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By Rachael Jarman, physician assistant
The last six months have been surreal. After
COVID-19 started spreading throughout the United States, I spent March
and April rolling out protocols and training our urgent care team in
combating the spread of the virus. I juggled that with examining
patients who came to our clinics with acute illnesses, some of them
life-threatening conditions that ultimately required hospitalization.
I
thought I was an essential worker, and I was willing to risk my life to
administer the care I’d spent years training to provide. But it turns
out my job was also at risk. In thanks for my service, I received a
furlough in April and a pink slip in June.
As
a lead physician assistant for an urgent care department, I never
thought my job would be dispensable during a global health disaster.
Getting rid of PAs as we face a pandemic is like laying off firefighters
when forests are ablaze. But I am hardly alone. As health care workers
get publicly celebrated for their heroics, behind the scenes thousands
are getting pushed out the door.
Nearly 1.5 million health care workers lost their jobs
in a single month this spring. Some positions have begun to reopen, but
far from all. That health care jobs are increasingly a casualty of
COVID-19 might sound absurd and unjust, but it makes cold-hearted sense
given the financial fragility — and focus — of the system. Profits are a
major driver of employment decisions, even in an industry that claims
to prioritize community health. When patient encounters decreased, it
was health care workers who saw their pay, benefits and hours decrease,
too.
Since I was a part of the leadership team in
an urgent care department, I know firsthand how we struggled to stay
abreast of ever-changing COVID-19 guidelines from health authorities. As
a team, we led our department through unprecedented uncertainty and
managed the rising anxiety of our patients and families. We planned to
work through this.
But soon, patients who
had appointments for routine care and illness were rescheduled, and
patient volume in outpatient care settings like mine decreased
dramatically. Patients were scared, and so were health care facilities.
Patients with coronavirus-like symptoms were told to go home and
self-quarantine. Their other healthcare needs were temporarily shelved
due to a fear of catching or spreading this novel virus, while COVID-19
tests were limited for weeks because of a lack of supplies. So, while
other healthcare workers walked into their hospitals to grateful
applause, I was quietly laid off.
I have 12 years of experience as a PA, mostly
in emergency and urgent care facilities. But one day last month, I
walked out of my office with a box full of well-worn medical textbooks
and an idle stethoscope. Many others face the same fate. According to
new research by the American Academy of PAs, almost nine percent of PAs
nationally are furloughed right now. And PAs are not alone; many
physicians, dentists and other clinicians also face this new reality.
One
of the ironies of this situation is that physician assistants are
taught to be flexible, quickly shift responsibilities and respond to
unanticipated needs. PAs are trained as generalists and can practice in
different specialties and settings as necessary. We diagnose illness,
develop and manage treatment plans, prescribe medications and often
serve as a patient’s principal healthcare provider. We are trained to
collaborate and work as a part of a team alongside physicians and
nurses.
Like all health care providers, PAs responded
to the COVID-19 crisis despite the lack of adequate personal protective
equipment and other resources when it first struck. They found
themselves working in other departments and specialties. When still
employed, I volunteered to be on a back-up list for the local emergency
department, though I was never called upon.
But
our versatility — perfectly suited to a time of crisis — hasn’t been
enough to save many of our jobs. Instead, it often seems the health care
industry’s ability to pivot PAs where we’re needed most is thwarted by
burdensome laws and regulations that mean we have less opportunity under
the best of circumstances, and create a domino effect when the economy
bottoms out. Though some states have removed barriers, others require each PA
to have a specific relationship with a physician in order to practice
medicine, even though PAs have their own licenses to practice and write
prescriptions.
This moment of dramatic change and need shows that these restrictions
are unnecessary. Several states removed this requirement during their
states of emergencies, a simple change that allowed patients to receive
essential, timely care. More states should follow their lead.
Even when there’s not a crisis, being tied to a
specific MD means that PAs can’t fill the vital need in providing care
to underserved patients in urban and rural communities because by
definition they lack those MDs. But now more than ever we need to
increase access to care by removing PA barriers to practice so we can
treat these communities, particularly communities of color that have
higher rates of COVID-19 infections.
Full Article & Source:
The coronavirus means doctors, nurses and PAs are essential workers — until they get laid off
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