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To honor and serve

Caring for our nation’s vets

By Joni Moths Mueller

“I’m terrible at multitasking,” apologizes Christine Davis, while simultaneously welcoming me, offering me a seat, responding to her pager and texting a message to a 62-year-old Vietnam veteran who wonders if he can have chemotherapy today. He has 100 percent service-connected chronic leukemia, caused by Agent Orange.

“No,” she texts him, “but you can have a transfusion. Come on in.”

Then, Davis, PA, H Sci ’12, takes a call from a veteran who has stage-4 renal failure caused by multiple myeloma. Pain shooting through his joints woke him in the middle of the night, he says, and it hasn’t stopped. Davis asks questions, listens closely and then promises to call back after she talks to his primary care doctor. She pauses for about 2 seconds to say, “I really like this role,” commenting on her job as a physician assistant in the hematology/oncology unit at the Clement J. Zablocki Veteran’s Medical Center in Milwaukee. “It’s what they brought me in to do ... help providers who are treating patients.”

Almost before those words are out of her mouth, she’s moving again, and quickly, heading down the hall and into an exam room where waits a 60-year-old female Air Force vet who has metastatic bladder cancer. She came into the VA this morning because of a sudden onset of cold symptoms and, while Davis is here, she asks: “Would you want to take a look at a strange bump I found near my abdomen?”

Yes, Yes, Yes. Davis is 45 minutes into her morning. Not good at multitasking? Really?

Milwaukee’s VA provides the full complement of health care services for veterans. Its proximity to Marquette enables terrific partnerships, and there may be no better example than the relationship between the VA and the physician assistant studies program. The two began collaborating the year this academic major and its academic home — the College of Health Sciences —  were established in 1998. Since then, PA students have completed clinical rotations in inpatient care, internal medicine, cardiology, general surgery, plastic surgery, emergency medicine, neurology and neurologic rehabilitation, neurosurgery, and psychiatric/behavioral medicine.



“Our students’ experiences are vast, and I have no doubt they make an impact on delivering care to our country’s veterans,” says Mary Jo Wiemiller, PA-C, clinical assistant professor and chair of the program. Of course, the anecdotal comments Wiemiller hears support her assessment. She’s continually told Marquette PAs are “a cut above,” “well-trained” and “prepared.”

In 2012, the PA program and the VA expanded their partnership when they joined forces as one of six programs selected nationally to pilot a residency program. The objective is to train PAs in primary care with advanced clinical knowledge and the ability to handle the complex health issues seen among the nation’s vets. In the first two years of this federally funded initiative, the four participating residents have all matriculated from Marquette. Faculty members from Marquette participate in the didactic teaching that supports the residency.

This still fairly young academic program sets a seriously high bar. Graduate PAs consistently score in the top 5 percent on the PANCE national certifying exam. But there’s something even more important to Wiemiller. “We think it’s great that they just crush the board exam, but what’s more telling is we have had 100 percent job placement for the past five years,” she says. “We’re in high demand.”

Talk to current PA students and there is a consistent complaint — but they say it while smiling. This is a killer program, they say, tougher than tough, tougher than they expected. Just getting admitted requires fortitude. Each year, between 750 – 900 applications are sifted down to find 200 – 230 candidates with strong academic credentials, the right background and the drive to be successful in the program. These candidates have only passed the first hurdle. Next comes the in-person interview, the final culling process. Ultimately, 55 candidates will take seats as members of the next class.

OK, so they made it in. But then their desire is really put to the test. The program is 32 months long in contrast to the average of 28 months at other PA programs in the nation. Wiemiller says the timeline fosters a curriculum that supports a hybrid program where one-half of the class constitutes Marquette undergraduates pursuing degrees in biomedical sciences. The other half comprises graduate students, many with prior health care experience. All students are put through the intense three-year cycle of didactic clinical medicine courses and clinical rotations.

“We train the students to come out prepared for primary care,” Wiemiller explains. From there, they can practice in primary care or move into a focus of special interest.

