Program Director Heather Bidinger with her newborn child. The inaugural class of St. Kate's new Master of Physician Assistant Studies program is 50 percent larger than University administrators anticipated, demonstrating the need for PAs in a changing healthcare environment.

Photos by Dawn Villella

Great Expectations

The birth of a new Physician Assistant program places St. Kate's in the healthcare forefront.

By Christina Capecchi

Three days after the first class of St. Catherine University’s new master of physician assistant studies met, program director Heather Bidinger delivered her fifth child, Luke. His name, coincidentally, is the same as the patron saint of medicine.

The timing — two labors of love birthed the same week, a baby and a program she grew from scratch — was no surprise to Bidinger, an energetic native of Redwood Falls, Minnesota, who is used to riding out twin peaks in her domestic and professional life. She had her firstborn at the very end of her physician assistant schooling, weeks before taking her boards. Her fourth baby arrived the same month that St. Kate's approved the PA program she had developed.

She's a get-'er-done Midwesterner who can whip up dinners sans cookbook, play piano by heart and fire off a coherent email at midnight. She even managed to sew her daughter's baptismal gown, which consumed an entire weekend. (Yes, she has read the Allison Pearson novel I Don't Know How She Does It.)

"Life doesn't happen linearly," Bidinger said during an August interview, patting her eight-and-a-half-month pregnant belly, rosy cheeks framed by long chestnut hair. "If there are certain things you value — family traditions, work goals — you must make them happen."

Make it happen, indeed. Since St. Kate's hired her three years ago, Bidinger has designed an integrated curriculum that experts call innovative, hired eight talented faculty members, passed an exhaustive accreditation process and attracted a high-quality pool of students, 24 of whom began classes in September. It is only the second physician assistant program in the state, keeping St. Kate's graduates at the forefront of healthcare, an increasingly strained system where physicians cannot keep up with demands and primary care increasingly falls to physician assistants and nurse practitioners.

A physician assistant can do 85 percent of what a physician does, but she or he must practice with a physician who serves in a supervisory relationship. Nurse practitioners, on the other hand, practice the nursing model and can be independent providers who run their own practices. Both PAs and NPs can diagnose, prescribe drugs and perform certain procedures.

The Bureau of Labor Statistics predicts that PAs will be the second-fastest-growing profession in the United States over the next decade, rising from 74,800 in 2008 to 103,900 in 2018. The number of licensed PAs working in Minnesota was 1,371 as of 2009, nearly triple the number from a decade earlier.

A 2011 report issued by the Governor's Workforce Development Council, and developed by a task force on which Bidinger served, makes the case for further growth in the profession: "The expanded use of physician assistants will be critical to the provision of primary care in the future," it states. The report cited St. Kate's program as a vital way the state will meet that need and pledged to support it through clinical education, student referral and integration into the healthcare education community.

Last year marked a turning point for primary-care providers in Minnesota: It was the first time Fairview Health Services hired more physician assistants and nurse practitioners than MDs, according to its system director of talent acquisition, Laura Beeth, who worked on the governor's report. She counted 32 PA job openings one day in August.

"St. Kate has taken a big leap," Beeth says. "They understand that healthcare is changing. They are meeting a need. They're nimble — they listen and respond and produce caring, competent providers."

Students are increasingly recognizing the advantages of being a physician assistant: meaningful contact with patients, useful collaboration with doctors, and the flexibility to change specialties from family practice to surgery to obstetrics, for example — a freedom that neither physicians nor nurse practitioners enjoy.

Because relatively few universities offer physician assistant programs, the competition to be accepted is formidable. These days, it's often considered as hard to get into a PA program as medical school, says Terry Larimer, a PA who is serving as clinical coordinator for St. Kate's master's-level program.

"We're reaching into a new frontier, and St. Kate's will really benefit from that," she says.

If all the graduates of its first class work full time over a 30-year career, they will see some 2.7 million patients, she figures. Not bad for a two-year master's program. "The curriculum is jam-packed," explains academic coordinator Donna DeGracia. "It's like medical school crunched into 29 months."

