This is the story of two PAs who have made the difficult decision to work from home during the novel coronavirus (COVID-19) pandemic.

Jim Anderson, MPAS, PA-C, DFAAPA

I have worked at an opioid use disorder treatment center for most of my 20 years as a physician assistant (PA). The clinic is based in Seattle, and I’ve grown to love it more than almost anything else in my life (except for my wife, my family, and my plastic Bonsai tree).  

As COVID-19 emerged in Asia, I became concerned. .  I wondered what would happen if it came to the United States, to Seattle, and to my high-density clinic. What would happen to the 1300-plus patients who are packed into our clinic for daily dosing? What might happen to our staff, our counselors, and our medical providers who work with our high-risk patients every day, many of whom are homeless and have chronic medical illnesses?

When COVID-19 rolled into the Seattle area, it came quickly. The Seattle area recorded the first reported case in the United States,1 and Seattle was named the “epicenter of US COVID-19.” Dread swept over me and I worried about the many people I work with, including my patients. What would happen to us?

As a 66-year-old man with asthma and hypertension, I fretted about my own risk while also wondering if I was being selfish to think this way. What about my patients? What about my younger, healthier PA/nurse practitioner (NP) colleagues?

I have long been blessed to have a PA who is both my friend and my health care provider. I recently started seeing another PA as my primary care provider and I frequently see an NP when my other providers are not available. They are the type of providers that any of us would be lucky to have. As the virus spread, I touched base with all 3 providers and asked them this question: “I’m nervous and worried about the high-risk setting I work in, and I’m wondering what I should do to keep myself, my patients, and my community safe?

All 3 clinicians responded with the same reply: “If you get COVID-19, you are more likely than others to have a bad outcome, and I recommend you work from home.” I was relieved, but conflicted, to receive this advice. I was overwhelmed with guilt and felt like I’d be abandoning my patients and colleagues if I worked from home. But I knew, after talking to my reliably wise wife, that this was the best thing to do.

I didn’t want to pause my responsibilities. I talked on the phone to my medical director, who was 100% supportive, and who immediately started helping me think about how I could perform my role from home. I met with my administrative supervisor, and as I told her about my situation, I started crying. She was kind and supportive, even though this change would place enormous burden on her. She helped me through the conversation in a way that I’ll never forget. 

I have been working at home for about 3 weeks [as of press time]. I have been able help screen sick patients through our telemedicine portal.  I miss my office, my refrigerator full of Spindrifts, seeing my colleagues, and my plastic Bonsai tree, but I’m enjoying my new role and I am particularly enjoying the increased opportunity to work more closely with our amazing nursing corps in the new position. I’m on call from 5:30 AM to 1:30 PM, and the adjustment in my hours has been newly challenging for me, but overall, it’s working out well.

I still feel guilty about my already stressed colleagues who now have to see my patients, and I also worry about what my patients have heard about my absence. Some of my patients have told me that they heard I was sick and that they’re worried for my well-being. While I assured them that I’m OK, I wondered about what they make of this situation, about their concerns for my health, and I’m deeply moved by their thinking about me.

I have been taking my situation day by day, but I’m very lucky to work in a place that has offered me support and the opportunity to continue to play a role in caring for our patients. Until then, I’ll be doing my best and keeping my Bonsai tree in mind.