Shanice Watts: Reimagining healthcare as a PA

17 minute read

Anjana 3:25  

So there’s a fairly new profession, being a physician’s assistant. And we this, we recently interviewed a woman named Shanice Watts who is really frickin cool. We talked to her about her journey to PA school, especially as a first generation student. And so she went to Cal and then Stanford. We talked about why she chose to become a PA instead of a doctor, and the intersections of gender and race, both in healthcare and in the PA field. And then we also talked about her work, bridging the diversity gap in medicine, which she’s doing a launch. It’s very, very impressive. Yeah,

Sydney 4:05  

Totally as, as our friend Epsa, would say, there’s a lot to unpack here. But we are excited to share this one with you all, and we hope you enjoy it just as much as we did. Okay, cool. Well, Shanice, thank you so much for joining us this Sunday morning. We’re super excited to learn more about your journey to PA school, and also just learn about this industry in general. But just to kick us off. Could you tell us a bit about what led you to pursue a path in healthcare like was this something that you always knew that you wanted to do? Or did you have kind of like, one defining moment that that led you to pursue this?

Shanice  4:49  

So I actually always knew that I wanted to go into medicine since I was in elementary school. And this was primarily because of my babysitter, Evelyn, who was battling with diabetes and would take me with her to her hospital appointments. And so that was kind of my first exposure to medicine and kind of the hospital setting. And there I was able to kind of see the caring compassion that the medical team had for that my babysitter. And then after seeing that, at a young age, I knew I wanted to kind of emulate those qualities and positive, positively impact patients lives as well. Um, but I had my challenges kind of making this dream a reality, because I was a first generation college student who kind of grew up in this single parent household. And as you can imagine, with parents that didn’t go to college, I didn’t really have a lot of pragmatic, pragmatic academic guidance. But so I had to kind of, you know, go through a few battles to kind of navigate college and helped me prepare for a career in medicine.

Anjana 5:59  

Definitely, and I can’t imagine how hard that must have been. But then you went to Berkeley, and then Stanford, so huge congratulations. I know that takes a lot of grit and perseverance. Can you tell us more about your journey as a woman of color and how you overcame those obstacles that you’d mentioned?

Sydney  6:19  

So I mean, like I mentioned before, I wanted to become a medical professional, when I was growing up, but I didn’t really think I was capable, because there wasn’t a lot of medical professionals who kind of looked like me. And it’s like, how can you be something if you can’t see it? So it wasn’t until I was introduced to an African American doctor, who sat with me and kind of answered all my questions and kind of helped me see that there is a place for me in these, you know, ivory towers of healthcare, which I didn’t see before. Um, as well as, like, when I was taking AP and honors classes, you know, in high school and whatnot, I kind of had imposter syndrome, because I thought I wasn’t good enough. And I felt like I had to prove myself and my word. And these kind of feelings continued at UC Berkeley and a little bit at Stanford. But I was able to join some groups and surround myself with, you know, a good group of friends who like helped me realize that there’s a place for me in higher education, and I do you belong. So that was really helpful. And it kind of helped me get to where I am today. Yeah, I

Anjana  7:33  

I think I mentioned this before in a pod. But I’ve heard before that imposter syndrome is only felt by people who don’t see themselves in the spaces that they occupy. So how many women of color or specifically African American woman were in your classes at Berkeley and Stanford.

Shanice 7:51  

Um, so I was a Chem major at Berkeley, and it was just me and one other girl who were women of color, or specifically African American women, and everyone else, were different races, different ethnicities. So it was kind of hard. And there was also a male dominated field at UC Berkeley, you know, stem in general, is not dominated. And then at Stanford, there’s only one girl in my class who was from Africa, and then there was me, is African American. And so it was really difficult. But, you know, everyone ends up finding their niche, and, you know, some way So,

Sydney 8:29  

yeah, totally. Yeah. And then, could you also explain to us a bit about, like, what are the different, I guess? Or Yeah, like, what are the differences between like, the choice in becoming a PA versus becoming a doctor?

