Making a Change
Lynchburg News and Advance
Wednesday, July 23, 2003Sitting at a desk in the Free Clinic of Central Virginia with a stethoscope resting on her shoulders, Denise B. Willis looks like a medical veteran. But the 51-year-old is changing careers - the stethoscope is a symbol of her new direction. Willis, a licensed pharmacist, is an intern in the master of physician assistant program out of Eastern Virginia Medical School (EVMS) in Norfolk.
Willis finishes up a rotation in community medicine today at the Free Clinic in Lynchburg.
The eight-week rotation has taught her a lot. "I learn something new every day," she said
Willis wanted to work in a small city or rural setting. And as a National Health Corps Scholar, she learned some fellowships were available through the SCEPTER program administered by the Virginia Primary Care Association."That's how I ended up here."
"We've been very fortunate to have her,'' said Bob Barlow, Free Clinic executive director. "It benefited us, having her."
Barlow said he hopes that EVMS will consider the site again - Willis is the Free Clinic's first physician assistant intern, and he'd like to have more.
Her preceptor at the Free Clinic was Melanie Smith, family nurse practitioner.
"She's definitely been an asset here," said Smith, who also works with nurse practitioner interns and senior Lynchburg College nursing students."Because of her experience as a pharmacist, she's already had patient contact out in the working world and her knowledge as a pharmacist has enhanced her ability to perform an intern role."
Willis, a pharmacist since 1978, earned her degree from Temple University in Philadelphia, where she practiced until she moved to Virginia in 1989.
She's worked in a number of pharmacy settings - hospital, retail, mail order, her own pharmacy (a franchise) and in short-term pharmacist jobs for an agency.
"I loved it," Willis said. "But I still wasn't happy ? my attitude was getting to be very poor."
She knew the signs of burn out: "responding negatively to customers, patients coworkers. Everything irritated me when I was at work. When I wasn't at work, I was fine."Her decision was clinched during a two-month job with the Indian Health Service.
"I was allowed not only to work in inpatient and outpatient pharmacy, I was allowed to go to some of the remote sites with the physician assistants and nurse practitioners."It was more patient contact, and I could see where I was helping the patient," Willis said. "I had gotten to the point in pharmacy I was no longer seeing where I was helping making a difference."
When she had started out in pharmacy in 1978, there were neighborhood drug stores to visit, even some house calls, but over the years, she said "that fell by the wayside."
Now there are leaflets to explain the drugs, constant high volume, and hours on the phone with insurance companies and doctors' offices. And pharmacy technicians began doing more of the work.
"I love pharmacy technicians - don't get me wrong - but because they were doing the actual work ? we'd do all the drug review utilization. Now we're doing paperwork."
So she made her decision to change.Now about halfway through, "my classmates laugh at me because I'm excited all the time," said Willis. "And I'm the oldest one in the class."
Willis is a part of a class of about 34 students, explained Patricia Shull, interim director of EVMS' master of physician assistant program, one of four in Virginia. EVMS graduated its first PA class in 2001.
A physician assistant is considered a dependent practitioner, working under the guidance of a physician to do evaluations, treatment, and therapies.
Physican Assistant programs are competitive - this year 114 applicants vied for 36 slots - and do attract older students. The average age is 34.
Having someone come in with a pharmacy degree is unusual - nationally only about 4 percent of PAs come in that way, said Shull. But it really helps in the pharmacology course, "one of the toughest."
The year-round program is pretty intense: 15 months of classes and 12 months of clinical rotation through nine specialty areas.
Willis will be through in May 2004. But she's not letting her pharmacy license lapse. "I worked too hard for that."
As a PA working under a doctor's supervision, she can diagnose, treat and order lab work, X-rays and some types of therapy. And that's given her new insight into the prescriptions she once filled.
Willis has no desire for an independent practice. "I've owned a businesses, I've been in supervisory positions - I'm sort of over that.
"I want to come in, do my job, help the patient. And go home for whatever else I'm going to do."
Even for a pharmacist, the PA program is hard work."The only thing I don't like is taking exams on computer," Willis said.
"I don't like that click, click, click. I've gotten used to it, but I don't care for it."As part of her rotation, Willis designed a free health screening for Jubilee Family Development Center on Florida Avenue. The first was this month and others are scheduled for October, January and April.
Her next rotation is internal medicine in Philadelphia.
Her time at the Free Clinic was educational.
"Because the volume here is not really heavy, I have time to really learn. And the type of patient that comes through here has such a wide range of problems, I have learned a lot."
Ultimately, Willis expects that when she completes the PA program, she'll join a family practice and work with the geriatric (older) patients.
"I know that's my calling."
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