A perfect example is the way Davis assists doctors on the hematology/ oncology unit. The PA always works with a supervising physician but has great autonomy to diagnose and treat illnesses, prescribe medications, gather health histories and perform physical exams, interpret tests, and develop treatment plans for patients.

“PAs are able to expand a health care team and allow more individual time to be spent with patients,” says Wiemiller.

With all of the changes coming as a result of the Affordable Health Care Act and 60 million more Americans poised to become health care consumers, Wiemiller sees great opportunities for PAs.

“It’s an exciting time because it’s competitive, the job market is here and the role that we play is so critical to the future of America’s health care.”


Meet some Marquette PAs

Christine Davis — H Sci ’12, PA partner with five attending physicians and 10 fellows on the hematology/oncology unit at the VA

Inspiration

Totally, completely elated to work as a PA. She had a background in medical sales and a desire to move into the role of a practitioner, to provide a high level of individualized care at the moment patients need it most. There could be no more suitable match than at the VA where, working with supervising physicians, she sees patients, spends time listening to them and planning treatment plans. In this unit, patients can be severely ill and Davis can be doing curative or palliative care. This is what she worked so long and hard to be able to do.

In her own words

“I’m here for patients who have something come up. There’s someone for them to see or talk to.” That’s evidenced when a Marine vet who has 100 percent service-connected chronic leukemia comes in for a transfusion. He’s waiting for a stem cell transplant, and the road traveled has been tough. He hands Davis a “challenge coin” with the Marine Corps emblem on one side, and, on the flip side, his unit’s motto, “Death before dishonor,” and says: “I thank you very much for fighting for me.”

Renan Saavedra — H Sci ’12, PA resident, focus primary care

Inspiration

Is one of two Marquette PAs selected for the residency program this year. He came to this role in medicine after a career in athletic training. While in that role, he worked with premier athletes on physical conditioning. Now, he works with vets on holistic health. There was always a part of him that cared for others. He recognized that early in life, but it took years of personal discernment to find the path to a PA.

In his own words

“It was always a passion to practice medicine. At the end of the day, you have the feeling that you made some type of difference or learned something new that you didn’t know the previous day. As a student, you learn about medical management. Once you transition to become an actual provider, your learning curve becomes exponentially steeper. You’re actually making medical decisions based on what you’ve learned and what you experience. It’s gratifying.”


Ryan Fell — Third-year PA student, second rotation at the VA

Inspiration

Totally passionate fella who has a great gift for gab and loves chatting with his patients, putting them at ease, learning their stories. Fell’s own story is entertaining. He pursued this dream for 14 years, after careers as an Army medic on tours of duty in Korea and Iraq and as an athletic trainer for student-athletes at Brookfield Central High School in Wisconsin. Fell met a PA when he was in the Army, and that pretty much ruled his future. After his discharge, Fell tried to resist that call. He had a great job, a wife and a baby on the way, but little by little his resistance gave way and he enrolled.

In his own words

“PA school has been everything I thought it would be. When it came time to decide what kind of rotations I was going to do, I asked outright whether there are opportunities at the VA. As a veteran, those are people that I felt I wanted to participate in their health care. I think it’s a fantastic place to learn because some of those patients are fairly complicated, some have lots of health issues — some by their own choice and some by the outcomes of being a defender of our country.”


Ben LaCoursiere — Third-year PA student, second rotation at the VA

Inspiration

May be the only PA student ever to walk into the surgery suite in mask and scrubs and spot his grandfather’s name on the white board that lists surgeries being prepped. He couldn’t resist the moment, so he moved into the operating room and said, “Hi, Grandpa.” Needless to say, a very proud grandfather perked up fast that day. LaCoursiere was a biomedical sciences major who went directly into PA studies. He says being a PA offers a balance of being able to diagnose and treat and spend time with patients.


