When Kevin Lohenry, PhD, PA-C, first tried higher education as a student, it did not work out. Aimless and dispirited, he left school and took his father’s advice to join the Navy. He did not realize it at the time, but Lohenry was setting sail on a course that would lead him to a career as a physician assistant and educator at the University of Arizona Health Sciences.
After enlisting in 1986, Lohenry worked as a Naval Hospital Corpsman where he was surrounded by medical professionals including physician assistants. He was quickly drawn to the profession.
“I was stationed near Boston in 1987, and I met the first PAs I’d ever known,” said Lohenry, who is interim dean of the UArizona College of Health Sciences and assistant vice president of interprofessional education for UArizona Health Sciences. “There was just something about the way they took care of patients. From that point on, I was excited about becoming a PA.”
Rooted in the military
The PA profession was rooted in the military’s approach to medicine — born out of necessity and inspired by military pragmatism.
Eugene A. Stead Jr., MD, of Duke University Medical Center, organized the first class of PAs in 1965 in response to a nationwide shortage of primary care physicians. He modeled the program after the World War II-era program for fast-tracking medical students to become doctors and recruited Navy Hospital Corpsmen with extensive medical training as the first students. The inaugural class graduated in 1967.
The medical community backed the profession by setting accreditation standards and establishing a national certification process with standardized exams, as well as continuing medical education requirements.
Over the next half century, physician assistants gained prominence. Just three years after the American Association of Physician Assistants was incorporated, the American Medical Association formally recognized the profession. In 1973, the first national PA-certifying exam was administered by the National Board of Medical Examiners. By 1992, PAs were commissioned in every military branch.
PAs continued to advance into the mainstream of health care at the turn of the century. In 1997, Medicare covered PA providers in all settings, and by 2000, all states authorized the PA practice. The profession made another breakthrough in 2007, when PAs received prescriptive authority in all 50 states and the District of Columbia.
From war veteran to white coat
Four years into his service, Lohenry was deployed to Iraq during the Gulf War. Even though he was referred to as “doc” – a common name given to U.S. Navy Hospital Corpsmen – Lohenry was only starting to see the possibilities that would one day lead him to becoming a medical professional.
One of the PAs who led Lohenry to the profession was Dennis Aucoin, an early graduate of the PA program at Duke University. Aucoin was a chief warrant officer and PA at the Branch Medical Clinic for Naval Air Station South Weymouth in Massachusetts.
“He was a provider in the clinic where I served as a Navy Corpsman. His mentorship as a Navy professional and his care of the patients that were entrusted to see him were the two main reasons the PA profession became a viable option for me,” Lohenry said.
A drive for diversity
More than 3.3 million Arizonans live in Health Professionals Shortage Areas, defined by the Health Resources and Service Administration as geographic areas with a shortage of providers for an entire group of people. According to the U.S. Department of Health and Human Services, Arizona needs more than 650 primary care physicians to meet the health care needs of its residents.
The shortage of health care workers makes it tough for patients to get the care they need, and more PAs could help make up for the shortfall, Lohenry says.
At the same time, the PA profession has been a homogeneous group, he says, both economically and ethnically. According to the National Commission on Certification of Physician Assistants, only 6.5% of PAs are Hispanic, while nearly one-third of Arizona residents are Hispanic.
Lohenry is building the PA program at the College of Health Sciences to focus on educating the next generation of health care professionals to provide compassionate and culturally sensitive care for all.
“When health care professionals only come from more affluent experiences, they tend to lack understanding of the culture and the nature of the needs of communities they serve,” Lohenry said adding that he hopes to create a diverse group of students that will reflect the rich diversity of Arizona’s residents.
To accomplish that goal, Lohenry seeks to inspire a new generation of PAs.
“The conversation at high schools or grade schools is about becoming a doctor or becoming a nurse or becoming a lawyer,” Lohenry said. “We need to share the beauty of the PA profession with these students and allow them to dream of something different.”
Making moves in geriatric physical therapy
Christine Childers, PT, PhD, did all she could to comfort her father as he dealt with Parkinson’s disease in the final phase of his life. As Childers watched him slip away, she began to consider a new career path – one that would lead her to become a geriatric physical therapist.
“I wanted some way to help him, to make his life better,” Childers said. “That drew me to geriatric physical therapy, just thinking of ways I could help older adults heal and build their strength.”
Since then, she has become a leading voice in the geriatric physical therapy field and helped countless older adults rehabilitate from injuries and chronic conditions. Now, as founding director of the University of Arizona College of Health Sciences’ Doctor of Physical Therapy program, she is empowering a new generation of therapists to do the same.
From the shadows to the spotlight
In 1969, Kansas City, Missouri, physical therapist Joan Mills established the American Physical Therapy Association’s first Section on Geriatrics to give targeted care to older patients in a 200-bed general hospital that previously gave uniform care to patients regardless of age.
Geriatric physical therapy was deemed a specialization in physical therapy in 1989, and the first geriatric clinical specialist examination was in 1992. The number of geriatric specialists skyrocketed from 14 in 1992 to 1,109 in 2010, and as of June 2023, there were 4,112. Childers is among that group.
Physical therapy’s geriatric specialty is dedicated to helping people 65 and older cope with the unique situations that come with aging, with the overall goal of maintaining excellent health and well-being. Therapists focus on bone health, mobility and joint pain while caring for patients with conditions that tend to accompany advanced age, such as arthritis. Customized treatment plans might include physical activities, stretching, functional movements and hands-on therapy.
A trained dance teacher, Childers emphasizes the connection between the moving body and active mind. She takes pleasure in busting myths about older adults, such as that they’re fragile or weak. Their longevity alone proves them to be among the toughest people around. Because of that, Childers believes it’s important to push older patients to their physical limits.
“Pushing them hard enough to get results is a skill, and that’s something that we have to help with,” Childers said. “They need our help to push them into a place they need to get to in order for the therapy to work.”
When working with patients, Childers emphasizes the importance of breaking away from a sedentary lifestyle. She teaches that movement and mental engagement are key to maintaining mental and physical health. Injecting activity into typically passive activities, such as marching or jogging in place while watching TV or doing crossword puzzles during commercial breaks, can keep the mind and body sharp.
“Commonplace things like doing laundry, going to check the mail and getting your own glass of water can mean the difference between taking a few thousand steps a day or less than 500,” Childers said. “Children of older adults are trying to protect their parents when they do things like that for them, but they’re really just putting them in more danger.”
Filling a local need
Compared with national averages, Arizona has fewer physical therapists per capita and a higher population of people age 65 and over. Childers says local clinicians tell her there is a severe lack of physical therapists in the region and a particular need for those with advanced certifications in geriatrics, as well as cardiopulmonary and neurology.
The College of Health Sciences’ Doctor of Physical Therapy program, which is currently seeking accreditation, is designed to help stem those shortages. Childers says the new program will create an expanded pipeline of skilled professional physical therapists to boost care for patients in the state.
As Childers works every day to build the Doctor of Physical Therapy program, she envisions a future in which its graduates are working throughout Arizona to give everyone including more older adults the physical therapy they need to find strength and fulfillment as they age.
“We want to fill the gaps. As a land grant university, we want to give back to the community,” Childers said. “People are living longer now, and we want to make sure they’re living better. Whether they’re recovering from a stroke or have a Parkinson’s diagnosis, we can work with them to make sure they live the best quality of life possible.”