Shanice 8:49  

Definitely, there is a lot of overlap. But one interesting thing about the PA profession, and what attracts a lot of people to it is that there’s a flexibility to change specialties seamlessly. So there’s a lot of lateral mobility. So let’s say you want to, you know, practice in primary care, and then later you want to go into surgery, you can totally do that without having to go back to school. Whereas as a doctor, if you wanted to do that, you’d have to repeat residency and potentially do another fellowship on top of that, to change specialties. So it’s a lot more complicated. And for PA school, it’s that it’s literally two years to three years, whereas becoming a doctor. It’s four years of medical school, and then four to seven years of residency. And then if you decide to do a fellowship on top of that, then it’s you know, one to two more years after that. So the path is a lot shorter for pa goal. And I feel like as a doctor, you have a lot more autonomy. Whereas pa is can we kind of collaborate with our you know, healthcare team of nurses and doctors to carry out treatment plans, whereas, you know, doctors are kind of more independent, I would say.

Sydney  10:09  

Right? Yeah, I do know that the road to being a doctor is a very long one, I have a few friends who are who are like it, you know, headed toward med school and everything, and they have a long, long road ahead for

Anjana 10:26  

a long road. I would love to talk about the intersections of race and gender in healthcare, we’re always talking about a lack of representation in any industry, really, but how does a lack of minority representation, specifically within healthcare providers affect treatment or the patient experience? Do you have any examples that you’ve like, witnessed or experienced yourself?

Shanice 10:55  

So one experience does come to mind, that happened a few times before PA school when I was a scribe, there were a lot of minority patients who would turn down, you know, necessary medical care, because they wanted to be cared for by someone who looked like them. But you know, a lot of the time the hospitals can’t fulfill their requests, because there’s not a lot of minority doctors or PA, you know, medical professionals in general. So then that kind of helped me see that a diverse workforce is definitely needed, you know, to combat like, a lot of these, like healthcare disparities that dispose disproportionately, like affect minorities, especially in underserved communities, right, because this happens, you know, all too often. I feel like.

Anjana 11:45

could you go into that a bit?

Shanice 11:50

 Yeah, definitely, I don’t know, specifics, but I did do a literature review on kind of this. And it’s been shown that if, like, racial and ethnic concordance, I guess, between healthcare professionals and patients is associated with increased access, improved compliance, better interpersonal care, and just greater patient satisfaction. Um, so that’s kind of one thing, and it just impacts the delivery and quality of health care, just because they feel more secure, there’s a lot of reasons they feel like, we’re safe. They trust you, you know, there’s a lot of factors.

Anjana 12:23  

So you just mentioned trust, something a lot of people have talked about recently with the COVID vaccines being distributed is the lack of trust between the African American community and healthcare specialists. So why is there that lack of trust that we’re seeing,

Shanice 12:41  

I think the lack of trust, you know, between the African American community and healthcare professionals kind of stems from the long history of trust, starting with the Tuskegee syphilis experiment. This was basically an unethical study that was conducted in the 1930s to 1970s. And the purpose of the study was to observe the hidden Natural History of untreated syphilis. And so they recruited a lot of African American males who participated. And they were told basically, that they would be receiving free health care from the federal government of the United States. The study was only supposed to last six months and ended up lasting 40 years. And then funding basically for treatment was lost. But they continued to kind of study without informing the men that they would never be treated for this. I feel like this definitely contributed to the lack of trust between the community and healthcare providers today.

Anjana 13:43  

Oh, yeah. I’ve never heard of that. That’s awful. I mean, no wonder honestly.

Sydney13:49  

Yeah. And, and so an earlier to you were talking about, you know, just like the disparities and with under served communities, and also access to health care, and we’ve seen that I feel like with COVID-19, as well, and just like the impacts on minority communities, in what ways, I guess, have you, you know, just like, what the pandemic and what ways Have you seen COVID-19 kind of magnify these disparities?

Shanice14:23  

Yeah, so, African Americans are definitely disproportionately represented and the covid 19 pandemic, was, there’s been a lot of studies on this and it although like they are kind of disproportionately represented. This isn’t a unique experience. Right? Right, because African American adults are 60% more likely to have diabetes than non Hispanic white adults, right? They’re 20% more likely to die from heart disease when compared to non Hispanic whites and they have a higher prevalence of asthma and then 1.3 times more likely to be obese and non Hispanic white, so I feel like they’re There’s a lot of things that play and social determinants of health, like the places that they live and work, you know that their access to quality health care, the resources, kind of lead a healthy lifestyle, and play a major role in determining kind of the health status and outcomes. So blacks typically live in dense, more densely populated areas, and they work you know, as essential workers in industries where they’re at greater risk of exposure and things like that. And they’re more likely to be uninsured or under insured, so then their access to quality care is kind of Hello, in that sense, and I feel like, um, because of these like social and economic factors, they’re definitely more affected by these conditions and have more outcomes that they get COVID just because of everything, you know, all these social determinants of health. So Right, right, a lot of factors going into play there, then. Yeah.

