|Author: Christie Rose|
|PA's Passions Are Patient Care, Education|
|In the late 80s and early 90s Lisa Shock was an eager young Neuroscience major at Colgate University in Hamilton, New York. "You learn about the physiology of the brain and how nerves work," Shock says. "The interesting stuff is on the cellular level where you learn why and how you can taste ice cream and smell perfume." Shock knew she wanted to work in the medical field and thought research would be an interesting venue under which to pursue a medical career.
Shock, MHS, PA-C is now a primary care physician assistant at North State Medical Center in Roxboro, North Carolina.
After graduating from Colgate, Shock moved to Chapel Hill, North Carolina where she worked for five years at the University of North Carolina at Chapel Hill as a biochemical researcher. But then several things happened. Lisa decided that perhaps research wasn't for her after all. She missed the interaction with people that other fields of medicine afforded. She also had a mentor, her college advisor from Colgate, Dr. Jun Yoshino, who kept tweaking her interest in people with information about a relative who was a physician assistant. "You need to find out what being a physician assistant is all about," Dr. Yoshino would tell her, "Because you would great at it."
That kind of sales pitch is hard to resist and Shock started the two-year physician assistant program at Duke University in Durham, North Carolina. Dr. Yoshino's belief that Shock's background and talents would be a perfect blend for a career as a physician assistant turned out to be right on the money. Two years later Lisa received her Masters of Health Science degree in Duke's Physician Assistant Curriculum, and she hasn't looked back since.
"For me, becoming a PA has allowed me to blend my love of science with my enjoyment of working with people," Shock says today. "Research was interesting, but I wanted to do more hands-on, people-oriented work, rather than simply lab work. I enjoy the positive feedback I get from patients every day. It makes me feel like I make a difference in people's lives. Research certainly makes a difference in the lives of many people. But, it's not accompanied by a smile."
Duke requires 1000 hours of paid clinical work so Shock's three years of volunteer work while at college didn't count. Nor did her two years of volunteering at the local nursing home. This desire to obtain clinical experience demanded that for a period of time, Shock held down two full-time jobs, one as a research assistant at the University of North Carolina, Chapel Hill as well as one as a clinical medical assistant with a busy primary care practice in Chapel Hill. Her medical assistant training took place at The Family Doctor from the spring of 1995 until late summer of 1997 when she made the decision to go back to school. "Duke doesn't allow you to work while attending their full-time physician assistant program," Shock says, "So I immersed myself in my studies."
Duke University was the first institution of higher learning to offer a PA program, and today, it's still considered one of the finest in the country. Duke was the first to offer a physician assistant curriculum in 1967. The curriculum includes a thirteen-month period of book learning followed by a thirteen-month period of clinical rotations including specialties such as obstetrics and gynecology and the emergency room. Students may also arrange other learning experiences at leading medical centers around the country. This allowed Shock to spend one month doing specialized training in Geriatrics at The Johns Hopkins University Geriatric Center in Baltimore, Maryland.
As part of her everyday routine while at Duke, Shock was on-call and doing clinical rotations. One of those rotations included working at the North State Medical Center, a primary care practice in Roxboro, North Carolina. She was so impressed with the staff at North State that when she graduated from Duke's PA program she went to work full-time with the two doctors and one physician assistant at this facility. Shock has worked at North State Medical since September of 2000 and, as the only female health care provider, she has eased her way into a couple of subspecialties she really enjoys - women's health and geriatrics.
"We are a private group family practice," Shock says. "We care for patients on an outpatient basis as well as on an inpatient basis when they are admitted to our local hospital. We also provide services to the area nursing home as well as two assisted living facilities." The group has been in business in Person County, North Carolina for more than twenty-five years. Person is a rural county that continues to be largely underserved with a low ratio of clinicians to community residents. The practice population is largely comprised of low income, Medicare/Medicaid and migrant worker patients. Person County itself is home to approximately 33,000 people, about 8000 of whom live in Roxboro. The North State Medical Center office has patients who also receive care at both Person Memorial Hospital and the County Health Department. These associations, according to Shock, allow her to provide health care to an especially diverse patient population. The nursing home and the two assisted living facilities provide Shock with ample opportunity to study and practice the geriatric end of the health care scale - an arena she is both comfortable with and interested in pursuing.
"We each carry our own patient panel at North State," Shock says. "And, of course we work together to care for patients of all ages as we are a family practice." Shock is also responsible for the nursing home and assisted living patients on her supervising physician's service. Her office is open extended hours (7:00 a.m. to 9:00 p.m.). Shock herself typically works 8:00 a.m. to 5:00 p.m. or 12:00 noon to 9:00 p.m., and takes her turn on rotating Saturdays so the facility can stay open six days a week. The North State physicians are reachable by phone should she need to call on them for counsel or assistance.
