanistan, which has one of the highest infant mortality rates in the world.

''This is a very sad day,'' said Maj. Eric Bloom, a U.S. military spokesman in Kabul. ''So many people, literally from around the world, came together
to help this young Afghan boy.''

On Wednesday, U.S. troops had escorted the boy and his father home to a joyous welcome at the camp next to an Afghan military barracks. More than
100 adults and children turned out to greet them in a heavy downpour, applauding wildly when the boy's father, Hakim Gul, emerged from a pickup
truck clutching his son, who looked plump and healthy after the two-day journey home.

Bloom said the boy's uncle arrived at the U.S. military's Camp Phoenix before dawn Friday with news of the child's death. Army medical officers
sent to the camp found the child lying under a blanket on a bed placed in front of the family tent, his veiled mother weeping over him.

''He still had glitter in his hair, from the big party they had for him,'' Capt. Michael Roscoe, PA-C, told reporters at Camp Phoenix, headquarters of the
U.S. training program for the new Afghan army.

Without an autopsy and no outward sign of what killed the child, ''our best guess is that it was something to do with his heart,'' Roscoe said.

Another uncle, Abdul Malik, said the boy seemed well on Thursday evening after receiving a dose of medicine prescribed by the doctors in
Indianapolis. But the boy developed problems at about 3 a.m., and his parents woke the rest of the family in a panic.

''His father and mother were putting their hands over his heart and said it was beating very fast,'' Malik told an Associated Press reporter at the
family's tent. ''They gave him his medicine for pain, and he seemed to calm down. His father felt for his heart again, then he asked me to try, but the
heartbeat was gone. Everybody was crying.''

Pills and a syringe lay strewn on the floor. A large green and red paper flower hung from the wall near three plastic boxes of gifts and toys from
American well-wishers.

Malik said the boy's parents and grandfather had departed for their home province of Kunduz, 150 miles to the north, to bury his body.

Two cardiologists who helped care for Qudrat during his stay at Riley Hospital for Children in Indianapolis refused to speculate on why he might
have died so soon after returning home to Afghanistan.

Dr. Richard Darragh said there were no signs of complications when the child was released and cleared to travel.

Darragh said the list of potential complications following complex heart surgery such as that undergone by Qudrat could fill a medical textbook, he
said, and some might not occur until years later.

''I don't think we have anything we could have done differently, or would do differently now,'' said Dr. Marcus Schamberger.

The boy and his father were quarantined for 3 1/2 weeks after Riley officials discovered they had been exposed to chickenpox, but hospital
spokesman Jon Mills said there was no sign of any infection Sunday.

Dr. Richard Schreiner, Riley's physician-in-chief, said the hospital's staff was ''devastated'' by the child's death.

''There's a lot of tears flowing,'' he said.

The boy's long journey began in September, when an Indiana National Guard doctor examined him at the camp and discovered a heart defect. Doctors in
Indianapolis later found that his heart's main blood vessels were reversed, a condition that stunted the baby's growth.

He weighed about as much as a typical 5-month-old when he arrived in the United States in late February.

Qudratullah and his father had stayed at the home of Rotary Club member Jim Graham in the Indianapolis suburb of Brownsburg. The Rotary Club helped
cover the $100,000 cost of the child's treatment.

''This baby had so much personality, he was so responsive to your attention.He just worked his way into our hearts so quickly,'' said Graham, who with
his wife Roberta, hosted the Wardaks during the quarantine.

The boy's father was seeking permanent residency in the United States, and the attorney helping the family said he did not know whether they wanted to
continue following the child's death.

''From a legal standpoint, it's still possible to go forward with that, but I don't know what their desires are,'' Indianapolis attorney Thomas Ruge
said.

Ruge said he intended to wait a few weeks out of respect for the family's grief before he asked Wardak whether to pursue the application.

In Kabul, Roscoe said many of the soldiers who were involved with the boy -- as well as nine reporters from Indiana who accompanied him back to
Afghanistan -- were distraught.

