This month’s PA Profile features rural health care provider Brady Hicks, PA-C, ATC, who pairs his experience as an athletic trainer and PA to treat a mostly Native American population. PA Hicks graduated from Dakota Wesleyan University with a Bachelor’s of Science in Athletic Training in 2019. In 2021, he graduated from the University of South Dakota Physician Assistant Program. After graduating, he returned to his hometown of Martin, South Dakota, where he currently practices at the Bennett County Hospital, Nursing Home, and Rural Health Clinic. Martin is located between 2 Native American reservations and is rural, with most specialties being at least a 2-hour drive away.
Q: What was your path to becoming a PA?
PA Hicks: When I was in high school, I knew I wanted to go into medicine because of my love for science and helping people. Originally, I intended to go into athletic training as I was very involved in sports and wanted to stay in that field. While I was in college at Dakota Wesleyan University, I realized I wanted to return to my hometown of Martin, South Dakota. I knew there wasn’t a likely career as an athletic trainer in Martin, so I began looking at medical and PA schools.
I attended a PA program at the University of South Dakota and graduated in July 2021. I was able to do 3 of my clinical rotations in Martin, which allowed me to experience working in rural clinics as well as in an emergency department. This experience was extremely helpful for me in deciding where to work. I began working for the Bennett County Hospital, Nursing Home, and Rural Health Clinic in September 2021, which are located all in 1 connected facility.
Q: How does your degree in athletic training help you better treat your patients?
PA Hicks: My prior education as an athletic trainer gave me a greater background in musculoskeletal and sports injuries than what I received in PA school. This is an area of medicine that I was able to make an immediate impact on when I began working in Martin.
Many of the physical examination skills I use for musculoskeletal and sports injuries were learned in the athletic training program. My background as an athletic trainer also gives me experience in rehabilitation exercises for injuries. As rural providers, many of my patients would have to travel 1 hour or more to access formal physical therapy. Some of these patients do not have the resources to reasonably make this work. Thus, I can educate patients on at-home exercises that are safe and effective without long commutes to access care.
Q: Tell us about your hometown of Martin, South Dakota, and why you selected this community to work in?
PA Hicks: Martin is located in southwestern South Dakota between the Pine Ridge and Rosebud Indian Reservations. Martin has a population of 1200, so growing up it felt like I knew everyone. It was this atmosphere that I wanted to return to and raise my family in. However, Martin and the surrounding area have a lot of poverty and many people are uninsured or underinsured. It can also be difficult to retain medical professionals in Martin because it is so rural. There are fewer activities or options for dining or shopping in Martin compared with suburban areas. I wanted to return and be the provider that the community knows and whom they can trust will still be there the next time they need to be seen.
Q: What is a day in your life like at work?
PA Hicks: My work day varies based on which site I am scheduled at for the day. Currently, I work 3 to 4 Emergency Department shifts each month. Our shifts are 24 hours and we stay at the facility. For a small community, we have a fairly busy Emergency Department and typically see approximately 8 patients per day. When covering the ER, I am the sole provider with a nurse. We frequently see trauma including car accidents, assaults, and other accidents that we have to manage until we can get them to either a trauma center or, in severe illnesses, a facility with appropriate resources and specialties.
At the clinic, I typically see 8 to 10 patients most days in addition to making rounds in the nursing home. Additionally, I will also care for hospitalized patients. We have a small hospital and can functionally care for a maximum of 6 to 8 patients with 1 nurse and an aid staffing the floor. When patients with severe trauma or multiple patients with trauma present to the Emergency Department at the same time, I may come from the clinic or nursing home to assist with those patients as well.
Q: What are the benefits and drawbacks of working in a rural setting?
PA Hicks: Working in a rural setting is unique in that your patients are people you engage with frequently outside of the health care setting. Some of the people I take care of helped raise me or were my friends growing up. This does make you feel more invested in the care that your patient receives; however, that same relationship can at times make it difficult to separate work from your personal life. People will often approach you outside of the clinic or hospital to discuss their medical concerns.
It is important to establish boundaries outside of work or you will feel like you never leave work. This relationship can also make working in a small Emergency Department difficult. There are shifts where you will treat family or friends, some of whom may be having the worst day of their life. Being able to separate your emotions from the situation can be difficult but is essential to providing proper care. At times this means taking a moment after the case to collect yourself before returning to work. While this can make work difficult, it can also be rewarding. In a small community, people will reach out to thank you for helping them. Those little things that happen in a small community are really what make working here worthwhile.
Q: How do you prevent/manage burnout?
PA Hicks: Working in a rural area, it is easy to become burnout as you will often get called in while at home or during the night as well as receive calls from people you know personally. Being able to set boundaries is important so that you can get time away from work. For me, being outdoors helps reduce burnout. My wife and I also own a ranch so I stay busy outside taking care of cows or fixing fences when I am not at work. This time outside allows me to not focus on health care and be in a relaxing setting.