John E. Padgett- 8/16/2010
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Jennifer: Now how do know Doctor Harbert?
Padgett: Ken Harbert through the Veterans Caucus through the American Academy of Physician Assistants. Ken is actually a founding board member of that organization and I am basically one of their charter members.
Jennifer: Great! Well, I know he has done great things for our program here in Knoxville.
Padgett: Please give him a hard time next time you see him.
Interviewer 1: We will!
Emily: We will enjoy that.
Jennifer: We will enjoy that! Any opportunity we get we! (Laughter from interviewers)We will look forward to that.
Padgett: Hopefully he won’t send you to [inaudible]
Jennifer: Right, right. We just want to start with just a little background history, just anything you want to tell us about yourself, especially why you decided to enter into the PA profession.
Padgett: It has to do with Dr. Pat Smith indirectly.
Jennifer: Ok.
Padgett: I was a Special Forces medic during the Vietnam War as a Green Beret type. I was at a classified Special Forces project in Kon Tum, Vietnam, where Dr. Smith’s hospital is located, because Special Forces had or has still a close relationship with theMontagnard people or the Malayo Polynesians; the residents who inhabit the central highlands of Vietnam are not ethnically Vietnamese. These folks would work as soldiers for us with regular troopsin the mountain areas and with certain other units like strike forces and reconnaissance units and what have you. There developed a real love and a real affectionbetween American Special Forces and troops and the Montagnard tribes.
Jennifer: Right.
Padgett: Because I knew of the Montagnard hospital that Dr. Smith started in Kon Tum, I would go over and volunteer my services and see what I could do for them from time to time,whenever I had some down time.
Jennifer: Right.
Padgett: Occasionally a case of penicillin would fall off my Jeep or you know a few IVs or something.
Jennifer: Right.
Padgett: I got to meet and know another former Special Forces medic who was working there as a physicians assistant.
Jennifer: Ok.
Padgett: He also volunteered there; his name was Tom Coles. I watched Tom work and I spoke to him and I said, “You aren’t a doc and you are no longer a Special Forces Medic,even though we are pretty highly qualified and you obviously have a lot of clinical skills. What is that you do? What are you?”
Jennifer: Right.
Padgett: And he briefed me on the Physician Assistant profession and graduated at the University of Washington PA Program, MEDEX, and said I should consider this; and as a matter of fact, he would write a letter to the good people at University of Washington and recommend me. He did and I applied and I got accepted, which was very convenient, too, because when I was back in the United States in ’71 September,I was accepted and my classes started in November so it transitioned very well.
Jennifer: Great. Well, that was one of the questions that we had because we had heard a little about the MEDEX program; but I just don’t know that much about it. Just wondered how it compared to traditional PA training today?
Padgett: Are you PA students?
Jennifer: We are PA students, yes.
Padgett: You have not been taught about the MEDEX concept. I am shocked beyond description.
Jennifer: No,not…
Emily: We had one guest lecturer come in and tell us about the founding of the PA field and he mentioned the MEDEX program to us briefly and how it was started, but it was more kind of a brief overview; kind of a five-minute thing. so we really don’t know too much about it.
Padgett: About the time that Dr. Stead started the first Physician Assistant Program at Duke, same time the Surgeon General and a guy by the name of Richard Smith the physician who worked in the public health field for many years was able to help start something similar in the Pacific Northwest. Being a physician shortage in that area, he remembered all the different concepts for all the training of the Physicians Assistants. As MEDEX, this is a competency-based PA program.
Jennifer: Ok.
Padgett: It opened I think not ’70, maybe a little earlier, but I was a graduate in ’73 maybe earlier ’68 or ’69, because Tom Coles was a graduate and it is a two-year program.
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Jennifer: Ok.
Padgett: About the same time that Duke started, just shortly thereafter DickSmith started the MEDEX program at the University of Washington in Seattle. It was very instrumentalin getting the state legislature to pass enabling laws for PAs to practice.
Jennifer: Is the training kind of similar to now?We have didactic 15 months clinical; is MEDEX kind of similar?
Padgett: I don’t know what it is today, but when I graduated,we had probably about three or four months of didactic then about a year of clinical rotation.
Jennifer: Ok.
Padgett: Then we were certified as PAs. We were actually MEDEX, which is the same thing as PAs.
Jennifer: Right.
Padgett: We will take the national board exam and go on from there.
Emily: That was one of my questions becausewe were told about Richard Smith and kind of the founding of the program, but we were not sure of how it was different or if it was the same concept but just starting it in the West.
Padgett: The Hawaii outfit, the University of Hawaiiis doing the MEDEX concept internationally, and I worked for him in 1974; started a MEDEX program out there.
Jennifer: What specialty areas have you worked in as a PA before you were an educator?
Padgett: I was in family practice most of my time then in urgent care.
Jennifer: Ok. What was your favorite thing about being a practicing PA?
