Monday, April 30, 2012

Nipple Fear and Breastfeeding Revisited

Nipple Fear and Breastfeeding

Americans puritan fear of nipples relates to their inability to embrace breastfeeding as a mother-baby process that can take place anywhere at the convenience of the mother baby pair. 

Click here:
to read my earlier post on Breastfeeding and Nipple Fear

Why are Americans so afraid of showing nipples, seeing nipples and even saying the word "nipple?"  And how does our apparent fear of nipples influence our concept of breastfeeding?

on the NBC Today Show web site epitomizes nipple fear in the United States.

"The latest in the breast-feeding wars comes all the way from South Korea and involves the epitome of American snacktime: the Oreo cookie.
An ad from Agency Cheil Worldwide pairs the crème-filled treat with an unlikely image: a super-cute baby holding the cookie while nursing on his mama’s breast.  The accompanying slogan: “Milk’s favorite cookie.” (It's unclear if Nabisco, maker of Oreos, is actually using the ad or if the agency just created it.)"

Breastfeeding sells
I say: Why not use breastfeeding to sell Oreo cookies?  Why not use Oreo cookies to sell breastfeeding.
Why cover the nipple in this baby's mouth?
"It’s one thing to cheer when other cultures portray breast-feeding as normal. But isn’t there something kind of... icky… about the way this ad blatantly sexualizes breast-feeding?" writes Varma-White.
How does this ad sexualize breastfeeding?  She makes the point that this polished picture idealizes a mother-baby moment with an airbrushed breast.  I say, so what!
The real focus in this photo is the baby's eyes looking out at the viewer as if to say, "Don't even think about taking my Oreo, dude!"
Here is the uncensored photo

 Sexualizing the nipple

We have sexualized the breast in this country so much that we must now engage in nipple fear and nipple covering to come to terms with our pilgrim-like sensibility.  We make pasties to cover women's nipples.  We write laws for strip clubs that limit how much of the breast a woman can show when dancing around on a pole for men who are paying to watch!  Really people!?
LP cover from the 1960s

But we are not really afraid of nipples and areolas and showing and seeing them in photographs and art work.  We are really afraid of admitting how much they represent what really tantalizes us-individually and as a culture.

Nipple Covers
We cover nipples with a lace bra that would never stay on
We even cover mermaid nipples with long hair.
These vintage LP record album covers from the 1960s are an example of the lengths that our culturally dictated norms regarding nipple portrayal lead us to.  They all show beautiful images of iconically erotic women engaged in a come hither dance or pose with their nipples strategically covered by a manufactured or artfully placed garment.

Nipple coverage today
And we are still doing this today, even when we decline to show a picture of a baby with his mother's breast in his mouth!  And isn't that a great place for a women's breast to be?

Happy 200th Birthday Louisiana!

© David Alan Harvey / Magnum Photos
Bicentennial la Louisiana

April 30, 1812 Louisiana became a state.

Slate has a moving montage of photos to celebrate Louisiana's big birthday.  The image at left reminds me of swamps, bayous and backroads I have been down in Louisiana.

Bayou Love

Whether viewed from a pirogue with my uncle or from my house in Maringouin (means mosquito-ville in French), cypress knees in a swamp or beautiful.

Playing Roy Orbison's "Blue Bayou" sung by Linda Ronstadt in my mind.

Happy birthday Louisiana!

Friday, April 27, 2012

"Tigering" and Mike the Tiger

My cat on my foot

My cat thinks he is Mike the Tiger, LSU mascot.  
Here he is trying out for the role.

The real Mike, resides comfortably in Baton Rouge in his habitat on the LSU campus.
Mike roars

My cat also enjoys the water as Mike does (see below).  But I allow my cat, Little Boy, to get in the shower with me.  I don't allow Mike the same privilege.

Tiger Roar
My credit union in Baton Rouge, has an automated call in phone system.  It's the usual "Press 1 for customer service" type deal.  But you are also invited to "Press 7 to hear Mike the Tiger Roar."

Mike enjoys a dip.

