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SUMMIT T A K I N G

H E A L T H C A R E

R O C K Y M O U N TA I N U N I V E R S I T Y of

H E A L T H P R O F E S S I O N S®

T O

N E W

H E I G H T S

from the president

REFLECTING on our Histor y Over the course of our collective history, Rocky Mountain University of Health Professions (RMUoHP) has grown its academic footprint. We have expanded our university family. We have experienced faculty and staff triumphs. We have chronicled numerous examples of student and alumni success. To challenge and prepare graduate students for success, we relied upon a team of highly-qualified individuals who have built an entire legacy for us as we create our future. Our 2021 Founders Day celebration marked the culmination of our 23-year story and our commitment to who we are in the context of our mission—a story that is woven by individuals dedicated to education within healthcare professions and who offer the reality of improved quality, delivery, and efficacy of healthcare.

That commitment has led to significant achievements and inspired innovation. On any anniversary, there is time for reflection. As I reflect on our history, I am reminded of all the important lessons we have learned that have strengthened us as individuals and as a university. First. Our people are the lifeblood of RMUoHP. People are the foundation on which everything is accomplished. When our people are successful, encouraged to exercise creativity and innovation, and supported to reach their full potential, we as an organization are also successful. Second. Our evidence-based traditions inspire best practices. Infusing evidence-based decisionmaking into our curricula, business practices, and clinical care increases accountability and supports the best possible outcomes.

Third. Our commitment to our core values and our culture has been unwavering. The culture that continues to resonate in our work, relationships, and core values has strengthened the RMUoHP experience since 1998. Fourth. Our dedication to serve others is the linchpin that holds us together. Because we value people above all else, we serve each other, our patients, our communities, and the world. There is a profound satisfaction in giving back. Fifth. Our community partnerships are essential. Our partnerships have served to strengthen, support, and even transform us. This has resulted in improved program quality, more effective use of shared resources, and life-long relationships with engaged community colleagues. Congratulations on yet another year of setting an example as a community that knows what it means to support student success and demonstrate team collaboration. Here is to another year of being great together! Onward and upward!

Dr. Richard P. Nielsen Founding President & CEO Rocky Mountain University of Health Professions

summit magazine

is published semi-annually for alumni, faculty, students, and friends of the university. dr. richard p. nielsen founding president & ceo

tyler anderson senior director of university marketing & communications

stephanie bentley

university marketing & communications manager , managing editor

mckinsey smith graphic designer , brand

manager

tanner grenko university videographer & photographer

madison gallini graphic designer

lindsey peterson graphic designer

jennifer fletcher writing & editing intern

talia blatter contributor

the views expressed in this magazine are those of the authors and do not necessarily reflect official university policy

T H IS ISSUE FEATURES

7 11 21

RMUoHP ADVOCATING at Utah’s Capitol Hill

THE BALANCING ACT of a Healthcare Career

STARTING

Your Own Practice

university marketing & communications 122 east 1700 south provo, ut 84606 news@rm.edu | 801.734.6798

nondiscrimination policy rocky mountain university of health professions affirms its commitment to fairness and equity, and does not discriminate on the basis of race, ethnicity, color, national origin, citizenship, personal appearance, religion (including no religion) or faith, political affiliation, economic status, disability (including whether physical or mental), age, marital status, sex, sexual orientation, gender identity, gender expression, pregnancy, veteran status, predisposing genetic characteristics, domestic violence victim status, or any other protected category or group under applicable local, state, or federal law, including protection from those opposing discrimination, attempting to prevent retaliation, or participating in any resolution process. for more information visit rm.edu/compliance

HIGHLIGHTS 03 Advancing Knowledge

25 Alumni Impact

05 Advancing Healthcare

27 University Updates

17 Student Success

R O C K Y M O U N TA I N U N I V E R S I T Y of

H E A L T H P R O F E S S I O N S®

A D VA N C I N G K N OW L E D G E

MS MedSLP Student, Alexia Carillo, practices her skills during a simulation lab at Utah Valley Hospital. 3

S U M M I T | S U M M E R 2 0 21

MS MedSLP

Simulation Lab On March 25, 2021, students in the Master of Science in Medical SpeechLanguage Pathology (MS MedSLP) program participated in a simulation lab at Utah Valley Hospital. MS MedSLP Associate Professor Phil Sechtem, PhD, CCC-SLP, commented on the importance of experiences like these for student learning. “From the very beginning of our MS MedSLP Program, we have been conducting simulationbased education (SBE) events to advance the knowledge and skills of our students. The SBE activities allow realistic evaluation and treatment activities in a relatively non-threatening environment.” Sechtem explained, “Learning occurs during activities based on performance and accuracy of service delivery. Learning also occurs during the debriefing period when students are prompted to reflect upon what went well and the challenges that occurred. Simulation educators do expect that mistakes will be made; however, educators also know that mistakes create a wealth of reflection and discussion for future modifications.” Simulation experiences advance the knowledge and skills of students so they are prepared for externships and future employment. 

A D VA N C I N G HE A LT H C A R E

ALTERNATIVE THERAPIES for Root Canals

If tooth decay, which can affect both adolescents and adults, progresses into the nerve region of the tooth, it must be treated with root canal therapy (RCT) to prevent infection to the tooth and surrounding bone. While RCT is often effective, some people have experienced bone deterioration, which can affect the stability of the affected and adjacent teeth. However, little research has been done to observe if alternative treatment interventions can preserve bone integrity. Doctors of dental surgery clinicians J. Chris Crawford, DDS, and Rick Leishman, DDS, were working with a patient who had undergone two root canal therapies for progressive tooth decay. Due to the lack of bone healing, the next step would have been either a bone graft or dental implantation. However, Kaiwi Chung-Hoon, PT, PhD, a professor in the Doctor of Physical Therapy program at Rocky Mountain University of Health Professions (RMUoHP), had an idea. Reported evidence suggested that externally applied compressional and shear forces administered at low intensities may promote bone healing. So, Dr. Chung-Hoon offered a conservative approach: to explore whether bone healing might occur with the aforementioned external 5

and shear forces to the affected tooth and jawbone region. Three times per day, external forces were applied for one-minute intervals in external to internal (compressional) and front to back (sheer) directions over the course of a six-month period. Radiologic imaging of the patient’s teeth revealed changes from a cavitation at the tooth socket and jawbone to remarkable bone growth

of the tooth socket at six months, one year, two years, and three years after alternative therapies. The successful bone growth for this patient provided support that conservative treatment methods may be beneficial to patients with compromised tooth socket and/ or bone deterioration. 

