Living our values: Physician assistants at U-M Health

October 11, 2022  //  FOUND IN: Our Employees,

Approximately a 6-minute read

Across Michigan Medicine, faculty and staff work hard to carry out exceptional patient care, education and research.

Part of those efforts are centered around the organization’s core values. Throughout our organization, you can find extraordinary examples of caring, inclusion, innovation, integrity and teamwork.

In honor of Physician Assistants Week 2022, here is a closer look at some ways U-M Health’s PAs are living out these values daily.

Caring

PAs know the importance of making sure patients feel heard and respected and remain committed to delivering patient-centered care while working collaboratively within the health care team — demonstrating both a commitment to high reliability and high-quality care. For the last 13 years, PAs have also taken this commitment beyond the exam room, extending it to the broader community. 

Each year, Oct. 6-12 is recognized nationally as PA Week. This is an opportunity to recognize the PA profession and its contributions to the nation’s health.

Beginning in 2009, PAs at U-M Health wanted greater local significance to PA Week than recognition of the profession alone. It was collectively felt that giving back to the community would fulfill that goal.  So PAs partnered with Habitat for Humanity, building homes for those who needed assistance. The project was inspired by the principle of “taking care of our own,” as the first homes renovated were for Michigan Medicine employees. Later projects helped any community member who needed it. 

This has become a tradition that we are extremely proud of,” said Marc Moote, chief PA at Michigan Medicine. “It’s something unique that has always differentiated us from other health systems, though we always hoped it would grow to other hospitals throughout the state.”

Once the COVID-19 pandemic hit, the philanthropy shown by Michigan Medicine PAs didn’t stop. Instead, the group pivoted their fundraising and volunteering efforts to focus on providing basic necessities to neighbors in the community by partnering with Food Gatherers. PAs and their families can make monetary donations or volunteer their own time at the organization’s location in Ann Arbor.

Between Food Gatherers and Habitat for Humanity, the running 13-year total for all causes raised by PAs at Michigan Medicine has surpassed $75,000, with more than $15,000 since the pandemic began — equivalent to more than 40,000 meals donated specifically to Food Gatherers.  

Inclusion

With the BASE priority of Belonging introduced among U-M Health’s strategic initiatives, many advanced practice providers are expanding their efforts to improve diversity, equity and inclusion.

“Some of our team members are serving on their departmental DEI committees and have become involved in DEI-related projects and programs,” said Brian Downie, APP director for PAs at U-M Health. “This work includes changing practices within departments to support DEI and raising awareness among our colleagues to recognize our own biases.”

Additionally, several Michigan Medicine PAs serve on the U-M Flint PA Program’s advisory board, with Chief PA Marc Moote chairing this important committee. Other members include Downie, Sarah Ketelhut and Stanley Mukundi. 

The advisory board, in close collaboration with Dean Donna Fry, PA program director Stephanie Gilkey, and U-M Flint faculty, have identified Diversity, Equity and Inclusion as a top priority for the PA Program that is actively monitored and tracked. With assistance and inspiration from the U-M Medical School Interim Associate Dean for Medical Student Education Steven Gay, M.D., the U-M Flint PA Program implemented a holistic admissions process, seeking to improve the profession’s diversity for future generations.

Meanwhile reaching the next generation of learner’s remains top of mind from a strategic perspective in diversifying the PA profession. PA leadership has participated in Operation Opportunity each year since its inception in 2016, a high school enrichment program run in a collaboration between U-M Health, the Wayne-Westland Community School District and EMU Bright Futures. 

“It is important that the next generation of PAs represent all backgrounds, beliefs, ethnicities, and perspectives in health care,” Moote said.

Innovation

Since the first PA was hired at U-M Health, administrative representation for PAs has been organically developed through local leadership, which has grown slowly over time. PA feedback suggested reporting to peer leaders would have desirable benefits. As a result, U-M Health set out to design and implement a new organizational structure to better serve all APPs. The structure PAs are helping implement will provide improved opportunities for professional growth and career advancement at U-M Health.

“The new structure will clarify our reporting structure, provide consistency in evaluations and create a work environment where everyone can thrive,” Moote said. 

The APP organizational structure will also help solidify mechanisms to support APPs when unexpected needs arise. The structure will soon provide a level of organization, support and readiness vastly different than the organically grown and siloed teams of the past.

The structure is in the early days of implementation but, once fully realized, will provide broad representation for all APPs. The first significant implementation milestone was to hire the PA and NP directors in May 2022. In the coming months, the structure will be hitting its next major milestone with the posting of several incremental APP manager positions to provide leadership for every service line.

Teamwork

The PA profession was built on the principle of teamwork and collaboration. The new APP organizational structure is standing behind these principles, forging partnerships between PAs and NPs that will build stronger, more effective teams. APP managers and leads, representing both PAs and NPs in their service lines, will enable a more cohesive team experience. 

“This approach prioritizes patient care while clarifying support and delivering care,” said Shahrzad Patterson, APP director for PAs at U-M Health. “With this structure, we hope to bring our teams together to create a stronger, more cohesive professional workforce.”

But physician assistants don’t limit their teamwork to local levels. A record number are stepping up to collaborate with U-M Flint to serve as preceptors for the inaugural class of student clinical rotations.

“Precepting supports our academic mission as well as creating a pipeline of future PAs to serve patients at U-M Health,” Downie said. “Precepting not only benefits the students but provides an opportunity for all precepting PAs to remain active learners themselves.”

To further enhance the student experience and that of the preceptors, efforts are underway to improve student documentation. Once implemented, these improvements will allow preceptors to review and verify (sign and date), rather than redocumenting, notes made in the medical record by other physicians, residents, medical and physician assistants, and APRN students, nurses, or other members of the medical team.

Integrity

Many PAs throughout the health system serve in other capacities while volunteering for specialty organizations, teaching and speaking nationally — cognizant of the importance of learning and sharing best practices.

But that’s not the only example you can find of PAs serving beyond their primary roles.

A number of current physician assistants have proudly served or serve in the U.S. military as active duty or reserve service members — some continuing to do so while working full-time. They have represented several branches of the military and practiced a variety of medical specialties.

For instance, Stanley Mukundi is a captain in the U.S. Army Reserve. He has been involved in providing health care during training missions for domestic and overseas deployment over the past six years, traveling to bases in the Horn of Africa and Poland.

“On those missions, our care is not confined to the four walls of a hospital room or clinic,” Mukundi said. “We care for patients wherever the mission takes us and wherever they need assistance.”

Mukundi said that U-M Health as an organization has been very supportive of his efforts.

“My coworkers pick up my work and continue providing incredible care to our patients in my absence,” Mukundi said.  “The support I have felt by my colleagues here at U-M Health has been exceptional.”   

Thank you to all of our PAs for everything you do every day!

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