Anjana 15:57  

So we talked a little bit about race and health care now. Shanice I would love to talk to you about gender in the professional self. And mutual friend of ours. elliana told us to ask you about the med bikini movement. Could you tell us what that’s about? How did it start? Your reaction to it? What was your role in it? Just the whole story?

Shanice 16:19  

Yeah, so basically, there was a med bikini movement in July of last year. And it was based on an article that was published in the Journal of vascular surgery. And it was basically about the prevalence of unprofessional social media content. And the authors were predominantly male, and they use these fake social media accounts to collect their data. And basically, what they they did is they deem things like wearing bikinis, unprofessional. And, personally, I don’t really think women should be judged based off of the things that they wear. And I feel like a provider is just as smart and capable if they’re wearing a bikini at the beach, or scrubs. So in response, I posted a picture of me and my white coat, and me in my bikini, and kind of explained my feelings about it. And it was just a movement that happened on social media, a lot of people were doing it, and the paper ended up getting revoked.

Anjana 17:23  

So okay, you go, first of all, what is that have to do with social, like social media and being unprofessional, quote, unquote. On social media has to do with the Journal of vascular surgery or whatever. It’s like, what is the relation?

Shanice 17:41  

Yeah, I think they were, I don’t know, people just do studies that they come up with, but I think they’re just trying to emphasize or trying to find a correlation between the quality of care they give to patients and dressing unprofessionally. And how it makes their profession look bad. In a sense. That’s so screwed up. Yeah. Like,

Anjana 18:06  

I have no words. Did you start the movement? Or was it already going on? And do you did a post,

Shanice  18:13  

so I saw the post in the morning. And then I like felt the urge to kind of also join the movement. And then a lot more people joined, like, few days after, and then like, four days after the paper was published, or something like that. 

Sydney 18:34  

yeah, yeah, I was just gonna say I love how that movement to like, so quickly, it led to that, to that being revoked as well. As it should have been published, right. Yeah. So just like on that note, from your experience, just like, you know, on the path to PA school and that of your colleagues, what are some examples of sexism that either you have experienced or you just know are or are prevalent that other female pa is have to deal with on a day to day basis? Yeah,

Shanice  19:20  

so there’s been a couple of experiences kind of speaking to my colleagues, my friends and things like that and PA school and who our pa is. One thing that I’ve heard multiple times is that male medical professionals or doctors or pa refer to some of the PA students as honey and Sweetie, which is not very professional. And, you know, when they ask them not to do it, they still keep doing it. So it’s kind of like, um, like, I don’t understand how that would be kind of okay in a medical setting, you know, to call people those names. Um, yeah, seriously bright study on that. Like, I think that’s more speaking of unprofessionalism. Yeah. And then also, when I was a scribe, I dealt with something, personally, that was kind of insulting. And it came from someone who was higher up than me. And basically, they called me some, like, really inappropriate names when I was working as a scribe. And it’s kind of crazy, because at the moment, I was just totally at a loss for words, because I was just trying to process what happened, because I couldn’t believe that someone would say such rude remarks to me. Um, and so I sat on it for a while, and I didn’t report it or anything, um, because I wasn’t sure if people were gonna listen to me who’s, you know, just, I’m just a scribe. And this person is like an actual medical professional, who has a higher rank than me. And so I, but I ended up reporting it kind of a week later. And I was kind of scared, but I’m happy that I did it because my workplace was pretty accommodating, and the person or we came to find out that the person had said similar things to other people. So I wasn’t the only one. And there was an investigation that kind of took place. And I had the choice to not work with him anymore. So it was really kind of a really good thing for me. And I don’t know, I feel like in the future, as a PA, I feel like we’re gonna continue to have to experience sexism, just based on the society that we live in. But I feel like from my personal experience, I know how to better handle the situation, because that already happened.

Anjana 21:45  

Yeah, I mean, I feel like the best thing would have been for him to be removed, because there’s nothing to say he won’t go do the same thing to other young woman, but at least you got to take yourself away from that situation. Yeah, I agree. Okay, so I would love to talk about your blog and Instagram, because you have a huge IG following. And you’re basically an influencer in the PA space. Could you tell us about why you started it?