Thursday, April 26, 2012

How to prepare for PA school (while shopping) & Pectus Repair Surgery

Shopping in Toronto
I recently found myself in Toronto for the weekend where I was able to squeeze in some preparation for physician assistant school while window shopping at Holt Renfrow department store.

My friend here at left was in the men's department and I couldn't resist a photo opp with him.

"You have a screw in your sternum."
Yes, my skeletal buddy here seems to have a screw in his sternum.

(I can't wait to get into anatomy lab this fall at Daemen College's physician assistant program!)

Pectus Carinatum Repair Surgery:
My son's sternal repair

Speaking of sternums (or is it "sterni"?), my son's sternum and ribs were reconstructed two years ago at Children's Hospital of the King's Daughters in Norfolk, Virginia by a very talented and diligent team of surgeons who corrected his pectus carinatum and pectus excavatum defect (sunken chest syndrome).

Pectus excavatum is a relatively common skeletal (chest wall) defect of the sternum and associated ribs.  Owen's defect was a combination pectus carinatum (aka pigeon-like rib cage) and pectus excavatum defect and was a particular challenge for surgical repair.
Pectus Carinatum
"Pectus carinatum is a deformity of the chest wall in which the sternum and rib cartilage protrude outward, something like the breast of a bird. It is much less common than other chest wall deformities, occurs four times more often in boys than in girls and typically becomes more pronounced during the early growth spurt of adolescenc." - from CHKD web site.
Click image to view slideshow

Dr. Kelly and the surgeons at CHKD's Pectus Clinic resected eight ribs and broke his sternum to lift it up into proper position then placed a ten inch steel bar to brace the sternum in a grueling eight hour surgery.
(And I say grueling as in Dr. Kelly admitted that this was a particularly difficult case and he looked exhausted and was wet with sweat when he emerged from the OR and spoke with us in the waiting room after eight hours of a difficult surgery - usual time is 3-4 hours.  Dr. Kelly had difficulty getting my son's sternum to conform to the proper angle and ultimately had to settle for a degree of correction that was not as much as hoped for.  And he had called other surgical partners into the OR and had another on video consult.  Owen was a tough case. )

Owen was not a candidate for the less invasive Nuss bar procedure you see here in this video.  He had an open chest surgery called a modified Ravitch procedure.

Click image to see Dr. Kelly performing a pectus carinatum repair.

Go to this link to see Dr. Kelly explaining the pectus carinatum surgery.

And by the way, Dr. Robert Kelly is a ROCK STAR!

By the way, Dr. Kelly's physician assistant cared for Owen post-operatively.  And that steel bar is still in place and will have to be removed in a second surgery.

Ronald McDonald

My son came through it like a champ.  And I will be a supporter of the Ronald McDonald House from now on--even though I don't eat the McDonald's restaurant offerings unless under dire duress.  We made multiple trips to Norfolk from Louisiana that year and the folks at the Ronald McDonald House in Norfolk were wonderful to us.  Thank you, Ronald!

This picture below is one of my favorite of Owen, Ronald and me in Norfolk, VA.

I never pass up an opportunity to pose for a pic whenever I see a Ronald McDonald figure.  I have a complete travelogue of photos of me with various Ronald McDonald figures all over the U.S.
Me, Ronald and Owen

Monday, April 23, 2012

Snow in Buffalo on April 23rd

If I was a native Buffalonian, I might say, "Here is why I LOVE Buffalo."

But I'm not.  So I won't.


An elegant breastfeeding image

My Cat Wrote this Post for Me

"Hmmm, If I only had opoosable thumbs."

Mom had to cover the top of the toaster because when I stand on the top my feet fall into the slots.

Sunday, April 22, 2012

Breastfeeding in the bath tub.

Breastfeeding in the bathtub
Nursing in a warm bath is a great way for mother and baby to relax and bond.  I love how the baby in this photo is looking up at his mother as if to ask permission for something.  Or it could be just a look of recognition, either way it is a sweet photo.

"When it gets cold in Buffalo, I wear my sweater."

