Ted Ruback, MS, PA-C Emeritus is widely known as the father of CASPA, the centralized application service for the PA profession. He is also the founding father of the Oregon Health and Sciences University PA program in Portland, OR and he is the recipient of the two highest honors in our profession; the American Academy of Physician Assistants Eugene A Stead Jr. Lifetime Achievement Award and the Master Faculty Award from the Physician Assistant Education Association. We discussed his path to becoming a pediatric PA, his passion for service, and the creation of OHSU's PA program and CASPA.
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Unknown Speaker 0:08
Welcome to this episode of the PA path podcast. I'm your host, Kevin Lohenry. We are glad you could join us as we seek to better understand the PA profession.
Unknown Speaker 0:25
That was my proposal to develop a centralized application service for PDAs.
Unknown Speaker 0:32
Well, hello, and thank you for joining us. Today we speak with Mr. Ted Ryback, who is the father of Casper, the centralized application service for PDAs and the father of the Oregon Health Sciences University PA school in Portland, Oregon. He is the recipient of the Eugene a stead Jr. Lifetime Achievement Award, and the PA master Faculty Award. He's a former president of PAA, as well as the Oregon society. CPAs he served as chair of the American Academy of pH Education Council was a site visitor for our accrediting body and served on the Oregon medical board as well. Today we're going to speak about his creation of OHSU, his career in pediatrics, his leadership for the profession, and one of the most significant contributions to our profession to date, the creation of Kasbah. Well, Ted, thank you so much for joining us today, it's really a pleasure to see you again. Let's start by talking about your path to becoming a PA because you joined the PA profession at a at a state where there weren't very many PhDs in the country.
Unknown Speaker 1:38
Now, that's true. First of all, Kevin, thank you so much for including me in this in this in this effort of yours, which I totally and fully support. I don't consider myself one of the dinosaurs. I've been around for a while and interesting lead into this. I honestly had a very tough transition into college. And I'm hoping that applicants that might be hearing this might relate to this a little bit. But, you know, I came from a background where, you know, in high school, I was president of the Student Council, I was president of future physicians of America. And then I went to college and college in upstate New York, one of the typical northeast, small liberal arts colleges. And I found out everyone in the class was president on the student council and president of future physicians of America. And suddenly, I really did have a tough transition. So starting off in in the first semester, I really had a hard time. And the dean, actually, to the credit of this small liberal arts college, the Dean actually called me into his office and said, Okay, you got to go in a different direction here, this isn't gonna work for you. And so it wasn't organic chemistry, it was more genetics that that finally did me in but the Dean sent me straight and I, I chose psychology as a major. And I thoroughly enjoyed that finished school, graduated in 71. And thought I might go to graduate school, but I decided I had an opportunity to work for a little while. So I worked in the insurance business of all things for a while, and then worked for a couple of years, and then traveled the country for a year, I took a year off, which was fun, and then ultimately settled in Denver. And that's kind of where the story really begins. So in Denver, I belong to an organization called Partners, which is a big brother, big sister type organization. I had a little, a little brother named John. And we did lots of things together partners made lots of opportunities available for these disadvantaged kids were working with and these were all kids that had been in the in the juvenile justice system. So these were interesting kids. So we we had lots of opportunities, skiing, took kids on airplane rides, and stuff like that. But I took John to a career fair one day, and lo and behold, there's a table there representing the child health Associate Program at at University of Colorado, now known as the University of Colorado, PA program. And that's the first I've ever heard about a PA. Growing up, I had always wanted to be a physician wanted to be a pediatrician, much to the chagrin of my orthopedic surgeon mentor that lived across the street. So the child health associate program seemed just right for me. So I did apply. I was fortunate to get in. I always tell applicants, however, that I got in as an alternate, so life doesn't end if you're if you're named an alternate, and I got in and the child health associate program was a three year program as well, also the very first master's level program in the country. And I finished that school, finished that program, I mean, and then went on to my first position clinically as a pediatric pa in Central Washington state, in a rural little town of about 7500 people. I grew up in suburban New Jersey, so this was quite a change for me, but it was a wonderful place to start my career. And that's pretty much where where it went.
Unknown Speaker 5:05
What was that initial draw to the rural community? Having grown up and on the East Coast and then also being in Denver? That seems like an interesting decision?