''It's like the loss of our own child,'' he said, blinking back tears. 

SEARCY - The Physician Assistant Program has received provisional accreditation and will begin interviewing and accepting applicants immediately, Harding University officials announced Monday.

On Jan. 13-14, representatives from the Accreditation Review Commission for the Education of Physician Assistant (ARC-PA) conducted a provisional accreditation site visit at Harding. Provisional accreditation by ARC-PA was necessary before Harding could begin offering classes.

"We have received provisional accreditation with no citations," says Dr. Mike Murphy, program director. The program will have the next 18-30 months to prepare for a continuing accreditation site visit by ARC-PA, which is the next step in the accreditation process.

But, says Murphy, the immediate task at hand is to enroll students. After the January site visit, the program began accepting applicants, confident the review would be positive. The application deadline is April 29, and classes begin June 6. "We have a lot of applicants to begin interviewing," Murphy says.

He plans to enroll 16 students for the first class. An additional 24 students will be added in June 2006.

Murphy, M.D., a 1977 Harding graduate, earned his medical degree from the University of Missouri in Columbia and has held academic appointments in family medicine residency at Southern Illinois, University of Illinois, University of Tennessee and Cox Health Systems. He has successfully led several residency programs through the accreditation process.

The master's-level program, which trains highly skilled licensed health professionals to practice medicine with physician supervision, will be the only one of its kind in Arkansas.

As part of their responsibilities, physician assistants take medical histories, perform physical exams, diagnose illnesses, develop and carry out treatment plans, order and interpret lab tests, suture lacerations, apply casts, assist in surgery, provide patient education and preventative health care counseling, and - in most states - prescribe medications.

A typical program is 26 months long, including one year of classroom instruction and at least one year of clinical work. Various clinical rotations may include emergency medicine, family practice, geriatrics, internal medicine, obstetrics and gynecology, pediatrics, and surgery. PAs must pass national certification exams prior to licensure.

The program application and additional information can be found online at www.harding.edu/paprogram. 

Physician Assistant 501-279-5642  PAprogram@harding.edu

Army Capt. Sean Grimes, 31, of Southfield, Mich.; assigned to the 1st Infantry Battalion, 9th Infantry Regiment, 2nd Brigade Combat Team, Fort Carson, Colo.; killed March 4 when an improvised explosive device detonated near his patrol in Ramadi, Iraq. Also killed were Sgt. 1st Class Donald W. Eacho, Cpl. Stephen M. McGowan and Spc. Wade Michael Twyman.

Soldier from Oakland County killed in Iraq bombing 

Associated Press
BLOOMFIELD HILLS, Mich. — An Army captain and nurse from Oakland County was killed when a roadside bomb exploded near his patrol in Iraq, the military said Tuesday.

Capt. Sean Grimes, 31, of Bloomfield Hills, serving as a physician’s assistant, was one of four soldiers killed Friday by an improvised explosive device in Ramadi, the Defense Department said. All four were assigned to the 1st Infantry Battalion based at Fort Carson, Colo. 

“Our family is very saddened and our hearts are filled with grief,” his family said in a statement released by the Army. “Sean loved the Army and the military and was devoted to his mission of providing the best possible medical care to soldiers.”

Grimes was born in Pontiac and graduated from Bloomfield Hills Lahser High School in 1991. He studied at Western Michigan University and graduated from Michigan State University in 1997 with a degree in nursing, the Detroit Free Press said. He was wearing a protective combat helmet and body armor at the time of his death.

“He died fighting for what he believed in, and our entire family is extremely proud of his service. Sean will always be a hero to us,” the family said.

Grimes’ father, Donald Grimes, lives in Bloomfield Hills, while his mother, Mary T. Grimes, lives in Dover, N.J., according to The Daily Oakland Press of Pontiac.