"When it gets cold in Buffalo, I wear my sweater," says Cornish Rex Odette.

"Yes, I have a big nose"

Ready for my close up.

AmIGone? Funeral Home in Buffalo

One location of Amigone Funeral Home in Buffalo, NY
Am I gone?  Well, if I am a customer at the Amigone Funeral Home in Buffalo, NY probably so!

Really, Buffalo!

Fitness Skirts make no sense

Fitness skirts

What's up with these things?  Why would you want to wear a fitness skirt (if you're not playing at Wimbledon)?

fitness skirts come in pink- a shock
Pink again- great abs and a maternity fitness skirt!
These fitness skirts are going to end up on every designers sale rack if I have anything to say about buying them.

I don't want to run, cycle or lift weights wearing a skirt much less a short skirt.


Thursday, April 19, 2012

What is the Human Microbiome? And why you should care.

The NIH has a common fund project to study the human microbiome.
What is a human microbiome, you ask?
It is the total microbial organism community in one given individual (bacteria and viruses).  The microbiome includes the genomes and the interactions of all these organisms in and on the human body.

Could this be another organ system that is not us but defines us and our health? 
  • Could this microbiome organ system define and regulate our digestive tract as early as birth when our gut is cultivated with bacteria from our mother's colostrum?
Below is a summary of the NIH's Human Microbiome Project.
"Program Snapshot
The Common Fund's Human Microbiome Project (HMP) aims to characterize the microbial communities found at several different sites on the human body, including nasal passages, oral cavities, skin, gastrointestinal tract, and urogenital tract, and to analyze the role of these microbes in human health and disease."
Joshua Lederberg, Nobel Prize winner and Yale graduate, pioneered this work as he discovered and uncovered bacterial sexual methods and techniques.
Once it was known that common bacteria, such as E. coli, were communicating genetic material amongst themselves via pilli (think strange tiny bacterial penis), we figured out that they were really one step ahead of us medical folks and our antibiotics as they engineered their resistance to antimicrobials.

Research on the microbiome and how it interacts with human physiology and disease is accelerating.  It is now thought that microbes play a role in Type I diabetes, obesity and a host of autoimmune diseases.

Animals benefit from colostrum. Our babies should too.
Medical Ethics

Here is a fascinating article on who owns the rights to your personal bacteria.  This brings up many new and interesting medical ethics issues.  Who is responsible for your personal microbiome?  What about the bacteria that you share with others and your environment?

Silent portents of our medical fate

Doesn't this all speak to the fact that we are but one organism in our environment, just one giant organism that tools around in an invisible but messy pool of microbes.  Our microbiome defines us, telegraphs our presence, leaves a footprint behind in our sewer systems as we slough off thousands of bacteria daily and tells untold tales of our biologic fate.

Tuesday, April 17, 2012

Power Blogger, Heather Armstrong, on Today Show

No British Accent
Power blogger, Heather Armstrong of, was on The Today Show yesterday morning.

Before she began to speak, I expected a British accent.  But the former Mormon from Tennessee speaks perfect Americanese.

The self-described mommy blogger, who turned her blog into a family supporting business and who has a vague Twiggy like resemblance was touting her new book and revealing her impending divorce.  Her blogs and tweets are pithy and saucy with a biting but humorous edge.

Here is a paragraph from her blog that is particularly amusing because it works in Al Roker's nipples into the convo.
"Last night I had a dream that Al Roker was demonstrating proper breastfeeding techniques to me and a room full of 18 other pregnant women. He had gigantic nipples and was handling them with an almost unlawful carelessness, just swinging them around and pinching them and mooshing them like little red meat patties. He made sure to warn us that we shouldn't try this at home, not yet anyway, because persistent nipple stimulation has been known to induce labor. And I know I had this dream because I just read about the whole nipple stimulation technique, that there are some doctors who recommend that a pregnant woman past her due date try twiddling her nipples for up to three hours at a time."
In her start to finish autobiographical "about me" section she describes that moment several years ago when she hired her first employee for her blog, and it reminded me of the moment when I hired my first employee of my breast pump rental business.
Linda was my son Owen's babysitter.  She kept several small children in her home.  She was middle aged, provincial and not really comfortable with breastfeeding, but she was willing to give it a shot and try.  And that we did.  Fifteen years later, after many more employees come and gone, I was ready to close the business and start a new chapter--readying myself for physician assistant school.

