Aubrey Fiacco, PA-C
Profession:
Physician Assistant
Alma Maters & Graduation Years/Degrees:
Boston University – BA Biology and Psychology, 2016
MGH Institute of Health Professions – MPAS Physician Assistant Studies, 2021
Preferred Pronouns:
she/her
Hometown:
Albany, NY
Where do you work, what are your main responsibilities, and are you working with a specific population?
I work at Atrius Health in Kenmore’s Internal Medicine Clinic. My job is to work with a primary care provider to see adult patients for all their needs from physical exams and wellness visits to acute sick visits. I work with patients to diagnose their conditions, treat any concerns, and provide preventative care. Some people don’t realize, but it is within my scope of practice as a PA to order labs and imaging, to refer to specialists, prescribe medications, and follow up with patients.
Can you share your journey about how you became a PA? Have you always known you wanted to be a PA? Is there a specific moment/experience that solidified your career choice?
I did not always know that I was going to be a PA. Up until my junior year at BU I only knew I wanted to be somewhere in the medical field (really thought I wanted to be a veterinarian). Research didn’t feel like somewhere I could see myself. Working with animals I realized I missed the human connection and that I wanted to work directly with human patients. I had followed a pre-med track, but knew that I did not want to go to med school. When I learned about the PA profession, I thought it was exactly what I was looking for- a team-based approach to patient care.
After graduation I worked at Boston Medical Center for 3 years in their outpatient cardiology department and in those interactions with patients, I solidified that this was the path for me. Many schools require a minimum number of hours of direct patient experience. I started as a patient service representative while getting my EMT license. I was then able to use that license to transition into a medical assistant role. I think taking time off and working after undergrad was the best thing for me and gave me a lot more knowledge about each role that goes into make a clinic run. It gives me a lot of respect for all the people in so many different roles that make patient care happen!
What does a typical day look like for you? Who do you work with most closely or collaborate with frequently? What does your work-life balance look like?
A typical day for me varies by who’s on my schedule. Usually, I have a least a few physicals and wellness exams. Other days there are more acute injuries or illnesses. A few months ago our clinic was seeing a lot of COVID patients with new or worsening symptoms. In between visits I respond to patient calls and messages, review lab results and make plans for patients, or refill medications. I work closely with other mid-level providers (PAs/NPs) as well as the physicians on my team to ensure patients are receiving the best evidence-based care we can provide. I love the work-life balance the PA profession provides (and encourages!) I work Monday to Friday regular business hours.
What are some challenges in your profession that you did not expect while you were in undergrad/PA school?
One challenge is the application process for PA schools, unlike med schools that usually have essentially the same required coursework, most PA schools each have their own requirements. While at BU I did not take anatomy and physiology since I was in CAS and it isn’t a required pre-med course, but to my surprise, it is required by most PA schools. I was able to take the additional coursework while working fulltime after graduation, but it is certainly something to be aware of if you are interested in applying. Explore schools and programs you’re interested in and see what coursework they require to avoid surprises.
How has COVID affected you and others in your profession?
I was still finishing my program when the pandemic began. PA students do 7 required clinical placements and usually several electives in order to graduate. COVID affected the availability of many of these sites to accommodate students during the PPE shortage and when population data showed infections were too high, we could be pulled from clerkships. Now as a provider, I picked up shifts with telecom to help assist the massive influx of calls we saw over the holidays. I think it has certainly created a sense of burnout in the past 2 years plus among many clinicians. Especially in having hard conversations with patients when we see the evidence of the utility of the COVID vaccine and have patients that disagree. I think it has made me work harder to find common ground and work on building the trust in a patient-provider relationship.
Can you share a memorable story or patient interaction during your time in PA school or in your profession?
I think my favorite interactions are where you help someone through a challenge. COVID has not been easy for anyone and for many patients it has been a time of struggling with their mental health. One patient in particular was dealing with anxiety and depression and had been dealing with these feelings alone for many months. I was able to get them started on a medication, initiate the referral process to start therapy, and work with them to create a plan for the short term. I like in primary care that I get to have longitudinal care and in following up with this patient they felt markedly improved, were tolerating the medication, and were seeing a therapist. I have time to really meet patients where they are at, listen to their concerns, and help them find solutions.
What are some specific things you remember doing to prepare for applying to PA school?
Making an excel sheet of the different school requirements! Each school has its own requirements, some have different classes you need to have taken, some require shadowing, most want 2000 hours or so of patient care experience, some have supplemental applications, letters of recommendations from specific people etc. It is very important to be organized and come up with a game plan to get through the application cycle. It’s daunting, but doable!
Is there a specific organization/establishment you would like to shout out?
BU Community Service Center and American Cancer Society’s Hope Lodge were places I spent a lot of time at during undergrad and then after graduation that helped me figure out that the PA profession was meant to be for me.
What are your hobbies/What do you like to do for fun?
I love to read (lots of biographies or mysteries) and indoor garden – I have an orange, lemon, and banana tree on my kitchen table. I play recreational volleyball or go for walks finding new places in Boston- Castle Island is my personal favorite.
On good weekends you can find me cheering on the BU hockey team!
Are there any tips/advice you would like to share with our pre-health students?
Don’t be afraid to reach out for help along the way! Everyone you’re asking has been in your shoes and most people are happy to help you on your journey.
Also write down why you want to go into a certain profession and keep it with you for the really hard days when you ask yourself why- medicine is a work of heart!