Practicing locum tenens in Antarctica -

Practicing locum tenens in Antarctica - - ModernMedicine

HOT TOPICS: Rx Adherence Predictor Tool ·

AHA 2010 Video Reports · Dermatology Images · Liability & Risk· Health Care IT · Oral Anticoagulation in Atrial Fibrillation [SPONSORED]

Barbie Brittell, PA-C, is in her 10th year of practicing as a physician assistant (PA). For the first 5 years, she held a permanent position in a small island community off of the northeastern coast, practicing family and emergency medicine. Periodically, she would also serve in a hospital emergency department on the mainland.

"After a while, though," Ms. Brittell comments, "I realized it was time to open up my professional opportunities, perhaps around seasonal work."

Not surprisingly, the idea of a locum tenens lifestyle appealed to this PA. Little did she know that a great deal of her mobile career would be spent on the icy, snow-covered continent of Antarctica.

AN INTRIGUING ADVENTURE

Ms. Brittell chose to go to Antarctica because she found it intriguing—she likes wilderness settings, including mountains, snow, and harsh environments. Initially, she learned about healthcare opportunities on the continent by reading about an astronaut who was doing work at the McMurdo Station. "I thought, Wow! What a fascinating place. So I did a little research on my own and discovered that there are medical clinics there. After some more digging, I was able to get in touch with a doctor who practiced at the South Pole Station and asked him a lot of questions. That is how I found out about Raytheon Polar Services Company, a Centennial, Colorado-based organization responsible for hiring support personnel for the U.S. Antarctic Program (USAP)."

Barbie Brittell, PA-C in front of the Dome at the old South Pole Station.

Professionally, Ms. Brittell was interested in the challenge of getting back to the fundamentals of medicine with thorough physical exams and accurate histories. Plus, she loved the thought of living and interacting with people in a scientific community. She recalls, "Researchers are studying a vast variety of issues: global warming at the very place it might be most obviously occurring, glacial formations, and investigating how environmental contamination is affecting local wildlife. The geek, the environmentalist, and the traveler in me all found it very fascinating."

BASIC NECESSITIES

Her first opportunity to go to Antarctica came in August 2003. In total so far, she has completed four seasons at the McMurdo Station on the Ross Sea, and filled in just briefly at the South Pole Station when someone was ill. That station is more constrained from flying personnel in and out because the severe weather can freeze the plane's hydraulics. There is also Palmer Station, which is a very small community closer to South America.

A Medivac helicopter transports a patient to an awaiting ship off the Antarctic coast.

Basically, there are two seasons in Antarctica, the austral summer and winter. The latter runs from February to late October. And, for the most part, people arrive during what is known as the Wind Fly, a brief period between winter and summer.

In the summertime, McMurdo reaches its maximum population of about 1,100 to 1,200. Often, people stop over before going onto the South Pole. McMurdo also receives ships a couple of times a year to bring in supplies, so the community may blossom with another 100 to 200 people. In the winter, however, the census drops to approximately 200 people, just enough to maintain the station. Ms. Brittell explains, "The McMurdo clinic is an old military building that was constructed when the station opened more than 50 years ago. It has a trauma area with two beds and one private room that is generally used for counseling and gynecological or private exams. Another area, that we call the ward, is considered an inpatient unit that holds three beds."

Moon over the Royal Society Range, Antarctica.

She adds, "The clinic is pretty well equipped with a crash cart, defibrillator, and ventilator. However, we are not prepared to provide long-term care. That said, we may be required to hold onto a patient for a few weeks while we arrange a Medivac transport. In the summer, weather permitting, we normally have access to military planes to fly patients out, but even then, the process could take hours to initiate. For example, on a good day with good weather, it will take a minimum of 8 to 10 hours to evacuate trauma cases or critical patients to definitive care in New Zealand. Approximately two or three times a year, someone will become seriously ill or sustain a substantial injury and will require an urgent Medivac. Still, the medical staff has the ability to practice very good trauma and emergency care."

12 3