Marching, but not yet graduating: PA student and activist Yukari Suzuki

Yukari Suzuki will be one of the cap-and-robe-wearing students in the School of Medicine’s (YSM) procession to Old Campus for Yale Commencement on May 21, but she has seven more months to go before she can make her mark as a Yale alumna. That is because she is participating in YSM’s 28-month Physician Associate (PA) Program, which holds its graduation ceremony in December.

However, through her volunteer work at HAVEN Free Clinic, a clinical rotation focused on rural medicine, and her activism, Suzuki is already having a positive impact on health and healthcare policy as a student.

Ever since eighth grade when her U.S. government teacher gave her class an assignment to participate in one community service project per semester, Suzuki has engaged in volunteer work. For example, while at San Diego State University obtaining her master’s in social work and public health, she was active with the University of California-San Diego Student-Run Free Clinic. This experience, she says, made her want to practice in a community health/free clinic setting in the future. Therefore, a key factor in Suzuki’s decision to attend YSM was the opportunity for Yale students across the health disciplines to work at HAVEN, a student-run clinic for underserved and uninsured populations.

Suzuki has played an integral role in the operations of HAVEN, starting off as a junior clinical healthcare team member conducting patient office visits. She then served a year as the director of the clinic’s fully-functioning laboratory, which offers diagnostic testing and vaccination services.  The relationships she built with the leaders on the clinic’s board of directors and within other departments have been the most rewarding part of volunteering at HAVEN, she says.

“I have found it an honor to work alongside others who were as driven as I was in making sure this clinic continues to thrive as a resource for New Haven and the surrounding community,” she says. “I think the most important lesson that has been reiterated to me from the experience is that much can be achieved from bringing people together who share a common goal and passion.”

Elizabeth Roessler, assistant professor in the PA Program, describes Suzuki as “generous of time and spirit.” This is something the student demonstrates routinely in both small and significant matters, according to Roessler. “Any email you send to the class to ask for help, she is the first to respond,” she says.

“Yukari’s willingness to go the extra step because of her dedication to YSM and the New Haven community was critical when HAVEN moved its clinic site from Fairhaven Community Health Center, its home for over 10 years, to its new location in the Yale Physician Building at 800 Howard Avenue.,” says Roessler. “Her hard work as a HAVEN board member and the laboratory director helped ensure this significant transition went smoothly.”

While Suzuki had health care experience in urban and suburban settings prior to joining the Yale PA Program, she had not worked in a rural setting. While most Yale PA rotations are in Connecticut, Suzuki chose to spend her first four-week clinical rotation in Evarts, Kentucky, focusing on primary care, largely in order to develop a greater understanding of the unique healthcare challenges and needs in rural communities. To access specialists, for example, patients in Evarts often had to travel to Lexington, Kentucky, which was a 2.5-hour drive away. Suzuki says she saw first-hand how time, finances, and access to transportation were significant factors in determining how soon patients would follow through with the discussed treatment plan, impacting outcomes.

Comparing this experience to her subsequent rotations, Suzuki says, “Everything about the Evarts rotation was different so that it is difficult to fully capture the experience. It is most certainly nothing like the other rotations in Connecticut. Evarts is a quintessential town of old America struggling to change with the times. However, it has retained the sense of community that other areas have lost.”  She says she especially valued the familiarity at the Clover Fork Clinic. “Patients would somehow be connected to each other and/or a staff member and socialize with updates about each other’s families.”

Beyond her clinical work, while at Yale, Suzuki has engaged in policy issues involving healthcare and the role of PAs. Having lived in Washington, D.C. for three years after college and completed a public health program with a focus on healthcare management and policy, Suzuki entered the Yale PA Program with a strong interest in advocacy work. When an opportunity arose to participate in the annual Leadership and Advocacy Summit (LAS) of the American Academy of PAs, the national professional society for PAs that advocates on behalf of the profession, Suzuki says she “really wanted to participate as an introduction to my future as an advocate.”    

During LAS, held in March 2018, Suzuki was part of a team of students who advocated for two bills: the Home Health Care Planning Improvement Act (S. 445/ H.R. 1825), which would allow Medicare payment for home health services ordered by a PA and other advanced care providers, and the Promoting Access to Diabetic Shoes Act (H.R. 1617), which would enable PAs, not just physicians as currently is the case, to prescribe diabetic shoes through Medicare. As Suzuki explains, both of these bills are important because they “allow for PAs to provide comprehensive care and maintain continuity in patient-provider relationships” — thereby improving the quality, accessibility, and cost-effectiveness of patient-centered healthcare access.

Even if these two provisions do not become law, Suzuki says, she felt empowered by the experience, “I challenged myself to exercise my capacity as an individual with a heart and voice. I am excited to have had positive reinforcement to continue this journey in being secure with myself to stand up for my beliefs and taking action.”

Suzuki says she frequently thinks about the changing healthcare landscape and the role of PAs within it, because she “wants to be a part of the driving force to implement changes that continue to improve our healthcare system,” adding that she believes focusing more on preventative medicine is critical. Noting that the federal budget consistently has devoted just 3% to prevention programs, she said she hopes that local programs focused on prevention begin to provide evidence of their cost savings to federal legislators, bolstering arguments that prevention spending is a worthwhile investment.

Suzuki says she believes PAs “must assume the responsibility of bringing personal experiences from the frontlines of medicine to the legislators who may be unaware of how their laws would impact patients” and be advocates on behalf of patients.  When asked if she envisions herself being involved in advocacy work after graduating, Suzuki responded “Heck yes. I will definitely be involved politically.”

While her clinical and policy work are influencing Suzuki’s future plans, when asked the most rewarding part of her PA Program experience, she replied “hands down, having built such incredible friendships with my classmates.”