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Pathway to PA: An Interview with Lara Francisco, PA-C

Pathway to PA

If this is your first venture onto our Pathway to PA series, you'll find that our focus is on highlighting the unique routes professionals took to becoming a Physician Assistant.  We hope to inspire and encourage young people with an interest in medicine and the sciences to consider exploring becoming a Physician Assistant as a career option, as well as build a community source for those currently working in the field. [caption id="attachment_3045" align="alignleft" width="200"]Pathway to PA Lara Francisco, PA-C, Medelita Founder[/caption] Today we are thrilled and honored to highlight Lara Francisco, PA-C, and the founder of Medelita.  Here is the interview:

Can you tell us about your education route to becoming a Physician Assistant and how you decided on which schools to attend?

I was in the pre-nursing program at Emory University in Atlanta, and during that time came to realize that my personality might be better suited for a clinical role in medicine.  I was considering the Nurse Practitioner route, but found that I could cut out a few years by going the PA route instead.  I became very serious about applying to PA school the summer before my Junior year of college.  At the time it was listed as the #1 “up and coming” profession and so I knew it would be difficult to get into a program; this was back in 1995/96 so there were not nearly as many programs as there are today. I applied to numerous schools and was accepted at Catholic Medical Centers Physician Assistant Program, which was renamed St. Vincent’s Catholic Medical Centers PA Program.  This inner-city program really shaped my entire career path, as I was able to focus in Emergency Medicine and do an extra rotation in ER.  Larry Herman, RPA-C and current AAPA president was my EM preceptor – best experience of my life and a good friend still today. I wasn’t competing for good cases because there was a plethora of good ones to go around.  I was doing spinal taps on AIDS patients on my 2nd rotation and there were absolutely endless learning opportunities.  Also as class President it was a great learning experience for me in a leadership role, very much shaping my ability to take on larger roles in the near future.

 How long have you been a PA?

I graduated in July 1999.  I worked clinically from August 1999 through May 2008, mainly in Pediatric Emergency Medicine and Urgent Care.  In May 2008 I transitioned full-time to run www.medelita.com. 

Did you consider becoming an MD or another career in medicine?

I never considered becoming an MD but I did consider becoming an RN or an NP. I think being a PA is the absolute perfect career for someone with a strong personality, someone who is very bright and has great clinical judgment, and especially for someone who has strong interpersonal skills. It’s a job ideal for someone that wants to balance a family and a career, and that was one of the main reasons I chose to be a PA.  I could not fathom sacrificing so much time away from my family/children if I was to go down the MD path.  If I were working clinically right now, it would be ideal to work the traditional three 12’s, as we have one year old twins and a three year old.

What are your biggest professional challenges?

I think my professional challenges (when I was working clinically) were not unique, in that we all share the same sort of issues.  Varying degrees of connectivity and  clinical preferences with supervising physicians, wait times in all directions – to be seen, for x-ray, for lab, for a room, etc., and liability risks with certain ER cases (headache, abdominal pain, etc.).  My professional challenges today (working at Medelita) revolve around the classics of a start up – fundraising, profitability, long lead times, quality control, weighing new product risk, and sourcing. I enjoy my current position very much and am very proud of what we have achieved in our 5 years as a start up, but to be honest I do miss working clinically, especially with children.  I know that I had a special gift in working with children and also just how well my training prepared me for all situations – I picked up on so many cases that were unusual or life threatening, and still to this day I am so grateful for that judgment.  I could always hear Larry Herman in the back of my head saying “Zebras.  Lara just think about the zebras. What’s the worst thing that this could be, and did you make sure it wasn’t that?”  It stuck with me and I got lucky more than a few times.

 If you could change any decisions you made along the way what would they be?

Always, always go with my gut clinically and don’t let anything – not time pressure or personality pressure or time of day influence me otherwise.

What advice would you give a student considering Med School?

Please study the www.aapa.org web site and find a PA in your area whom you can shadow.  It is absolutely the most amazing career.  You work at the level of a physician but are not “stuck” in a specialty.  For example, as a PA you could work dermatology for a few years, and then, if you choose, you could go on to work orthopedics or any other specialty.  No one is limiting your education and/or journal reading. Go to the very best MD CME programs in the country.  Gain the highest level of licensure in anything/everything related to your specialty.  Pursue leadership opportunities within your work setting and beyond.  Be a clinical preceptor.  Become active in your state and national organizations.  The sky is the limit in this profession and you’ll never regret it. In terms of salary, there are recent published articles pointing out that a PA is likely to make more money over their career than an MD in certain specialties, as the debt is so high for med school and many women, especially, are forced to work part-time as an MD in order to balance family and career.     If you are a PA and would like to be interviewed for our Pathway to PA series, please email us here. email us here.