Mitch Runge PA represents the new breed of certified physician assistants that are filling a medical care gap in rural and small town hospitals and clinics all across the nation. His practice is located at the Southwest Medical Associates Clinic building in Hermann, just west of Hermann Area District Hospital.
JOHN BUCKNER PHOTO
For Mitch Runge, PA, at Southwest Medical Associates (SWMA), becoming a physician’s assistant (PA) was a matter of science interests. He made a summertime visit to see a cousin who was a PA and her husband, a surgical PA, in Atlanta, Ga.
“He invited me to shadow some surgeries and that fall, I got into the big core [studies] like anatomy,” he explained. “You just have to be around medicine to realize you might be interested in the academic challenge of figuring out what’s wrong with people and how to make them better.”
“There’s a little bit of a nerd factor in there,” he jokes.
He attended University of Missouri - Kansas City for another three years after earning his undergraduate degree, to complete his PA studies. He heard about the PA opening at HADH while at school and since he wanted to get back to the greater St. Louis area (he’s a St.Paul/O’Fallon native), Hermann was a step in the right direction. He lives in Hermann and likes the town.
“I like to work in a smaller setting, which means for this job, we get to do more and take on more responsibility,” he explained.
For those that might not be familiar with what a physician assistant does, the A-C asked Mitch to explain.
“We’re commonly referred as an extension of the physician,” he said. “In primary care, we do a lot of the same job. We see a similar group of patients—we diagnose, treat, work up labs and interpret diagnostic tests. That also includes physical exams and followups.”
The existence and role of the PA is a relatively new addition to the hospital organization chart. The medical profession across the nation has been challenged primarily because of an increasing population, an aging population and not enough doctors in rural areas to fill healthcare needs. In the mid-1960s, physicians and educators recognized there was a shortage of primary care physicians. To help remedy this, Eugene A. Stead Jr., MD, of the Duke University Medical Center, put together the first class of PAs in 1965. The role has proven to be beneficial, particularly in areas with doctor shortages.
So, Mitch fills an important role at Hermann Area District Hospital within the SWMA clinic. HADH is not alone in taking advantage of the physician assistant role to bolster health care demands in rural communities. According to the Bureau of Labor Statistics, employment of physician assistants is projected to grow 37 percent from 2016 to 2026, much faster than the average for all occupations.
“You still need physicians for that higher level of care, but the additional two-and-a-half-to-three years of additional school [to pass exams to be PA-certified] is maybe 80 to 85 of what you would get at medical school,” he explains. “You don’t get the residency, but you get that training and consulting with the physician.”
He has to know all about the major human organ systems—pulmonary, hematologic, gastrointestinal, reproductive, dermatologic and cardiovascular systems.
Mitch particularly enjoys one of HADH’s specialties—acute care. Acute care examples are bone breaks, sprains and cuts or upper respiratory ailments—immediate medical needs that can be treated in a clinic setting.
“I like something I can fix that day, instantly,” he says. “Something like a laceration that we can sew up, treat pink eye or an arthritic knee that needs an injection.”
He likes when someone comes in and they treat something that will get that person back on their feet quickly.
“You know they’re not coming back for a while because they feel good,” he adds.
Though he’s been here about a year, he says it took a few months before he understood what the clinic and HADH had to offer.
“We’ve got out-patient clinics, Saturday hours, a hospital that admits people overnight, a good nursing staff, a swing-bed facility, physical therapy—those are all great,” he said.
Mitch says he likes that he can refer a patient to Dr. Swayze, a surgeon that can handle many different procedures, for the continuity of care here in Hermann.
“In primary care, we’re supposed to know a little bit about everything and to do certain things well,” he notes.
He talks about all the services the clinic and hospital provide, such as pulmonary function testing, stress testing, allergy workups, etc., along with a cardiology team that comes to Hermann every other week.
“We’re continuing to learn what we can co here, just to keep people from having to drive two hours [and not necessarily getting better care].
Mitch likes the service that a small town clinic can provide. He says most people get a 30 minute time slot so he can have a conversation with his patient about their needs, so they don’t feel like a number in the rush to see more patients.
“I try to spend as much time as necessary,” he says. “and I hope they appreciate the extra five minutes it might take to explain the process [of treatment]. “I think people here are pleased that they can come to the clinic for many things that aren’t at an emergency level.”