Dr. Kaiwi Chung-Hoon explains how applied force may promote bone growth.

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Doctor of Physical Therapy Professor Dr. Kaiwi Chung Hoon uses physical therapy to improve dental care. 6

CO M M U N I TY I M PACT

RMUoHP ADVOCATING At Utah’s Capitol Hill

In the 2021 Utah legislative session, the Utah Academy of Physician Assistants (UAPA) joined with other organizations to sponsor two senate bills, SB027 and SB028, to amend the regulations of physician assistant (PA) practices for the state of Utah. Jon Baird, DMSc, PA-C, ATC, a faculty member in the Master of Physician Assistant Studies (MPAS) program at Rocky Mountain University of Health Professions (RMUoHP), recently

served as UAPA President and was a critical advocate for the bills on capitol hill. Thanks to his efforts, and the efforts of many other healthcare professionals and community organizations, SB027 and SB028 were approved by both the Utah Senate and House of Representatives. The bills were signed by Utah Governor Spencer Cox on March 17, 2021, and went into effect on May 5, 2021. 

Understanding Bills SB027 and SB028

SB027 - Physician Assistant Act Amendments • Allow physician assistant (PA) scope of practice to be determined at the practice-level by clinical leadership, through the credentialing and privileging process in accordance with the education, experience, and training of the PA. • Remove legal requirements for a specific relationship between a PA and a physician, or any other specific healthcare provider, in favor of an integrated team-based care model, after 10,000 hours of practice experience. ◦ PAs with less than 4,000 hours of post-graduate practice experience will require a collaborative agreement with a physician. ◦ PAs with 4,000 to 10,000 hours of post-graduate practice may collaborate with either a physician or a PA with more than 10,000 hours of experience. • Promote top-of-training practice for PAs where they collaborate or consult with appropriate member(s) of the healthcare team as indicated by the patient’s condition. • Authorize PA eligibility for direct payment by all public and private insurers. • Permit PAs to respond during healthcare emergencies or disasters. SB028 - Physician Assistant Mental Health Practice • Amend the Mental Health Professional Practice Act to allow a PA who specializes in mental health to engage in the practice of mental health therapy. • Describe the qualifications scope of of practice for a PA to specialize in mental healthcare. • Increase access to desperately needed mental health services across the state, particularly in rural areas.

Q&A

With Dr. Jon Baird

RMUoHP Faculty Member & Physician Assistant Advocate

How did you get involved with UAPA, leading up to your term as President? When I came to RMUoHP, I sat down with then PA Program Director David Payne, PA-C, to map out where I’d best utilize my time as a faculty member. In discussing service, we discussed not just how I could serve the university but how I could help tie the program to the profession at large. At the time, I was involved with the inaugural cohort student association of the American Academy of Physician Assistants (AAPA) and had touchpoints with the Utah Academy of Physician Assistants (UAPA). That led to an opportunity to help out on the UAPA’s Membership Committee, and after being on the committee for a few months, I was asked to chair the committee. I devoted some thought to how to help build membership and I came up with a few ideas that some considered novel. One of which involved the modification of the bylaws to include subgroups, or specialty groups, of UAPA. The idea was successful and we have had growth in the academy since then. A year or so after that, I was approached by the outgoing

S U M M I T | S U M M E R 2 0 21 UAPA president who asked if I would consider running for UAPA president. It was a fairly significant time commitment so I went and talked to the PA department chair and my supervisor. They felt that it would be a good opportunity for me professionally, as well as benefit the program at large. It’s given me an opportunity to help elevate the position, prominence, and recognition of the RMUoHP MPAS program throughout the state. I couldn’t have done it without the program administration’s support. Overall, I’ve been able to do some good things that have lifted the profession and the program in the state. My participation and involvement led to dozens of speaking opportunities for our faculty, numerous poster presentations from our students, and influence with state and institutional policies.

How did you get involved with PA senate bills SB027 and SB028? Over the last five years, I have been a member of the UAPA Legislative Committee. We’ve run several bills over the past few years with focused initiatives, all of them dealing with recurring problems. For example, we were working on a bill to allow PAs to sign death certificates. Some laws contradicted others in terms of what PAs could do. So we created a harmonization act, where we went through all the laws and where it said physician, we added physician assistant or, where applicable, nurse practitioner. We kept thinking we solved the problem and then we kept encountering problems. The laws governing PAs are 30 years old, so with the help of the AAPA, we started putting plans together in 2018 for a modernization act for PAs, with a sub-issue related to mental health.

But the timing was an issue. We sat on it for a year in 2019, then when COVID hit, we thought, “it’s a tough year to do something like this.” But the circumstances with the COVID pandemic caused some headaches. For example, some organizations wanted to take PAs from one part of their organization to another to help with COVID-related needs, but things in the law about supervising physicians made it difficult. It took an emergency declaration from the governor for PAs to be able to have the flexibility to better make a difference. So we decided to propose the bills. I’ve been involved in the whole process. I’m really not someone special; I don’t have a special dual degree in political activism. I just started a little bit and it’s grown.

What have you learned throughout this process?

Schoolhouse Rock didn’t teach me enough about the legislative process. It’s all about relationships. It’s about who you know, and that’s everything.

PA advocate and RMUoHP faculty member, Dr. Jon Baird. 8

CO M M U N I TY I M PACT

PA Perspective

With Dr. Tim McCreary The passage of Utah Senate bills SB027 and SB028 this year resulted in a dramatic modernization of the Physician Assistant (PA) Practice Act, and the inclusion of the PA profession into the Mental Health Practice Act. These changes will make it much easier for healthcare facilities who employ PAs to utilize all of their clinical skills in caring for patients. Collective improvements include the removal of outdated physician supervisory requirements for experienced PAs, removal of physician liability for PA-provided care, allowing PAs to be paid directly by insurance instead of through physician partners, the ability of experienced PAs to own and operate their own healthcare facilities, and for qualifying PAs to be recognized as independent prescribing psychotherapists. These bills, which were the result of an enormous collaborative effort by a large group of stakeholders, including the Utah Medical Association, enjoyed broad support in both the Utah House of Representatives and Senate. We believe each of these changes, which eases regulatory burdens for healthcare employers, will result in greater access to the essential healthcare services PAs provide in Utah, both for large team-based practice settings on the Wasatch Front, as well as in our small rural underserved communities with only a single PA provider. AUTHOR: Tim McCreary, DMSc, MMS, PA-C, CAQ-PSY, is the Psychiatry Track Director for the Doctor of Medical Science Program at Rocky Mountain University of Health Professions. He currently serves as the UAPA Board of Directors President.

