Advancing patient care

Lee Tomatsu and Ken VanDerBeck like the pace, autonomy and variety that come with their jobs at the Sharp Grossmont Hospital Emergency Department (ED). They not only have an opportunity to rotate through various stations in the county’s busiest ED, but also engage in patient interactions that make a significant difference in their health and well-being.

The two physician assistants are among a team of mid-level practitioners known as advanced practice clinicians (APCs), who care for patients across Sharp hospitals and clinics. They practice medicine as part of a team, working in collaboration with supervising doctors.

Physician assistants are trained in the medical model similarly to doctors, whereas nurse practitioners (NPs) generally begin their careers as nurses and later pursue an advanced nursing degree. Among the ranks of health care practitioners, their job is often misunderstood yet they play an integral role in patient care.

APCs are trained at the master’s or doctoral level. Their education includes an academic foundation as well as clinical rotations in a specialty such as family medicine, emergency medicine, surgery and OBGYN, to name a few. When they graduate, they are considered generalists with the choice to stay in the primary care setting or to specialize.

Tomatsu and VanDerBeck treat patients in the Fast Track area of the hospital’s ED, where they see lower acuity patients who present with issues such as coughs, colds, ankle sprains and lacerations. In the department’s designated D station, they care for patients with moderately acute problems such as abdominal pain and headaches.

The licensed medical providers evaluate patients, order diagnostic studies and render treatment — performing procedures such as suturing, making diagnoses and prescribing medications. In all, there are 30 PAs and NPs employed in the ED, all under the supervision of Tomatsu.

Although patients benefit from the specialized level of care provided by APCs, they’re usually apprehensive at first, but then they warm up to the idea of a provider who isn’t a doctor.

“Our biggest challenge is when patients are seen by an APC and feel as though they haven’t been seen by the ‘real doctor,’” says Tomatsu. “We are fully capable of providing a high level of care within our scope of practice, while freeing up the physicians to focus on the most critical patients.” In certain instances — usually more complex cases — the PAs consult with the doctors on a patient’s plan of care. “We’re also able to spend a little more time with them and provide education, which the patients appreciate,” she adds.

Treating patients with empathy is the cornerstone of The Sharp Experience — and a philosophy that VanDerBeck takes to heart. “I sit down with each patient and always shake hands with everyone in the room and make sure they are part of the decision making so they feel involved and empowered,” he says. VanDerBeck seems to have found his calling. On a recent shift, he provides a calming, reassuring gesture and warm smile to a young mother and her infant in the ED, instantly putting them at ease.

Tomatsu sums it up nicely. “My greatest sense of satisfaction stems from making connections with patients and their families, turning what could be a frightening experience into a positive one, and hopefully sending them home feeling better than they did when they arrived.”