Primary care is preventive care

It’s a frustration many of us have felt. You pick up the phone and can’t get an appointment with your primary care office.

Across the country, our healthcare network is facing a crisis at one of its most critical entry points in patient care. Family medicine offices, also known as primary care, are buckling under the strain of doctors retiring from practices, increased demands for healthcare further amplified by the COVID pandemic and staffing shortages.

The importance of primary care cannot be underestimated. It is the foundation of our healthcare system. For many of us, when you are ill or have a problem, the first person you speak to is a primary care provider, or PCP. And whether you live in a rural area or an urban neighborhood, your primary care office most likely is staffed by a team of PCPs, led by a physician, and includes nurse practitioners and physician assistants, known as PAs. They are your long-term partners, sharing the responsibility for your physical health and well-being.

While there is much work to be done in shoring up primary care so that it can be the best that it can be—such as offering more incentives for medical students to enter primary care, decreasing administrative work, lessening insurance regulation and investing more into the primary care system—the medical professionals who work in the primary care field believe strongly they are making a difference at a personal and community level. And physician assistants are a big part of this solution.

According to the National Commission on Certification of Physician Assistant’s (NCCPA) 2021 Statistical Profile of Certified PAs, the family medicine sector experienced the greatest proportional growth between 2017 and 2021 for all graduating PAs across the country. 

Facts about primary care

• There are 168.7 primary care providers (PCPs) for every 100,000 Americans.
• 51.1 percent of PCPs are nurse practitioners and physician assistants
• Physician assistant and nurse practitioner jobs are among the 10 fastest-growing professions in America
  (Source: ValuePenguin Research)

Meet our Bay Path PAs who love their jobs

Since graduating from Bay Path, Emanuel “Manny” Parrilla ’20, has worked at the Baystate High Street Health Center Adult Medicine in Springfield.

“During school, and after I graduated from the University of Massachusetts, Amherst, in 2017, I worked as an EMT. We responded to mostly trauma and Level I calls. In my senior year, I decided to be a physician assistant because I wanted to know what had happened to those people our EMT team had helped, and, in some cases, if their problems could have been addressed earlier. Over time, I learned that primary care was important because it is preventative care. If more people had access to PCPs, there would be less strain on ERs.

If I were to say what would make a difference in our health system, it would be educating people to make them aware that they don’t have to go the ER as their first option and having more people go into primary or family care. Other medical specialties may pay more, but I believe that if you want to make a real and noticeable impact in a person’s life, practicing primary care is second to none. 

Do I love my job? Absolutely. I’ve developed a rapport with my patients, and at the same time, I know I am working for my community. I put in a lot of hours, but my job is incredibly satisfying. Every day is different. Every day has new challenges. But I am also lucky. I can see my rewards every day in the faces of my patients.”

A COVID Frontline Hero

It was March 2020 and Manny Parrilla was just months away from graduating.  After years of hard work, he could see the light at the end of the tunnel.  Then the pandemic hit.  Suddenly, everything turned upside down, including the normal routines in hospitals, healthcare clinics, and offices.  

As a seasoned frontline responder, in April 2020 Manny was deployed by FEMA to New York City as an EMT working with the Fire Department of New York (FDNY).  Luckily, he was able to fulfill his obligation because there was a hiatus in the PA program as it set up learning and clinical protocols to adhere to new public health recommendations.  Manny found himself in the midst of ground zero of the pandemic.

“I worked for American Medical Response, often in 12 hour shifts.  The whole situation was very hard to process.  Here we were telling people NOT to go the hospital.  You hurt your ankle.  We would say ‘Don’t go.’  Or you had a cut.  Again, ‘Don’t go.’ It was so important to stay away from the hospitals because COVID was inside the hospital, too.  Often, there was no capacity. No space.  It wasn’t unusual for our ambulance to be waiting in line for three or four hours with patients.  It was brutal.”

Manny’s experience in New York City prepared him well for his transition to working as a physician assistant.  He knew firsthand what to expect and how COVID had changed the patient-primary care provider dynamics. The protocols he had learned in the physician assistant program, many high-touch and patient centered, were dramatically altered.  As COVID subsided, Manny returned to in person, patient-centered care with a wealth of experience that made him appreciate even more his role as a PCP.

Robert O’Rourke ’18 is a staff provider at the Northwest Community Health Center in Libby, Montana. Nestled in northwest Montana, the location is both a blessing and a detriment.

“I worked as a respiratory therapist for 17 years at a local hospital. Ultimately, I was recruited by a cardiologist friend who encouraged me to go back to college to be a PA. Our area of the country is resource-strapped for providers, so I could see there was an immediate need.

Our practice covers Lincoln County, and we serve around 15,000 people. 

In a typical day, I see everything. Even in my first week on the job, I saw patients from five days old to 95 years old. It is the beauty of primary care. You see something different every day. You never get bored. 

One of the challenges we have out here is definitely staffing. First, there are just not enough providers going into family care. That’s true across the country, particularly in rural areas. And then there is the location. It seems romantic to move to the big outdoors of Montana, but when a person experiences the remoteness and the reality of long winters, well, it makes it hard to retain people. But all the providers from the various clinics work together to give our Lincoln County the best healthcare. It’s a special place.

Yes, I love my job. There is a lot to be said for providing care in a small community, and there is a real satisfaction in helping to make people’s lives better. You are giving back to a community that you love, and it cultivates a sense of belonging. Personally, I have regular experiences when someone will come in and they will be at a low point in their lives, and I am able to make a huge impact. And then when I see them doing well—it doesn’t get any better!”

Please visit the MS in Physician Assistant Studies program page to learn about curriculum, faculty, program options, and more!