Unknown Speaker 5:14
Yeah, no, very, very good point. Couple of things. Number one is the influence of the program encouraging people into into rural and underserved areas, clinical experiences I got as part of the Child Health associate program in rural areas. I was single at that time. So there were lots of friends who told me, you know, don't go to a town of 7500 people, but but I did. And yeah, and it was those sorts of influences, and just the desire to go someplace where I knew I would be needed. And that certainly proved to be true. I was in Ellensburg, Washington for three years, and under the mentorship of a wonderful pediatrician, who had a huge impact on my life. It thoroughly enjoyed it. And I did meet my wife there, too. So that helped. So yeah, the rest of the rest is history sort of thing. And then you went to Atlanta, as I recall. That's correct. Yeah. So I, one thing that might be of interest, and I'll make this short. But if there's graduates listening, one of the huge mistakes I made in my life was in this wonderful little practice that I had in Ellensburg. Washington, in a town where I was pretty settled in. Ultimately, there was there was contract issues. I heard you and Tony Miller talking about first contracts, my first contract was $20,000. And after three years, we still weren't getting very far in terms of trying to increase that. And literally, I went on strike. And that's, that's the piece of advice I have for for anybody listening that, you know, might think too highly of themselves. We're all replaceable. So I actually was on strike and was let go, and ended up being unemployed for about six months. And I don't recommend that probably took about five to six years to make up for that. But I did end up in a practice down in Atlanta, Georgia, working for a staff model HMO down there. And that was sort of run by Prudential insurance company. And during that time, I started doing some lecturing for the Emory PA program, they asked me to come and talk on about pediatrics. And so I started doing some lecturing for the PA program and continued my clinical practice. During that time, obviously, I was just guest lecturing. But eventually I was asked to join their faculty.
Unknown Speaker 7:34
So your first academic job was Emory. And it sounds like you started out as a guest lecturer. And then slowly the, they hooked you in to a full time academic career.
Unknown Speaker 7:44
Exactly right. Brown Manning, who has passed away was was program director at the time. And we developed a relationship. And ultimately he asked if I would join their faculty, and I spent a year as clinical coordinator, and then became associate director and director of admissions, where I found my first real true love. And that was, was admissions. Yeah. So I, I served on the Emory faculty, and served there for for several years. And my wife and I, my wife is from the Northwest, and we had met up in the Northwest in my head, and we were very interested in returning to the northwest. So we heard about this possibility in Oregon Health and Science University up in Portland. And I applied for the job, and was very fortunate to to get that job. And I left Emory and moved my family across the country to the Great Northwest.
Unknown Speaker 8:40
So the draw to OHSU was somewhat personal in terms of being back closer to your roots or your wife's roots. But also, what was the draw for you in terms of starting a new program?
Unknown Speaker 8:51
Yeah, it was, it was just a tremendous opportunity. It was. It was an institution with a well recognized School of Medicine School of Nursing. And there was a real interest. When I interviewed I remember one of my interviews with three former genes, and I met a whole roomful of people. And there was there was lots of questions. There was there was lots of, we need to learn a little bit more about this kind of thing. But but there clearly was great interest. And there was actually even some support from the School of Nursing, which was kind of nice. I mean, they certainly weren't trying to block anything. And ultimately, we developed a nice relationship. But yeah, it was just the uniqueness of starting the first program in the state. I saw a very active state society that had done a lot to encourage the development of a new program and it just seemed like a wonderful place. And and again, my my interview process, the provost, President all the way down was just very, very positive. So it was fortunate and something that Um, I look back upon it's a real positive step for me to to come out here and start the first PA program in Oregon.
Unknown Speaker 10:05
And now one of the top 10 ranked programs in the country. So yeah,
Unknown Speaker 10:09
tied with you. I might, I might add, but yeah, no actually that, you know, if you ask, you know, some of my sources of pride, our program broke the top 10 list when we were seven years old. And that's pretty amazing.