Shanice 22:14  

Yeah, so I basically started it because, one, there wasn’t a lot of resources when I was applying to PA school. Because one other thing I didn’t mention is unlike medical school, there’s different requirements for every single pay school. There’s no standardization of requirements. And it’s kind of a new profession. So I remember when I was kind of going through the PA process, I was looking up things frantically on Google and just trying to figure it out. And so, one, I started my Instagram to kind of help people with the process. So I started out kind of sharing my experience, how to get you know, like, shadowing hours, volunteer hours, and things like that. And then I created my blog, because I felt like I needed, like a central place to have all of this information. And I also was really passionate about, you know, increasing diversity and bridging the diversity gap in the PA profession. So I was like, what better way to kind of do that, you know, than to create an Instagram and, and a blog to help like recruit these minorities to this profession. So I’ve been doing that for about three years. And then I had the opportunity to work with med school insiders, also on YouTube, to kind of show people like a day in the life as a Stanford pa student, because there’s not a lot of like information on that either. Like what is the typical day look like? Right? Like no one knows. So I felt like that was super helpful to you know, pre pa students. And then I’ve done like Kappa student takeovers, which is the state organization for the PA profession, and you know, that I’ve organised multiple improves in person informational sessions in the Bay Area, to kind of help these prospective applicants matriculate into PA school. And at Stanford, I’ve actually done a few things here. I basically co-founded the Stanford University diversity affinity group. And this is basically a community devoted to promoting the academic and social advancement of students of color, and underrepresented minorities from low resource communities outside and within the PA profession. So we are working currently on a pre pa panel, composed of Stanford pa students and working with faculty to help increase diversity at Stanford and the PA school. And we’ve also implemented diversity mixers into kind of interview weekends and We’re working with Summa, which is basically a minority medical conference at Stanford. We’ve been doing a lot. So, like, we’re gonna local high schools, mentoring, and, you know, just kind of giving back and helping promote the PA profession just in general.

Anjana 25:17  

It sounds like you’ve been doing a lot. That’s, I love how much you’re giving back. How big is the club? Oh, um,

Shanie 25:24  

so there’s three, or actually four officers right now. And it’s just like, the PA classes. So there’s, there would be, even new students are so. So that’s pretty awesome.

Sydney 25:41  

That’s great. Yeah, and I can’t like all of this work that you’re doing is so necessary and so impactful, just in terms of, like we were talking about earlier, increasing representation in this industry, and bringing in more, you know, diverse people into this profession. But I also can’t like, it sounds like you’re just super busy, like working on all this on top of being a PA student, like you’re a rock star. And I’m curious to know, too, just in your three years, with this blog, and then having that Instagram account, have you had people reach out to you? And just like saying, like, thank you so much for being this voice in this space and like providing these resources? Yeah, I’m just curious, like, have you had people reach out to you just because of the platform that you’re building?

Shanice 26:40  

Yeah, it actually happens quite often, I’ll get messages like, oh, my goodness, I got into PA school. Thank you for helping me so much. Like your blog was so helpful and integral and like, you know, helping me achieve that. And also, I did like a personal statement review, kind of, not event, but I did it for a few months over the summer. And everyone that I worked with, got into PA school, and that made me feel so good. And see that, you know, people are getting into PA school, and we’re diversifying the workforce. So it’s, it’s been really good.

Anjana 27:19  

That’s amazing. Yeah, was there and I meant to touch on this, the very first question about, you know, when you were deciding between becoming a PA and becoming a doctor, like, were you ever thinking. Would people think, you know, being a physician’s assistant? Doesn’t sound the same as being a doctor. You know, we’re friends and family asking you about that? And how did you kind of overcome that to and decide that you want to you did want to become a PA?

