Madeline

Thursday, April 17, 2014

PY 104 Th 11:00-12:15
Jeffry Katz—PA-C
Jeffry Katz attended the Catawba Valley Technical Institute’s PA school after
earning a bachelor’s degree in biology, where he received only a certificate upon
graduating with nine classmates in 1979. This program was closed by Duke University
after graduating three classes because it was based in a tertiary care center. However,
each of the students had to work for four hours per week in the emergency room and do
between eight and ten clinical rotations to graduate. The most difficult clinical rotation,
according to Mr. Katz, was in the Veterans’ Hospital’s alcoholic ward. His favorite
clinical rotation, as well as the one he deemed most helpful to his career, was in
emergency medicine. The fast pace and variety of conditions gave a wealth of experience
and knowledge that could not have been gained elsewhere.
Catawba Valley Tech’s PA program was similar to ours here at Quinnipiac. The
students were required to complete one year of classes and one year of clinical rotations.
Unlike our program, however, the final three months was spent not on classes, but on job
placement and experience to ensure that each student was ready to become an integrated
part of the workforce. I really liked this idea because the main reason for the creation of
the PA profession was to get more people with general medical training into the
workforce quickly. Allowing PA students to assimilate into a working environment for
the last three months of their education would definitely help this cause. There were also
no opportunities for PA student involvement. Students went to classes, did their clinical
rotations, and graduated without making any lasting impact on the school or community.
Upon graduation, Mr. Katz got a job in the emergency room, where he remained
for nine years. When he started, he had little autonomy. He spent most of his time asking
questions and getting help from his supervising physician. After a few years, he gained
more responsibilities than he had previously held. He was able to see patients on his own,
and his supervising physician rarely cosigned his charts. At the end of nine years,
however, Mr. Katz decided to get a job at a rural family practice so he could have more
normal hours and time to spend with his family. In this setting, his roles as a clinically
practicing PA have not changed much since he began working. He is good friends with
his supervising physician and has almost complete autonomy. He sees his own patients
and is allowed to treat them by prescribing medication, performing procedures that can be
done in the office, and any other means that could be employed by a physician. However,
after working at this practice for a few years, Mr. Katz became a part owner and has
taken on an administrative role in addition to his clinical duties. He never intended to
have an administrative job, but decided that he could handle the responsibilities while
still practicing clinically. He does not enjoy his administrative work as much as his
clinical work. When he is not practicing or tending to administrative issues, Mr. Katz
earns his CME hours by attending conferences both on local and national levels. He
believes that the new CME requirements are going to greatly improve PA education and
PA’s desires to fill their CME requirements instead of just trying to get them done.
Mr. Katz’s practice rests in his graduating state of North Carolina, the only state
in which he is licensed. He is NCCPA certified and has been since he received his
certificate from PA school. North Carolina has put five of AAPA’s six key elements into
law; the one they have not adopted is the adaptable supervision requirements. However,
instead of limiting practicing PA’s, this lack of legislation has given PA’s in North
Carolina more freedom, allowing them to have greater autonomy and practice with little
supervision. Mr. Katz has taken the PANRE a number of times. He has always felt
prepared for the test and says that working in family medicine has made it even easier. I
found this interesting because I would have guessed that emergency medicine would give
more varied experiences that would better prepare one for the comprehensive test.
Mr. Katz has always maintained a good relationship with his supervising
physicians. During his first years at his job in the emergency room, his supervising
physician acted as a mentor and guide, but once he became comfortable practicing on his
own, his supervising physician became like a helpful friend. After switching jobs, he
immediately befriended his supervising physician, who trusted him because of his many
years of experience in the ER. At both jobs, Mr. Katz has been the only PA under the
supervision of his assigned physician. At his current job, his supervising physician has
never cosigned his charts; chart cosignature has not been required in North Carolina since
1985. He has never had a meeting with his supervising physician to discuss his progress
or performance, although the entire staff has a collective meeting every six months to
discuss patient progress and the direction in which the practice is heading. Despite this
autonomy, Mr. Katz expressed a great affinity for the team dynamics within his practice.
He and his supervising physician view each other as equals and act accordingly, asking
the other for help or advice whenever necessary.
In addition to his many other jobs, Mr. Katz is currently serving his third term on
AAPA’s board of directors. He plans on running for president during their next election.
He has been the president of the North Carolina Academy of Physician Assistants twice
and has held multiple positions at NCCPA, including president, vice president, and
others. He is very involved in local committees and has served in AAPA’s house of
delegates. While working with AAPA, he helped to develop and implement plans to take
the organization in the right direction. This included amassing and allocating resources
and helping to make judiciary decisions. These responsibilities were and continue to be a
huge time commitment for Mr. Katz. He must attend local meetings, join conference
calls, and even travel out of state to attend conferences. He is also the medical director for
Medicaid services in his county, which requires him to educate medical and
pharmaceutical providers about current and upcoming medical news. Despite all these
other commitments, Mr. Katz still manages to contribute to his community through
service and volunteering. He was honored for his contributions with NCCPA’s
President’s Award in 2003. It seems a small token for all the hard work he has done, but
he seemed perfectly content and even surprised that he received this single award.
According to Mr. Katz, the future of the PA profession is very uncertain. He
believes the number one key issue faced by the profession is going to be better defining
who and what PA’s are. The conflicts that can arise due to this confusion are especially
visible in North Carolina because of PA’s increased autonomy. He argues that these
conflicts will only grow until the profession’s exact nature is universally defined. I agree
that this is an important issue that will have to be addressed to ensure the survival of both
the PA and physician professions. The second key issue he describes lies in ensuring that
PA’s are “immersed in the medical landscape”. With this statement, he is trying to
encourage PA’s to become more involved in policies and politics. In order to prove our
worth, he argues, we must fight for our place in the medical system. I agree that PA’s
should be involved in policymaking so that the policies will benefit them. He also
expressed some concern over issues that will arise for people within the PA profession.
One of these is the PA’s discounted salary. As PA’s become more autonomous and take
on more responsibilities in specialized settings, many are adopting the belief that they
should be paid more. While this makes sense on a basic level, Mr. Katz is concerned that
either PA’s will be hired less or doctors will become obsolete due to increased salaries
for PA’s, who have less training. I think that this is a valid concern because young people
who are deciding on a profession will not want to spend time and money on medical
school if they can get a similar salary as a PA. Another of his concerns is that there will
be greater competition among PA students for clinical sites. He fears that students who
are the wealthiest or who go to the most expensive schools will get special treatment
when choosing clinical sites. I do not think that this is going to be a big problem because
there are so many medical centers and they can always use more help.
At the conclusion of the interview, I did not even have to ask Mr. Katz about his
job satisfaction to know that he would never want to do anything else. He told me that
becoming a PA was the best decision of his life and that he would never want to change
his career. This interview was a definite reassurance for me that I have made the right
choice by coming to Quinnipiac as a part of the PA program. I learned so much about the
profession and cannot wait to start my clinical rotations and get into the work force.
However, I think that Mr. Katz’s answers have dissuaded me from going into family
medicine. It sounded quite boring and routine, especially when compared to his accounts
of his time in the ER. Overall, this interview has had a positive influence on my PA
education as well as my mindset regarding the PA profession.