Heather's description of that moment in her business and her family life struck a chord.  I remember that feeling of momentum, of striving for that next thing, the next goal.  Goals are simple to quantify on blogs--readers, views, comments, posts, ads, ad revenue.  I measured success in my business, Mother's Best, by how many breast pumps I had, how many I rented out and how many times a day the phone rang.  It was gratifying, exciting and exhausting, as I'm sure running the business that Heather's blog became is also.

There must be something freaky, scary about making the dialogue of your life into a business that sustains you a la Kate plus Eight Gosselin,
name your K Kardashian, or OctoMom.  They have more guts than I do.


I wish Heather good luck as she divides her family.  I know how painful this process is and how many years it can take to heal financially, emotionally and completely.  Here's hoping her process is not as lengthy and painful as mine.

Monday, April 16, 2012

Memorable patient experience - PART II

Here is Memorable patient experience- Part I 
for your review before Part II.
  • time: it's Easter weekend 
  • place: small hospital in Louisiana
  • characters:  young patient came in through the ER who had coded multiple times prior to moving to ICU; me still practicing drawing blood gases.

    Easter Sunday
      It was Easter Sunday, and I was back at work in microbiology. 
      My patient's blood cultures, tracheal aspirates were all growing the same pathogen.  This 25 year old was clearly headed down a septic path.

      When I returned to ICU to draw more blood gases later that day, the seasoned ICU nurse quipped, "So you're back for more blood from the pedophile in Bed 3?"

      I held his hand while using a Doppler to try to locate the swooshing sound that would help me locate an artery I could hit.  I wondered what level of consciousness he was in.

      I was fighting back the audio playing in my head--a strange combo of Gregorian chants, Queen blasting at a high decibal rate and a recitation of John Milton's "Paradise Lost." 
      My patient never stirred;  he looked peaceful as I stabbed at his radial artery.

      Monday morning

      He died that Sunday night.
      The ICU nurses said his death was noisy, violent  and unlike the quiet slipping away that many of their patients experience.  They firmly maintained that "a dark force came and got him."

      And when I returned to work that Monday, I learned he was a convicted pedophile who had sustained brain damage in prison at the hands of other inmates.  He was out of prison and in the care of his family who couldn't keep him from repeatedly pulling his trach out.

      I admit to having the urge to pour undiluted bleach on my hands (not ever a good idea) because I had handled his hands repeatedly, and I now associated them with unsavory acts that I imagined him doing.

      BUT...I had felt sympathy for him as I visited his bedside that holiday weekend.  And it was not my place to judge him or sentence him.  Those jobs had already been done by designated elected officials.  It was my job to collect and perform blood gases and read and report on his microbiology cultures.  My role was easy.  Though it caused me much reflection after the fact.


      I was sent to do a morgue check that Monday morning, and he was there in a body bag.  I had seen him everyday since Good Friday in different stages and now in the morgue.

      Morgues are generally starkly quiet places inspiring a certain level of reflection and this is very true at 6am in the morning and when there is only one occupant.

      Take away message: 

      Every patient deserves equal respect and appropriate care and treatment.  Patient's are rarely the attractive, smiling models that hospitals show in their publicity campaigns.  Our perceptions of a patient's past or place in life should not influence our care for them.

      Friday, April 13, 2012

      Memorable patient experience - PART I

      PA school interviewers often ask applicants about memorable patient interactions.

      As a veteran of several physician assistant school interviews, and I sat in several group interviews where I listened to fellow applicants detail how they had "made a difference" for elderly residents of nursing homes they volunteered at or had assisted a stressed out patient in the emergency room as they transported them through the hospital.