Shanice 27:49  

Yeah, I did experience that, actually. Because my family didn’t know what a kid was. And so they just couldn’t grasp the concept of like, you know, physician assistant, they’re like, Are you an assistant to the physician? I don’t understand, like, why would you choose that over becoming a doctor. So it took a lot of educating them and inviting them to my white coat ceremony and kind of telling them about my day, to help them understand that I’m not anyone’s assistant, or we work as a team. And we also provide care to patients, you know, and we can do very similar things like prescribe medication and diagnose. So it took a while, I would say it took maybe a few years for them to really understand and support me on this journey. But um, I think most people do experience that just because it is a new field. And it wasn’t really around when our parents were growing up. So I feel like a lot of people kind of have to do a lot of explaining and educating their family members. And so they can kind of understand it a lot better. And what’s the piece of advice you would give someone who is considering PA school, I would say you should do kind of what aligns most with your values. Because I feel like in the end, you’re going to be the most happy if you do that. And also doing it because of you and not because your parents want you to do it. Because that’s, you know, just a recipe, recipe for disaster and like can lead to just a life of unhappiness. So, let’s say Do what you feel called to do.

Anjana 29:34  

I love that. And I mean for your own values, what are your own values? And how does being a PA align with them?

Shanice 29:42  

Yeah, so I, you know, really want to help with all my passion of bridging the diversity gap in medicine one so that was something that was really important and I wanted to do something or join a profession where I could do that. And then I wanted to change specialties, just because I have multiple interests. You know, I want to do dermatology, but one day, I might want to do surgery, you know, and I want it to be in this constant learning environment. And as you know, medicine, like there’s always new guidelines coming out, and there’s always something new to learn. And I really just wanted to be part of the healthcare team, I love, you know, working with nurses and doctors, and, you know, kind of having this joint effort to carry out treatment plans, you know, it’s not just dogs, it’s not just me, it’s like the whole team. So I really like that aspect of it. Awesome.

Sydney 30:43  

Well, I think, if we’re ready to wrap up with our kind of, like, final question that we always like to ask our guests and again, just because of your expertise, and experience, um, you know, and all of the obstacles and challenges that you have faced in the healthcare industry, we know there are a lot of things that need to change, like in the medical field in terms of, you know, like, of course, access to health care,diversity, what would you say are, like one or two of the biggest things that that need to change and be reimagined in the health care industry? 

Shanice 31:27  

The one that comes to mind is kind of the one that I’ve been working on. And that’s just improving diversity in kind of healthcare, especially the PA profession, because according to PA, which is like the one of the National Association, so the PA profession, um, the I guess, distribution of ethnicities among first year, PA students is pretty skewed compared to like the US population in general. So, for instance, in this last cycle, or last two cycles, like in 2017 2018 30, or 73.5%, of first year pa students were Caucasian, while only 6.5% were Hispanic and 3.9%. were African American. So basically, it doesn’t reflect the US population. And because it because it doesn’t reflect the US population, I feel like that’s a problem, because those are our patients, right. And we should make sure that, you know, we do reflect, you know, our patients and health care, because as I mentioned before, lack of diversity impacts the quality of health care to minority patients. And if you’re being cared for by someone who looks like you, you’re more likely to, I guess, follow through and have greater patient satisfaction. And I feel like specifically for the PA profession, its historical mission, initially, when the field was created was to improve the quality of health care and populations in need. So I feel like we need to focus on recruiting and educating more students from backgrounds like my own. So I feel like that’s a huge problem.

Anjana 33:08  

Is it my last question, because you brought that up? Is it um, they use this in tech, they use it pretty much in every industry? Is it a pipeline problem?

Shanice  33:17  

So I actually did research from my master’s thesis project on understanding the contributing factors to the lack of underrepresented minorities in the PA profession. And I looked at pipeline programs to see if that was one of the main reasons that people aren’t, minorities aren’t matriculating into the PA profession. And it is that but it’s also resources and lack of awareness, because minority patients are finding out about the PA profession in college, whereas like, you know, Caucasians, for instance, are finding out about it in high school. And you know, when you go to college, you’re already set on like what you want to do, potentially. So it’s harder to like, kind of sculpt someone’s mind or like, help introduce them to like other professions at that time. So it’s a multi systemic problem.

Anjana 34:09  

Like most processes, most issues, but it’s awesome that you’re toggling this through all those workshops you’re doing and the club and your blog. I don’t know it sounds like you’re doing 500 different things, which is amazing. session. Nice. I know you’re busy. Thank you so much for your time today and for reimagining healthcare as a physician’s assistant. Was there anything you wanted to add or talk about? 

Shanice 34:38  

We’ve talked about everything I wanted to talk about and I really appreciate you taking the time to let me be on this podcast and just kind of hear about my PA school journey and you know some of the issues in healthcare.