Unknown Speaker 10:25
That is, that is quite quite an estimate, I had the opportunity to visit your campus many years ago, right before you move to the new space. So you want to talk to talk to you about Oregon Health Sciences University is program their beautiful new campus down by the harbor. Tell us more about it from maybe so that applicants can understand what you offer. Sure,
Unknown Speaker 10:44
I don't think were absolutely unique in many in many ways, but I think in some ways, we are OHSU is the primary facility, the primary institution is up on a hill overlooking the city and overlooking the Willamette River. And that's where we started out and all the classroom spaces up there, lots of interaction among students up there. But ultimately, it was decided that they should build a campus at the bottom of the hill, right on the river. And there was a tram built from the the hill what's referred to as pill Hill or the hill down to the campus down below, which is a great fun and slowly but surely becoming a hallmark of Portland. But again, it was so all students were literally moved down to this new campus on the on the river. And it's just beautiful. And you know, from whence we had really spacious office, we were in a position to be able to design the classroom space. OHSU was very, very open to whatever we needed, they were going to try to provide for us. So again, it was very unique opportunity. And again, I felt very strongly about being in an institution with a strong medical school and ultimately becoming part of that medic school. Initially, the program was located sort of out of the Provost Office, it didn't really have a home. But the dean who who was Dean when I was hired, committed to me right from the very beginning that he would move the program into the School of Medicine and and just around 1999 2000 or so we developed the division of physician assistant education within the School of Medicine, which was, which was a huge step forward. Dean, Dean bloom, Joe bloom was the one responsible for that. And
Unknown Speaker 12:39
so as an applicant, I'm looking at your school, what are kind of the key things that I need to be prepared to present to you to be a competitive applicant?
Unknown Speaker 12:47
I think one of the attractions is that we're a stable program we've had I've been very fortunate in I hired faculty and staff, many of whom are still there, 25 years later, which I think is fairly unique. So I think an applicant to our program, in applicant anywhere, for that matter, should go into the process with confidence and be able to present themselves in an honest way. I we obviously, like many POS, most PA programs have a very rigorous curriculum. So somebody needs to be able to demonstrate that academically they can succeed. And be aware that help is available if help is needed. So I think that is is one thing that's very important. And, you know, I just encourage folks that it's a great career path, you know, come to the interview. We actually still do interviews, the last couple of years, it's it's been online, which is after, by the way, I should have mentioned I retired in 2017. But we you know, we we still believe in interviews, I know there are some programs that have stopped doing that. I think that our program is pretty committed to diversity. And we've tried to create and change and adjust our process to allow for a greater diversity in our applicant pool. I think we all benefit the program benefits fellow students benefit, as does the profession as a whole with an a more diverse applicant pool. But, you know, academically they need to meet the demands of the curriculum. And they have to be motivated. And I think this is best demonstrated by things that they do in community service and such. They have to be motivated by compassion and have a desire, a real desire to serve others. And again, to me, that's where the that's where the interview really helps cement that sort of thinking, Ted,
Unknown Speaker 14:47
with OHSU. How many months is the program?
Unknown Speaker 14:49
It's 26 months, and we have a master of Physician Assistant Studies.
Unknown Speaker 14:54
Okay, and then how many months of those are clinical rotations versus didactic?
Unknown Speaker 14:59
It's 12 months of didactic and 14 months of clinical, I hesitate only because due to COVID there's been a slight shift in that. So I'm not sure that's totally accurate, but it's pretty much broken down that way.
Unknown Speaker 15:13
And do you have elective rotations?
Unknown Speaker 15:15
We do have elective rotations as well, yes, I believe there's two elective rotations and a lot of those rotations up on the hill, many, especially in the COVID time it is. But we, we've always prided ourselves in getting students out into the community, much as I described, my interest in rural medicine coming from the experiences. So we have a rural campus at OHSU, where there are fo sigh of clinical rotation sites that are used by medical students, PA students, nursing students, so it helps with some interprofessional interaction as well in those in those areas in those sites. Yeah,
Unknown Speaker 15:52
and those are traditionally primary carer training sites. And those were,
Unknown Speaker 15:55
most of them are primary care. But there are some communities, there's a coastal community, for instance, where there's a sort of a hub. And there are some specialties available out in that area as well. So
Unknown Speaker 16:08
and then your graduates tell us about your grads were weren't Do they seem to end up typically practicing, if you could,
Unknown Speaker 16:15
you know, I think based on our education of the still there's the vast majority of them that that desire, primary care, whether the marketplace supports that at the time they graduate, it's another story. I think, when students end up in specialty practice, they're always a little bit nervous about, hey, I really want to do primary care. But this is the job I've been offered, you know, will this sort of lock me into something in the future. And my advice is always that that's not the case that in many specialty practices. The PhDs that are in the practice are often the ones that are doing the medicine, you know, during the post op care, and the pre op care and some of the things that the surgeons, for instance, don't want to deal with. So that it doesn't necessarily lock you into that. But I encourage them to keep CME going in terms of not just their specialty, but across the board, if in fact, primary care is ultimately where they want to go. But really, the marketplace kind of students obviously leave with debt, and they need a job. So it depending upon where they want to go, if they want primary care, they need to be just more flexible as to where they go.
