A rural focus
OHSU student steps into Vale slot
By Johna Strickland
Argus Observer
Tuesday, June 10, 2008 10:11 AM PDT
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| Physician assistant Carly Hammer examines Sandra Pittmann Monday in Vale at Valley Family Health Center. Hammer, a student at Oregon Health & Science University in Portland, has come to Vale for 10 weeks to practice family medicine. |
VALE — Carly Hammer gets around in the world of medicine.
For nearly a year now, she has been something of a gypsy doctor, flitting from one practice to another as she hones her physician assistant skills.
Hammer, a student at Oregon Health and Science University, recently landed in Vale at Valley Family Health Center. Under the direction of Bob Davis, PA-C, Hammer will spend the next 10 weeks practicing family medicine. It is the capstone project of a 26-month physician assistant program at OHSU. The first year, Hammer — a Kimberly, Idaho, native — spent in a classroom furthering her knowledge of medicine. The next found her cycling through a set of nine, five-week rotations in various Oregon and Idaho practices. She studied inpatient medicine, orthopedics, obstetrics/gynecology, emergency medicine, general surgery, pediatrics, women’s health and dermatology. Then her 10-week preceptorship in family medicine.
“They send us out to do a little bit of everything so we get a little experience in every area of medicine,” Hammer said. “We typically do every other rotation outside of Portland.”
During each rotation, Hammer works under the supervision of a licensed doctor or physician assistant called a preceptor.
Her duties have varied from doctor to doctor, she said. Each preceptor first learned where she was in the program to determine how much supervision Hammer needed.
Under Davis’ supervision, Hammer meets with patients alone first, then she and Davis reevaluate the patient together.
“You take the history, do the physical exam, then kinda formulate a plan. Then you come out and discuss it with your preceptor,” Hammer said of her duties.
After they decide on a diagnosis and plan, they return to the patient “and do it all over again,” Davis said, referencing the history and physical.
In the months of her practical training, Hammer has learned how to insert a chest tube, do a spinal tap, and two months ago she participated in her first birth.
There have been challenges though. One came during a rotation at OHSU. The patient had severe liver disease and didn’t speak English.
Hammer had to explain his condition and treatment procedures through an interpreter.
Another hard moment arrived when Hammer met a patient who thought she had some food caught in her throat.
Hammer discovered a tumor in her esophagus and early testing didn’t show if was malignant or not. Hammer had to break the news to a surprised patient, she said.
“I think it’s really challenging as a provider to decide what to tell them to not scare them more than you have to,” Hammer said.
Still, Hammer said she likes the field she picked while completing her undergraduate degree in health science services at Boise State University.
“I decided in college that I really enjoyed biology and the other sciences ... then I chose PA because there’s a lot of flexibility. You can go into family medicine, then 10 years later go into cardiology,” Hammer said. “Being a PA is great because you still get to make the decisions ... you have your own patients. You just work under the supervision of a doctor.”
The flexibility in switching areas comes from Hammer’s broad training rather than the specific, specialized training an M.D. undergoes, she said.
As her August graduation draws closer, Hammer has begun to interview for a job in family or emergency medicine in the Boise area.
But for now, she’s busy practicing in Vale.
“I love the feel of community clinics,” she said.