Padgett: I think the family-practice concept is what I really came to know and love. The fact that you start with the patient; for example, take a young woman, you are giving her an athletic physical.
Jennifer: Right.
Padgett: And you are counseling on everything from safe sex to wearing a helmet when she rides a bike, and everything else. Then, a couple of years later, you see her for prenatal checkups she has been married and now she is having a child.Thena year or so later you see her child, a little baby checkup.
Jennifer: Right.
Padgett: The transition to family involvement, it just means so much to not only the family but also the practitioner as well.
Jennifer: Absolutely. Were you in a practice in a small area?
Padgett: No, I moved around. I spent most of my time in St. Clemente, California, which is a relatively small beach town.
Jennifer: Ok.
Padgett: It had a surfing team, if you can believe that, at the high school.
Emily: Wow!
Jennifer: Oh wow, yeah, we would not know much about that.
Padgett: We wouldn’t know much about that.
Jennifer: Don’t know much about that in our mountains.
Emily: Not really.
Padgett: Do you have a lake or anything?
Emily: We do have a lake and people ski and stuff like that, but no surfing around here. (Laughter from interviewers) Wish we did.
Jennifer: Tell us about the time you spent working with the Alaska pipeline project?
Padgett: As I mentioned, I went to work with[inaudible] Micronesia and then in ’75…’76 I think it was…no ’75. Bill Hardy,whois the medical director out there in Micronesia, became the medical director for the Alaska Pipeline project.
Jennifer: Ok.
Padgett: And he thought of me and asked me to come up and work on the pipeline and work asa medical technician. I thought it was pretty good, so off I went.
Jennifer: What was that like? Were you a provider to the men and women working on the pipeline? What kinds of things did you see?
Padgett: Our camp was in a place called Sheep Creek, which just coincidentally had the highest piece of elevation on the pipeline and the lowest.
Jennifer: Oh, wow.
Padgett: Went really from a mountainous environment to a canyonenvironmentbefore the pipeline finally went into the terminal in Valdez and I took care of anywhere from 400 to 1200 people a season, depending on who worked there.
Jennifer: Sure.
Padgett: I was it for the medical care for the camp.
Jennifer: Ok.
Padgett: They did have the possibility to evacuate patients who needed evacuation to the hospital about 26 miles away at Valdez. Sometimes the weather prohibited us getting people out. There are some pretty spectacular things that happened. I was repelled down cliffs, for example, to go get patients that tumbled down there. One time, there was a gunshot wound at one of the lodges with the gunman still around. (Laughter from Padgett)
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Jennifer: Wow.
Padgett: And just a whole bunch of stuff. Now that we were responsible for a pipeline camp, the agreement with the City of Alaska was we were also responsible medical treatment for the highway that included our pipeline area. Anywhere from auto accidents to shootings to what have you, there we were.
Jennifer: So you saw a variety of things I am sure.
Padgett: Yes ma’am.
Jennifer: Ok, so with your military background that you mentioned that you hadserved in Vietnam, where else had you served in your career?
Padgett:I was active duty and reserve. I started my active duty services in ’65 then got to Vietnam in ’67; all that time a Special Forces soldier. Left Vietnam for a year in ’69; then in ’70, came back in ‘70 and ’71.During’69 and ’70, I was in Thailand doing pretty much the same thing.
Jennifer: Ok. What was your rank when you retired?
Padgett: Major.
Jennifer: Ok.
Padgett: Started out as an enlisted man and was a war officer for a while then retired out as a Major.
Jennifer: Right.
Padgett: I started out my military career in Vietnam and ended in Iraq.
Jennifer: Oh, wow. What was it like there, when you were there?
Padgett: I was right on the tail end of the invasion. So my job was I became the public health officerin Baghdad then.
Jennifer: I bet that was interesting.
Padgett: I had to access assess the status of the hospital in Baghdad, the water works, medical schools, the supply systems, the zoo.
Jennifer: The zoo fit in that as well?
Padgett: It did.
Jennifer: What was it like over there? What was your assessment?
Padgett: Obviously, Saddam had other things in mind for money for the oil for food program. He let the infrastructure of the hotel, of the hospitals, just deteriorate dramatically.
Jennifer: Oh, wow.
Padgett: Exactly. There was hardly any medicine at all. No cancer medicine. The medicine that would come into the country would generally be parceled out to his favorites--politically and for money.
Jennifer: Sure.
Padgett: Children’s Cancer Hospital would be somewhere you took your kids to die, not necessarily to be treated.
Jennifer: Sure.
Padgett: Some of the hospitalsmaintained themselves after the government collapsed some; of them that were taken over by militia, some of them were thoroughly looted and destroyed, just all depended.
Jennifer: Oh, my goodness! That was going to be my next question. How do you think they would compare today...but I think you just answered that It just depends on probably the reason they’re in and who is in control there.