Unknown Speaker 17:21
Ted, from the moment we first started working together at your heart for service is very clear. And not surprisingly, it's started a long time ago, when you were first in that Big Brother Big Sister Life program, talks a little bit about service from the perspective of the profession, because I think you have done an extraordinary job of serving both your state at the professional level as well as the national level. And you were part of the original Casper creation story the origin of Casper, you are credited with by many people as being the father of Casper, I know you I know you have more to that story. So would you share a little bit about kind of service at the state and national level? And tell us a little bit about that story?
Unknown Speaker 18:02
Sure. As you mentioned, I I've enjoyed leadership roles, even going back to high school, as I mentioned earlier, in the PA profession. Again, it's so all consuming when you start into practice. It's hard to think that you're going to find room for much of anything else. But when I came out to OHSU, I was working at that time, Lynn Katyn, who was former president of aapa worked for us for a while and his wife, Kate Turi, was chair of the Education Council of the APA when that existed. And that was actually my first foray into a leadership role in the profession was to join the Education Council. And I then went on to serve as chair of that. And I served as chair during a really interesting time during the transition to the master's degree. And I learned a heck of a lot during that time. I learned a lot of parliamentary procedures and learned how to call for a vote when I was tired of listening to people debating issues. So that was my first foray into that. And I really enjoyed that that role. A lot of the Education Council eventually went away PA or a PAP at the time, always felt like it was sort of an overreach of APA. And ultimately they agreed with that. So that sort of went away on a state level. Quite frankly, when I came to OHSU, I mentioned earlier that the osba, the Oregon Society of Physician Assistants, had been very instrumental in helping the program get started and members of osba served on the selection committee. So I was told in no uncertain terms that I owed something back. And so you know, I arrived in October of 94 and the fall CME conference was there and I was told you need to be there. And so I went we hadn't even unpacked yet. But we went out to the coast to a meeting there and got to meet a lot of folks that became very good friends of mine throughout the state. Clearly, you know, the door was open for me to take a leadership role there as well. I started mostly with government affairs and served as in government affairs until last year, so probably 25 years on the government fairs. And we made a lot of progress over those times in terms of practice in Wayne, Oregon. And then Casbah is really the greatest pride I have often slate in 1990. Let's see what when was, it was 1994. Yeah, 1994, Laura Kaposi. And I gave a talk at the annual meeting. And it was about the applicant pool. And at that time, it was just a question of talking to people about some things that we found about the applicant pool that might help them dealing with, which at that time was a growing applicant pool. A year later, I went to a PAP meeting and presented something called Cabot central central application for physician assistant training is what I called it. That was my proposal to develop a centralized application service for PDAs. In all honesty, there was there was a lot of naysayers to this, especially some people that had been around in in a PAP leadership for a while, I was told, Hey, this isn't a new idea, which I never pretended it was, obviously the medical profession had essential application service. But it took a while. But over the next two or three years, I continued to advocate for this. And I really credit Wayne bottom who was director of the University of Florida program, he was on the board at the time I was I was still pretty young in PA education. But he was on the board at the time. And if you know Wayne, he never held back from speaking his mind. So he advocated very strongly in the book on the board, and I do credit him for actually getting it approved. I him and Timmy Hagar Barwick who again, took a while to convince it was a huge risk for her. And
Unknown Speaker 22:04
you know, we spent many hours on the phone talking about the advantages of this. And so I basically sold Casper on the idea. And again, it wasn't me alone. But we sold Casper on the idea that number one, it was a huge service to programs, who were bogged down in their staff was bogged down in a lot of admissions tasks that could easily be taken care of, by a central office, a certainly a service to applicants who were filling out multiple applications with fees associated with each one of them, etc, etc. And then finally, the biggest selling point I thought was that to that point, in in 19 2000, we still had no idea as to the size of the applicant pool, we had no idea as to who was interested in joining our profession in terms of numbers. We collected some data in the annual report every year. But that was aggregate data, it was data that is, you know, counted in applicant multiple times, depending upon where they had applied. So I really pulled really strongly for the idea that the profession needed this data. And that Casper could provide that. So caspo was launched in 2001 2002. The Board approved it in 2001 2001 2002 applicants cycle, we represented 58 programs, which was 51% of the programs at the time. So we started with a good good, you know, majority of programs at the time. And were able for the first time ever to identify that we had 4669 applicants to PA education at that point. So that was a huge big step forward.
