Delivery of Care

Physician assistant in training from South Dakota falls in love with RI

The investment by Johnson & Wales in beginning a PA program appears to reaping dividends

PHOTO BY Richard Asinof

Ashley Stoltenburg, left, in May of 2014, with one-quarter of the inaugural first class of 24 physician assistants at Johnson & Wales new Center for Physician Assistant Studies inside the new $13.3 million facility at 35 Claverick St. in Providence.

By Richard Asinof
Posted 10/5/15
The launch of the Center for Physician Assistant Studies at Johnson & Wales began with a lot of hope and expectations that the students who trained here in Providence would stay here in Rhode Island and become part of the health care delivery system. Based on the experiences of PA student Ashley Stoltenburg, who said she has fallen in love with Rhode Island’s medical community, the investment has proven its worth.
As Rhode Island embarks on its next round of practice transformation as part of the federally funded Transforming Clinical Practices Initiative, how will the role of physician assistants be characterized? Will the new PA program at Bryant University, begun in 2015 as part of the School of Health Sciences, targeting health care as the fastest-growing sector in the U.S. economy, become a collaborator or a competitor? Will the PA programs in Rhode Island develop a way to interact with nursing schools as a way to build the concept of team within the curriculum?
Now the state of Rhode Island has invested some $5 million in its tourism development program, featuring a new brand design, a new PR approach and a story-telling firm to promote the concept beyond license plates and signage on highways when crossing into Rhode Island, what still appears to be missing is the basic market research on who’s the audience being targeted. The way that Ashley Stoltenburg expressed her love of Rhode Island, as a young millennial going to school here, and her desire to stay here, represents some keen insight into what any branding process should consider. Branding is all about what the audience and consumer think, not what the government and its hires think.

PROVIDENCE – The inaugural class of the physician assistant program at Johnson & Wales University has moved into the home stretch, with its 24 students now in clinical rotations and scheduled to graduate in May of 2016.

ConvergenceRI had recently wondered, while driving through what some have called the Knowledge District and others the former Jewelry District: how is the program progressing? Wouldn’t it make a good story to find one of the students and talk with them about their experiences?

The very first issue of ConvergenceRI on Sept. 23, 2013, had featured an interview with George Bottomley, the director of the new Center for Physician Assistant Studies at Johnson & Wales University. “Our mission speaks to providing humanistic medical care to patients,” he had told ConvergenceRI at that time. “We’re going to be looking for students who have the most academic horsepower. We’re also looking for students who have manifested or exemplified not just brains but a heart and soul.”

The story featured a photo of Bottomley sitting perched on concrete pipes in front of the construction site of the new $13.3 million facility at 35 Claverick St., in the midst of work rehabbing the former jewelry manufacturing site to turn it into a LEED gold-certified building. [See link to ConvergenceRI story below.]

The opening of the building and the inaugural ceremony introducing the first 24 students was held on May 29, 2014, replete with a ribbon cutting with dignitaries. The first class – 19 women and 5 men – had been chosen from more than 1,000 applicants. They proudly wore their new bright white coats that day as part of the celebration. [See link to ConvergenceRI story below.]

The students that earn their master’s degree in the two-year program will have the opportunity to compete for jobs that offer an entry wage of about $93,000. The decision to expand Johnson & Wales curriculum to include a master’s program in physician assistant studies in Rhode Island was made based on research analyzing where the good-paying jobs of the future would be, according to Bottomley.

“The physician assistant program is [an example of] Johnson & Wales branching out to do for the health care industry what they [had previously done] with business administration, hospitality and culinary arts,” said then Gov. Lincoln Chafee, in an interview with ConvergenceRI.

Serendipity strikes
Soon afterward, ConvergenceRI had a serendipitous meeting with Ashley Stoltenburg, a member of the first class, who had come from South Dakota to Providence to attend the Johnson & Wales program. Don’t I know you?

