The blog has recently featured anniversary stories from alumni and we are starting a new series focusing on alumni that are living out the Augsburg PA mission of providing medical care to underserved populations. Hoshmand Las, PA-C has been practicing for 5 years since graduating from the Augsburg PA Program in 2014. He currently works for Advanced Practice Solutions, a contract staffing agency of several local correctional and government facilities including, Ramsey County’s workhouse, juvenile detention center, jail, and prison. A few times a week he also provides primary and urgent care services in North Minneapolis at NorthPoint Health and Wellness Center where the patient population is characterized as mostly refugee and immigrant.
Hoshmand knew he always wanted to pursue a career in medicine because he is fascinated with how the body functions. The PA profession was first introduced to him during high school. As he pursued an undergraduate degree at Metropolitan State University, he enrolled in core science courses to prepare for PA school. “I leaned toward the PA route because it allowed me to practice medicine but also have a work/life balance.”
There was no gap in between high school, undergraduate and graduate school for Hoshmand. He applied to ten schools during his last year at Metropolitan State University. A program in Pennsylvania accepted him but a week later he received an invitation to participate in a phone interview with Augsburg. Augsburg accepted him shortly thereafter! He was excited that his first choice extended an offer and he could stay in Minnesota.
The highlight of the didactic phase for Hoshmand was the hands-on skills workshops including casting and suturing. He recalls, “You were around a bunch of other adults, but yet we had the chance to act like kids again because we were all learning something new.” He remembers it being so interesting as it was a glimpse of his future. A challenging moment came during his first rotation where the political side of medicine was exposed. Hoshmand learned that sometimes you need to take out the umbrella in order to weather the storm. Throughout rotations, he remembered to always stay humble and really focus on the true reason he went into medicine.
After graduation, Hoshmand and two other classmates applied and were accepted at Emergency Physicians Professional Association (EPPA). EPPA was hiring new PA graduates so that they could train them in the EPPA model. Essentially, the first 7 months was a fellowship where Hoshmand worked directly under a physician and staffed every patient. Hoshmand recalls that he learned so much during his time there; “It was the best decision I could have made after graduate school because it made me more confident.”
After a year and a half at EPPA, Hoshmand decided to look for another position that allowed for a better work schedule. Advanced Practice Solutions was hiring for a correctional medicine position to staff Boys Totem Town, the county workhouse, jail, prison, and juvenile detention center. During his clinical year, Hoshmand completed a six-week rotation at Rochester Federal Medical so he was familiar with the correctional healthcare environment.
Although correctional medicine may seem on the opposite end of the spectrum from emergency medicine, Hoshmand believes that it is different yet the same. “These are the same types of patients who utilize a large amount of the ER resources because they are coming from similar socioeconomic backgrounds whether that be homelessness or poverty. They don’t necessarily follow up with their primary care provider or specialty appointments. When they are in pain or something goes wrong, they go to the ER.” The difference now is that Hoshmand is able to follow up with his patients instead of never seeing them again. For a period of time, he is able to establish a relationship and provide continuity care when something does go wrong. Over time he can see blood pressure lower, blood sugars get better, fractures heal, pain improve, and overall, quality of life improve.
Not too far after starting with Advanced Practice Solutions, he started work at NorthPoint Wellness and Health Center located in North Minneapolis. North Minneapolis has a large underserved population including many patients from the refugee and immigrant communities. The majority of patients that Hoshmand sees identify as Hispanic, Hmong or Somali. NorthPoint has in-house translators for four different languages. Instead of Hoshmand utilizing an interpreter service, the translation can happen in-person which helps with the overall provider and patient communication.
When Hoshmand is at NorthPoint many of his patients are new. Patients from the refugee or immigrant communities have a different mindset around medicine than those who grew up in America. “A lot of times they do not have that routine care” and oftentimes Hoshmand sees patients when a medication runs out or a side effect from an untreated condition becomes intolerable. NorthPoint will see any patients no matter their ability to pay. NorthPoint Coverage is a program through the federal government available to patients who qualify based on their household, dependents and income level. If patients qualify for the program, their healthcare is completely free. The majority of patient Hoshmand treats fall under this coverage.
After being in practice for five years, Hoshmand has learned to hear what the patient is not saying. He believes there are different motivations for why an appointment is made. “They don’t necessarily say what is on their mind. . . and you have to pick up on what words they are using and how they are saying it, as it will mean different things.”
His advice to current students is to “learn as much as you can right now.” It’s easy to study for a test, to know enough to pass; but if you do it that way, you will find there is a significant gap in your knowledge when you are practicing. If you really study into the why’s of certain diseases, you’ll retain the information much better.”
In his free time, you’ll catch Hoshmand working on cars, traveling and enjoying life! When we met for the interview he was preparing for a three-week trip to Kurdistan to visit extended family. The last time he had been there was before PA school. In the past five years, Hoshmand is now in a place that he feels more settled in his career and can also enjoy the work/life balance that comes with being a PA.