Joy Adams, PA-C, and Kelsey McFarlane, PA-C are both 2014 graduates of the Augsburg PA program. After graduation, they found themselves at Bluestone Physician Services. Bluestone is onsite integrated primary care for individuals with disabilities living in assisted living and group homes. Before applying to PA school, both alumni worked as direct support professionals at group homes at ACR Homes, so this was a perfect fit for their passion. In the Bluestone model, our alumni travel to the resident to provide care on a monthly or quarterly visit schedule. The patient’s care team is able to communicate with their providers on a 24/7 basis via an online platform. The practice employs patient care coordinators who are able to share resources with patients to manage care.
Joy and Kelsey each have their own patient panel ranging between 150 to 200 patients. At the first meeting, Joy shares that as a provider she needs to be vulnerable and open with the patient. Through relationship development, the PA is able to know every in and out of their patient. When a patient care coordinator receives a message about an issue, the provider is able to determine if it is an episode or ongoing issue versus an emergent problem. Because the providers are so in tune with the patients, it reduces the overutilization of emergency departments.
Two of the most challenging aspects of being in practice are navigating insurance and the patient’s social and emotional needs. Joy acknowledges, “The patients we manage are very sick and it is challenging to manage multiple conditions.” Because of the nature of their disability, each patient is so different and unique that they may present differently than others. Due to the diversity of patient conditions, the profession really does involve lifelong learning. A provider can make a recommendation, but the patient needs to be ready to try it. If a patient is not ready, Joy and Kelsey can only encourage and wait until they are ready. Kelsey shares that she herself becomes excited when a patient is motivated to take control of their health and shares the progress they’ve made.
More often than not, a visit is much more than medicine. Kelsey and Joy could spend their whole visit conversing about the patient’s psychosocial needs. Because the Bluestone model focuses on the frequency of visits and openness of communication, both Kelsey and Joy have learned “if you do not make any changes in a visit it is considered a win because the patient’s care is managed well overall.” The most fulfilling part of the work they say “is making a connection with the person in front of you.” The patient is appreciative every time they show up.