In this month’s PA profile, we feature Carlos Gutiérrez, EdD, MMS, PA-C, who is passionate about promoting diversity in the PA profession in his academic work and supporting LGBTQ+ and other minoritized patients in his clinical practice. Since 2015, Gutierrez has been practicing family medicine at Glendale Pediatrics and Family Care with a focus on LGBTQ+ health serving a mostly Spanish-speaking community near Phoenix, Arizona. He is the chair of the DEI Taskforce at the Arizona State Association of Physician Assistants. In addition, Dr Gutiérrez is an associate professor in the Department of PA Studies at the University of Pittsburgh and serves as the department’s inaugural vice chair for Student Success.

Dr Gutiérrez started in academia as adjunct faculty in the Physician Assistant Studies Hybrid Program in 2021 and is adjunct faculty for the Doctor of Education in Health Professions program at A.T. Still University. He earned his Bachelor of Science at New Mexico State University, Master of Medical Science in physician assistant studies at Midwestern University-Glendale, and Doctor of Education in health professions at A.T. Still University. He previously worked at the Mayo Clinic, Arizona, specializing in preoperative medicine.

Q: What experience(s) helped determine your career path?

Dr Gutiérrez: My family’s experiences related to health care access and inequities, specifically those related to rural Americans and Hispanics, were the driving forces for me becoming a PA. My father was heavily affected by the lack of access to health care throughout his life. For example, the day my father tripped into a watering canal in the rural community of Las Uvas, New Mexico, he suffered an open mid-tibial fracture. He drove himself home just in time for my mother to call a friend to drive him to the closest hospital 1 hour away. He was subsequently transferred to a Level 1 Trauma Center in El Paso, Texas. Although this occurred before my birth, I chose the path of becoming a PA because my father continued suffering from the lack of access to health care, likely resulting in his death, and I wanted to make sure I could come back and serve my community. I have been lucky to do just that.

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Q: What are the biggest health challenges facing your community?

Dr Gutiérrez: My community faces a myriad of challenges related to their health. I am lucky to serve a largely Spanish-speaking, underserved population in western Phoenix, Arizona. Unfortunately, the same lack of access to health care my father experienced still exists for many minoritized individuals today. Specifically, my community often faces challenges in health care related to language barriers. As a Spanish-speaking PA and one fluent in American Sign Language, my patient base is better served by assuring some language barriers are torn down.

My community also faces limited access to health care related to insurance coverage. Health care in the United States is extremely expensive and uninsured or underinsured individuals in my community have difficulty with access to specialty and preventive care. For example, I often request some of these patients undergo colonoscopy and mammography in Mexico. Luckily, many gastroenterologists practice along Mexican border towns and cities. At the same time, I am proud to serve LGBTQ+ individuals within my community. These individuals often lack proper access related to preventative services and other health care services.

Q: What unique programs or projects have you started or participated in to advance patients’ health?

Dr Gutiérrez: Although I am better equipped now than I was when I began my PA career, my work has just begun to advance patient health, particularly health within my community. We know that PAs who come from minoritized communities are more likely to come back to practice there. Understanding this notion, I decided to run for chair of the Diversity Task Force at the Arizona State Association of Physician Assistants (ASAPA) and was selected by the President. I have made it our task force’s priority to establish itself as a standing DEI Committee of ASAPA. The first initiative of the committee includes diversifying the PA workforce in Arizona through various outreach projects in minoritized communities. This is important work as our ASAPA leadership works towards legislation that modernizes health care.

Q: Who is/was your mentor in the PA field? 

Dr Gutiérrez: Navigating the administrative challenges that come with being a new PA, I was thankful to have Elizabeth Lopez, DHeD, MPH, PA-C, as a mentor through my formative PA years. Now, I am grateful to have David C. Beck, EdD, MMS, PA-C, DFAAPA, chair of the Department of Physician Assistant Studies at the University of Pittsburgh, serve as my mentor as I transitioned into PA education. He has made it a priority to bring in faculty from various backgrounds and is acutely aware of how to support me in furthering my work in expanding access to health care.

Q: What aspects of your profession are most rewarding?

Dr Gutiérrez: A PA I worked with in college during my time as a scribe in the emergency department told me not to go to medical school because I would be able to serve my community more quickly if I took this path. He was right. I have made such a positive impact on so many members of my community that I could not be more honored and assured I made the right decision to become a PA. Nonetheless, the collaborative team approach, the flexibility of working in different roles, and the positive work-life balance I have experienced are other rewarding aspects of my profession.

Q: What aspects of your profession are most challenging? Have you found a way to overcome these challenges?

Dr Gutiérrez: The most challenging aspect of my profession is related to burnout and interprofessional toxicity. Exhaustion often is related to the need of the US health care system to accommodate as many patients as possible, the challenge of caring for ill patients, and high levels of stress. I transitioned to academia to serve the PA profession in another manner that has helped improve the exhaustion related to caring for patients. However, the rewards that come with being a PA often outweigh these challenges. Of note, my department is currently working to matriculate a diverse cohort in hopes of working on reducing interpersonal toxicity in medicine.

Q: What do you bring to the table that helps LGBTQ+ patients?

Dr Gutiérrez: Individuals from the LGBTQ+ community have unique health care needs. As a PA who has been trained in LGBTQ+ health care, I bring a unique set of skills and knowledge that can benefit LGBTQ+ patients:

  1. Cultural competency: I have developed an understanding of the unique health care needs and challenges faced by LGBTQ+ individuals. This includes recognizing and addressing biases, using appropriate language and terminology, and developing an inclusive and nonjudgmental approach to patient care.
  2. Knowledge of specific health care concerns: I am knowledgeable about the specific health care concerns that affect LGBTQ+ patients, such as HIV/AIDS, mental health, gender-affirming care, preventative care (particularly for transgendered individuals), and sexual and reproductive health. This allows me to provide targeted care that is tailored to the needs of this patient population.
  3. Support and advocacy: I am committed to supporting and advocating for LGBTQ+ patients and ensuring they receive the same high-quality care as all other patients. This includes providing resources, referrals, and support for patients and their families, and working to promote policies and practices promoting health equity and access to care for all.

Overall, as a PA with training in LGBTQ+ health care, I bring a unique perspective and skill set to patient care and I am committed to providing compassionate, comprehensive, and inclusive care to all patients, regardless of their sexual orientation or gender identity.

Q: How do you address mental health issues in the LGBTQ+ community?

Dr Gutiérrez: Addressing mental health issues in the LGBTQ+ community requires a comprehensive and inclusive approach recognizing the unique experiences and challenges faced by this population. In my practice, I begin by assuring a safe and welcoming environment where LGBTQ+ individuals feel safe and comfortable discussing their mental health concerns. I also offer referrals to specialized services because LGBTQ+ individuals may have specific mental health concerns that require specialized care. Finally, I provide support and resources to LGBTQ+ individuals as they may benefit from resources and support that address their mental health concerns.

Q: How do you avoid burnout? What do you do for fun?

Dr Gutiérrez: I decided upon a role that would provide a positive work-life balance for me. I also make sure to practice self-care to keep myself grounded. I always make time for activities I enjoy and help me recharge. I love traveling to places where I can relax, I love to exercise, and I love spending time with my loved ones, particularly, my 2 Boxers.

Q: What is 1 valuable lesson that you learned working in this field?

Dr Gutiérrez: Do what makes you happy. If you are not in the right place, don’t stay.