Unknown Speaker 23:44
And when I came on the Finance Committee for PA Yeah, my very first year on the finance committee, our PA annual budget was around $900,000. And by the time I became president, right after you I believe or I was a you were before me, right?
Unknown Speaker 24:03
Yes, as a matter of fact, I credit you because you called me up one day and said, Ted, you need to run for president because I'm not ready. And and and I want to run next year, but we need somebody for this year. So oh, I give you credit
Unknown Speaker 24:14
for that. But I forgot about that. So by the time you and I were on the board, we were pushing, I want to say we're close to $4 million
Unknown Speaker 24:22
at that. Yeah, I think that's about right three to $4 million. Yeah. And that was Casper
Unknown Speaker 24:25
Casper. Yeah. And that you know from a an applicant perspective, who's paying these fees to apply to schools. Let me just kind of outline what why that mattered. Because that allowed pa EA to significantly beef up their faculty development opportunities, their conferences, their their educational processes and their student service processes to really legitimize I think the application process and Pa education. We have a lot of PA educators who came right out of clinical practice and had never taught and teaching is a very different skill. Yeah.
Unknown Speaker 25:01
Yeah, no, I totally agree. I think that it wasn't a question of of just the dollars, it was what was done with those dollars in terms of funding research funding Educational Leadership outreach from PA. So there's a lot of good that came from that. And ultimately, the research that we did, people really weren't paying anything more in fees, they were just paying it to a central service to handle everything. And it just made life for everybody a lot easier.
Unknown Speaker 25:29
Yeah. Yeah. What are some of the other I mean, you've had your hand involved in a wide variety of other initiatives? Are there any other initiatives that really stand out for you something you're really proud of?
Unknown Speaker 25:41
Well, you know, I think the master's degree was another one that I've mentioned previously, but that was a real fight. You know, at that time, even the Baccalaureate degree was kind of optional, you know, steering that, you know, with the help of Pa Pa working together, it was a hard sell. But I think that was very, very important. And yeah, I think there are other things, you know, statewide, we did a lot in this state, again, as part of the of the board of the osba. There were, there was a lot of effort put into improving practice for PDAs in the state.
Unknown Speaker 26:17
Ted, as a longtime member of the House of Delegates, you You represented, or again, for many, many years, I'm sure you you were watching with interest this last year, as they discussed the name change, do you care to share a little bit about your perspective on that?
Unknown Speaker 26:31
Yeah, you know, I would, and I appreciate the opportunity to do so I have real mixed thoughts about the name change. I think it's important to note that Physician Associate was a name that was originally proposed 50 plus years ago, that this was really nothing new at all. But at the time, as you well know, organized medicine was unwilling to accept the fact that PDAs were associates that their associates, physician associates, were other physicians. And so the name was rejected by by the AMA, and, and ultimately, we chose physician assistant, none of us were ever, ever happy with that. I don't think it caused problems from in terms of understanding on the legislative level, even our patients, I think, you know, might have had some difficulty with that. I always took the belief that in my 18 years of clinical practice full and part time, I never had a patient reject me because of my title. And so I think this, this whole issue has been much ado about nothing. But I don't necessarily disagree with the idea if this can actually be done. I just think that there's going to be some cost associated with this, it's going to be a hard sell across. So we'll have to wait and see how it all plays out. But yeah, I have real mixed emotions about it. I like the idea of just using PA, I think that works pretty well. But again, I always felt that my patients once they got to know me, they never really questioned my role or for that matter, my title. But that said, it's now been accepted. And and I certainly support that and want to help any way I can to have that work, but it's going to involve. And I think it's unfortunate, quite frankly, that so much money was spent on the name change in order to go back to where we were 50 years ago. But But again, all that said, it's what's been decided and and I certainly support that. So
Unknown Speaker 28:37
when I was early in practice, I had a patient who was really struggling with the fact that I wasn't a doctor. I didn't struggle with it at all I was I had phenomenal physicians that I worked with, and they treated me as an associate. And in fact, I think the associate term is better for patients and understanding that it conveys a a trust and a level of esteem from a physician when they're giving a warm handoff to their associate, as compared to I'd like you to see my assistant that sounds, it just sounds off. And I'm like you I never had an issue with it. Because once patients had a chance to meet with me, they realized that I really was on top of their care and in communication with their physician of record. I totally
Unknown Speaker 29:21
agree. And I hope quite frankly, that this transition goes as easily as I'd like to hope it goes. I hope that your physicians, you know, as you describe the physicians will accept the new term. And I do think it will will improve things like I thought it would have 50 years ago, but this is an old issue that we've been hashing around for a long time. So I'm I'm glad that it's finally been decided and let's move forward and make it happen.
