In honor of National PA Week, Clinical Advisor is featuring PAs who are making a difference in the field. Today, we highlight Leticia Banker MPAS, PA-C, who is a Lieutenant Commander in the US Navy. She has been in practice for over 12 years, 11 of which she served in the Navy. In spring 2018, she assumed the role of the Deputy Regimental Surgeon with 7th Marine Regiment, responsible for 8,000 Marines and the oversight of 10 battalion medical officers. She sat as the acting Regimental Surgeon from March to July 2018 and was later selected for Task Force Spartan in Al Taqaddum, Iraq, as Task Force Surgeon in support of Operation INHERENT RESOLVE. When she returned to the US she was appointed to the position as 7th Marines Regimental Surgeon. She has received 2 Navy Commendation Medals, 2 Navy and Marine Corps Achievement Medals, 1 Meritorious Service Medal and various unit-specific service acknowledgments.

She currently serves as the department head of Navy Medicine Readiness and Training Command (NMRTU) San Diego Miramar, which is home to over 40 clinicians, 3 ancillary clinics, and 3 specialty departments. She has worked on credentialing committees, developed standard operating procedures for patient-centered medical clinics, and assisted in the clinician’s transition to a new electronic medical record system. PA Banker, is currently pursuing her DMSc and is hoping to one day return to the world of teaching and help mold the next generation of PAs.

Q: What is your role as a PA in the US Navy?

PA Banker: Working as a PA in the Navy is different than in other clinical settings. We are not only medical providers; we are so much more due to the demand of the eclectic job. I have been afforded the opportunity to be a clinic administrator, a metrics manager, and an educator. I am often the counsel in operational planning and sometimes the health benefits coordinator with specialty clinics. There are times I have been given opportunities to attend leadership courses, acupuncture training, and various fellowships. I also have worked as a medical assistant, front desk manager, and in a nursing capacity when needed — whatever was required to ensure that the patient received appropriate care.

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Q: What encouraged you to become a PA?

PA Banker: I was working as the interim head athletic trainer for the University of Missouri-Kansas City while completing my Master’s in Education when I met someone who was planning on starting PA school. I was already sucked into sports medicine, but I was attracted to other areas of medicine also. Our university had a relationship with the medical school and they would send doctors to help with various other dermatological or medical issues. One night I was working with one of the residents and I found myself teaching him how to perform a proper knee examination. That was the moment I thought “I should be doing more,” and decided to enroll in PA school. 

Q: What is the most rewarding part of your job?

PA Banker: The most rewarding aspect of my job is the leadership opportunities—the ability to make a change. I currently sit in a position responsible for leading an extensive clinic that is the work home for over 80 people. I am also responsible for signing performance reviews for both active duty and enlisted individuals.

I recently received a review for a young man who was informed that he had failed to be selected for the next rank and that his military service would soon end. Unfortunately, such scenarios happen too often. I was not happy and I didn’t feel that the evaluation represented all the hard work that he had contributed to the clinic. There was an underlying thought process that he was transitioning into civilian life and this last evaluation was unnecessary. We discussed his philosophy on life, medicine, and serving in the military. I expressed my concerns, and while he didn’t agree with my thought process, he did agree to provide my leadership with an updated CV to assist us in augmenting his evaluation. Three weeks later, an announcement informed my team that this young man was promoted to the next rank, which comes with a pay raise and an opportunity to complete 20 years in the Navy and retire with a pension. Those stories are the ones that stick with me the most. The people that I touch in this job. 

Q: What is the most challenging part of your profession?

PA Banker: The aspects of my profession that are most challenging, are the daily reminders to those around us that we are so much more than just a PA. PAs in the Navy sit in critical positions worldwide. Yet, relatively speaking we are new to the Navy (1989) and have not been afforded leadership opportunities.

The continued need for our clinical presence, constant demand to deploy, and competition with doctors and nurses for leadership positions make it challenging. I have not yet found the silver bullet that will assist in fixing this problem, but I keep pushing that glass ceiling along with other PAs. I am hopeful that one day, others higher up will say, “I don’t care if they are a PA; I just want someone who can do the job.”  

Q: What is your most memorable patient?

PA Banker: My most memorable patient was one who taught me more than he knew. He had a poisonous scorpion bite that occurred in the desert. We were too far to transport him to the ER, and we needed to give antivenom. Unfortunately, no one knew how to administer the medication. It turned out the drug required a timed administration and I didn’t have an IV pump, let alone a nurse. After speed reading and a quick nursing lesson online, I learned how to calculate a drip count, reconstitute the drug, and provide the needed medication. I know that many may share a story of a fantastic patient that touched their hearts, which I do experience daily, but the scorpion patient means more to me. He taught me that I need to always be on my toes and that I am more than “just a PA.” I am a medical professional who trained, studied, and helped save his life. 

Q: How do you avoid burnout?

PA Banker: It is so hard to avoid burnout in the Navy, due to the need to move from place to place, not knowing what department I will be working, and maintaining continued superior performance. I feel that we experience a different type of burnout because our jobs change frequently and we are required to wear several hats. That is why I say burnout is a practically unavoidable situation for almost everyone in medical with such candor; because sooner or later, I will move away to a new position and have a fresh start in a new location, with new people, and new leadership. We do have a Navy PA support group, which helps with burnout quite a bit, and often we will call and say, “I don’t need any suggestions right now; I just need you to listen to me vent.” Additionally, I dance to keep the stress away. I was a professional dancer in a previous life, and now I dance at a great small school with other adults who embrace life in tap shoes. 

Q: What do you know now that you wish you knew before PA school?

PA Banker: The only thing that I know now that I wish I knew coming out of school was the process for getting into the Navy sooner. If I had joined the Navy while in PA school, my finances would be less daunting.

Q: Any last thoughts for our readers?

PA Banker: While my life as a PA is much different from those working at the local community clinic, we share the exact same attributes. Our jobs are complex, the people are amazing, the patients are worth it all, and I wouldn’t change a thing.