ConvergenceRI had first interviewed Stoltenburg in May of 2014, at the official opening of the school. “The mission statement, focused on humanistic medicine, that’s what drew me to the school,” she said at that time. “Not many PA programs that I’d looked into focused on humanistic medicine.” She described trying to get to know Rhode Island better. “I took a road trip last weekend, and each time I went past a road sign, I tried pronouncing it. Paw-tuck-it,” she said with a laugh.

Stoltenburg, who is 26 years old, told ConvergenceRI that she was now completely enamored of Rhode Island, and that she intends to stay here when she begins her career as a PA.

“I have really fallen in love with the medical community here,” she said. “I definitely will be sticking around, indefinitely.”

Here, then, is an interview with Stoltenburg, who is scheduled to graduate in May of 2016 as a member of the inaugural class of Johnson & Wales physician assistant program.

ConvergenceRI: What has your experience been like during the last 18 months as a member of the first class?
STOLTENBERG:
I graduate in May 2016. I can’t begin to describe how quickly the time has passed. It’s been such a whirlwind, it just seems like yesterday the class was standing outside with the president [of Johnson & Wales] at the ribbon cutting, and now we’re in the workforce, taking care of patients. I blinked, and the next thing, I had a stethoscope around my neck and my white coat, seeing patients.

ConvergenceRI: Were there things, as the pioneers, that you had to invent, to become trailblazers as part of a brand new program?
STOLTENBERG:
Dr. Bottomley, he really laid a strong foundation. This wasn’t his first PA program [he had developed]. He has a solid track record. He knew what a successful PA program was. It didn’t feel like we were an inaugural program. The entire program has run seamlessly.

The faculty was always on top of things, willing to listen to our concerns, with constant real time change. If there was an issue that needed to be addressed, they immediately got things done. It wasn’t: we’ll fix that for the next class.

I have had a very positive experience, both with people in the community and with all of the faculty and staff at Johnson & Wales.

ConvergenceRI: Where are you in clinical rotation now?
STOLTENBURG:
I’m at Blackstone Valley Community Health Care Center. I’ve had a wonderful learning experience there. Every rotation is five weeks.

This is kind of like the standard for all PA schools, a set of core rotations – surgery, family medicine, internal medicine, ob-gyn, and two electives. The entire 12 months of clinical rotation is this constant roller coaster; every five weeks, it’s like you are starting your first day of high school at a new site, you have new instructors, a new set of rules you have to learn, and a constant roller coaster of emotions and feelings.

Blackstone is my third rotation. My first rotation was in internal medicine at Anchor Medical in downtown Providence; my second rotation was at the Cancer Care Center at The Miriam Hospital.

I have one more week at Blackstone; next I’ll be doing surgery in urology at Rhode Island Hospital.

ConvergenceRI: Have you found it difficult to go back and forth between different health IT systems and different electronic health records?
STOLTENBURG:
Fortunately, for myself, and for many in my class, we were brought up in a very tech savvy era. For the most part, every electronic health record has the same foundation. We were trained knowing all the components to write thorough notes.

ConvergenceRI: How do the EHRs change the way that clinicians interact with patients, in your experience?
STOLTENBURG:
I’ve noticed that it is really provider dependent. Some providers are very efficient in being able to communicate with the patient and be on the computer at the same time. It doesn’t [seem] to take away from the interaction.

But other providers, when they go into the [examination] room, they want to give the patient their full attention, and they write up their notes later.

It’s a personal preference.

ConvergenceRI: How has your experience been in working with the medical community in Rhode Island?
STOLTENBURG:
I really have fallen in love with the medical community here. I definitely will be sticking around, indefinitely.

ConvergenceRI: Have you decided on one clinical area in which you want to pursue?
STOLTENBURG:
It’s still early on in my training, and I’m certainly trying to keep an open mind. Some of the fields that I’ve enjoyed are oncology, urology, and I am passionate about dermatology.

ConvergenceRI: What do you like most about Rhode Island?
STOLTENBURG:
How much time do you have? Quite frankly, I love the people. There’s something about the authenticity of everyone that I’ve met.