People get into government or positions of advocacy for a variety of reasons. My reason has been to see if I can do good to benefit patients and the people who take care of them. Legislators want to do good things but they don’t know everything. So the process involves going up there to meet them to let them know that there are things that affect us and we want our voices to be heard.

Just start small. Look around and ask what do you have an interest in and what time commitment do you have. I would rather have 100 PAs give me one hour than one PA give me 100 hours. In the UAPA, I can find something to do for anyone who wants to get involved. When you volunteer, you get to have relationships, and with relationships, you get to have influence.

The fact is that we all have to live together. If we want things to get done and be functional, there are certain ideologies that people need to let go of so we can work together to get things done.

People think to be involved in that world it has to be big—it doesn’t. We had one person at UAPA who kept apologizing for not being able to do much, but that person who serves as secretary used to be a transcriptionist—so what she’s doing is so helpful and so enough! Everyone in the organization has a skill that helps.

I’ve learned a lot about compromise. I’ve learned to be bold, make friends, reach out, and speak my mind, but speak it in ways that don’t alienate people. I’ve learned that I can do things that I didn’t think I could do before.

What do you think are some of the key parts of getting involved? Start little. You don’t have to do everything. Go volunteer for someone’s committee. They’re easy and that’s where stuff gets done— committees and the people on them go out and get stuff done. Meet people, exchange business cards, learn their names, and get to know them on a personal level. Make friends, be kind, and build your network. Working on committees has led to new opportunities and friendships. For example, my involvement and subsequent connections have led to clinical rotation opportunities for our students and guest lecturers that have come into the program.

These opportunities reveal strengths and develop new ones. I think it can be beneficial especially for newer professionials who maybe don’t plan on staying at their same job forever. When you have a resume that shows you to be the multidimensional person that you are, it helps you stand out as you progress through your career professionally.

What are some benefits to being involved for those who don’t think they can? Sometimes organizations just want a PA who sees patients. And you want to make sure they’re productive and growing the company. But not all growth of a company comes in the form of dollars coming through the door. Some of the things we’ve been working on have been related to influencing the policies and laws that govern the PA profession, and that creates opportunities that didn’t exist before, like patient access and subsequent revenue. Maybe it doesn’t make sense from a capitalistic point of view, but when

S U M M I T | S U M M E R 2 0 21 successful, it’s yielded fruits that, from the long point of view, have been very beneficial. Imagine if every employer took that approach. For example, if every employee had time each month to be involved in their professional association—that’s the equivalent of many full-time employees. There are a lot of things you can get done with that many hands.

How did you gain the confidence to represent the PA profession as an advocate? My motivation isn’t to be right; my motivation is to do what’s right. I went from just standing around the proverbial water cooler to realizing that I’m “they.” It’s easy to say “those folks,” but if you’re a member of the organization, you’re in charge. If you’re just sitting around for them to read your mind, you’ll have a permanent position by the water cooler. I’ve reached a point in my life where I value doing. If it’s not going to be you, then who is it going to be?

What advice do you have for new healthcare professionals looking to get involved? The best first step is to make it a priority to join your state organization. A lot of people will join their national organization, but if there’s a bit of legislation in your state, no one on the national association level is watching those, but your state organization is. I will get calls or emails from PAs who have an opinion, but they’re not members of the organization. So I suggest they join the organization. If nothing else your dues help to keep those organizations afloat, and if they hold a CE meeting or something, go to it. Collect your CE hours. Go around and shake hands with people. And maybe you’ll find opportunities to connect with people.

Dr. Jon Baird educates listeners about legislative bills SB027 and SB028 on the RMUpload podcast.

I’m coming to the end of my presidency, and I’ve been asking myself where do I go from here? I’ve been uber involved, and honestly, I’m a little tired. But I’m looking at what I’ve learned about the process. My time serving in UAPA has been good for our MPAS program, for RMUoHP, and for me.

before you know it, you’re in the third year of your association presidency and you say, “I just wanted to get involved.” It just happens bit by bit.  By Stephanie Bentley

Everyone has a little time. Everyone has that little something. Take a service-based approach to it and go at it from a perspective of what I can give. Not so much what I’ll get out of it or if it’s worth it. And then 10

H E A LT H C A R E J O U R N E Y

S U M M I T | S U M M E R 2 0 21

THE BALANCING ACT of a Healthcare Career By Stephanie Bentley

As a young girl, Jennifer Makuakane, DMSc, MPAS, PA-C, MT (AAB), watched her older brother be diagnosed with diabetes and the challenges he faced with that diagnosis. She saw how sad and upsetting it was for him to have to test his diabetes, especially in front of other people. Having a yearning to help her brother, she resolutely declared at that young age that she would find a cure for diabetes. Now, many years later, and while not finding a cure for diabetes specifically, Makuakane is a physician assistant (PA) making a difference for people who need it the most. But the path for Makuakane wasn’t straightforward or easy. It was a balancing act between being a wife, a mother, a student, and a healthcare professional. Makuakane never felt like she could be a traditional university student; she had to work to pay for an apartment and for food. When Makuakane was 20 years old, she decided to join the military where she trained and became a laboratory technician. With the substantial amount of hours of training and working as a lab tech, she was able to complete a few courses through George Washington University to earn her associate’s degree in laboratory training.

