Steve Hanson, PA-C 

On January 1, 2020, I made the difficult decision to nearly fully retire.  I have been a PA for 39 years, and for the last 11 years, I have been working in an outpatient surgical clinic. The OR was becoming physically challenging for me, so I had moved to two part-time gigs (one day each per week) and I enjoyed them. When the stay-at-home order was enforced in California on March 19, 2020,2 I had some difficult decisions to make.

My domestic partner is responsible for 2 teenage boys who are now taking classes at home due to the high school closures. My partner is also a PA; she works in cardiology at the local county hospital. It fell to me to stay home and home school the boys while she went to work.  

I told my workers’ compensation practice that I was not going to be available to work for at least 4 weeks, maybe even more.  I also had concerns about my general surgery outpatient clinic. However, with the changes to the laws governing telemedicine and HIPPA, the clinic transitioned fully to telemedicine over a 24-hour period and I was able to see 15 patients from my house. Then came the suspension of elective surgery in our community.


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The bulk of our practice is bariatric surgery and, in the next 24-hour period, my surgeon partner made the difficult decision to lay off most of the staff and close the office to all but emergencies. I was out of that job, too.

Jim Anderson and I began talking about the challenges that the pandemic poses for us in the twilight of our careers as PAs and health care providers. Prior to being a PA, I was a paramedic, and my career started with a guiding principle: when everyone else runs out, we run in.  

I have many PA and physician friends who are on the front lines here in my community of Bakersfield, CA. We have not yet been hit as hard with the virus as other communities, but the number of cases and hospitalizations are increasing daily. I have never asked a colleague to do a job that I would not be willing to do myself.

My situation is complicated right now because of my age and my health history. I am at a greater risk for complications with exposure to COVID-19.

I have a number of what I perceive as “duties” right now. My first duty is to my family to keep them safe and healthy. While my partner continues to work full time, I have been holding down the fort, making sure that her boys are protected and that she has a safe space to come home to.

My second duty is the one that I swore to when I began working as a PA in 1981, and that was to put the interest of my patients, and the health interests of my community, ahead of my own. I rationalize in my mind that I have done more than 40 years of my PA obligations to my community and my patients; however, I cannot help but feel more than a little guilt that I am not standing shoulder-to-shoulder with my physician and PA colleagues doing what I can to fight this pandemic.

In the past few weeks, PAs and NPs have stepped up like never before. I am hopeful that this pandemic will be the catalyst that will forever allow PAs to take their place in the health care dynamic at the top of their training and experience.

It is difficult to not be part of this revolution right now, even though Jim and I had laid the foundation for change over many years in leadership both on the state and local level. So, for people like us, what is next?

While Jim has a robust telemedicine practice, I am looking for other ways to contribute. My first step was to contact both the chief medical officer and the head of the emergency department at my community hospital (where I am still on staff). I let them know that while it doesn’t make sense for me to directly care for acute COVID-19 patients, there are a number of ways in which I can help the hospital staff and relieve the pressure on them when the surge hits, including through administrative staff support, telemedicine screening and follow-up of homebound patients, and caring for patients without COVID-19.

I also contacted California Health Corps, recently announced by Governor Gavin Newsom, to volunteer part-time in my community as a PA, or whatever other jobs that needs to be done.

It is hard to say what will happen in our respective states, but there are many PAs like us, as well as working PAs, who have been displaced from their jobs, wither as elective surgeries have been cancelled or primary care practices have been downsized.

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I try to keep reminding myself that I have done my duty throughout many decades as a PA and at many levels. I still find it difficult to “sit on the sidelines” so to speak, especially when I still experience, usable skills, and I am still physically able to work. Time will tell what will happen in this unprecedented pandemic, and whether or not we get to an “all hands on deck” crisis in our respective states.

References

1. Holshue ML, DeBolt C, Lindquist S, et al. First case of 2019 novel coronavirus in the United States. N Engl J Med. 2020;382:929-936.

2. Governor Gavin Newsom issues stay at home order. CA.gov. https://www.gov.ca.gov/2020/03/19/governor-gavin-newsom-issues-stay-at-home-order/. Accessed April 9, 2020.