I don’t know if it’s because I’m an outlier from South Dakota, but I’ve found [Rhode Islanders] to be very receptive, welcoming me, inviting me to different family gatherings. I’ve met some really great people.

I love the ocean; in South Dakota, we have lakes, but nothing compares to the ocean.

And, the Italian food, and the seafood. I don’t think I could ever have too much fresh seafood.

ConvergenceRI: Have your experiences been similar to those of your classmates?
STOLTENBURG:
I can’t speak for my classmates, but based on conversations I have had with them, I would say yes.

I think I can say, wholeheartedly, that everyone has had a positive experience.

We recently have had a number of different accreditors [visit] to evaluate our program, to make sure, as the inaugural program, everything is falling into place as it should be.

These people said that undoubtedly, we had the nicest facility in the nation. And, they were positive, that in the next five to 10 years, [Johnson & Wales] would be one of the top PA programs in the country.

I honestly cannot think of anything negative about the program.

ConvergenceRI: What have you learned about yourself?
STOLTENBURG:
That’s a tough question, let me think on that.

ConvergenceRI: How does the emergence of PAs as part of the health care delivery system reflect on the evolution of the delivery of care as part of a team-based approach?
STOLTENBURG:
As a physician assistant in training, we learn from day one that becoming a successful PA involves being a team player.

From my personal experience, I have learned that I wouldn’t be successfully doing my work without interacting with everyone, nurses, social workers; everyone is a team player.

I am a huge proponent of teamwork. Ultimately, it doesn’t come down to our title, what training we have, but how can we best treat and serve and take care of the patient.

ConvergenceRI: When I spoke with you a year ago, you expressed some trepidation about the move to New England from South Dakota and how you would fit it. Now, you appear to have fallen in love with Rhode Island. Can you talk about the reasons why?
STOLTENBURG:
When I moved to Rhode Island a year ago, I never guessed that in my wildest dreams that I would have had such a positive experience. I genuinely, genuinely have had a fabulous experience. That’s why I plan on staying in Rhode Island indefinitely.

ConvergenceRI: What is it about the quality of life here that you have found so attractive?
STOLTENBERG:
Let me put it this way. Everyone has a different definition of good quality of life. I can only speak on behalf of my own definition of quality of life.

Some of the things that are important to me, that define good quality of life, are being able to travel and experience new cultures, new environments.

In that sense, Rhode Island is the perfect place, everything is a short drive away; everything is right there.

The way I would describe Providence is that it offers big city amenities with a small town feel.

And, in terms of my quality of life, it really offers everything, amazing restaurants, a lively art and music scene, the ocean, studios and gyms, healthy food, everything that you need, it’s all there within a 10- to 15-minute drive.

Here’s the thing. I think native Rhode Islanders take for granted what they have. Coming from South Dakota, a lot of the towns there are quite desolate, the nearest mall is a three-hour drive away, the big grocery store an hour’s drive away.

We are very lucky here.

ConvergenceRI: How have your responded to the stress of an intensive, 24-month program, with little or no vacation time?
STOLTENBURG:
We are aware, and we were made aware, in our training, that burnout in the health care community is very prevalent.

The beautiful thing about our program is that humanism is part of the foundation, it’s in our mission. We were also taught, very early on, that during the most stressful times in our lives, to find the adequate time to take care of ourselves.

ConvergenceRI: What has been the hardest part of the program for you?
STOLTENBURG:
Missing my family has been the hardest part. I definitely didn’t think I would miss them as much as I do. It’s hard, because during our clinical year, we don’t have any vacation time built in. I don’t think I’ll be able to see my family for seven or eight months.

They’ve been extremely supportive, even though they’re 1,500 miles away. My older sister is a PA.

But, they’re all coming for my graduation.

I’ve sending a lobster to my dad as his Christmas present.

ConvergenceRI: Will he know how to prepare it?
STOLTENBURG:
 [laughing] He lived in Maine for a few years; he’ll know what to do.

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