Makuakane left the military after four years of service but continued to work for another 17 years with her degree. During that time, Makuakane got married and started a family. However, after 17 years of working in a lab, Makuakane didn’t feel like she had done what she wanted to do. The older she got, the more she

“

Throughout her career as a lab tech and even in her personal life, friends would always come to Makuakane for medical advice, not because she always knew the answer, but because she would always help them find the answer. They motivated her to push herself to finally pursue a career in healthcare like she had planned as a young girl. So she took the first step and decided to go to PA school. But the path to becoming a PA wasn’t clear cut either. Not knowing exactly what prerequisites she would need for PA school, Makuakane just started taking classes at Salt Lake Community College (SLCC) in Salt Lake City, Utah.

as a mom, we tend to use our kids as an excuse to not care for ourselves and our own needs, whether that’s pursuing my own education and my own goals.” wanted to go back, learn more, and better herself. But as a provider and a mother, the choice wasn’t a simple one. “As a mom, we tend to use our kids as an excuse to not care for ourselves and our own needs, whether that’s pursuing my own education and my own goals,” said Makuakane. “I was married, got divorced, and then was a single mom. That was my excuse,” she added. “Then I got remarried, then I had kids, and I used that as an excuse.” It wasn’t until someone told her, that she was only thing holding herself back. “And I thought, maybe they’re right,” said Makuakane.

“I was working graveyard and going to school during the day, as well as volunteering at my kids’ school.” With balancing work, having a family, and taking college classes, Makuakane used that time to get into the rhythm of juggling all those priorities and the stress that comes with them. After a semester, Makuakane understood what prerequisites she needed, but there was another major obstacle: she needed a bachelor’s degree to get into PA school. 12

H E A LT H C A R E J O U R N E Y

Dr. Jennifer Makuakane, with the support of her family, graduated from RMUoHP’s Master of Physician Assistant Studies and Doctor of Medical Science programs.

One of her former coworkers had become the director of Clinical Laboratory Sciences at Idaho State University (ISU) and encouraged her to apply to the program. Since Makuakane already had an associate’s degree and military coursework, as well as 17 years of lab experience, she was able to enroll at ISU with quite a few transfer credits and waive the clinical coursework.

still continued volunteering once a week at her daughter’s school.

So while taking prerequisite courses at SLCC, working full time, and raising a family, Makuakane added another 16 credits of online coursework through Idaho State University. Her combined university coursework totaled 25 credits a semester, and she

And that wasn’t all. “My first semester, I was pregnant,” said Makuakane. “I gave birth to my son the week of Thanksgiving—the week before finals—with the support of family and faculty at Idaho State and SLCC. All my instructors were flexible with my family situation.”

“It’s not ideal for every student,” said Makuakane. She credits her work schedule; she worked seven days and then had seven days off. “So I did a lot of school work during my week off…it helped me get ahead on what I could so I didn’t have to stress when I was at work,” said Makuakane.

After two semesters, Makuakane completed all of her prerequisites and earned her bachelor’s degree. “I was lucky,” said Makuakane. But luck doesn’t account for it all. Makuakane worked hard to balance caring for her family, working to provide for her family, and a substantial university credit load. And that was just the beginning. By the time Makuakane applied to PA school, she had five children. So she and her husband sat down and talked about options for PA school. She explained, “Some people apply to as many PA schools as they can, but I didn’t want to do that and be unhappy living somewhere we

S U M M I T | S U M M E R 2 0 21 didn’t want to live. I picked schools that would be a good fit for the family and where we wanted to relocate to and raise a family.”

“The first two weeks were the hardest,” said Makuakane. “I cried more than I ever have in my entire life.” Makuakane would get home late from school and then her husband would go to work a graveyard shift. “So I’d come home and he’d go to work, and I’d be frustrated constantly because I had to study…I yelled back to a lot at my kids. I felt like a terrible mom.”

Having lived in Utah their whole lives, Makuakane and her family decided to only apply to schools outside of Utah to allow their children to

“

i knew if i went school, it was about pursuing my dreams.” experience life outside of the Beehive State. Then ultimately, she decided to apply to Rocky Mountain University of Health Professions (RMUoHP) to keep at least one Utah option. During the onsite interview for the Master of Physician Assistant Studies (MPAS) program at RMUoHP, Makuakane was feeling frazzled. Her one-year-old son had been hospitalized with meningitis and was discharged the night before the interview and her husband had been traveling for work.

With five children to care for, a husband working graveyard, and now an advanced graduate degree course load, it all became too much. So Makuakane made a decision. “I came home from school every day and I was mom. I was mom until 9 p.m. Then when they went to bed at 9 p.m, I went to bed. I woke up at 3 a.m. and studied until 5 or 6 in the morning.” Then she went to school.

They decided that her husband would quit working while she was in school, so their family of seven had to live entirely off of student loans. “That was rough. Because there were financial challenges, we had to consider cutting back on things,” said Makuakane. Her children had to give up playing sports or find sponsors to pay the fees. They downsized their home and cohabitated with family to split living expenses. “There were a lot of sacrifices we had to make,” said Makuakane. It wasn’t easy for her as a parent, and it wasn’t easy for her children. “My daughter was understanding because she was older, and my younger boys had to adapt,” said Makuakane. Makuakane recalled a meeting she went to when she first entered the MPAS program. One of the faculty told the new students, “This is only

Before going into the interview, she decided not to tell anyone about what was going on in her personal life. “I didn’t want sympathy acceptance or them to know that I had personal challenges that might interfere with my success in school.” Walking in resigned, Makuakane said to herself, “If I flop, this is good practice.” But Makuakane was surprised. “The faculty were so amazing that it helped distract me from what happened at home. It’s ironic because RMUoHP was the one place I didn’t want to go with it still being in Utah. But I felt so comfortable that I knew if they offered me a seat, I would accept.” When Makuakane got the acceptance call, she accepted and enrolled.

Dr. Jennifer Makuakane enjoys the time she spends with her family. 14

H E A LT H C A R E J O U R N E Y

Dr. Jennifer Makuakane strives to set an example for her children that education is important.

28 months of your life. If your reason for doing this is your family, then are you and them willing to sacrifice for 28 months? That’s not too long in the grand scheme of things.” For Makuakane, she knew that was how she would survive. “I knew if I went back to school, it was about pursuing my dreams. But if there was the possibility to work less in

“

everything with a positive attitude. We didn’t just tell them we had to sacrifice; we focused on the positives—that when mom goes to school and graduates, she’ll make more money, and then we can do more fun things. We had a very positive mindset,” said Makuakane.

“And now,” said Makuakane, “they’re reaping the benefits.” As a PA, she has Wednesdays off and it doesn’t matter how dedicates the entire day to spend it with her children. old you are or if you

stumble. it’s about getting past the mental roadblock.”

the future because I was making more money, then there were opportunities to benefit my kids. “My kids adapted well, despite the sacrifices. We went forward with 15

She adds, “It’s been a good example for my daughter. She’s seen how important it is to go to school and to reach for your dreams. It doesn’t matter how old you are or if you stumble. It’s about getting past the mental roadblock.”