Mission work

The new physician assistant program clearly fulfills St. Kate's mission, points out Penelope Moyers, dean of the Henrietta Schmoll School of Health: "This really is about making sure healthcare is available to everyone who needs it."

The program is grounded in Catholic social teaching: an expanded public health curriculum intended to examine communities — not just individuals — for the underlying cause of an illness. That is social justice in action, says DeGracia, because it effects change.

"I always thought there was a natural fit between the PA profession and St. Kate's founding mission of 'serving the dear neighbor,'" adds Bidinger, who is the product of Catholic education, the daughter of a St. Kate's alumna (Patricia Asleson SP'70) and an advocate for the liberal arts.

A broad education has certainly benefitted Debby Gray SP'66, who majored in English and biology and now works as a physician assistant, reaching underserved patients in Appalachia. Gray was delighted to learn of her alma mater's newest offering.

"This degree program combines a whole lot of what St. Catherine is about," she says. "As a physician assistant, you bring everything in your past to bear. You never know what you're going to get in the next exam room, so you're making all sorts of decisions quickly. The flexibility I learned through the liberal arts helps me with those decisions."

For all their common ground, physician assistants and nurse practitioners have tended to view each other as professionals who sit in separate camps. But the PA students at St. Kate's will be studying within the same Henrietta Schmoll School of Health and in the same location — the fourth floor of Whitby Hall — as the university's NP students.

That's a point of pride for Moyers. "The key is to develop not competition but collaboration, with the patient at the center," she says. "We believe that the education we offer in the Henrietta Schmoll School of Health is transformed by that concept."

Making the grade

Preparing to be accredited was a rigorous process for the PA team at St. Kate's. Unlike some programs, a physician assistant program must receive accreditation before any classes can be taught. That required a great deal of hard work and foresight: laying out a detailed curriculum, hammering out academic standards, and arranging clinical sites for all the students before they were admitted.

At times, Bidinger would arrange 50 Post-it® Notes on a wall to pinpoint her thinking. She and her colleagues assembled stacks of three-ringer binders lining three office walls. In total, they sent out 47 pounds of paperwork for review by the accreditation agency.

The group sought counsel from Scott Massey, a multi-degreed physician assistant and author who has guided 10 private universities seeking accreditation of their PA programs. He was wowed by Bidinger's integrated curriculum, which weaves core concepts such as ethics throughout all the coursework and integrates various ways to study a given topic — how the heart works, for example, how to examine and dissect it, how to treat conditions of the heart and administer medications — into one course, rather than separating those concepts class by class. "I've seen many curricula over the years, but never one like this," he says. "I think it will produce very strong students."

The hard work paid off: St. Kate's received unusually high marks in its accreditation. And, as for those strong students, members of the first class were thrilled to get started last month. Among them is Lisa Cemenski, a 41-year-old soccer mom who works in registration and scheduling at Allina Medical Clinic in Northfield, Minnesota. Formerly an interior designer, she was drawn to healthcare and admitted into the University of Minnesota's pharmacy school. Then she learned more about St. Kate's.

"Being a PA just seemed like the best path for me at this point in my life," she says. Cemenski hopes to serve a rural area and forge close relationships with patients. "You treat the grandma and daughter and son, and then you treat their children, because there's such a level of trust."

Her classmate Cassi-Jo Budsberg SP'12, who finished her bachelor's in food and nutrition science last spring, is happy to continue her education at St. Kate's. "It felt meant to be," says Budsberg, 22, of Rosholt, Wisconsin. "I think being a PA is a profession where I can look forward to work every day."

Bidinger, meanwhile, has reached a career pinnacle, having set the program she built into motion — a significant feat for the woman who, as a girl of 4, felt drawn to healthcare and diagnosed stuffed animals. She'll continue working as a PA, a program director and a mother — treating patients, training students, treating and training her children. One role informs another, Bidinger believes, preparing her for the unexpected and equipping her to take in lots of data.

Prelude to Spring