Shock's practice involves urgent care management of patients as well, though she focuses on her clinical interests of women's health and geriatrics. This setting gives her the opportunity to care for more patients in these areas and she does a great deal of health and wellness work as well as chronic disease management. Being the only female health care provider at North State means she gets quite a lot of female patients, especially those who prefer a woman health care provider. "Women are very involved in their own healthcare," says Shock, "As, of course, they should be." Within this framework, Shock has the freedom to spend more time with her patients than most M.D.s have the time for, and she likes that. Shock enjoys spending time with patients. "The little extra time I can spend with my patients makes me more responsive to their needs and concerns," Shock says. "And health care should be responsive as well as educational.
"My patients appreciate the extra time and education I provide them," Shocks says. "In primary care, we treat both acute and chronic disease states and lifetime illnesses such as diabetes, heart disease and hypertension which require a large amount of patient education to augment the medical treatment we provide in the office." Addressing lifestyle changes such as cigarette smoking and alcohol use are constant challenges to a patient's overall health care.
Shock enjoys a high degree of autonomy in caring for patients at North State Medical with physicians always available when consultation is needed.
Shock enjoys educating patients and the lay public about her role on the health care team. "Many people do not fully understand my job title or my role in their health care," says Shock, "I try to look at each encounter as an educational opportunity to share information about my profession." In Shock's small community, reputation means a lot and many patients are very comfortable with the quality of care they receive from the PAs at North State Medical Center.
"In North Carolina," Shock says, "we are fortunate to have state legislation that allows PAs to prescribe drugs including controlled substances. The pharmaceutical industry traditionally has used only data from physicians in their marketing research, but they are also realizing that PAs make up a large component of the prescribing market."
Shock hopes to not only enhance PA awareness, but also provide a forum for networking, discussing professional issues and CME by reviving the Triangle Chapter of Physician Assistants (TAPA). The Triangle area has not had a local group for PAs living and working in the Raleigh/Durham area for several years, and Shock has taken to reorganizing one. Shock hopes that TAPA will again work closely with the state PA organization, the North Carolina Academy of Physician Assistants (NCAPA) to address concerns and promote the PA profession state-wide.
She is also interested in clinical research as it applies to clinical practice. Her many years of research experience both in college and at UNC-Chapel Hill lend themselves toward answering clinical questions in the future. In that regard, she is in the early stages of research with a former professor from Duke University and the University of North Carolina at Chapel Hill on geriatrics and heart disease that she hopes will yield a valuable publication.
Shock finds herself consistently challenged in her work by chronic diseases and their effects on her patients. She sees such a variety of patients that her work is always stimulating, though the vagaries of working within the framework of the managed care system are often taxing. It is also, according to Shock, a daunting task to remain current on the latest medical advances as well as the newest drugs coming into the marketplace.
In addition to her work at North State Medical Center, Shock has served as a preceptor for Duke University's PA Curriculum as well as the Nurse Practitioner program at the University of North Carolina, Chapel Hill. She was asked to host students and has enjoyed being a mentor to those who work with her. In addition she has started a local wellness class at the community senior center, which she does on a volunteer basis. She spends about an hour each week covering health and wellness topics as well as discussing specific chronic disease issues such as diabetes and heart disease. Her classes are popular and are usually attended by twenty to thirty community residents who visit the senior center regularly. Shock is passionate about patient and community education. That's part of the reason why Shock feels compelled to be involved on both a community and professional level.
Lisa Shock received her Bachelor of Arts in Neuroscience at Colgate University in Hamilton, NY in 1992. In 1997 Shock started the two-year PA program at Duke University in Durham, North Carolina where she received her Masters of Health Science degree as well as completing the Duke Physician Assistant Curriculum. She now works at North State Medical Center in Roxboro, North Carolina as a primary care physician assistant in a two-PA, two-M.D. facility. Shock is currently a member of the American Academy of Physician Assistants (AAPA) and was instrumental in reviving the local chapter of the Triangle Association of Physician Assistants (TAPA) in the Raleigh, Durham, Chapel Hill area of North Carolina. Shock is also a member of the NCAPA (North Carolina Academy of Physician Assistants). She is a preceptor for her alma mater, Duke University and she has written and published articles for professional journals including an article on elder abuse that has appeared in the Journal of the American Academy of Physician Assistants (JAAPA).
Christie Rose is a freelance writer from California. She is on the Editorial Staff of NEWS-Line for Physician Assistants.