Frontier Medicine: One County, One PA

Amanda Roy, PA-C, Sole Healthcare Provider for Wheeler County, Oregon

September 2, 2021

By Kate Maloney

Wheeler County is the least populous county in Oregon. Its largest city, Fossil, has about 500 residents. An additional 800 or so residents live throughout the rest of the county, in rural, rugged terrain. The county has only one healthcare provider: Amanda Roy, PA-C. Roy is one of two 2019 PA Foundation William H. Marquardt Fellows, an award that recognizes work in promoting accessible primary care in underserved populations. Her remote practice area, with its sparse population, is the very definition of frontier medicine. In this rural reality, Roy’s patients must travel up to three hours away when they need to see specialists.

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As a child, Roy knew she wanted to work in the medical field, and, as a young adult, a physician mentor encouraged her to pursue her dreams. When Roy started researching medical careers, she found herself especially drawn to the PA career. “I loved the team aspect,” she says. “I liked the idea of collaborating with physicians, seeing patients, and having flexibility among specialties.”

She attended PA school at Pacific University in Pacific Grove, Oregon, and knew she wanted to stay in the state after graduation. A National Health Service Corps Health Scholar, she was committed to working in a health professional shortage area. She made a two-year commitment to work in Fossil and provide healthcare to the residents of Wheeler County. That was eight years ago.

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She loves many things about frontier medicine, but one thing stands out to her: her ability to practice to her fullest potential. As the sole healthcare provider, she sees – and must deal with – everything. With specialists so far away, she performs excisions, sutures wounds, performs well-baby checks, manages insulin, treats patients with chronic diseases, and more. “My patients put a lot of trust in me to care for them,” she says. (She has even delivered a goat!)

Her collaborating physician visits twice a month from Hood River, about two hours away. But he’s always reachable by phone and they have a great working relationship. “Sometimes I miss being able to walk down the hall and ask him to check something out,” she admits. “But technology helps with that, and he’s always available.” She has also developed meaningful relationships with other specialists at the closest hospital in Bend, 100 miles away, and keeps up with mentors and her own preceptors. “I’ve assembled my own team,” she says. “I have a dermatologist I’ll ask to look at pictures, a cardiologist I’ll call, a palliative care physician I can consult with. Working and collaborating with these different physicians is one of the joys of being a PA.”

During PA school, Roy found her preceptors to be some of her most meaningful and memorable teachers. She returns the favor by precepting students when she can. “I learned professionalism and confidence from my preceptors, as well as clinical skills,” she recalls. “I hope that I pass those lessons on to the students who come here on their rotations.” A natural and happy byproduct of small-town life, Roy is friendly with many of her patients. She says her patients, who trust her, let her PA students do a lot. With willing patients, she can offer her PA students on rotations many hands-on experiences and spend time talking to them after they perform exams or procedures. Her one warning for PA students interested in a Wheeler County rotation: “You can’t get car sick! There aren’t any straight roads out here,” she laughs.

[Two Fellowship Awards Available for Preceptors Serving Underserved Populations]

Being one of the first William H. Marquardt Community Health Access Fellows, Roy’s dedication to patients on the frontier epitomizes the purpose of program, which aims to benefit PAs serving in mentoring and/or precepting roles who are dedicated to promoting accessible primary and preventive healthcare amongst underserved populations. The Foundation provides this fellowship through the generous support of long-time supporter William “Bill” Marquardt, MA, PA-C Emeritus, DFAAPA.

Marquardt, a former PA and PA educator, established the fellowship so that PA preceptors are appropriately recognized. “Learning with, and from, experienced and motivated PAs is crucial to students’ career transitions,” he says. “Simply put, compassionate, quality healthcare and clinical skills can’t be learned from books or sitting in a classroom.” Of equal importance, Marquardt’s fellowship focuses on underserved areas. “Despite many decades of efforts and initiatives to promote access to adequate and appropriate healthcare, millions continue to lack even basic primary/preventive healthcare. Recognizing PAs, and others, who are making a difference in underserved areas should remain a major focus.”

Given Roy’s practice location and her dedication to precepting, she was an exceptional candidate. “I take great pride in being a PA. Working in a rural, underserved area brings me great joy. Providing service to my community requires me to think outside the box. Working as a preceptor allows me to expose students to the rewards of rural medicine and share my passion with the next generation of PAs who will represent our great profession.”

Roy has found frontier medicine to be a wonderful career for her. “Frontier medicine allows you to get good fundamental knowledge and grow your skill set. When someone with chest pain comes in, it doesn’t go to anyone else – you’re it,” she says. “You don’t need to know everything, but you do need to know what you don’t know. You need to be able to identify when you need to escalate something and make a call to a specialist. You gain confidence and you’ll start to trust your instincts. I can’t imagine practicing anywhere else.”

The PA Foundation is currently accepting nominations for the 2020 William H. Marquardt Community Health Access Fellowship through September 11. Two fellowship awards of $2,500 each are available. Do you fit the description of a Marquardt Fellow – or know someone who does? Submit a nomination today.

Kate Maloney is AAPA’s senior manager, corporate communications. She can be reached at [email protected]. 

Editor’s note: This information is current as of the original publish date: September 4, 2020.

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