June 15, 2016

After catching up with alumni of the Physician Assistant Program in San Antonio last month, where she was one of the keynote speakers at the AAPA’s annual veteran’s caucus Memorial Day ceremony, Rubina DaSilva ‘01, an alumna of then MCP Hahnemann University’s Physician Assistant Program, reflected on her career, which was a long, but rewarding road that saw her through active duty as a Navy Corpsman, to rural West Virginia and back to her military roots in her current role as president of the Veterans Affairs Physician Assistant Association (VAPAA).

— Drexel CNHP (@DrexelCNHP) June 15, 2016

“I really wanted to work at the VA,” she said, recalling her move back to her native Texas. “After my husband and other friends who were deployed came back from the Middle East, I felt like that was where I wanted to be – back with veterans.”

Elements from each of her past experiences made DaSilva uniquely qualified for the role she accepted in with the Houston VA medical center in a satellite clinic. “It’s interesting how things work out that way. They selected me because I had worked so independently in rural West Virginia, and they knew I could work at a satellite clinic without minimal oversight, and no stat labs or X-rays on site.”

Though her role at the VA seemed a perfect fit for DaSilva, her five years working in underserved, rural West Virginia, was somewhat of a leap. “I’m not from there, and I had never set foot in the state until I interviewed for the job,” she said. “I just wanted to be a do-gooder and work in an underserved area.” At one of the satellite clinics in a town with a population of 2,000 (a stark contrast to Philadelphia), DaSilva lead a team of three as the only clinician on site. The collaborating physicians were 20 miles away, and without internet or smart phones, her interpretation of what she saw in her patients was critical. 

DaSilva describes this experience as equal parts challenging and rewarding. “It was challenging to be the only medical provider on site with the nearest hospital more than 15 miles away. There were no second opinions, and I couldn’t just send someone to the emergency room unless I was really certain – the patients had very limited resources and I didn’t want to waste it.” The rewarding part came from the diversity of patients she came to see in primary care – something she may never have explored. “I saw everyone from six-weeks-old to more than 90-years-old,” she said, fondly remembering a particular patient who was a veteran of the Second World War “He would come in and bring his fiddle to play in the waiting room. It was so surreal coming from Philadelphia!”

But DaSilva built strong connections and learned to love the personal relationships she would develop with patients in a primary care setting. Though her Hahnemann education prepared her for her career, at times DaSilva was filled with doubt on the pursuit of her degree. “It was very competitive at the time to get into a PA program from the military. After leaving active duty to join active reserves, I was anxious to move on and enrolled in community college. I had a professor who advised me to apply to as many programs as I could afford to, wait for the rejection letters to come in and figure out what to do for next year – that’s how challenging it was.” To DaSilva’s delight she applied and got into Hahnemann on her first shot. Sitting in the classroom on her first day, she anxiously listened as her peers stood up and talked about where they earned their undergraduate and graduate degrees. “They were all amazing, brilliant people and I was the only one with a community college degree, I was the only veteran who served on active duty – I remember thinking they must have made a mistake.”

DaSilva pursued her hunch only to be told by the program director that it was no mistake. “She told me I deserved to be there and I would do fine.  I felt relieved and that’s what I did!”

DaSilva took another leap of faith when she stepped in to an advocacy role with VAPAA. It was something she hadn’t considered, until 2012, when she attended the organization’s conference to accept the Outstanding Clinician award and started mixing and mingling with the board members. “I got involved to help with bylaws and membership. Shortly after that, they asked me to run for treasurer. I was very passionate and was very involved, so in 2014 I ran and became the president.” 

She took the position at a pivotal time. An opportunity was coming to the surface to advocate for PAs to solve the problem of increasing access to care to meet the needs for veterans. “I wanted people to know that PAs can be a part of the solution. We weren’t being utilized enough,” she said. So she started lobbying Congress and meeting with legislative staffers.  She went to the DC to advocate for the profession every few months. “We also saw history repeating itself, we have a shortage of medical providers and we have Corpsmen and Medics returning from Iraq and Afghanistan with all this training and medical experience who want to become PAs. It is how our profession got started.  We wanted to assist in providing a pathway for them, in obtaining scholarships and assistance so they could pursue this career goal, and then come back to the VA to serve. In October 2015 the ‘Grow Your Own’ directive senate bill S. 2134 and House bill H.R. 3974 was introduced to provide pathways for Corpsmen to become PAs, and address pay disparities to keep us competitive with the private sector,” she said. The bills are still making its way through Congress. 

Though this result was a phenomenal one for a short period of lobbying, DaSilva’s proudest achievement in this role has been getting the invitation for PAs to come to the decision-making table. “I’m not a lobbyist. I’m a clinician. Going through the process of having an idea, lobbying for it, meeting and chatting with key people, and then testifying in front of Congress last year was very important for us. The VAPAA has been around since 1984, and that was the first time we’d been invited to testify in front of Congress. I’ve provided written testimony twice since that invitation in May, so I’m probably most proud of the fact that we are actually part of  discussions. It’s critical—PAs were excluded before in my opinion,” she said.  “Being able to assist fellow veterans and help shape our role and profession will be the greatest achievement.” 

It’s safe to say DaSilva is having an impact on veterans, on the profession and on future clinicians; an opportunity she credits to the PA program director who took a chance on her. To other program directors she added an important message, “Take a chance on someone who is a veteran and who may not have all of the accolades or accomplishments as others because of deployments or other military factors that come into play.”

By Margaret DeGennaro ’12