Practicing in Primary Care: Rewarding Work, Life-Changing Outcomes

Cindy Bunde, MPAS, PA-C, DipACLM, and Erin Fitzpatrick Lepp, MMSc, PA-C

November 16, 2021

PAs are doing extraordinary work in practice and in their communities. Through the generosity of one of our long-time donors, William H. Marquardt, the PA Foundation has the honor to work with and to recognize PAs who are going beyond their day-to-day practice to reach patients at risk of not receiving the care they need. Professor Marquardt’s passion is PAs who treat patient populations who have limited access to healthcare services. In 2019 he established the William H. Marquardt Community Health Access Fellowship, which aims to benefit PAs serving in mentoring/precepting roles who are dedicated to promoting accessible primary and preventive healthcare amongst underserved populations. The 2020 Fellows, Cindy Bunde and Erin Lepp, share their perspectives and stories on practicing in primary care, serving with compassion, and inspiring the next generation of PA leaders.

Cindy Bunde, MPAS, PA-C, DipACLM

Day-to-day encounters with patients at the free clinic where I work in Pocatello, Idaho, are not always challenging medicine – but for patients who lack access to primary care, these interactions make a huge difference in their lives.

Just this morning, my clinical year PA student and I saw a woman with rheumatoid arthritis. “Judy” works in manual labor, doesn’t qualify for Medicaid, and missed her employer’s deadline for insurance. While she waits for insurance eligibility, she urgently needs refills of her prescriptions, which her primary care provider refuses to fill unless she does lab tests. She can’t afford them. When we said we’d run those labs and refill her medications, at no cost to her, Judy was visibly relieved and so grateful.

Later, we saw “Tony” for a painful arm rash. He works hard doing very dirty work in mold and lead abatement. He neither qualifies for Medicaid nor can afford to purchase insurance. While he tried to encourage his employer to use small business benefits to offer insurance, they unfortunately have refused. The student and I diagnosed and treated his shingles and Tony was incredibly appreciative.

My work in a primary care free clinic is meaningful for Judy, Tony, and so many like them – and it’s meaningful and fulfilling to me. We can do simple things well when we work with compassion. At the same time, having resources helps. This includes the funds to pay for those medicines and labs, and a point-of-care ultrasound and associated training to use it. Thanks to the generosity of William Marquardt and the PA Foundation through the William H. Marquardt Community Health Access Fellowship, our clinic has the latter – I donated the awarded funds towards the purchase of a Butterfly IQ point of care ultrasound. Later this week, we might use it to examine the depth of “Jason’s” ongoing foot cellulitis or check “Lupe’s” gallbladder. It might not be glamorous, but it will mean better diagnostics and better treatment for these patients – and that means the world to them and to me.

Erin Fitzpatrick Lepp, MMSc, PA-C

Being honored with the William H. Marquardt Community Health Access Fellowship this past year has been a transformational experience for me and allowed me to share my passion for primary care with my Mercer PA students. I used the monetary award from the fellowship to fund a variety of new projects and initiatives that our students took an active leadership role on, including launching nutrition education classes over taught over Zoom for families facing food insecurity, purchasing the supplies needed to provide health outreach and medical care to over 300 people experiencing homelessness in downtown Atlanta, funding our travel to South Georgia to help vaccinate migrant farmworkers against COVID-19, and providing a donation to help kickstart our students’ efforts to raise funds to cover the formulary costs of the Grace Village Medical Clinic, where we volunteer on Saturdays with refugee patients.

To help make this honor enduring, I also established the William H. Marquardt Community Health Access Writing Award, which will be given to a student whose professional medical writing in our Senior Seminar Capstone course highlights the role PAs can play in addressing health disparities. I hope my efforts to mentor a new generation of PAs will result in more students deciding to pursue primary care as their specialty after graduation. Thank you to the PA Foundation for this amazing opportunity!

With the help of volunteer medical interpreters and a local hospital’s language line, Erin Lepp, MMSc, PA-C, works to educate her patients with diabetes. “I care for refugees patients who hail from over 54 countries and who speak 47 languages and dialects, so it is important that I practice medicine with a special attention to my patients’ culture, language, and literacy needs.”

Learn more about the William H. Marquardt Community Health Access Fellowship and meet other Marquardt Fellows here.