Alumni Profile: Carole Hohl
What first inspired you to pursue a career as a physician assistant?
As a kid, I always loved science. My mother was a nurse and I knew that was not what I wanted to do. As a biology major in college, I was fascinated by the physiology of the human body and life in general. My advisors tried to steer me to teaching or nursing, neither of which appealed. After college, I worked in a couple of different labs where I had mentors who really encouraged me to go to medical school. I loved working with patients in the Cath lab and in the Vascular Surgery labs.
Can you walk me through your path to PA school and what that process was like for you?
By the time I was ready to make a decision about my next step in my education, I was a single mother with a 2-year-old. I had not known about PA’s at that time (1977) but someone sent me an article about this “new” career in medicine, and it seemed perfect for me. I was ready to leave Detroit for good. My interview at Duke was on a beautiful spring day while there was still snow on the ground in Detroit and that did not hurt. My mentor and boss at the Vascular Lab, Ramon Berguer, was very encouraging and lent me money to go. I really could not have done it without his encouragement and loan. Looking back, I am kind of amazed I had the courage to do that, but I was young and looking for a new career.
What stands out in your memory from your time at the Duke PA program?
I absolutely loved the rigor of the classes and all the knowledge the instructors were trying to impart to us. Several of the friends I made are still my dearest friends to this day. A few things stand out from the didactic phase of the years. One is my friend, Eric Cullander entertaining my 3-year-old in the back of the classroom on days he could not go to daycare. I remember learning about all these esoteric microorganisms that I thought I would never see in real life and then many years later, I worked with people infected with HIV and all those weird parasites, bacteria and viruses were infecting my patients. Our class was quite eclectic but incredibly supportive of each other. That was wonderful. I also loved that on our rotations, especially at Duke and the VA, the residents really treated us the same as the medical students. We did the same patient evaluations and presentations, assisted in surgery and had access to rounds.
Were there any challenges you faced during PA school that helped shape your approach to medicine?
My biggest challenge was probably being a single parent. What I learned during this time is the value of work/life balance. I eventually had 2 more children and always looked for jobs where I could work part time. This was possible because I had a husband with a job who was a great co-parent. When the kids were older, I worked full time again but never regretted this time I spent with them.
What was it like stepping into the profession after graduation?
I was very lucky and got a job at the Methodist Retirement Home where I had excellent supervision which is key for a new grad. My next job with Lakewood Family Practice had a really good set up for new grads. Although we had access to the docs at any time for consults, we went over all our patients at the end of the day with one of the supervising physicians. It was an excellent learning situation for a new PA. I have often recommended this structure to PA’s starting their careers.
What kind of work are you doing now, and what have been some of the roles you've held over the years?
I have been retired for about six years now. Most of my career, I worked in primary care and later with a focus on HIV care, which really turned out to be my passion. In 2000, working at the Boston Health Care for the Homeless Program (BHCHP), I was working in the HIV Clinic doing primary care and wrote a grant to the Ryan White Program and we got it. I became director of the program and developed a multidisciplinary team to care for people with HIV who are homeless. I modeled it somewhat on a program in Santa Cruz, California where I had worked for nine years. The key to the success of this program was the incorporation of nurse case managers and medical case managers to help keep the patient’s adherent to their meds and their care. I could go on and on.
Another fun and interesting project I worked on was a joint collaboration with Boston University School of Public Health looking at different programs that took care of people with HIV who were homeless and assessing their program design and outcomes. We had a nice supplement in the American Journal of Public Health.
How have you seen the PA profession grow or change since you entered the field?
When I first started practicing, very few people knew what a PA was. That has definitely changed. Most people have seen a PA or know someone who has a PA as a practitioner. One thing I noticed here in Boston was that there are fewer and fewer PA’s going into primary care. Emergency medicine and surgery seem to be the bigger draws.
Have you been involved in anything outside of clinical practice, such as teaching, leadership, or advocacy?
I did have students while I was working at BHCHP.
What lessons or experiences from your journey would you want to share with students today?
I always encourage students to make sure that there is good supervision at the first job. We know a lot of medicine when we graduate but working in collaboration with either a physician or an experienced PA or NP really helps with confidence and good decision making. Teamwork is critical to good practice.
When you look back at your career so far, what are you most proud of?
No doubt, I am most proud of the HIV Team I helped develop at BHCHP. We had such an excellent team of practitioners (physicians, NP’s, PA’s, RNs, case managers) that we were able to maintain an overall viral suppression rate of 94% in a population who were homeless and often using substances and suffering from serious mental illness. That team continues to do the work.