That PA is Amanda Shelley, who practices in Gilbert, Ariz., on a mobile health unit treating geriatric patients. She applied for health insurance under the Affordable Care Act and was soon hospitalized to have her gallbladder removed.
She recently talked to PA Professional about attending the State of the Union, why she became a PA and what it’s like being a healthcare provider without insurance.
How did you become a PA?
I was interested in medicine from a young age. But I wanted to be able to balance family life.
My undergraduate degree is actually in Spanish, but I did pre-med. I went to A.T. Still University in Mesa, Ariz., for my physician assistant degree and graduated in 2005.
Why did you choose geriatrics as a specialty?
That’s a fairly new specialty for me. I’ve been with my current employer [MH7, LLC] for about a year. I’m an independent contractor with them. It’s the best job I’ve had so far.
I did urgent care for most of my career, and I always enjoyed working with the geriatric population.
Why did you choose to be an independent contractor?
That’s pretty common in Arizona. Most PA jobs are independent contractors unless you work for a large practice or a large hospital.
Being an independent contractor gives you more freedom. You can go job to job.
How did you come to NPR’s attention?
When I was still in the hospital, my cousin, who follows NPR on Facebook, saw a blurb from them asking for stories of people who’d benefited from the Affordable Care Act (ACA).
I emailed Nate Rott [at NPR] and gave him a synopsis. We did a 10-15 minute interview, and they used about 45 seconds of it. That’s how the White House found me.
How did the White House get in touch with you? What were you doing at the time?
I’d just finished my patient day on Friday, Jan. 24. I was back at work doing half-days.
I got a call on my phone, but it was blocked. So I ignored it. They left a message and said, “This is so-and-so from the White House communications office.” I thought, “Yeah, right.” I thought it was friends pranking me.
But I called them back, and they said they found my story on NPR. They invited me to the State of the Union speech.
How long had you been without health insurance?
My COBRA coverage ended in April , so I didn’t have anything for several months.
I’d applied for insurance several times over the years. But I’d been turned down due to pre-existing conditions. I tried one more time after my COBRA expired but was turned down again.
I knew the ACA was coming, so I bided my time and paid cash for routine care.
How did being uninsured affect you physically and mentally?
You self-treat a lot. I was still getting routine care. But not as often as I probably should have.
I avoided doing anything where I might be injured. For example, I have a 7-year-old boy, and I avoided riding bikes with him or crawling on the jungle gym.
I dreaded someone crashing into me with their car because if they didn’t have insurance, I’d be stuck with bills I wouldn’t be able to pay.
What was it like being a healthcare provider without insurance?
Incredibly frustrating. But at the same time, I felt a little safer than the general population because I knew what to look for and when something was an emergency. People without medical training might be more likely to ignore big symptoms and big problems.
It was especially frustrating when I was in urgent care, because I was seeing so many other people going without insurance, too.
Did you get any chances to discuss PAs with the president or first lady?
I got a 10-second handshake from the president and a “thank you.”
The first lady was amazing. She gave hugs rather than handshakes. She was very thankful for me being there.
Who else did you meet?
I talked to a lot of the other guests. Many of them knew what a PA was, which was great.
Cory Remsburg, the solider sitting in front of me, was treated by a PA when he was injured in Afghanistan. He actually lives very close to me in Arizona. It was really nice to talk to Cory and his dad.
If only the president had gotten the name right…
If you look up the text of the speech, you’ll see that I fixed the name with the speechwriters. And he still said it!
I was happy to represent patients and providers in a way I never thought possible. Being a PA is a point of pride for me, and I was glad that the president pointed that out.
Dan Wagener is communications manager at the American Academy of Physician Assistants and assistant editor for PA Professional.
See also: PA Attending State of the Union Address