      I, too, had many remarkable patient interactions during my years as a lactation consultant in Baton Rouge.  As well as a few interactions with patients at hospitals and clinics where I worked as a clinical lab scientist.  And one of my most memorable and poignant patient experiences, is one I chose NOT to share during any of my interviews.*

      Well, here's the patient experience (in two installments) I didn't share:

      *I really hesitated to write about this experience because it is anything but warm and fuzzy.  It is counter to everything that people want to hear about.  But the memories are still sharp and the take away message feels strong.

      A patient I won't forget...

      It was Easter week and I was working several overtime shifts in the lab at a small regional hospital in Louisiana.   (Southern Louisiana is predominantly Catholic, and Good Friday is a big holiday.)  Most businesses are closed and families often gather for the first crawfish boil of the season as they prepare for traditional Easter church and family activities.

      Blood gases
      Drawing an arterial blood gas sample

      I was training to draw arterial blood gases.   I was eager to learn how to draw blood gases, even though I was in the microbiology division of the lab, because I craved patient interaction and I aspired to become a physician assistant.  So I badgered the techs in chemistry incessantly to bring me with them when they went out on the wards or to the ER to draw arterial blood gases.
      And I got to practice my arterial sticking skills (which were not too awesome).

      Blood gas assay
      Good Friday

      It was Good Friday, when I accompanied a tech to the ER to draw blood gases on a 25 year old man.  When I first saw him he was non-responsive, covered in homemade tattoos and had an obviously inflamed tracheostomy.  His restraints tethered him to the bed in a way that gave him a crucified appearance.   A couple of disinterested looking family members looked on.  I knew he had already coded once and I wondered why such a young person was in this situation.
      The other tech showed me how to palpate the arterial pulse and I attempted an arterial stick unsuccessfully.
      I felt sympathy for this young guy in the ER in restraints and wondered how he and his family came to spend Good Friday and indeed Easter weekend in the hospital.
      We drew blood cultures in addition to the blood gases (thanks to my trusty senior tech) and returned to the lab.

      Positive Blood Cultures

      Blood cultures should never be positive.
      But this guy's blood cultures were all positive with the same Streptococcus pneumoniae that his tracheal aspirate cultures were growing.  Strep pneumo is a frequent causative agent of pneumonia and it is never an organism that you would want multiplying in your blood!  He was septic with an encapsulated strain of Strep pneumo that had probably set up housekeeping in his trachosteomy site partially as a result of his habitual the trach out.

      The young man was moved to a bed in the ICU.  Over the course of the Easter weekend, I went to the patient's bed side to draw multiple sets of blood gases.  Or attempt to I should say.  He was on a respirator and was completely out of it--a good patient for me to practice drawing arterial blood gases on my senior tech pointed out.  Arterial punctures in the wrist are particularly painful due to the tight structure there with ligaments and such, and they are equally difficult to collect.

      Throwing darts

      I found myself holding his hand, feeling his wrist for an arterial pulse and studying where to insert the needle.

      My preceptor advised me to hold the syringe like a dart.  Then after observing my next futile attempt she said, "hold it like a dart, don't throw it like a dart!"
      I think I was likely the butt of more than one joke in the lab that day.  And I felt particularly sad that I was making a pin cushion out of this young guy in ICU who was now alone in the sterile environment there with no family.

      But he was silent, on a respirator and deeply sedated as I tried again and again to hit an artery in his wrist...

      Stay tuned for PART II.

      *DISCLAIMER:  Please note that the above situation in no way identifies a patient.  No privacy rights have or ever will be violated here.

      Thursday, April 12, 2012

      Snapshot of current PA demographics

      This article in the April issue of JAAPA gives an interesting snapshot of the PA profession in the United States as of the end of 2011.

      Where does the average PA practice? 

      This snapshot reveals the profession as predominantly female.  The states of New York and California have the greatest numbers of practicing physician assistants.

      It jumped out at me that the states of Mississippi and Louisiana only have 111 and 744 physician assistants respectively.  And Arkansas has fewer than 200.  As a resident of Louisiana (and New York), I am a bit surprised that PAs are so few and far between in my home state of La.
      Our Mississippi friends need more PAs.