Makuakane thinks back to one of her clinical rotations, which took her to Hawaii for six weeks by herself. One day, she decided to undertake one of the nation’s steepest hikes, a six-mile hike up to a breathtaking view of Hawaii. As she was hiking, she thought, “I can’t do this out of shape and by myself.” She stopped next to a guardrail where someone had written, “½ way keep it up.” At that moment, looking back at the beauty of the valley, Makuakane reflected on everything that she had done in her life, with her family, doing all the work to get into PA school, and the seemingly insurmountable coursework to become a PA. “When I looked back, it was still worth it. It was still full of so much beauty—

S U M M I T | S U M M E R 2 0 21 all of my challenges to get me to where I was. There were a lot of tears. I regretted not doing school earlier, but I realized if I did school earlier, I wouldn’t have had the focus without my kids. Because they were my focus.

“

my challenges are what made all of it worth it, no matter how much it took to get there.” My challenges are what made all of it worth it, no matter how much it took to get there,” said Makuakane. Two months after that arduous hike, Makuakane graduated from the MPAS program. While waiting for her official PA credentials, Makuakane used the time off to enroll in the RMUoHP

Doctor of Medical Science program. She graduated with her clinical doctorate in August of 2020. Currently, Makuakane works at the Bone and Marrow Transplant Clinic at the University of Utah’s Huntsman Center. She uses her education, skills, and life experiences to provide compassion and care to patients. “Professor Jon Baird always said that patients don’t have to choose us to be the ones to provide their care. They can choose anyone. So we should be honored to be part of their care. In my situation, they are choosing for me to be part of one of the most difficult experiences they’ll face in their life. They’re choosing to build a relationship with me in possibly the last few months of their life,” said Makuakane.

One of her first patients as a PA was a young mom who ended up passing away. “I got to know her in the hardest time of her life. She shared her time with me, her smiles, her good and bad moments,” said Makuakane. All of the challenges that Makuakane overcame to become a PA and balance her family with her career have paid off. “No matter how hard it gets, it still feels like a blessing knowing that I was a part of that,” said Makuakane. “It’s definitely a gift that these patients give me. I know they’re grateful for what we do. But I’m grateful to be a part of it.” 

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ST U D E N T S U CC E SS

MAKING A STAND for Mental Health as a PA

Sherlonda Adkins, PA-C, has been working as a psychiatric physician assistant (PA) since graduating from the Medical University of South Carolina’s PA school in 2014. While also working part-time for four and a half years in internal medicine, Adkins saw the reality of the statistic that one out of four primary care patients has some type of mental health problem. She committed to utilizing her influence to increase awareness of mental health and the importance of seeking professional help. “Being a trusted voice to encourage patients to follow up on other health problems and navigate interpersonal relationships has been a big staple in the care I provide for my patients,” said Adkins. PAs have a well-rounded medical education so she uses that to help her patients holistically. “Even if my patients are coming to me specifically for help just with managing symptoms of depression, I take the holistic approach, and as a PA that’s the education we have. We’re trained and board-certified, and that certification comes with knowing all the body systems, and it comes in handy because not all depression is primary depression. It could be depression that is secondary to a change in another medication, maybe blood pressure medication. It could be a problem with an abnormal thyroid,” explained Adkins. “These are ways I 17

utilize my comprehensive education to help me when seeing a patient.” Adkins currently manages her own telepsychiatry practice, PsychMyWay, the first psychiatry PA-owned practice in the state of South Carolina. When she started the practice in January 2020, she decided to also go back to school with the thought that the added credibility of having a doctorate would be helpful in establishing her practice in South Carolina. “And it was a way for me to increase my knowledge in psychiatry,” said Adkins.

“As many people and organizations were desperately seeking help with mental health strategies and wanting to learn about telemedicine,” Adkins was asked to speak, write articles, and consult because of her experiences.

She added, “I am big on clinicians continuing their education. I believe that you should constantly learn and perfect your craft.”

Adkins remains incredibly busy as she not only runs her own practice, provides patient care, and is working toward her doctoral degree, but she also mentors potential PA students, trains current PA students, lectures at her alma mater and the South Carolina PA’s annual conference, writes and records self-help tips on her social media (@psychmyway), consults with others interested in telemedicine, and advocates for black healthcare providers.

Adkins is currently a student in the Doctor of Medical Science (DMSc) program at Rocky

For example, in 2020, Adkins started the Black PAs of South Carolina group, a group dedicated to supporting

“

i am big on clinicians continuing their education. i believe that you should constantly learn and perfect your craft.”

Mountain University of Health Professions (RMUoHP).

Black healthcare providers and Black PA students in South Carolina.

Aside from returning to school in 2020, the COVID-19 global pandemic presented Adkins with special opportunities as someone experienced in telemedicine.

Support is a crucial component to success in life, and Adkins understands that well. Adkins was in her early thirties when she decided to start the journey to become a PA, and her journey was met with challenges.

S U M M I T | S U M M E R 2 0 21 She had to attend a local technical college and redo some of the prerequisites for PA school, as she had taken the classes decades prior. Adkins was a mom to three children ages four, seven, and ten. “Balancing my school schedule with their schedules, while not sacrificing being a mommy, was challenging at times.” She acknowledges the essential support of her husband: “My husband was and still is my biggest supporter. He made space for me to just be a student. At that time, I didn’t know a lot about Google Docs and he’s an IT guy so he created a Google Doc for me to add anything to the list that I needed to be done and he would take care of it so I could just focus on going to school.” When Adkins returned to graduate school in 2020 for her clinical doctorate, she began to understand the significance of her own mental health. “Being back in school has helped me in ways I didn’t expect. Connecting with a broader group of colleagues has contributed to my sense of purpose, expanded my connection with others, and added discipline to my life.” She also takes advantage of the school-provided counseling resources and encourages other students to take advantage of those resources. Adkins explains how her experiences, which some may consider nontraditional, have established her as a compassionate healthcare provider. “Being a wife, mother, business owner, contractor, and world traveler—I can relate to patients on many different levels,” said Adkins. “I’ve worked in a variety of professions prior to PA school: insurance claims adjuster for State Farm, non-profit employee, college instructor, real estate agent, and motivational 18

ST U D E N T S U CC E SS speaker. This has helped with being able to quickly find common ground and build rapport with patients.” She adds, “I can’t think of a time that I’ve met a person, whether in the professional setting or the social setting, that I couldn’t find some way to connect with them and that’s important when you’re working in healthcare—to be able to connect with people and build that rapport.”