Unknown Speaker 29:49
Absolutely. Over the years in your career as a director, I am sure because I've been a director now for almost 20 years. I think the the truth is we see every year we see some of the Same kind of situations that come up for students who are in the program that struggle. And then usually we see something new that we haven't encountered yet. You know, without breaking FERPA, obviously, maybe we can talk more generalization about some of those challenges that students do encounter. And kind of your go to advice to help them keep on their path to becoming a BA.
Unknown Speaker 30:19
You Yeah, I don't think it's news to anyone that this is a really rigorous process. This is a very rigorous curriculum, and it takes some fortitude to get through it, I think the biggest challenge that students have, this is not anything new is is just juggling everything. Our typical age, I really don't know, the last couple of cycles, but generally, our students were about 2526 years old. And some of them had families and some of them were leaving jobs. So there's lots of things that are going on in their personal life that then, you know, became part of how am I going to juggle all this and fit school in as well. So that's the biggest challenge that any pa student has. And so I think the the advice that I always give students from the very first day they arrived, I would talk to them about the importance of trusting the faculty, we call it trust the system, we know what we're doing, we've been doing this a while we know what we're doing, you have to sit back and trust us don't work so hard against it, you know, listen, and most importantly, this is particularly true in the clinical phase of the program. But it's even a message I give in the very beginning, the the need to be flexible, and and the need to take full advantage of every opportunity that's given to you, I think those are the things that you know, if somebody listens to that advice, it makes it makes the process a lot easier, when they when they just just step back and realize these guys know what they're doing. And I'm just going to trust this. And we're going to move forward and not get all bogged down in issues. All that said, as you as you alluded to, there are some students that really, really have trouble. And you got to deal with those individually. You've got to provide whatever resources that you can bring to bear to help them through the process. And I think very importantly for the future of the profession, is if ultimately you've not made a good choice, and somebody does not have what it takes, they don't have the compassion, the competence, whatever it is, to be a good PA, that you have to put the patient first and say, you know, we're going to cut the cord here. So but but I think that's, that's a last resort, obviously. So, and again, I I always going back to my admissions had I, I always stress the idea that, you know, admissions is the first place where we can control the quality of our profession. If we choose correctly, if we take admission seriously, as a program director, I was always intimately involved in admissions. And I know not all program directors take that approach. But I did. And I really believe that it's a huge benefit to the profession to make an initial selection, that will will hopefully produce a compassionate and competent pa at the other end. The other two areas are accreditation, we put a lot of faith in accreditation to make certain that programs have what it takes to deliver and produce the PDAs we're looking for. And then ultimately, as you know, from your work with NCCPA, that we have a certification process that also ensures that we have the best TAS out there representing our profession.
