Insights From Wapiti

Written by Kim Herrmann – Physician Assistant and Wapiti CEO

For my entire high school career, I was sure I wanted to be a physician. Fast forward a few years, graduation from PA school at the University of South Dakota set me up to work with patients, to “help people” as I had always wanted. Did I ever dream that I would want to move away from patient care and “help” in another way? Not in a million years.

The Desire to “Fix”

I started my career as a PA in general surgery, on-call 24 hours a day unless out of town. Not a big deal in a small town, but we were always on. Surgery allows many wins in that it definitively fixes something … appendectomy, hernia repair, etc. I enjoyed being part of a surgical team that worked together to “fix” whatever it was and being able to work with the patient and family as they improved both in hospital and outpatient for follow-ups. Occasionally, the result was the opposite… a cancer patient or something similar that was not fixable. Working with families through grief and hard times knits an even closer relationship, which was something I cherished.

Most of my clinical career was spent in Emergency Medicine: same small town, same numbers, but enough to challenge me. The same “fix it” part of me was satisfied with suturing lacerations, relieving abdominal pain, or splinting fractures. And a similar grief pattern happened with those that were not fixable, whether it be a trauma or code. The satisfaction of knowing what to do in an emergency, running to the code rather than away, knowing we could help that patient and calming fears was exhilarating. Ten years of night shifts and then several more years of day shifts kept my craving for adrenaline satisfied.

A New Idea

In the midst of my tenure working night shifts, working 1 week on for 118 hours and 2 weeks off, I found myself bored. A co-worker and I decided to start a small company providing care to the underserved population on reservations. This started in 2004. We worked our regular jobs in the ER plus many clinic and ER shifts at these sites. Eventually, more people joined this venture, and the administrative side of me started to form. It was not a conscious choice at that time but rather one of necessity.

I really enjoyed the relationships formed with our providers as part of learning more about their lives and helping them find work that fits their particular situation. I still had no thoughts of turning to administration as a way of life, but my son had a way of changing my mindset about this. Being present for kindergarten graduation, concerts, conferences, and all that goes with having a little one pointed out the importance of some “normalcy” as well as the need for flexibility.

Merging with Wapiti

In 2012, my little company became part of Wapiti Medical Staffing, and I began officially spending half of my time with administrative duties. I went from having an impact on 2,000 patients a year to 300,000 patients a year, but in a more indirect way. I liked the busyness of doing both, and it allowed me more time at home. As the needs of Wapiti increased, though, the ER shifts began to decrease. I needed to consider how often I could travel to sites to work and still be able to maintain balance.

An increasing concern for me was how many shifts per week or month it would take to remain proficient at my clinical job. I needed to spend time in the administration to be effective, but I also needed clinical time to remain proficient. In 2015, I gave up my part-time ER job and continued with locums only, and then eventually moved away from most clinical work. It wasn’t really a conscious choice but rather a more gradual evolution to the point I am today.

I am still able to interact with our providers through teaching PALS, BLS, and ACLS. I continue to wonder if I will get back to more clinical work someday and fully believe I will. I find it interesting that medicine scares me more now that I am out of it, and administration scares me less. I guess we get used to doing whatever it is that we do all day. I’ll be honest in that I miss the “fixing.” In administration, there are always things to improve, but it is not quick. It is typically over time, and my impatient self finds this challenging. It is another opportunity to grow myself to see what I can become.

You might ask if I would recommend this to others? It has been extremely rewarding for me, albeit in a different way than what I dreamed of in high school. I truly believe that there is a plan and purpose for all of us, and my prayer is always to fulfill that. Helping our internal employees and all of you to fulfill your purpose is the reason I get to do this every day. As we cross paths, I would love to hear your story. Thanks for letting me share mine.