Adkins has also learned to understand how her unique experiences and

“

“Over the years, I’ve gained much more confidence in blending the

over the years, i’ve gained much more confidence in blending the embracement of my black culture with my professional knowledge and training…”

personality, especially being black, add to her ability to provide patient-centered care.

embracement of my black culture with my professional knowledge and training and being able to see what that does for my patients. A lot of times when patients come in they’re already experiencing some level of anxiety. So for patients to come in and see that there is a provider who looks like them, who is both knowledgeable as well as down-to-earth, goes a long way.” Adkins is paving the way not only for mental healthcare providers, black healthcare providers, and PAs as entrepreneurs, but her example has had a direct impact on her family, particularly her children. Following a career in healthcare like her mother, Adkins’ 16-yearold daughter made history as the youngest student ever accepted to the Medical University of South Carolina’s Doctor of Pharmacy program. She is now in her fourth year and starting clinical rotations. Her son is following her business example and starting Carnegie Mellon’s Tepper School of Business this fall. Whether for her children, patients, students, or community, Adkins is making an impact through her commitment as a PA to improving mental health and wellness.  By Stephanie Bentley

Sherlonda Adkins manages her own telepsychiatry practice, PsychMyWay. 19

CONTINUING

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E X P E RT ADV I C E

STARTING

Your Own Practice The idea of starting a new business, let alone a new healthcare practice, can be intimidating and taxing. However, there are many benefits and advantages of owning and managing your own practice in healthcare. Graduates of Rocky Mountain University of Health Professions (RMUoHP) Kelly Walker DNP, FNP-C, and owner of Walker Wellness LLC, and Porsché Battle, SLPD, CCC-SLP, owner of Battle Speech & Swallowing Services, LLC, know firsthand just how rewarding it can be. Prior to enrolling in the Doctor of Nursing Practice (DNP) program at RMUoHP, Walker’s dream was to help care for people in a way that was both respectful and humble—Walker wanted to be a medical professional who listened to her patients. For her, it started when she was a patient seeking medical care and often felt as though she was not really seen nor heard. It was not until a nurse practitioner really listened to her that she was able to be successfully diagnosed and treated. “It was at that moment,” said Walker, “that I decided to go back to school with the goal to someday open my own family practice.” In starting one’s own practice, Walker said to “write down the pros and cons and do not overthink it.”

She adds, “Talk to your family and to those who know you best.” Battle, who recently graduated from the RMUoHP Doctor of Speech-Language Pathology (SLPD) program, explained that one of the biggest challenges of starting her own practice was the amount of time it takes, especially with balancing work, family, and other responsibilities. “Starting a private practice while catering to a little one who wants all of my attention, going to school full-time, and being a wife was a huge hurdle,” said Battle. “I love being a speech-language pathologist,” said Battle, “but becoming a business owner was not automatic. I had to do a lot of research on starting and running a business.” Battle and Walker share what they’ve learned along their journeys of starting their own businesses and provide insights for other healthcare professionals. Determine Your Mission When starting a healthcare practice, it is important to keep in mind one’s own mission or objectives that a private practice will fulfill. For Battle, her mission is focused on four key aspects: (1) provide personalized care with excellence through in-home and teletherapy services; (2) educate patients and

family members about treatment options and interventions to improve their quality of life; (3) bring awareness about the profession of speech-language pathology; and (4) provide resources and ongoing support to patients and their families. Walker’s mission in starting her practice was to “empower patients to strive for their best quality self by helping them reach their goals.” She adds, “We partner in their care. I am not the boss of them; they are the boss of themselves, and when they can see that and take measures to improve their overall being, health ensues.” Find a Mentor Battle encourages all prospective business owners to find someone who can help them along their journey. “I have linked up with some of the most amazing coaches and mentors throughout my career.” She adds, “As a private practice owner, investing in a business coach or mentor could save you time and money in the long run.” Decide on Your Scope of Practice There are many different types of practices to choose from and ways to make that practice uniquely capable of adding value to the community. For Walker, a major priority for her private healthcare practice is to “truly listen, investigate, and be thorough in her work.” She said, “I am also not afraid of being real with patients…Most patients want to change and, when given the tools, are excited when they see their body transform to a healthier them.” It’s not just about being a healthcare provider, explained Walker. “I am also their cheerleader. Small changes need to be celebrated. Life is hard; it is not my job to discourage. So in being honest with them and

S U M M I T | S U M M E R 2 0 21 offering tools, you encourage people and give them hope.”

based practice and research, policy and ethics, and healthcare economics.

These techniques and mannerisms are critical to what makes Walker’s business different from other healthcare practices in her community.

“I learned crucial skills before going out into the world,” said Walker.

Battle’s speech and swallowing practice focuses on being up-todate and open for everyone. “Our practice is not one-size-fits-all,” said Battle. “We don’t operate with cookiecutter techniques and antiquated practices. Instead, we strive to provide updated, evidence-based care to each individual that we serve. We treat our patients like family, and sometimes that means going the extra mile.” Educate Yourself While doctoral degrees aren’t required for starting your own practice, both Battle and Kelly credit their educational programs for assisting them in the process. For Walker, the DNP program prepared her both to care for patients’ medical needs and to start a solo practice with the necessary background in informatics, evidence-

Battle’s education from RMUoHP was a demanding but positive challenge as it increased her “understanding and use of evidence-based practice.” She discovered an enjoyment for writing and qualitative research. “My spirit of inquiry has grown because of my education at RMUoHP,” said Battle. Remember Why You Started The process of creating a medical practice certainly requires hard work and dedication, but owning a private practice is an obtainable reality if you determine your mission, find mentors and supporters, decide your scope of practice, and continue forward. Walker found that being your own boss can create a rewarding career. “I really am my own boss. Upon opening, I structured a contract for patients to sign that states that I do not do emergent or urgent care, and I don’t work or take calls after hours or weekends. This has streamlined the type of patients that migrate to the practice; they are the ones who genuinely want to engage and do work to help themselves. This makes practicing so rewarding!” said Walker. Battle started her own practice because “flexibility, autonomy, and freedom” were her top priorities in her career.

