My journey

As a volunteer Referral Coordinator at a local community health clinic, I was reminded daily that one does not need to travel far to find disparities in healthcare. Without the help of the clinic, many homeless, minority and uninsured clients would be forced to choose between basic necessities and healthcare; a choice no one should have to make.

I will never forget my conversation with a homeless woman who refused to schedule a necessary radiology exam. She could not bear the thought of accruing additional medical expenses. The woman declined my efforts to connect her with financial resources stating she was more afraid of debt than death. It is her story and countless others like it that fuel my passion to work as a Physician Assistant (PA) with marginalized populations in rural and underserved communities. 

My early experiences growing up in the small town of Baker City, Oregon have provided me with a unique perspective of the challenges facing rural healthcare providers and were the impetus for my decision to become a Physician Assistant in similar communities. Unfortunately, the disparities that existed when I was a child have not improved by much. According to recent reports, Baker County is ranked in the bottom 40% of counties in Oregon for its physician to patient ratio with only 1.39 physicians per 1,000 people. Shortages of healthcare providers in rural communities like Baker City inherently increase the number of patients seen by each provider, and decrease the amount of time providers are able to spend with their patients. Additionally, rural medical providers treat a higher ratio of low-income and uninsured clients who are unable to pay for their services.  These conditions make it difficult for rural communities to attract and retain primary care providers.

The ramifications of limited access to healthcare are also painfully evident in places like Antigua, Guatemala where I volunteered twice as a patient advocate and Spanish medical interpreter for an American surgical team. Although many of the patients we treated suffered from conditions that could have at one time been ameliorated by simple procedures, little to no access to healthcare complicated their medical needs. Our team was grateful for the opportunity to help improve the lives of so many people, but it was impossible to deny that our collective efforts only scratched the surface of a much deeper issue. Without improved access to healthcare, the quality of life of Antiguans and others like them will continually be compromised by unnecessary pain and suffering.

Over recent years, a challenged U.S. economy and a growing population of uninsured patients has placed a greater tax on an already fragile healthcare system.  As a result of these stresses, healthcare professionals are providing medical care for a sicker population with fewer resources. It is only through an innovative and collaborative approach that new challenges facing our healthcare system can be adequately addressed. PAs are a promising solution to the healthcare dilemma our nation currently faces as they can be trained within two years and are capable of providing frontline preventive care.

Low cost, high quality preventive medicine is fundamental to changing the dynamic of unnecessary and costly interventions. For me, becoming a PA represents an opportunity to provide compassionate and evidence-based health care to communities with the end goal of enhancing overall quality of life. I look forward to working within a team of healthcare professionals in order to meet the needs of a diverse patient population in a rural community similar to the one where I was raised. My experiences in the distinct, yet integrative worlds of free clinics, rural, and international healthcare, have provided me with an invaluable and broad set of perspectives that have helped prepare me for this next step in my journey.

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Comments

  1. Thanks for sharing your story, Andrea! Proud to be in such good company in the PA program. :)

  2. Very well-written, Andrea. You are already making a difference. Your passion and commitment to improving the lives of others is an inspiration.

  3. Thanks for sharing, Andrea! It’s always so interesting to learn about our student passions.

  4. Wonderful commentary on your motivation towards your chosen profession, the unique role PAs can play in addressing the current health care challenges in our country and your obvious passion to contribute to the care of the medically underserved. You make us proud.

  5. I loved reading this, Andrea. Your innate wisdom and conscious compassion are things we can not teach. You are going to be an amazing PA! We at OHSU (and soon society at large) are lucky to have you!

  6. You are so inspirational to all of us fighting through this journey. Thank you for reminding me of all the good we could do for people who need it most.

  7. Good for you, Andrea. I have lived in Baker City and know the desperate need for general physicians. I am 72 and do not have a doctor. They retire or leave here. St. Al’s took over the hospital and clinic. St. Luke’s took over the other clinic. The hospital is hostile to the St. Luke’s. Only one St. Luke’s doctor can see patients. You most likely will not get to see your own doctor if admitted, just the one allowed in for the assigned period of time. So so sad.

About the Author

Andrea Kuchler was Born and raised in Baker City, Oregon and graduated from Willamette University in 2005 with a Bachelor of Arts Degree in foreign language and Spanish. She worked for 3 years in the critical care tower at Providence St. Vincent Medical Center prior to transitioning to clinical research at OHSU. At OHSU, Andrea enjoyed 3 awesome years as a Research Coordinator for the Oregon Clinical Translational Research Institute (OCTRI). Andrea is proud to be a student in the OHSU Physician Assistant Program, class of 2015!
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StudentSpeak

Ever wondered what life is like as a student at OHSU? What does it take to become a researcher? Just how gross is gross anatomy? Welcome to the blog that answers these – and many other – questions. It’s students writing first-hand about their commitment to careers in science and health care. It’s honest about the challenges as well as the joys. It’s not always pretty. But it is our story. Thank you for sharing it with us. And please, let us know what you think.

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