{"id":7762,"date":"2015-12-20T14:05:49","date_gmt":"2015-12-20T22:05:49","guid":{"rendered":"https:\/\/familymedicine.uw.edu\/medex\/?post_type=post&#038;p=7762"},"modified":"2022-04-04T20:31:24","modified_gmt":"2022-04-04T20:31:24","slug":"modeling-respect-for-those-in-need","status":"publish","type":"post","link":"https:\/\/familymedicine.uw.edu\/medex\/magazine\/2015\/12\/20\/modeling-respect-for-those-in-need\/","title":{"rendered":"Modeling Respect for Those in Need"},"content":{"rendered":"<p><span style=\"font-size: 18pt\">Joshua Lumsden \u2014 Seattle Class 48<\/span><\/p>\n<p>Joshua Lumsden is in his family practice preceptorship at the East Wenatchee Express Clinic of Columbia Valley Community Health Services. Now in his second year of physician assistant studies, Joshua is working directly in clinic for the first time.<\/p>\n<p>\u201cYes, I love it,\u201d he says. \u201cIt still amazes that people who are sick care what I think, and that they think I&#8217;m credible.\u201d<\/p>\n<p>But credible he is. During his didactic year in April of 2015, the MEDEX faculty awarded Joshua Lumsden the prestigious Richard Smith scholarship, named after the founder of MEDEX. Winners of this award are seen as visionaries with a commitment to increasing access to healthcare for the underserved, especially from a broad global perspective.<\/p>\n<p>\u201cColumbia Valley&#8217;s commitment towards remedying health disparities, especially with the Hispanic community, is just admirable,\u201d he says. \u201cIt&#8217;s exactly the kind of clinic I would like to work with.\u201c<\/p>\n<div><div id=\"amw_galleria_slideshow_1\" class=\"amw-galleria-slideshow\"><\/div>\n<script type=\"text\/javascript\">jQuery(document).ready(function(){ 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put to good use. He worked in Nicaragua and El Salvador during the summer of 2015, in part to freshen up his Spanish. The trip also provided him with the subject for his Capstone Project, due before graduation in August 2016. He explains that there&#8217;s a variant form of kidney disease, Mesoamerican nephropathy, that disproportionately affects sugarcane workers, who experience some of the worst working conditions in the world. \u201cI interviewed nephrologists, activists and academic researchers about the struggles they encounter trying to address kidney disease in that population,\u201d he explains. \u201cMy project focuses on the structural and political barriers these people encounter when they&#8217;re trying to address an entirely preventable epidemic.\u201d<\/p>\n<p>\u201cThese things\u2014 concepts like water, rest and shade\u2014 are completely a given here, something that you wouldn&#8217;t have to think about on a job site,\u201d he says. But the workers in Nicaragua and El Salvador don&#8217;t always have access to these basics. \u201cAs a result, they&#8217;re dying of kidney disease at 30, 35 years old. It was depressing, walking through the hospital nephrology wards and seeing people my age, emaciated, in their dialysis beds.\u201d<\/p>\n<p><span class=\"dropcap\">J<\/span><strong><span style=\"font-size: 18pt\">oshua received his first master\u2019s degree<\/span><\/strong> in Linguistics at Indiana University in 2003. While in school, a friend asked him to come work in a group home for developmentally disabled adults. \u201cIt was rewarding, but also I got paid to take people bowling.\u201d<\/p>\n<figure id=\"attachment_7794\" aria-describedby=\"caption-attachment-7794\" style=\"width: 232px\" class=\"wp-caption alignright\"><a href=\"https:\/\/familymedicine.uw.edu\/medex\/wp-content\/uploads\/Joshua-Lumsden-with-Nicaraguan-Red-Cross.jpg\" rel=\"attachment wp-att-7794\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-7794 size-thumbnail\" src=\"https:\/\/familymedicine.uw.edu\/medex\/wp-content\/uploads\/sites\/3\/2016\/01\/Joshua-Lumsden-with-Nicaraguan-Red-Cross.jpg\" alt=\"Joshua Lumsden with Nicaraguan Red Cross\" width=\"232\" height=\"250\" srcset=\"https:\/\/familymedicine.uw.edu\/medex\/wp-content\/uploads\/sites\/3\/2016\/01\/Joshua-Lumsden-with-Nicaraguan-Red-Cross.jpg 486w, https:\/\/familymedicine.uw.edu\/medex\/wp-content\/uploads\/sites\/3\/2016\/01\/Joshua-Lumsden-with-Nicaraguan-Red-Cross-279x300.jpg 279w\" sizes=\"auto, (max-width: 232px) 100vw, 232px\" \/><\/a><figcaption id=\"caption-attachment-7794\" class=\"wp-caption-text\">Joshua volunteered with the Nicaraguan Red Cross in Granada in Summer 2013.