4
Tess Messer gets JobShadowed about her career as a Physician Assistant.  You can find her website here.

What do you do for a living?

I work 24 hours a week as a Physician Assistant in an Urgent Care and Emergency medicine setting.  The rest of my week is spent doing volunteer activities for my kid’s school and writing my blog.  For the last seven months or so I have also been busy writing a book called “Commanding Attention-The Science of Non-Drug ADHD Treatments.

How would you describe what you do?

As a Physician Assistant I see patients injuries and illnesses and evaluate and treat them. I consult with my supervising physician on any patient that has a complicated medical presentation and I work closely with  my other coleagues including nurses, lab technicians. medical technicians,  and xray technicians.

I mentor P.A. students and I like to tell them that being a Physician Assistant is all the fun of medicine without all the responsibility.

What does your work entail?

Seeing patients in an urgent care or Emergency Medicine setting involves a lot of physical as well as mental work.  Setting and casting broken bones, suturing cuts, removing foreign bodies from ears, noses and other places are all physical activities that P.A.s in these types of settings perform.

The PA profession has grown tremendously in its scope and in the respect it recieves from the greater medical community. I have had a great time being a PA and I could not have picked a better career. I am proud to have been a pioneer of this great profession.

The mental work involves listening and really hearing what the patient’s symptoms are, determining a differential diagnosis of what could be causing the symptoms, determining a treatment plan and communicating with the patient and the patient’s family about what you are doing and why.

What’s a typical work week like?

I typically spend one day a week in the Emergency department and one day a week in the Urgent Care center where I see about 20-30 patients a day that have injuries such as burns, cuts, sprains and broken bones  or illnesses such as urinary tract infections, viral infections or upper respirtatory problems.

In the Emergency department I may also see patients with abdominal pain, migraine headaches, threatened miscarriages or chest pain.

How did you get started?

I was a volunteer nurses aid in high school.  The hospital where I worked as a volunteer asked me to apply for a paying nurses aid job which I did.  I worked as a nurse’s aid for one year and then worked as an Operating room circulator for this same hospital.

I liked medicine and thought that I would become a clinical psychologist because I liked talking to the patients at the hospital about their problems.

I went to the University of Florida as an undergraduate and they had one of the first PA programs in the country. The husband of one of my very best friends was in the 2nd PA class at the University.  He told me about the PA program and I thought that I would like the PA program better than the clinical psychology program so I applied to the University of Florida for my PA degree.

When I applied to the University of Florida program, there were 934 other students also applying.  I was accepted on the waiting list.  I had applied to a total of five programs and was immediately accepted to the Wake Forest program and came very close to going up to Winston-Salem for my PA degree.  In the end, a spot opened up at the University of Florida and I went there.

What do you like about what you do?

I love being a PA.  I love the procedures that I do.  I like suturing and fixing dislocated fingers and shoulders.  I love pulling beads and bugs our of patient’s ears and I love opening up boils and cleaning the infection inside them.  This sounds gross to many people but I really find those procedures to be satisfying.

The thing that I love the most about being a PA though is trying to help people.  I try to really listen carefully and thoughtfully to every patient that I see.  I try to treat them as if they were in my family.  I think to myself,  “If this were my mom (brother, sister, etc) how would I evaluate and treat them.”

This approach ensures that I take every patient’s problems seriously and evaluate it completely.  Some PA students sometimes say to me, “Oh the patient in room 3 is probably trying to get out of work.”  I never assume that the  patient  is faking it because that kind of attitude is not only disrespectful, it makes you a lot less thorough.

What do you dislike?

I do not like it when patients assume that the medical provider seeing them is the ‘bad guy’.  When people assume that you are just out to torture them or dismiss them in some way, it makes my work harder.

How do you make money/or how are you compensated?

I get paid a salary based on the amount of hours that I work.

How much money do you make as a Physician Assistant?

I make between $45 and $65 per hour.

How much money do Physician Assistants make starting out?

I believe that the range nationally is between $70,000 to $150,000.00 per year for Emergency Room PAs.  Other specialties are compensated at different salary ranges.

What education, schooling, or skills are needed to become a Physician’s Assistant?

Most states now require that you have a Master’s Degree from an accredited PA program to practice and that you be certified by the National Certifying agency for PAs the NCCPA. You need to take the board exam every seven years to keep your certification active. To get into most PA programs you have to have had at least one or two years of patient care experience.

What is most challenging about what you do?

Knowing what you do not know and making certain that your certifying physician is involved in all complicated or difficult medical cases.  Sometimes physicians will say, “I trust your judgement.” but if I am calling on my supervisong MD it is because I do not trust my own judgement and I want them involved in the patient’s evaluation and treatment.  The physicians that I work with know that if I am speaking to them about a case it is because I want them involved in the patient’s care.

Another challenge for everyone in the medical profession is making certain that you are thorough when performing your medical examinations and completing your medical records.  You can get into legal trouble if your medical records are sloppy or incomplete.

Taking the boards every seven years keeps your skills current but this is also a challenge as you have to study a lot to make certain that you will pass them.

What is most rewarding?

When a patient that is sick or in pain gets better and thanks you.

What advice would you offer someone considering this career?

Get some medical experience under your belt even if it is just as a volunteer.  You will need it to apply to PA school and you will be better prepared for PA school when you get in.  Apply to at least 5-7 programs as PA schools are hard to get into and the more programs that you apply to, the better your chances of getting accepted.

How much time off do you get/take?

I work PRN which mean I only work the shifts that I want to work.  I do not get paid for this time off but I am able to take quite a bit of time off in the summer to be with my children.

What is a common misconception people have about what you do?

Because the title is Physician Assistant, people sometimes think that I am a medical assistant.  This used to happen a lot before the profession became so well known.  Now most people know the difference.

People also do not realize that a physician is not always in the room or even in the building, looking over my shoulder , while I am working and that PAs can write prescriptions and work independently with a physician on call by phone.

What are your goals/dreams for the future?

I want to continue to write books about medical conditions that I believe are misunderstood or under evaluated by the medical profession.

What else would you like people to know about your job/career?

I have been a PA for over thirty years.  I became a PA at a time when PAs were so unkown that they  had to walk into a patient’s room and say, “Hi, my name is Tess Messer and I am a Physician Assistant.  Do you know what that is?”  I have not had to say those words in a very long time.  The PA profession has grown tremendously in its scope and in the respect it recieves from the greater medical community.  I have had a great time being a PA and I could not have picked a better career.  I am proud to have been a pioneer of this great profession.


4