A look at the role of physician assistants from the point of view of the PAs who work in the UConn John Dempsey Hospital emergency department
The physician assistants who staff the UConn John Dempsey Hospital emergency department include, from left: Katie Smith, Erica Sheehan, Alex Skonieczny, Ersilda Ajce, Thomas Yantus, Carly Roy, and Heather Kurtzman. (Photo by Chris DeFrancesco)
When you're a patient in an emergency room, given the circumstances you may not be likely to remember all the different roles, let alone the names, of the people involved in your care.
In the UConn John Dempsey Hospital emergency department, patients often encounter a member of the care team whose credentials and function may not be immediately obvious. But if you've been a patient there, chances are your care has been in the qualified hands of a physician assistant.
"PAs are trained in the medical model like physicians," says Heather Kurtzman, who's been a PA for 14 years, the last six at UConn Health. "We are an extension of the physicians and are fully capable of handling almost all emergencies that come through the doors. We function mostly independently but have the physicians support if needed. We also often spend significant face time with patients in the ED, getting their history and making their care plan while consulting with the doctors behind the scenes."
Kurtzman is among the dozen PAs who work in the ED,. She also covers in the urgent care clinic in Canton.
This group of PAs is just amazing and we are so lucky to have them here at the UConn ED. Working with them every day is seriously one of the best parts of my job. — Dr. Alise Fralliciardi
"Our PAs in the ED are the backbone of our entire system," says Dr. Alise Fralliciardi, UConn Health's medical director of emergency medicine. "They cover our ED 24 hours a day and quietly and efficiently make an unpredictable ED flow smoothly. The team we have is insanely talented, smart, effective, compassionate and professional. They take their work so seriously and take pride in their patient care. They bend over backwards to make sure patients have what they need."
Katie Smith, the ED's lead PA for the last five years, says physician assistants work both independently and in partnership with Fralliciardi and the other attending physicians to care for patients with a wide range of conditions.
"PAs are an integral part of the operations of the emergency department here at UConn Health," Smith says. "With the fluidity to see patients in all areas of the department and of varying levels of acuity, our PAs play a major role in ensuring department flow."
Recalling the height of the pandemic, Kurtzman says the group drew a collective strength from working through it together, supporting each other with a blend of humor and sarcasm.
"I grew up playing sports and the ED has always provided a team atmosphere," Kurtzman says.
She acknowledges that emergency medicine also comes with its share of challenges.
"We have chosen to be PAs because we love this career and medicine and love this specific role," Kurtzman says. "Working in patient care can be challenging in today's world where people expect instant satisfaction and problems to be solved immediately, which we often cannot do. We are often yelled at, insulted, and talked down to, but you grow a thick skin and know that in the end, we always try to do our best and do what is best for the patient."
Kurtzman is a graduate of the PA program at Weill Cornell Graduate School of Medical Sciences. She says she knew as an undergrad she wanted to be a physician assistant, so she worked as a phlebotomist in New York City to build patient care hours for her application.
"We have a great group of PAs from various backgrounds," Smith says. "Some have backgrounds in primary care, urgent care and surgical specialties, while others came to us straight from their student rotations here in the ED."
That was Smith's road to UConn Health, straight out of the PA program at Springfield College in 2013.
Four years later, that was Carly Roy's path.
"Getting to interact with and treat patients of all ages, from different backgrounds and with their own stories is one of my favorite things about this job," Roy says. "The most rewarding aspect of my job is when I am able to make a patient's day a little better. Patients don't typically come to the ED because they're having a good day. Providing a patient care with compassion and understanding is equally as important to me as providing the actual medicine."
She notes that she and her fellow PAs treat conditions that involve all organ systems and perform a variety of procedures, such that no two days in the ED are alike. The variation appeals to her.
What also appeals to Roy about UConn Health is her experience in the ED during her elective rotation as a PA student, which she says was her favorite rotation.
"UConn truly is a learning hospital," Roy says. "I wasn't only taught by my preceptor, but by the entire team. I learned from the PAs, attendings, nurses and MAs. Everyone really is willing to help the students learn. I continue to see this now with the different students and residents who cycle through. My coworkers play a big role in what keeps me here. I feel very thankful to be a part of this team."
Ersilda Ajce, who also joined UConn Health in the ED right out of the Springfield College program, three years after Roy did, reports a similar experience.
"I had a rotation here and loved the environment and was happy to start my career as a PA here," Ajce says. "Everyone is a great teacher and wants you to learn to be the best provider you can be. I love the environment of the ED. You never get bored. Every day is different and there is always so much to be learned."
Erica Sheehan '10 (ED) has been an emergency medicine PA for six years. She joined UConn Health from Lawrence and Memorial Hospital in New London early last year.
"I actually never thought that I would end up working in an ED but I found that I really enjoy it," Sheehan says. "I like being exposed to all sorts of different medical conditions and different patient populations. Every day I see and learn something new. I am certainly never bored at work!"
The PAs in UConn Heath's ED mostly work 12-hour shifts, three days a week, rotating to cover one weekend a month and dividing the major holidays.
Sheehan, who studied exercise science as a UConn undergrad, says what she finds most rewarding about her work is any time she can help a patient.
"This can be something as simple as prescribing an antibiotic for strep throat or providing a referral to a specialist and helping coordinate outpatient care," she says. "Other times it's identifying a serious condition and initiating management from the ED and then coordinating inpatient care."
Oct. 6-12 is National Physician Assistant Week.
"This group of PAs is just amazing and we are so lucky to have them here at the UConn ED," Fralliciardi says. "Working with them every day is seriously one of the best parts of my job. The ED is a hard place to work. It is long hours, nights, holidays and weekends. They do this because they love it, and it shows."
UConn Health has more than 60 physician assistants working in its hospital or outpatient practices.
"We are most fortunate to have such a remarkable group of clinicians in our physician assistants, who provide outstanding care daily in service to our patients," says John Dempsey Hospital Chief Operating Officer and Chief Nursing Officer Caryl Ryan. "It is important that we recognize and acknowledge their contributions, not just this week, but year-round."
"Our physician assistants are an integral part of our provider teams," says Dr. Scott Allen, UConn Health's chief medical officer. "Their range of expertise spans emergency and critical care to assisting on surgeries and to our ambulatory clinics. They are an outstanding group of practitioners who elevate the quality of care and patient experience at UConn Health."
Physician assistants, also sometimes referred to as physician associates, are licensed clinicians who've completed an accredited master's degree-level program, performed 2,000 hours of clinical rotations, and passed a certification exam, according to the American Academy of Physician Associates, which estimates more than 168,000 PAs are practicing in the U.S.
"A lot of people are under the impression that we really are 'assistants' - the name is misleading - but in the ED we are very independent, see our own patients and come up with our own plans," Ajce says.