Padgett: There was...I can’t remember how many floorsI think about a 20 story hospital in downtown Bagdad, which was their sort-of showplace hospital and each floor was occupied by different Iraqi militia.
Jennifer: Oh, my goodness.
Padgett: We had to go in and disabuse them of the idea that they could hold the health service hostage.
Jennifer: Oh, my goodness. Tell us a little bit about your teaching career. How long have you been doing that? What made you come out of the clinic and into the classroom?
Padgett: It started with Samuel Merritt College in 2001; clinical coordinator and assistant professor for a couple of years until I was alerted for the Iraqi invasion in 2003. When I was in Iraq, my wife had an opportunity to tour the University of Nevada to help start the PA program in [inaudible] University actually and she told the Touro people that you want one, you get two.
Jennifer: Right. (Laughter from interviewer 1)
Padgett: She brought me with her as clinical coordinator with her since 2004 here. I got back from Iraq and she said, “Don’t unpack honey.We’re moving.”
Jennifer: Right, exactly. Did you say she was at South University?
Padgett: Touro University.
Jennifer: Oh, ok. What do you think about being in the classroom? What do you think of the future of PAs? Do you have hope for us?
Padgett: I have no hope at all, of course. You kidding? (Laughter from interviewer) I’m actually the clinical coordinator here at the program. I have taught a few classes but my primary reason for being here is to place students on rotation.
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Jennifer: Oh, ok.
Padgett: Follow them up.
Jennifer: Yeah.
Padgett: I’m certainly aproponent of the PA concept. My son is actually applying to become a PA here at Touro. He likes the program as well as others. I recommendedboth the... PA profession highly of course, but not only do we have a great future with the current way that the health care is being structured; I think physiciansare going to be finding the services of PAs quite a bit to help them and to help them open the doors to many manyprimary-care patientswho heretoforehave not had access to care.
Jennifer: What would you say is the best part of being involved with the education of PAs?
Padgett: It is just great. We at this program for example, have a philosophy, a culture if you will, on mentoring PA students. We are student-friendly here. We have an open door policy; when the door is open you can come in.
Jennifer: Right.
Padgett: To have the ability to help shape the future and impressions of future Physician Assistants; point them to the direction of service to the underserved. To help mentor them and show them what professionalism is. And teach that compassion and a patient-centered care philosophy that is so important.
Jennifer: Absolutely.
Padgett: Then get into a specialty.
Jennifer: Right, absolutely. Now we understand you are a movie star? (Laughter from everyone)
Padgett: Of course though I haven’t had a part in one movie.
Emily: Pearl Harbor military Chaplin, is that true?
Padgett: When I retire next year I plan to get back into that.
Jennifer: Absolutely! What was that like?
Padgett: Lots of fun actually. Probably the most fun I have ever had with my clothes on. (Laughter from everyone)
Jennifer: That we could talk about right now anyways. (Laughter from interviewer) How did the opportunity come up for you?
Padgett: I have a friend who was special operations for a long time who became an advisor for the movie industry on combat tactics and techniques.
Jennifer: Oh, yeah?
Padgett: Pearl Harbor,had a big mass casualtysituations asyou might recall. He contacted me to be the technical advisor for the medical portionforall that. When you see all the guys sitting there on the ventilators there at Pearl Harbor at the medical department, that’s my stuff; the way I advised them to do, youknow markthe wounded in a masscasualties situation and all of that stuff.
Jennifer: Right.
Padgett: And, for example, how to stock the medicalshelves withthings that were pertinent in 1941. Then the director…I was spending most of my time with him, Michael Bay, and he turned to me one day and he said, “Doc, I want you to be the priest” Me, do I get a script or any lines? “No,I want you to be spontaneous. So much the better. Go down to wardrobe.”
Interviewer: That is wonderful. (Laughter from interviewers) That’s right place at the right time, huh?
Padgett: Yep.
Interviewer: That sounds really neat! Looking down at our questions here to see if there is anything we haven’t spoken with you about. What is it like being a PA family?
Padgett: It certainly, from my standpoint, is very enjoyable. Like for an example, I just got a partial knee replacement. She did not cut me any slack.
Interviewer: What’s that?She did not cut you any slack?
Padgett: We are both strong proponentsof the PA profession. We have become involved as a husband and wife team in Nevada Physician Assistant affairs. We are both very active with the Nevada Academy. Vicky was president and board member and I have been a House of Delegates Representative for years now, both delegate and associate delegate.
Jennifer: Yeah.
Emily: You said you are in the House of Representatives?
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Padgett: We are very happy to have brought what we can for the profession here in Nevada and I might add that before, when there was no PA school here, you can see the contrast after the school got started.Not only have we added a lot of members to the Nevada Academy that are profession here because the school is here but also we can have some influence on thelegislative process. Speaking from the staff point of educators.