<\/figcaption><\/figure>\n<p>Eventually, Joshua moved to the Seattle area and took a job working with this same population for a non-profit in Issaquah. Later, he became a case manager for the State of Washington. Over ten years this contributed to over 18,000 hours of healthcare experience, well over the 4,000 hours required by MEDEX at the time of his application.<\/p>\n<p>The majority of his clients not only had developmental disabilities, but also mental health issues. \u201cThe people I worked with had existing services. They had residential and vocational care.\u201d Joshua\u2019s job was to make sure that those services were going well, and to respond to crises that came up.<\/p>\n<p>He offers up an example. An individual with disabilities might lose their residential placement due to mental health decompensation. It then became Joshua\u2019s job to assess the situation, obtain the necessary support from mental health agencies and medical care, and work on a plan to get the patient stabilized and into new residential placement<\/p>\n<p>These situations put Josh in close contact with a variety of medical providers. Although he was not qualified to make a formal diagnosis, he learned how to gather the data needed to help the professionals make appropriate diagnoses. During his time in Issaquah, Joshua met \u201can awesome mental health PA\u201d.<\/p>\n<blockquote><p>\u201cI really admired the way that he worked with people with disabilities,\u201d he recalls. \u201cHe modeled respect for a person with disabilities in a way that I&#8217;d never seen.\u201d<\/p><\/blockquote>\n<p>The physician assistant he\u2019s referring to is Dale Sanderson PA-C, a MEDEX graduate from 1995, and currently a behavioral medicine specialist at Sound Mental Health.<\/p>\n<p>\u201cOur clients had pretty complex psychoactive medication management needs, and Dale was the contact,\u201d Josh recalls. \u201cHe was the one that did the prescribing.\u201d<\/p>\n<p><span class=\"dropcap\">B<\/span><strong><span style=\"font-size: 18pt\">ecoming a physician assistant<\/span><\/strong> really resonated for Josh. \u201cIn every job you get to a point where you&#8217;re not very challenged,\u201d he recalls. He looked at what advancement as a case manager for the state might look like. \u201cIt meant supervising other social workers, and\/or writing policy on how a group home should be run. And those are pretty important jobs.\u201d<\/p>\n<figure id=\"attachment_7793\" aria-describedby=\"caption-attachment-7793\" style=\"width: 182px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/familymedicine.uw.edu\/medex\/wp-content\/uploads\/Joshua-Lumsden-Rugby.jpg\" rel=\"attachment wp-att-7793\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-7793 size-thumbnail\" src=\"https:\/\/familymedicine.uw.edu\/medex\/wp-content\/uploads\/sites\/3\/2016\/01\/Joshua-Lumsden-Rugby.jpg\" alt=\"Joshua Lumsden Rugby\" width=\"182\" height=\"250\" \/><\/a><figcaption id=\"caption-attachment-7793\" class=\"wp-caption-text\">Joshua played with the Seattle Quake Rugby football club for three years.<\/figcaption><\/figure>\n<p>But Josh wanted more contact with people, and the physician assistant path appeared intellectually challenging while granting the hands-on access he needed. \u201cIn time the pull got a little too strong, and so I decided to apply.\u201d<\/p>\n<p>In 2013 Joshua applied to six PA schools around the country. After the interview at MEDEX he knew where he wanted to go. \u201cI had seen who they produced,\u201d he says. \u201cThe MEDEX physician assistants that I encountered working in the community were excellent.\u201d<\/p>\n<p>When he received a call from MEDEX, Josh accepted immediately, and withdrew his application from every other university he\u2019d applied to.<\/p>\n<p>The challenges of that first year at MEDEX\u2014 the didactic year\u2014 are well known, and Joshua says little to dispel the notion. \u201cIt&#8217;s just astonishing,\u201d he says. \u201cJust when you think that you have been stretched to the end, another quarter comes along and it&#8217;s even harder. You give up on things like exercising, and you start scheduling bathroom breaks because that much time management is required.