Describe your pre-medical and/or pre-locum work experience.

My medical experience started in high school in 1988. Our school offered Health Occupations Education where, for the first two class periods of my senior year, we went to the Carl T. Hayden Veterans Administration Hospital in Phoenix, AZ. We had four elective rotations and I chose: radiology, microbiology, vascular lab, and GI lab.

In 1989, I joined the Marine Corps and served four years as an Aviation Ordnanceman, loading, maintaining, and troubleshooting the weapons systems on the F/A 18 Hornet at Marine Corps Air Station El Toro in Southern California. Once my commitment was up, I used the GI bill and joined the Arizona Army National Guard Tuition Assistance to put myself through undergrad and graduated in 1998 from Grand Canyon University with a Bachelor’s Degree in Biology. My guard Commander was a phase 2 PA student. When he heard that a 28-year-old me was looking to start applying to medical schools, we had a long talk weighing the pros and cons of medical school vs. PA school. PA was a better fit for me. I applied to the two Arizona PA schools and ultimately chose Kirksville College of Osteopathic Medicine Southwest School of Science and Allied Health (now A.T. Still University).

I chose A.T. Still because of its emphasis on rural and underserved communities. All but one of my rotations were in rural Arizona communities and the one I had in Phoenix was at the Phoenix Indian Medical Center. After graduation, I chose to work in Sun City, AZ, a senior living community west of Phoenix. There I practiced Pulmonary and Critical Care Medicine, Internal Medicine, and Cardiology in three separate private practices. In 2006, the Army was aggressively recruiting civilian-trained PAs to come onto active duty. My wife and I were newly married and expecting our first daughter. The travel, pay, and benefits of the military were unbeatable so I joined and entered active duty on January 1, 2007.

The Army stationed us in Germany from 2007-2013. There I deployed to Romania, Iraq, and Afghanistan. I was assigned to Field Artillery, Infantry, and Aviation units. Two of our girls were born in Germany. We then returned to the U.S. for me to start the US Army-Baylor University Physician Assistant Doctor of Science in General Surgery/Trauma and Critical Care residency at Brooke Army Medical Center (BAMC) in San Antonio, TX. Upon graduation, I stayed at BAMC to work in trauma and as primary faculty for the residency. During that time, I also deployed to Jordan and ran a small aid station for the Joint Task Force deployed there. Shortly after returning from Jordan, I was called away to teach surgery and radiology at the Interservice Physician Assistant Program at Fort Sam Houston, TX. There, I was also the Branch Chief for all of the Army students. The Army then reassigned me to BAMC and back into trauma and the Army-Baylor program. The field hospital was deployed to NYC during the initial COVID outbreak and we converted the Javits Convention Center into a large field hospital. There, we housed over 1000 patients with COVID and also augmented local NYC hospitals with respite providers and nurses to ease the strain of the providers on the front line. We returned to BAMC where I retired in January 2023.

What drew you to locum tenens work?

One of the PAs I served with in Germany retired and e-mailed me when I was in NYC. He was asking my opinion on him voluntarily returning to active duty during the pandemic. I called him and we talked for over 2 hours. He was working with WMS already and I was intrigued. Although he called me for career advice, we equally split the time talking, listening, and advising each other. He gave me the website and I couldn’t sleep that night. The WMS mission is perfect for me and my post-retirement career. Becoming a vital member of an underserved community and making a difference is exactly what I was looking for.

Why did you choose to work with Wilderness Medical Staffing?

WMS was highly recommended by my friend. The website is very forthright about their willingness to work around your schedule, finding assignments that fit you and your skill set, the upfront pay rates, dates of assignment, work hours, and call requirements. Unlike most other locums companies, the quantity and variety of open positions (especially in AK) are second to none. There is almost always an assignment that fits my skills and availability.

What have you enjoyed most about your locum tenens experiences?

Being accepted into the community. A very wise cardiologist I worked with taught me the 3 As of being a great provider. You have to be Able, Available, and, most importantly, Affable. Being able to remain grounded, build a rapport with people, and be open to new experiences makes these assignments memorable. It allows me to connect with the community members instead of just being a transient provider who is just here to see patients. By far, my most enjoyable moments come from community engagement like playing Santa Clause and handing out presents to the children of [a small community in] AK and leading an elementary school field trip to [another] clinic, where the kids learned about the importance of oral hygiene and helped me make sure the ambulance was in working order.

How has your experience been with WMS?

Phenomenal. I always feel supported. From my initial encounter with Lisa V. through my assignments, they have always been there for me. WMS is not simply looking for a body to fill an open assignment; they want to ensure that the community has the right person taking care of them and they also make sure you feel comfortable in your ability to provide quality patient care.

What surprised you most about your locum tenens experiences?

The support we have from our team in Anchorage. The ED docs are always ready to help over the phone and readily accept our patients. We may have to hold and treat a sick/injured patient for a few hours to days, but everyone in the chain is dedicated to doing what is best for the patients. I am also in awe of the skill of our USCG crews when hoisting patients off of ships in rough seas and their willingness to risk their lives to help a patient in distress.

What stands out to you about the communities and cultures you have interacted with as a locum tenens provider?

The diversity amongst the different villages in the Aleutian Islands. Some villages are mostly seasonal fishermen whose populations can vary from 30 in the off-season to over 4000 when the cannery and fishing boats are active. Some are active and steady year-round with FAA and DOT workers and have large improved runways. Some are inhabited by just one local family.

What advice do you have for prospective locum tenens providers?

You must have a strong background in whatever discipline the client is advertising. Be confident in your skill but humble enough to ask for help. Be comfortable presenting a patient over the phone and paint a brief but accurate picture of the situation. Be able to recognize what can go wrong and MEDEVAC early. Weather and distance are two variables that play a huge part in making the decision to treat locally or to MEDEVAC sooner.

Personally: Be comfortable being alone. Usually, movie, dining, and live entertainment opportunities are limited at these assignments. Know how to cook. Have a growth mindset and take up a new hobby while on assignment. Get out of the clinic and interact with the locals.

What is the most interesting thing you’ve learned while out on assignment?

Personally: How much time I wasted in traffic every day commuting and my over-reliance on restaurants.

Professionally: These patients need quality providers taking care of them. Although we are physically far from the nearest hospital, someone is always available via phone or VTC to help us through a situation if needed.

Is there anything else you would like to share?

I could not do this without the love and support of my wife and three girls. The Army has normalized me leaving for a period of time so they are somewhat used to it. Sometimes it’s hard to be gone but the reunions are always great. Plus, when I’m home…I’m home. No pager. No calls back to the hospital or taking overnight/weekend/holiday call. 100% of my time is dedicated to my family. For us, there is nothing better than that!

As I have told Lisa, Diann, and Ethan [from WMS]: Thank you for this awesome opportunity. I love coming to work every morning. This is the best job I’ve ever had.