      Why so few PAs in some states?

      This is curious.  I wonder why these states are so under represented. 

      • Is this because large cities in some of these Southern states are widely separated?  
      • Is the scarcity of PA programs in these states a large contributing factor?  There are only two PA programs in the state of Louisiana and one each in Arkansas and Mississippi.

      Observation:  Hawaii has only 233 practicing PAs. 
      Conclusion:  Clearly Hawaii is underserved!
      To do list:  Complete PA school, lose 10 lbs., look great in bikini, move to Hawaii to practice.

      Tuesday, April 10, 2012

      Florida physician assistant student saves child's life with CPR

      Florida physician assistant student saves child's life with CPR.

      This article at describes the events surrounding the Florida 25 year old physician assistant student who dove in to a closed community pool and rescued a young child by performing CPR.

      Who says students don't make a difference!? 

      Wow, how awesome!  That'll make you want to sit up straighter in your CPR class!

      I've been CPR certified for a while now as my work in hospitals and also as a fencing coach requires it.  I have never been called upon to use the CPR skills.  And I admit to not feeling uber confident to do so at this point.  But I certainly hope my PA school training changes this and that I may be able to perform as admirably as this woman did in such a moment.

      Monday, April 9, 2012

      Choosing the right Physician Assistant school

      I just wrote a guest post for one of my favorite physician assistant students sites,, on choosing the best physician assistant program for your needs, so it seems a good time to let everyone know which physician assistant school I have chosen.

      Daemen College in Amherst, NY
      Daemen College

      I will be attending Daemen College's physician assistant program starting this fall.  This seems like a good fit for me.

      Their reputation in Western New York is excellent.  Physician assistants I have shadowed with and their supervising MDs have had only good things to say about Daemen and their graduates.  I have attended several WNYPAA meetings and events, met current students and faculty who all seemed like people I would enjoy working and learning with.

      Non-traditional student

      I am a non-traditional student with a diverse background in healthcare, education and business.  (Some schools seemed to look at my extensive and varied background as an advantage and some as a disadvantage.) 
      As such, I really worked hard at my application process for a few reasons:

      1. Firstly, because it was so incredibly important to me that I get into PA school.
      2. I felt that I needed to level the playing field for myself.
      3. But I found that the more I worked at it, the more I explored, read, researched and networked with people, the more I learned and became a better candidate.
      Finding a voice and a mentor:

      On my path to PA school, I decided to leave nothing to chance.  I made every possible effort to make sure I would be favorably received as a candidate.
      I became an avid reader of JAAPA, a student member of AAPA, as well as my state and local PA organizations, attended meetings and generally soaked up everything PA.

      Along the way, I found a mentor, new friends and a voice for myself.  I learned the value of Twitter.  And I even learned some interviewing lessons--see my post on interviewing while sick to follow some of my recent travails.

      So, in a way, I am saying good bye to that stage of my process and getting ready to open the door to my new stage -- starting physician assistant school in the fall at Daemen College.  Can't wait!

      Sunday, April 8, 2012

      Happy Easter!

      Chocolate covered Peeps rule!
      Happy Easter everyone!

      The Easter Bunny visited here this morning and left Easter eggs, tulips and chocolate covered Peeps.
      Chocolate covered Peep has been CHOMPED!

      Me and the Man Cub, aka Owen.

      Owen is here for Easter week.
      We are planning a roasted pork loin, mashed sweet potatoes with ginger and fresh asparagus for dinner today.  Cooked pig, always good.

      Saturday, April 7, 2012

      Mass. bill urges inclusion of Physician Assistants as Providers

      A bill proposed in Massachusetts would include physician assistants and nurse practitoners in the definition of providers.

      The MMS (Mass. Medical Society) opposed this terminology as they fear it would limit consumer's ability to locate them as primary care providers.  And they state this would "undermine(s) the quality of our health care system."

