Filling the Void
Posted by Lawrence HermanComment
 4Musings-Blog-HeaderThis article appears on the Journal of the American Academy of Physician Assistants’ blog, Musings.

Like many PAs, I’ve practiced in a host of specialties over my two-decades-plus career. I started in emergency medicine and concurrently did some moonlighting as a hospitalist, in occupational medicine, urgent care, and then moved into full-time family practice, other internal medicine subspecialties and finally education. What has been the singular constant is that every one of these specialties had a void, what is sometimes referred to as a vacuum. What I am describing is an area with a specific need that nobody was consistently filling. In mentoring students and new graduates, I have always recommended seeking out that void and moving into it.

Bright and forward-thinking PAs, perceptive in their areas of expertise, have seen these voids and responded. Locally, we have a hospital system in which the PAs have seen voids and taken the initiative by developing and implementing new and innovative programs.

The first instance that comes to mind is a program associated with developing protocols—as well as training advanced practice providers—with respect to central venous access devices (CVADs). In this hospital, PAs independently developed a protocol to determine which patients needed a CVAD, how to monitor the CVAD and when to remove the device. They also developed an educational program to train providers who would be inserting the CVADs. The focus of the protocol was on reducing CVAD infection rates. Were they successful? Yes, but beyond reducing CVAD infection rates (beneficial to patients and costs on multiple levels), they also reduced length of stay, something that was not necessarily anticipated.



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