RMUoHP graduate and business owner Dr. Kelly Walker.

“I always have to remind myself of my ‘why.’ I decided to make my life reflect the top values that I profess: faith, family, and well-being. Once I started making decisions from that viewpoint, it was a lot easier to keep going when things got challenging,” said Battle. “There are definitely times of fear, anxiety, and doubt,” said Walker. “But when that happens, spend time away from business activities and do self-care, spend time with family—keep the faith.”  By Jennifer Fletcher

“When I started my practice, I wanted the freedom to offer specialized services to specific populations, as well as the flexibility to set a schedule that works best for my family and me.”

RMUoHP graduate and business owner Dr. Porsché Battle.

For Battle, “the benefits definitely outweigh the disadvantages” that come from starting a practice.

E X P E RT ADV I C E

8Starting STEPS TO Your Own Practice By Kelly Walker, DNP, FNP-C

HAVE AT LEAST 6 MONTHS OF OPERATING MONEY

Establishing a business and building a patient load takes time, so you need to have enough money to support your practice and personal expenses as you set up your practice and prior to earning an income.

SECURE YOUR BUILDING SPACE

Having your established office is a necessary expense before being able to start a practice. Unfortunately, the building may be empty six months prior to opening because a physical location is needed to garner important documentation for a tax ID, a business banking account, and signing on with an Electronic Medical Record (EMR) company.

ESTABLISH A MAILING ADDRESS

Decide if your building location will also be the practice mailing address. Or you may consider using a PO Box address. If you decide to take insurance, your payers need to know where to send payments to. Everything must match when beginning to credential with insurance companies or the startup will never get reimbursed. 23

S U M M I T | S U M M E R 2 0 21

GET MALPRACTICE INSURANCE

Malpractice insurance can protect your degree and licensure. And once you have your business space, you will likely want liability insurance. Select an insurance package that will be sufficient for your practice and space. Make sure to start your insurance the very day you acquire the office space as you will be liable otherwise.

FORM A BUSINESS ENTITY

Get a federal tax identification number and decide what the business will look like in terms of ownership, organization, structure, and taxation. Decide early on what your future practice will look like and move forward with your decision.

FILE YOUR BUSINESS NAME WITH YOUR STATE

Registering your business name with your state is often required and is important for tax purposes. Companies such as Zen Business can help new business owners meet state registration requirements.

CREATE AN ADDITIONAL UNITED STATES DRUG ENFORCEMENT ADMINISTRATION (DEA) NUMBER

If you plan on staying at your job while establishing your private practice and there is any chance you will see a patient at your new practice, you will need an additional DEA number. DEA numbers correspond to your workplace location. If you quit your job, you can use the same DEA number by changing your practice location; however, you cannot prescribe medication under the same DEA number if you practice in two locations.

CREATE A SECONDARY NATIONAL PROVIDER IDENTIFIER (NPI)

Know your login information for the National Plan and Provider Enumeration System (NPPES) website. If you continue working while establishing your practice, you will need to add a second practice location for your individual NPI and you will need a secondary NPI for your private practice. If you quit your employer and only work in your private practice, you can log back in and update the information. The NPPES website is also where you will upload your current malpractice insurance information. Once you go live with an EMR, the endpoint address is the address where all of the patient information is exchanged with other hospitals, etc. You cannot try to credential for insurance companies until you go to the NPPES website and update changes. Incorrect information will slow down insurance reimbursement processes.

A LU M N I I M PACT

IMPROVING ACCESS TO Mental Healthcare in Underserved Communities “There is a big need in low-income communities for mental health services and I want to be able to provide that service to patients,” said Theressa Williams, MSN, CRNP, FNP-BC, PMHNP-BC. What makes Williams’ efforts particularly important is the fact that there are few African American healthcare providers in her community, which can create barriers to receiving proper care. Williams is hoping to be the change that her community needs to receive essential health and mental health services. Williams’ journey into healthcare started with her undergraduate education at Morgan State University (MSU) in Baltimore, Maryland. With the goal of becoming a pharmacist, she earned a bachelor’s degree in chemistry. However, after researching the role of a pharmacist, she realized she wanted to have more direct contact with patients to help them achieve their optimal level of health. Her friend told her to consider becoming a nurse, and after research into nursing professions revealed the opportunities to specialize in a variety of areas, she knew it was the right path for her. Williams received a nursing degree from MSU in 2012 and then obtained her master’s degree as a family nurse practitioner (FNP) in 2017. 25

While working as an FNP in Baltimore, Maryland, she noted that “many patients suffered from substance use disorder, opioid use disorder, depression, and anxiety. And many people have posttraumatic stress disorder due to witnessing violence in the area.” Recognizing the need for increased access to mental health services, Williams enrolled in the Psychiatric Mental Health Nurse Practitioner Certificate (PMHNPC) program at Rocky Mountain University of Health Professions (RMUoHP) in 2019. Her commitment to and focus on bringing more mental health services

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“The patients fear they will be judged or be deemed weak for talking to someone about their mental health. Some low-income patients don’t have insurance so they can’t afford to pay out of pocket for mental health services. There are many negative attitudes and beliefs toward people who have mental health conditions, which may cause a patient to be ashamed about having a mental illness or they may feel they will be discriminated against because of their mental illness.” As an African American healthcare provider, now armed with the education and expertise to provide psychiatric mental healthcare services,

[patients] felt better receiving care from someone who looks like them and can understand them”

to her community motivated her throughout the PMHNPC program, leading to her graduation and certification in December 2020. Not only has Williams identified the need for better access to mental health services in lowerincome communities, but she also acknowledges that one of the main barriers these communities face is the stigma surrounding getting help. “There are not many African American mental health providers where I live,” said Williams.

she is not only improving access to more healthcare services but her work also helps address the stigma surrounding healthcare within the African American community. “Not only in mental health but other fields I have worked in such as primary care and gynecology, patients have told me they were relieved to have an African American provider walk into the room to provide their care,” said Williams. “They felt better receiving care from someone who looks like them and

S U M M I T | S U M M E R 2 0 21 can understand them, which put their fears at ease. I have had many patients say they would return for various services because they felt comfortable and connected with me and they opened up to me. Patients have stated they have not discussed some issues with other providers who weren’t African American because they just didn’t feel comfortable to open up and ask certain questions.” Williams is motivated to make a difference by educating the community and teaching those around her that it is OK to ask for assistance and receive mental health support and services. “I want to help erase the negative beliefs toward receiving mental health treatment.” To make lasting change in improving better mental health services to low-income and culturally diverse communities, as well as to create easier access to those services, Williams stresses the importance of education in making changes.

