Becoming a physician assistant (PA) for me was a fortunate stroke of serendipity similar to the path that led me to become a physical therapist (PT). You may refer to my PA school application essay “PT to PA” for my impetus to give up my spot in medical school and become a PT and my novel “I Have No Earthly Idea” which chronicles this journey in a rom-com novel. “I Have No Earthly Idea” is the only novel with a PA as the protagonist.

Coming from India, I was fortunate to work as a contract physical therapist in various healthcare settings. I chose to be a contract physical therapist as it gave me the opportunity and flexibility to explore America without the need to take a vacation.

I graduated as a physical therapist from the reputable Government Institute of Rehabilitation Medicine in Chennai, India.  Subsequently, I had the privilege to work for two years in the state-of-the-art Apollo Hospital’s Department of Physiotherapy which boasted all the modern and cutting-edge technology and gadgets. A company in Dallas, Texas recruited me and sponsored my work visa which enabled me to come to America. I was licensed in Colorado, Indiana, Illinois, Michigan, and Texas. I enjoyed exploring the Midwest and working in skilled nursing facilities, rehabilitation centers, outpatient clinics, and special education schools.

Most of my assignments were in small cities and towns that lacked the lure and glamor of big cities where the facilities had a hard time hiring therapists of their own and had to rely on contract companies for their PTs, OTs(occupational therapists), and SLPs (speech-language pathologists). As someone new to this country, I not only enjoyed but also thrived in these places as I found the people more welcoming and friendly. After a few years, my company sponsored my green card. My professional life was flourishing.

Ironically, the Balanced Budget Act of 1997 coupled with the midlife crisis forced me to stare at the crossroads of my life for the second time. The Balanced Budget Act of 1997 stands as a landmark piece of legislation in the United States, representing a concerted bipartisan effort to achieve fiscal responsibility and balance the federal budget by the year 2002. This legislation aimed to eliminate the federal budget deficit through spending cuts, revenue increases, and reforms in healthcare and taxation. Significant changes were made to Medicare and Medicaid, including the establishment of the Children’s Health Insurance Program (CHIP) and reforms to control costs. Various cost-saving measures were introduced, promoting the use of managed care in Medicaid. The Act expanded healthcare coverage for children through CHIP, but reductions in Medicare payments sparked debates over potential impacts on quality of care. The Act led to reductions in Medicare payments to healthcare providers, including those offering PT, OT, and SLP services. Institutions faced challenges in adapting to these reimbursement cuts, necessitating adjustments in practice management, increased scrutiny of costs, and efforts to maintain financial viability. The changes in reimbursement rates influenced the landscape of therapy services, with providers needing to navigate the evolving healthcare payment environment.

The Balanced Budget Act of 1997 had a broad impact on allied health professions, including PT, OT, and SLP. The common thread was the need for these healthcare providers to adapt to reduced reimbursement rates, navigate changes in healthcare delivery models, and find ways to sustain quality care in the face of fiscal constraints. Faced with never-before-seen challenges in delivering physical therapy services, fiscal constraints, and undue pressure from entities on therapists to be more productive took a toll on me. Working in an acute care hospital and treating patients in the intensive care unit, I grew tired of writing “Patient too sick to participate in therapy. PT withheld”, Patient with unstable vital signs. PT on hold. Reconsult PT when appropriate.” I could not help but think, I was turning my back on these sick patients and blamed myself for not being able to do more. A changing healthcare landscape and feeling helpless in caring for sick patients led me to a midlife crisis. I was at a crossroads again. I seriously contemplated buying a sports car and being reckless or changing my career. I think I chose wisely. Being a physical therapist in India and America provided me with the opportunity to meet some amazing patients and people who influenced me positively and made me who I am today. Looking back, I would not change my path in any way. I enjoyed being a physical therapist, but I wanted to do more in the healthcare setting.

Needless to say, I cannot explain the overwhelming joy I experienced when a chance encounter with a student counselor at Wayne State University exposed me to the PA profession. There are no PAs in India. To learn more about a profession unfamiliar to me, a career that sounded too good to be true, I was thankful for the opportunity to shadow Annie McCaig, a PA, and learn firsthand the role of a PA. As much as I enjoyed being a PT, I love being a PA. For more about my career path, please check out the tab “About” on the home page.

I am thankful to the faculty of Wayne State University PA Program for a world-class education, the Duke Postgraduate PA Surgical Residency Program, and the Duke Department of Neurosurgery for my career and accomplishments. Many renowned figures played a key role in the success of my career and most notable are the neurosurgeons Dr. Allan Friedman, Dr. John Sampson, Dr. Herbert Fuchs, and Dr. Gerald Grant. I would not be the physician assistant and the person I am today without the influence of physician assistants James Harvey Carter, Jr, Eric Ryan Butler, AnaLisa Nardin, Kristina Eilbacher, and Rachel Jeffrey who are more than my colleagues and mean the world to me. I owe my gratitude to all the Duke University neurosurgical residents and PA surgical residents for enriching my career. I am thankful to work with talented and caring nurses, pharmacists, PTs, OTs, SLPs, RTs, and case managers.

As a way to give back to the profession, to shed some limelight on the PA profession, a profession although five decades old still unfamiliar to many people – both patients and healthcare providers alike, I wrote a novel with a PA as the protagonist. I have motivated and mentored several individuals from all walks of life in their journey to become PAs.

With an intent to do more for the future of the PA profession and help students applying to PA school, I am writing a series of blogs to educate them about PAs, make myself available to talk to anyone interested in the PA profession, connect new applicants with my network of recent PA graduates, and read and critique their application essay as a free service. Please feel free to contact me via my social media – the website has links to Facebook, Instagram, and LinkedIn or email me at skr@skradhakrishnan.com or my publisher email at kanvihouse@gmail.com

You can watch my interviews with Pre-PAs, recent PA graduates and veteran PAs at my YouTube Channel. Please subscribe to my website and YouTube channel to be notified of new blogs and videos. https://youtube.com/playlist?list=PL-Ys56zpnLvku2MINygXMHwpuQ2szJdGD&si=z-gK3CIX1vfK5UKS

 

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