In his own words

“I wanted to go into health care, wanted to help people — as clichι as that sounds. Working with vets is an honor and a privilege. There’s one common theme in all my patients at the VA — gratitude. They are appreciative, more so than at any other hospital I’ve been to. I will always look back on my time fondly, both for the experience it brought me and the opportunity to work with those who so bravely defended our country.”



Partnering

The Clement J. Zablocki VA Medical Center’s proximity to Marquette enables partnerships that attract faculty researchers and that bridge the gap between academics and practice. Walk down any hall and chances are good that alumni, graduate students and students currently studying anything from nursing to physical therapy to psychology to biomedical engineering will cross your path.

Law School’s legal aid

War-related wounds and ailments aren’t the only challenges facing those who serve their country. Many also need legal advice. Marquette’s Volunteer Legal Clinic pro bono program includes twice-a-month sessions for veterans and their families to receive free brief legal advice and referral services on civil legal issues.

“These folks made sacrifices, and the least I can do is help them out with some of their legal problems,” says Ian Thomson, Law ’10, who began working in the legal clinic as a student and continues today as a volunteer attorney.

Under the supervision of Julie Darnieder, Law ’78, clinic director, the legal clinic opened in 2009 on the grounds of the Milwaukee VA. It was moved to the nearby Milwaukee County Veterans Service Office in 2012.

The cases can be emotional, often involving family law, bankruptcy and foreclosure. Sometimes, the answers aren’t ideal. Volunteer attorneys often find themselves consoling as well as counseling — another example of the Jesuit ideal of cura personalis.

“People come in, and they clearly think the weight of the world is against them,” says C.J. Szafir, Law ’11, a volunteer attorney. “They’ve given up all hope.”

But for all the tough cases, there are many veterans who are thrilled to have help solving a minor dispute or writing a will. For Marquette law students, volunteering provides a practical lesson. Attorneys aren’t expected to know all the answers — just how to find them.

“It’s amazing,” says Joy Sisler, a third-year law student. “I try to tell everyone who’s an incoming student that they should do the legal clinic because it gives you a little bit of experience in just about everything.” — Chris Jenkins

College of Nursing partnership for vets

Maggie Brumley is no stranger to serving her country. A junior in the College of Nursing and a member of Marquette’s Navy ROTC program, she will be the ninth member of her family to serve when she begins her required five years of active duty and two years of reserve duty after graduating in May 2015.

Brumley jumped at the chance to be a part of the college’s new veteran-centric cohort, which will ensure veterans continue to receive the specialized care they’ve earned.

“Most of the students in the cohort are either ROTC members or have family members in the military, so we’re excited to be a part of a program that brings recognition to veterans’ health care needs after service,” Brumley explains.

A five-year, $5 million VA Nursing Academy Nursing Academic Partnership Program administered by the Department of Veterans Affairs is being instituted at five nursing schools around the country to help fill expected future vacancies at VA hospitals. The nurses will be prepared to care for the specific needs of veterans and their families.

The College of Nursing partners with the Clement J. Zablocki VA Medical Center, which provides a clinical setting for students. The partnership also funds 10 additional full-time College of Nursing faculty members during the next five years, allowing 40 more students to enroll at Marquette by 2014–15.

“We integrated a veteran-centric curriculum into the majority of our undergraduate pre-licensure courses,” explains Dr. Kerry Kosmoski-Goepfert, associate dean in the college. “The students in the veteran-centric cohort receive the same education as their peers, but they complete all of their clinical rotations at Zablocki.”

Participation in this cohort, Brumley says, “will put me a step ahead of other nurses once I go into active duty.” — Lynn C. Sheka


Comments


Comment by Karen Davis at Jan 17 2014 06:19 pm
As a veteran and a sister, I could not be more proud of Chrisine Davis...you go girl! :)
Comment by Kayt Havens MD at Jan 22 2014 02:13 pm
AS a faculty for this PA residency, I am so proud of our residents and graduates. They exemplify the finest of Marquette.
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