{"id":8041,"date":"2016-02-16T09:51:18","date_gmt":"2016-02-16T17:51:18","guid":{"rendered":"http:\/\/depts.washington.edu\/medex\/?p=8041"},"modified":"2016-02-16T09:51:18","modified_gmt":"2016-02-16T17:51:18","slug":"you-do-what-you-have-to-do","status":"publish","type":"post","link":"https:\/\/familymedicine.uw.edu\/test\/you-do-what-you-have-to-do\/","title":{"rendered":"You Do What You Have To Do"},"content":{"rendered":"

Jeff Stubblefield, PA-C<\/strong><\/span><\/p>\n

As a physician assistant neurological surgical first assist in Anchorage, Jeff Stubblefield sees a lot of need. \u201cIt\u2019s impressive in a bad way,\u201d he says of\u00a0the challenges\u00a0to meet the health needs of the Alaska Native population. \u201cUnderserved is the word, but I don\u2019t know that it captures the whole issues we have here.<\/p>\n

An employee of the Alaska Native Tribal Health Consortium (ANTHC), which provides health services to 130,000 Alaska Natives and American Indians, Jeff is clear not to fault the medical side. \u201cThere\u2019s a lot of\u00a0obstacles\u00a0we face trying to care for this population,\u201d he says. \u201cWhen it\u2019s winter time here I can have somebody with a ruptured aneurysm sitting in cold bay for three days. And that\u2019s just weather.\u201d<\/p>\n

Prior to being given a recommendation to the Neurosurgery clinic most patients have seen other providers over several years for relief of their symptoms. By the time Jeff sees some patients at the Alaskan Native Medical Center in Anchorage, \u201cThey may have seen a health aide in a remote village, or perhaps a mid-level or physician at a regional clinic.\u201d<\/p>\n

[smartslider3 slider=18]<\/div>\n

Even in instances where the need for neurological services is identified accessing care can be difficult.\u00a0\u00a0Jeff recounts a favorable scenario. \u201cI’ll get a phone call from Savoonga. They’ll say, \u2018I’ve got somebody who fell down. They’re having paresthesia, or they’re myopathic or what have you.\u2019 And I can expedite those to a certain extent, but the geographic space of Alaska,\u00a0weather,\u00a0transportation obstacles, and the limited services available to the patients all work against speedy access.\u201d\u00a0Medivac planes trying to get patients out of rural communities have had to wait days due to snow, rains, wind or fog.<\/p>\n

Over the years Jeff has noticed a high incidence of aneurysms within the Native Alaskan population. \u201cIt’s extremely high up here,\u201d he says. \u201cIt was something that I wasn’t quite prepared for.\u201d<\/p><\/blockquote>\n

Because the Alaskan Native Medical Center is a level 2 trauma hospital, they see a small number of trauma patients who are not Native Alaskan. Over the years Jeff has noticed a high incidence of aneurysms within the Native Alaskan population. \u201cIt’s extremely high up here,\u201d he says. \u201cIt was something that I wasn’t quite prepared for.\u201d In the past three or four years that Jeff\u2019s been practicing, if he finds one aneurysm\u2014 whether it’s a ruptured aneurysm or one that’s an incidental finding\u2014 frequently somebody else in the family has had one as well. Sometimes he\u2019s uncovered a history of multiple aneurysms within a family lineage. \u201cThe numbers that I was seeing within a single family unit were impressive.\u201d He doesn\u2019t know if there\u2019s a familial link, and admits there\u2019s no scientific evidence supporting that.<\/p>\n

J<\/span>eff\u2019s insight and adaptability<\/span><\/strong> are the result of 21 years in the military as an independent duty medical officer, or IDMT. This Air Force program required him to rotate through different specialties including ER, dental, surgery, family practice and aerospace medicine. He would practice medicine as an individual provider underneath the guidance of a physician in remote locations or, in the vernacular, downrange medicine. \u201cYou\u2019re doing the medicine, you\u2019re seeing patients, and you don\u2019t have anyone else out there,\u201c he says.<\/p>\n

\"Jeff<\/a>He started out in Desert Shield, then Desert Storm. \u201cI went through all the rest of them,\u201d he says. \u201cYeah, I got a couple of times in the theatre.\u201d<\/p>\n

Jeff offered his talents as a MEDCAP (Medical Civic Action Program) at the invitation of host nations such as Vietnam, Cambodia, Laos and New Guinea. \u201cI\u2019ve hit just about every piece of dirt in the world,\u201d he says. The Southeast Asian assignments were part of the POW\/MIA missions mandated by Congress to recover the remains of US veterans from the Vietnam era war. In these situations he\u2019d set up a clinic and provide medical services for the local people that worked with the American forensic pathologists on the recovery effort.<\/p>\n

\u201cI\u2019d spent most of my adult life doing remote assignments in other countries, away from my family,\u201d he says.<\/p><\/blockquote>\n

