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Physician Assistant
General News
When thinking about healthcare providers for behavioral and mental health issues, many often think about psychiatrists, psychologists and therapists, but physician assistants (PAs) play a significant role in assisting within these conditions, according to Jennifer Hodges, PA-C, MMS, MPH, clinical preceptor for the PA Department’s behavior/mental health rotation.
“The demand for psychiatric services has increased significantly, while state and federal funding have been cut or remained limited,” she explained. “This increases the need for quality, but cost effective care. Midlevel providers, such as physician assistants, are ideal to fill this role. The demand for follow-up outpatient appointments is increasing too with very long waiting lists to be seen and PAs can help meet this need.”
As part of the experiential learning component of the University’s PA program, all students embark on a five-week rotation at a local inpatient or outpatient behavioral health facility. During the rotation, students are paired with a clinical preceptor like Hodges, and perform a wide variety of assignments to strengthen their clinical skills into practice. Students are exposed to patients of all ages – from pediatric to geriatric – and an array of mental health conditions. Bipolar disorders (both manic and depressive), schizophrenia, major depressive disorder, substance abuse disorders and personality disorders were some of the most common conditions Sarah Levitski ’18MMS came across during her rotation with Hodges at a 200-bed inpatient psychiatric hospital.
Levitski assisted with performing physical exams and taking medical histories for newly admitted patients. She also ensured all their medical conditions were being taken care of properly during their stay and handled acute injuries or additional medical problems that arose. She even had the opportunity to sit in on a few group therapy sessions and observe initial and follow-up sessions with a psychiatrist. Working with an interdisciplinary team of PAs, doctors, nurses, mental health technicians, and therapists, she was able to participate in discussions about therapeutic plans for patients. Most importantly, she learned how to not only adjust her interviewing approach depending on what mental health condition the patient had and their mood, but how to be an overall compassionate clinician.
“This population of patients doesn’t want to be seen only as their mental illness; they want to be listened to and treated with the same respect as anyone else,” she said. “I think this is helpful to remember in any specialty.”
Hodges agrees and emphasizes that the behavior/mental health rotation is much more than diagnosing conditions and prescribing medications.
“The most important thing that I stress with my students is how to relate to and approach these patients,” she said. “It is really important to be able to observe the patient, pick up nonverbal cues, understand their current mental status and how they best communicate, and adjust your approach based on these subtle details.”
She believes empathy is one of the most important skills a PA can have when working with psychiatric patients. But, when it’s not innate, it can be a difficult skill to acquire.
“While exhibiting empathy is important with all patients, psychiatric patients can really sense when you are being genuine or if you are insincere, and they respond accordingly,” Hodges explained. “These are not skills that can easily be taught. They have to be observed, practiced and developed over time. In my experience, I have found that the best providers are usually the ones who pick up on this and incorporate it into their practice quickly.”
In the end, Levitski enjoyed the fast-paced, yet perhaps unpredictable, environment at the inpatient facility and felt the experience helped her grow as a soon-to-be PA professional.
“There was never a dull moment, and I loved that,” she said. “I never knew what to expect. I was lucky enough to have a great preceptor who went above and beyond to facilitate my learning, gave me the opportunity to be exposed to many conditions in the mental health field, and gave me the chance to work with all parts of the team.”