“His family said he had a strong sense of service to his country and his fellow man,” said Army spokesman Henry Kearney. “He felt he was making a positive difference in Iraq.”

Besides having a “strong desire to serve,” Grimes joined the Army out of a sense of family tradition, his sister, Mary T. Grimes, told The Detroit News. His father was in the Navy and his brother was an Army Ranger.

Grimes had been in Iraq for about six months when he was killed. He loved his job because of the chance to travel, said family spokesman Henry Kearney. While stationed in Germany, Grimes traveled through much of Europe, and he visited Japan and China while based in South Korea, Kearney said.

Grimes is survived by his parents, sister, and brother Donald Grimes Jr.

Memorial services will be held in Michigan and New Jersey after his body is returned from Iraq. 
 

 Died: March 04, 2005

Email: scornell@merion.com
Wednesday Jan. 5 at 9:29 p.m. 

This really looks like an unfortunate situation. A PA looking for a job gets hooked up with a shady employer. 
 

TWENTY YEARS of experience as a physician's assistant didn't prepare Karen Berman (not her real name) for a short-lived stint writing medical marijuana recommendations. In the summer of 2004, she responded to a lively ad on the PA World website (www.paworld.net). "San Jose non-profit needs PA's immediately!" it said. "We have a huge demand and will be hiring an estimated 85 PA's by the end of the year." 
The ad didn't specify the nature of the work, but stated, "We offer informational programs for patients who are suffering from a wide variety of symptoms. Our team of professionals will design specific plans to alleviate the discomforts associated with their symptoms." Berman admits that she was skeptical at first, but Donye Mitchell, the owner of the Suffering Patients clinic in Santa Clara, reassured her that he was a lawyer and knew everything there was to know about Proposition 215, the state law passed in 1996 which allows people with certain medical conditions the private use of marijuana if approved by a physician.

Link: http://www.metroactive.com/papers/metro/01.05.05/suspicion-0501.html

This is one danger of internet job sites that will post an ad for pretty much anyone for almost no charge. Amazingly the ad is still live (!) on a site called NP World with only a note of "caution." 

A little more from the article. 

Berman crossed this shaky territory with raised eyebrows, and her story suggests that Mitchell may be pushing the boundaries of medical marijuana too far. After many phone calls and emails, the owner of Suffering Patients could not be contacted for this article. Several other parties questioning him about his practices have also failed to contact him, although his website (www.sufferingpatients.com) and answering machine say that the clinic on Stevens Creek Boulevard is still accepting patients. 

In mid-September, Berman was hired as the only PA at the small Santa Clara clinic (Mitchell has two other locations in Salinas and Venice), which she says was run more like a business office than a nonprofit medical facility. She saw patients in a room behind the reception area that lacked an exam table and a blood pressure console, among other things necessary for a proper physical examination. In the same room, Mitchell kept computers where he and another employee would have discussions while Berman was seeing patients. She demanded that Mitchell at least put up a curtain for some privacy. 

Berman soon found out that "designing specific plans" for patients really meant conducting two- to three-minute consultations and sending them on their way with medical marijuana recommendations that were pre-signed by Dr. Jordan Paul Weiss, who lives in Southern California. 

The entire situation makes the PA profession look bad by association. 

Five weeks into the assignment, Berman called Mitchell from out of town and quit without notice. She admits that should have given him more time but his behavior after that point has only infuriated her more, and has resulted in a small claims suit for back pay. As alleged in the suit, Berman's second paycheck for $1,500 bounced, and when she called Mitchell about the money, they had a screaming fight. He refused to pay her for her last four days (which fell outside the second pay period) and told her she could come into the office to pick up her second paycheck. Fearing he might "go ballistic," she said she wanted him to send it to her. By November she hadn't received it. 

"She admits that she should have given him more time"?! She should have called the DEA and the FBI and the state and local cops. 

This is the topper. A "cautionary note!?" Something's wrong here. 