It was these remote medicine experiences where Jeff learned remote medicine, which served him well in Alaska. The military sent him out to small villages throughout the state where he provided basic medical and dental services. Jeff had spent much of his adult life in remote areas throughout the world. Facing retirement from the military, his wife and family wanted him to stay in a more populous setting. \u201cI\u2019d spent most of my adult life doing remote assignments in other countries, away from my family,\u201d he says. \u201cWe were looking at the south central region of Alaska, whether that was in Eagle River, Palmer, Wasilla, or that area. The family was really okay with that.\u201d<\/p>\n

J<\/span>eff retired from the Air Force<\/span><\/strong> while at Joint Base Elmendorf-Richardson, his last duty station in 2009. It was time to apply his valued medical skills to the civilian population, and the MEDEX Northwest physician assistant training program in Anchorage provided that opportunity. The origins of the PA profession were with returning military veterans and, today, over 30% of the students come from the ranks of Army medics, Navy corpsmen or Air Force IDMTs.<\/p>\n

\"Jeff<\/a>
Jeff Stubblefield, PA-C, neurological surgical first assist at the Alaskan Native Medical Center in Anchorage.<\/figcaption><\/figure>\n

\u201cThat\u2019s what glued me to MEDEX,\u201d says Jeff. Even at the MEDEX Information Session the faculty present were more than receiving of those candidates from a military background. \u201cAt MEDEX, it felt like I was transitioning from active duty to reserve status.\u201d In 2010 Jeff entered MEDEX Anchorage Class 2, graduating in 2012.<\/p>\n

While finishing up his second to last rotation in Valdez, Alaska, Jeff was recruited by the Alaska Native Medical Center to work as a neurological surgical first assist. \u201cI had no real exposure to neurology,\u201d he says. \u201cI’d been in some inner theatre operating rooms where there was some brain surgery done, but I was not exposed to neurosurgery per se. I was never trained in it.\u201d He had completed an earlier rotation at the hospital, but it wasn\u2019t in neurosurgery.<\/p>\n

Ash Marquardt, the Anchorage site director for MEDEX, explains how Jeff came to be offered the opportunity to work at the hospital in neurology. \u201cWe recommended him,\u201d says Ash. \u201cHe\u2019s knowledgeable. It\u2019s true; Jeff didn\u2019t exit MEDEX as a neurological surgical assist PA. But he has the tenacity to study what he needs to know.\u00a0 I\u2019m sure he went into the job at ANTHC, got an idea of what was expected of him, went home for probably 3 or 4 months and just hit the books every night after work until he was tuned up. That\u2019s the kind of guy he is. He may not know everything, but he\u2019ll find out in short order. That\u2019s a huge value, more by example when he\u2019s precepting our students.\u201d<\/p>\n

\u201cI get to expose these students to an inpatient population that’s very grateful for just honest care,\u201d he says. \u201cI think the students get a lot out of that.\u201d<\/p><\/blockquote>\n

In his position at the Alaska Native Medical Center, Jeff has precepted as many as five PA and medical students within the year. \u201cI get to expose these students to an inpatient population that’s very grateful for just honest care,\u201d he says. \u201cI think the students get a lot out of that.\u201d This exposure gives the students a window into the Alaskan social system, and just how difficult it is for the patient. \u201cIt has a big impact on them,\u201d he says of his students. \u201cAs long as they’re willing and eager to learn, I’m willing to give them an opportunity.\u201d<\/p>\n

J<\/span>eff also teaches as a guest lecturer at MEDEX<\/span><\/strong>. \u201cHe\u2019s a natural teacher,\u201d says Ash Marquardt. \u201cA lot of this goes back to his military training.\u201d In the service the emphasis is on teaching and training skills so that more than one person knows how to do the job. \u201cJeff can lay it out in steps instead of overwhelming someone with the entire task.\u201d<\/p>\n

Given the challenges of patient care in Alaska, Jeff has developed his own guiding principles.\u00a0 \u201cWhen it comes to this, I’ve always been task oriented,\u201d he explains. \u201cThe patient needs something, you do what you have to do to make it happen. Even when you have bad news for the patient, or you can’t do what they need, as long as I\u2019m honest with them about it, I get a pretty good reception from the patient.\u201d<\/p>\n

\u201cIt\u2019s not brain surgery,\u201d he says.<\/p>\n","protected":false},"excerpt":{"rendered":"

Jeff Stubblefield spent considerable time traveling and working around the world\u2014 21 years with the Air Force as an Independent Duty Medical Officer. Now a PA neurological surgical first assist at the Alaska Native Medical Center in Anchorage, Jeff meets the challenges of delivering specialized medical care in a region challenged by geographical isolation and the elements. <\/p>\n","protected":false},"author":1,"featured_media":8047,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[29],"tags":[],"class_list":["post-8041","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medex-stories"],"_links":{"self":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/posts\/8041","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/comments?post=8041"}],"version-history":[{"count":0,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/posts\/8041\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/media?parent=8041"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/categories?post=8041"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/tags?post=8041"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}