RMUoHP graduate Theressa Williams works on bringing more mental health services to her local community.

“Many people don’t realize that mental the majority of the residents didn’t health issues are real and affect people, have insurance. And then I also completed clinical hours in a private including children, in various ways. doctor’s office where the majority People in low-income communities had insurance. Education related to usually seek primary care services diversity so the ability no matter the race, and cultural to integrate competencies mental health gender, or income help students services with level, all patients should learn to put primary their personal care services receive equal care” beliefs aside can provide in order to provide the best care to all more essential mental healthcare patients,” she said. to patients,” said Williams.

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She explains how the diversity of her clinical experiences while in her graduate programs helped provide her a holistic perspective to treating patients of all backgrounds.

“No matter the race, gender, or income level, all patients should receive equal care and the best care to help them reach their optimal level of health,” added Williams.

“When obtaining my FNP, I did clinical hours in a culturally diverse low-income community where

“It takes a lot of work to provide effective care to low-income patients,

but accept the challenge and don’t give up because these patients need us.” For Williams, the most rewarding part of being a nurse practitioner is working with a patient, no matter their background, and seeing their successes following therapy, medication, or a combination of treatments to help with their mental health disorder. Her commitment to furthering her education and clinical skills has been motivated by just that—helping all patients in her community improve their physical and mental health.  By Talia Blatter

U N I V E RS I TY U P DAT E S

PROGRAM UPDATES

Advancing Healthcare Education

Master of Physician Assistant Studies (MPAS) The program is excited to be able to transition back to oncampus instructional delivery. The program is planning a White Coat Ceremony for Cohort 6 on July 9.

Master of Science in Health Science (MSHS) The Functional Nutrition concentration track was added to the program starting January 2020. Dr. Pat St. Louis was hired to co-teach the Integrated Biomechanics course.

Master of Science in Medical Speech-Language Pathology (MS MedSLP) To align with its medical emphasis, the program changed its name to Master of Science in Medical SpeechLanguage Pathology. The third cohort of students presented their capstone projects in April in fulfillment of their graduation requirements. Faculty member Dr. Priscilla Danielson initiated the Augmentative and Alternative Communication (AAC) Family Support Network at the Center for Communication Disorders to support families and caregivers of individuals who use AAC. With four years of well-received annual reports during candidacy, the program will host a virtual site visit this fall as a final step for full accreditation with the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) of the American Speech-Language-Hearing Association. 27

Master of Science in Clinical Mental Health Counseling (MSC) and Master of Science in School Counseling (SC) To further address the shortage of mental health and school counselors in the state of Utah, two new certificate programs were started: a School Counseling Certificate program and a Mental Health Counseling Certificate program. Dr. Kevin Knutson was hired as a full-time assistant professor of counseling.

Doctor of Occupational Therapy (OTD) The program is expanding its capstone project options for students to create new opportunities for research and dissemination. A new Health and Wellness Coaching elective track will be open for enrollment starting in fall 2021.

Doctor of Medical Science (DMSc) Faculty Dr. Laura McClary gave a presentation on the “Use of Telemedicine in Primary Care” at the American Academy of PAs We Are Family Medicine conference in January. Faculty Dr. Priscilla Marsicovetere and Program Director Dr. Bartley Rust participated in the annual Physician Assistant Education Association Exam Development Summit in March. Psychiatric Concentration Track Director Dr. Tim McCreary gave a presentation on “Motivational Interviewing” at the annual conference of the American Academy of PAs in May. Faculty Dr. Mace Hamblin completed

the RMUoHP Health & Wellness Coaching Certificate program in August 2020.

Doctor of Nursing Practice (DNP), Family Nurse Practitioner (DNP/FNP, FNPC), Psychiatric Mental Health Nurse Practitioner (PMHNPC), and Emergency Nurse Practitioner (ENPC, FNPC/ENPC) With the University’s formation of a new college structure, all nursing programs are now under the College of Nursing. Former Program Assistant Director Dr. Kelly Conway is now the Interim Dean of the College of Nursing. Dr. Kevin Ballard is now full-time as the DNP/FNP Program Director. Dr. Bill Fiebig was hired as an assistant professor in the FNP/ ENP program. Dr. Jason Nupdal is now a part-time PMHNP Certificate program faculty.

Doctor of Philosophy (PhD) in Health Sciences Dr. Mary Shotwell was hired as a fulltime faculty member and will teach a variety of courses in the program and work with students to enhance qualitative research methodology. Two new concentration tracks were added: Integrated Health Sciences has a multidisciplinary focus and the option to explore multiple facets and content knowledge across the health sciences, and Orthopedic Sport Sciences focuses on higher-order critical thinking toward differential diagnosis as problem identification and clarification for orthopedic and sports conditions.

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Doctor of Physical Therapy (DPT) Dr. Megan Kisner, a 2014 program graduate and Certified Orthopaedic Manual Therapist, was hired as faculty.

Doctor of Speech-Language Pathology (SLPD)

online-only options available for the summer 2022 semester start.

Certificates and Continuing Education New continuing education courses are available at learn.rm.edu. 

The online-only SLPD option, introduced with the fall 2020 semester, expanded enrollments and continues the program’s reputation as a national leader, enrolling more first-year clinical doctoral students than all other similar US programs combined. The program will be enrolling students in the online-only option for fall 2021, with both limited-residency and

WINTER 2021 THE REACH OF RMUoHP'S CLINICAL EDUCATION Clinical Rotations Present 1 program

2 programs

3 programs

4 programs

Numbers reﬂect the total number of students serving clinicals in that state

10 9

6 10 19

204

1 1 4

2 2

1 4

A CLOSER LOOK Program Clinicals Located by State Master of Science in Speech-Language Pathology

Doctor of Physcial Therapy

Master of Physician Assistant Studies

Nursing Programs

(DNP, DNP/FNP, FNPC, ENPC, Dual FNP/ENP, PMHNPC)

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