After she quit her job, Berman contacted the PA World webmaster, where Mitchell's ad was still posted, and told him of the problems she had with her employment. The webmaster says he tried to verify this complaint by sending three emails to Mitchell. He never received a reply, so he posted a cautionary note next to the ad. 

http://physician-assistant.advanceweb.com/common/Newslinks/dailyNewsWatch.aspx

One witness does not make a case. But it does raise a caution and a reason to offer to help bring resolution.  Failure by one or both parties to participate in a resolution process (in this case the PA was encouraged to contact the alternative dispute resolution program in their state) qualifies for a published caution.

The ad was kept with the caution as more of an announcement.  Having removed the ad would have left no trace of a caution in the face there would be other places for the employers ads to be posted.

I wish Steve would have contacted me and I would have not only explained our policy but would have also explained how I encouraged the PA to contact the authorities and how I've cooperated with the press to bring this dispute to more public scrutiny.

Bill@paworld.net

Thanks so much for helping me find the source for this article. I think you made an honest effort to contact Mitchell, and the cautionary note you provided seemed appropriate. It alerted me! I might suggest that you even put a link to my article by the note just to give a potential ad respondent the opportunity to find out more and make a more informed decision. 

Okay, take care,

Vrinda Normand
 Silicon Valley Metro Newspaper

WHITE PLAINS, N.Y., -- "There's something about an Aqua Velva Man(TM)" and that something special describes Jason Champine of Royal Oak, Michigan. Chosen as the winner of the "2004 Search for Today's Aqua Velva Man(TM) Contest," Champine, a 30-year-old physician's assistant in the Cardiology Cath Lab at St. Joseph Mercy of Macomb Hospital, exemplifies character, values and appearance qualities required to win this unique national contest.

"To re-launch this brand to a new generation of consumers, we feel that Jason is truly the Aqua Velva man for today," explains Georganne Shirk, senior brand manager for the Aqua Velva(R) brand. "He's the 'model' man for this decade and beyond ... a man who gives back to his family and community and who represents the type of person we'd all like as a friend, co-worker or brother -- a real 'stand-up' type of guy." In fact, according to the recent Aqua Velva "Ideal Man" survey*, when it comes to picking the most important male qualities, faithfulness, kindness and compassion, as well as a good sense of humor, were most important to more than half the women polled. 

"In addition to all these wonderful personality qualities, Jason is good looking, stays in shape and cares about his appearance, but doesn't fuss with it. We feel that he represents 'Today's Aqua Velva Man(TM),'" adds Shirk.

The national search for the new Aqua Velva Man(R) kicked off in August 2004, marking the re-launch of Aqua Velva(R), the number three brand of men's aftershave products. As the winner and the official "2004 Aqua Velva Man(TM)," Champine will choose from five exciting "Bring on the Blue" prize packages valued at up to $4,500, plus a year's supply of Aqua Velva(R) products. Champine will also represent the brand as the new Aqua Velva Man(TM) on the web site at http://www.aquavelvausa.com/ .

When notified that he was chosen as the contest winner, Champine said that he learned about the contest from a friend. "Although I try to be a 'stand-up guy' and help out whenever I can, I am really surprised that I was chosen as the winner. I guess nice guys do finish first," says Champine.

Combe Incorporated, manufacturer of Aqua Velva(R) products, considers this contest to be a big success. "The '2004 Search for Today's Aqua Velva Man(TM)' is our way of finding a new, contemporary face for the Aqua Velva(R) brand," says Shirk. "While the brand has an amazingly strong and loyal franchise, we want to modernize its image and reach a younger, hipper market, who might not be aware of the cooling and soothing benefits of the brand. We thought the '2004 Search for Today's Aqua Velva Man(TM) Contest' would be a great way to do this along with some new product entries we plan to introduce in 2005."

For more information about the cooling and skin smoothing benefits of the Aqua Velva(R) products, visit http://www.aquavelvaman.com/ .