\u201d<\/p>\n<p><span class=\"dropcap\">N<\/span><strong><span style=\"font-size: 18pt\">ow in his clinical year<\/span><\/strong> at MEDEX, Joshua is working hands-on with patients under the supervision of his preceptor, Casey Wyatt PA-C, himself a graduate of MEDEX Spokane class 13. There are not as many deadlines and tests as in the didactic year, but the self-study has proven to be quite intense. \u201cAfter my 12 hours in clinic, I&#8217;m spending two hours at night working on my Capstone project, studying for the PANCE certification exam, and managing other communications with MEDEX,\u201d he says. \u201cBut still, it&#8217;s a different kind of intense. It&#8217;s more fun.\u201d<\/p>\n<p>After concluding his 4-month family medicine preceptorship at the end of January, Joshua will move on to fulfill six 1-month long specialty rotations, all to be determined by MEDEX. Next in line is general surgery at Franciscan Medical Clinic in Lakewood, WA.<\/p>\n<figure id=\"attachment_7792\" aria-describedby=\"caption-attachment-7792\" style=\"width: 960px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/familymedicine.uw.edu\/medex\/wp-content\/uploads\/Brian-Arbanas-Joshua-Lumsden.jpg\" rel=\"attachment wp-att-7792\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-7792 size-full\" src=\"https:\/\/familymedicine.uw.edu\/medex\/wp-content\/uploads\/sites\/3\/2016\/01\/Brian-Arbanas-Joshua-Lumsden.jpg\" alt=\"Brian Arbanas + Joshua Lumsden\" width=\"960\" height=\"540\" srcset=\"https:\/\/familymedicine.uw.edu\/medex\/wp-content\/uploads\/sites\/3\/2016\/01\/Brian-Arbanas-Joshua-Lumsden.jpg 960w, https:\/\/familymedicine.uw.edu\/medex\/wp-content\/uploads\/sites\/3\/2016\/01\/Brian-Arbanas-Joshua-Lumsden-300x169.jpg 300w, https:\/\/familymedicine.uw.edu\/medex\/wp-content\/uploads\/sites\/3\/2016\/01\/Brian-Arbanas-Joshua-Lumsden-768x432.jpg 768w\" sizes=\"auto, (max-width: 960px) 100vw, 960px\" \/><\/a><figcaption id=\"caption-attachment-7792\" class=\"wp-caption-text\">Joshua with his partner of eight years, Brian Arbanas (left).<\/figcaption><\/figure>\n<p>We wonder if Josh has any thoughts past graduation in August 2016. What kind of medical practice does he imagine for himself? \u201cPreviously, I saw myself doing behavioral medicine,\u201d he says. \u201cBut as I encounter more and more primary care, I think primary care is the way to go. You still get to do some behavioral medicine work here, and it relates well to the case management I did before. You can work on social issues a little bit. You get a broad base of challenges.\u201d<\/p>\n<p>Reflecting on the pace of the 2-year MEDEX program, Joshua states, \u201cit moves really, really quickly. This is a time of great growth. I don&#8217;t know if there will be another time like this in my life, and so I&#8217;m happy.\u201d<\/p>\n<p>Appreciating his first taste of medical patient contact at East Wenatchee Express Clinic, Josh declares, \u201cThis place is a dream\u201d.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>After over 10 years of working with developmentally disabled adults, Joshua Lumsden is embarking on a new career as a physician assistant. During his family medicine preceptorship in a small Eastern Washington agricultural community, Joshua puts his Spanish language skills to use along with his finely tuned advocacy skills for the underserved. <\/p>\n","protected":false},"author":1,"featured_media":7763,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21],"tags":[],"class_list":["post-7762","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-clinical-experience"],"cp_meta_data":{"_edit_last":["1"],"_thumbnail_id":["7763"],"student_name":["Joshua Lumsden"],"_webdados_fb_open_graph_specific_image":[""]},"_links":{"self":[{"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/posts\/7762","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/comments?post=7762"}],"version-history":[{"count":6,"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/posts\/7762\/revisions"}],"predecessor-version":[{"id":17377,"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/posts\/7762\/revisions\/17377"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/media\/7763"}],"wp:attachment":[{"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/media?parent=7762"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/categories?post=7762"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/tags?post=7762"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}