      Massachusetts Medical Society

      Just sayin'

      Wouldn't it be excellent if MDs, PAs and NPs were all on the same page on this matter?

      These three groups of medical professionals work together as a team, why can't they unite in supporting one another in legislation?

      Thursday, April 5, 2012

      Lobbying on Capitol Hill for Physician Assistant Healthcare Issues

      Supreme Court building
      Last week was healthcare week in Washington DC.

      Capitol Hill was besieged by healthcare professionals and protestors as the Supreme Court debated the constitutionality of healthcare reform.

      I was in DC as a student member of the American Academy of Physician Assistants (AAPA) to participate in the Capitol Connection and lobby my senators and representatives.  After attending some educational sessions on the do's and don'ts of speaking with your congressional representative, some role playing, pep talks, and a reception, we all hiked over to the "Hill."
      Cat ("Pud") on a leash in front of the Capitol

      The steps of the Supreme Court were like a scene out of a movie--Mr. and Mrs. Smith go to Washington.  Police lined up on the steps and protestors from both sides of the healthcare reform issue paraded in front of them.  Then there were the MDs, PAs, RNs and others there to lobby their congressional representatives on healthcare issues near and dear to their professions.

      Personal nightmare

      I admit to walking briskly by the Supreme Court step protestors not wishing to be caught in the fray of an unknown protest when I was unclear about their position.  Personal nightmare = being photographed on CNN "protesting" in front of the Supreme Court for a view that is not my own.   So I proceeded efficiently over to the Senate office buildings for my first morning appointment with Senator Landrieu's office.
      Calder mobile "Mountains and Clouds" in atrium of the Hart Senate Building

      PAs and PA students speak out to their legislators

      Physician assistants and Physician assistant students lobbied Senators and representatives on these four issues:

      1. Medicare Hospice Care Access Act (Senate bill 891/ HR 3831) Providing for reimbursement for PAs who provide hospice care.   The ASK:  Improve patient access and continuity of care by including physician assistants in hospice care.
      2. Title VII Health Professions Program  Funding for primary care practitioner education - we need more physician assistant educational program funding.  The ASK:  Support for $12 million in funding for PA educational programs in fiscal year 2013.
      3. Federal Workers' Compensation Modernization and Improvement Act (HR 2465) Allowing PAs to treat federal employees under workman's compensation.   The ASK:  Improve federal employees access to affordable medical care by including physician assistants as providers.
      4. Health IT Modernization for Underserved Communities Act of 2011 (HR 2729)  We need to include physician assistants in the list of eligible health professionals who receive the EHR (electronic health record) incentive payment.  This will encourage more facilities to meet the federal mandate for EHR use by 2015 with more physician assistants on board.    The ASK:  Include physician assistants in this federal incentive along with physicians, dentists and advanced practice nurses.

      Take away message here:  Physician assistants need to be included.  

      More grass roots advocacy needed

      We need more physician assistants speaking up and establishing a professional presence and position to our legislators.   I was surprised that there were only some 240 attendees at the Capitol Connection and some states were not represented at all. This is when I inquired if we had any physician assistants from Louisiana there and when learning that we did not (I'm sure they were all at home working) I decided to visit my Louisiana senators, Sen. Mary Landrieu and Sen. David Vitter and Representative Rodney Alexander.  I also visited New York Senator Gillibrand and Representative Brian Higgins (Congressman Higgins represents Western New York).

      Physician assistants are too often left out of legislation because bill authors assumed that if it covered physicians it covered physician assistants.  And this is not so!
      A beautiful day on Capitol Hill

      Physician assistant students as advocates

      Physician assistant students are in a unique position to become advocates for their newly chosen profession.  As students we often have more flexible use of our time and we have the fresh, in-your-face, enthusiastic spirit that the public and our legislators need to see and experience.  More physician assistant students need to step in and speak out.

      Capitol Hill is full of fresh faced, young, legislative assistants who are making their names as interns and young policy professionals who inform and advise their bosses on the issues.  Let's let them see some of our fresh faced physician assistant students advocating for their profession.