Unknown Speaker 33:39
Yeah. When I was a preceptor prior becoming a PA educator, what I always enjoyed was when a student who was training at our site looked for ways to help the process move more efficiently, because ultimately, that impacts patients, and it makes everybody's life easier at the practice. And then I have more time to teach. And so that was my reward when I saw a student that was actually helping the medical assistants out helping the nurses out running that urine test for somebody so that we could keep the rooms moving. I would stay late, and I would make myself available to them in the weekends when we're rounding at the hospital to teach. And when students were watching their clock looking for their time to get out at 330. You know, I remember very distinctly a student who I had who has a mid career change. And he was sitting over my shoulder at about four o'clock in the afternoon on a Wednesday, when the nurse came by and said I have a patient out front who has chest pain. She said can we add him on? He said absolutely. And I heard the student gasp and yeah, that did not go well. So
Unknown Speaker 34:43
no, no, I totally agree. I think it's so important that students do take advantage of every opportunity and and I often tell applicants Now this may not be true anymore. I often told students that the only payment and preceptors get out At that time when preceptors weren't being paid, is the opportunity to work with an engaged learner, somebody, somebody who's really engaged and wanting to learn and wanting to learn everything they possibly could from that preceptor. And that's, that's a real boost. And so I always I always tried to encourage students to see it in that way. And it's just as you described, a tissue described. Yeah, so
Unknown Speaker 35:25
sure. I'm intrigued by your interest in pediatrics. So one of my good friends in PA education, Allison Smith, yeah. As always, she and I, we started in PA education together, and in the same office, and she she and I always have this friendly banter about pediatrics versus other primary care specialties. And so few PDAs typically go into pediatrics. So I think it's less than five or 7%. Yeah, but such a rich field. And I do see a little bit of a resurgence among our grads heading into peds. So what was that initial draw to pediatrics for
Unknown Speaker 35:58
you? Well, I mean, the initial draw just was my overall, you know, my lifelong interest in kids and, and I've always been interested in kids and always had some activities with children along the way. But when I wanted to be a physician, all I wanted to be was a pediatrician. And, and as I said, my orthopedic surgeon, neighbor, mentor, you know, was was was not happy with the fact that I wanted to do pediatrics and change diapers kind of thing. That was his view of it anyhow. But I do I not only not only like pediatrics, I like general pediatrics, I like well, child care, I like developing relationships with patients and their families and serving the whole family as as, as a whole. That's the part that really, I enjoy, and to have an impact on how kids are raised and teaching parenting. It's, when I talk pediatrics in the program, I always get on my soapbox, of saying that, you know, we still exist in a society that does literally nothing to teach people about being parents. And, you know, I understand the reasoning for that, because, you know, it's brought with politics and everything else like that. But I think it's really a shame that we don't, and we continue to have a child abuse issue because of the fact that we really don't teach other ways of raising other than the way you were raised, so to speak. So. So I've always been interested in pediatrics. And it just was fortunate that when, when I landed in Denver, that the PA program that existed there at the time was was a three year program in pediatrics. And so I got a wonderful background from some wonderful people I learned about child abuse from Henry Kemp, the Henry silver was director of the program at the time. So these were people that were instrumental in defining the battered child syndrome. So it was an amazing education.
Unknown Speaker 37:54
Yeah, yeah. Well, Ted, are there any of the things you're hoping we talked about today that we haven't had a chance to talk about?
Unknown Speaker 38:01
No, I think you know, you, you asked me about that. And the only thing that I really wanted to say is that, you know, our profession is still young, it's 50 plus years old, but it's still very young and very much evolving. As we discussed earlier, with even the name change, you know, our profession is always sort of taking the high road in terms of making decisions about ourselves that it was always about the patient first. So whether it came to the degree issue, or whether it master's degree, and now now discussion of doctoral degrees, name change, whatever, you know, we've always said, you know, whatever is going to help our patients is what we would be, what would we be supportive of, but things change Time changes. And and as I mentioned to you in our conversation the other day, you know, my approach has been that I'm very proud of the leadership role that I've taken over the years. But I also believe that part of being a leadership is also recognizing that it's time to turn leadership over to others. So I look at the new leaders of PA and I'm really excited that some of them I don't know. And that's very exciting to me, you know, that, that there's a whole bunch of people coming up behind us that that will help continue to shape this profession, which I think is a tremendous opportunity. I'm proud of the fact that I had something to do with that. But I'm more than happy to turn that over at this point. And let people make those kinds of decisions that will affect their future. It still is my profession. But in terms of actively involved, I think those most actively involved should be the ones that set the future. And so I'm going to sit back and watch and with interest, and always be prepared to provide a historical viewpoint if that might be helpful. That's what I've told the Government Affairs Committee of the osba that you know, if you ever need some some information about the way it used to be, I'm more than happy to provide that but the future is yours, so to speak.
Unknown Speaker 39:55
Yeah, that's that's very, very magnanimous of you. and very classic Ted, you've always been such a gentleman and I have had you just it's been an honor for me to work alongside of you on the board and to collaborate with you conversationally for many, many years. And I too, look forward to grabbing a box of popcorn with you and watch professional growth. So thank you.
Unknown Speaker 40:18
Well, I'm and I would also say that I value our friendship as well. So thank you so much for including me in this.
Unknown Speaker 40:26
Well, there you have it. Ted rebacked is truly one of the nicest people on the planet and an inspiration for his lifelong commitment to service education and leadership. The impact he has made on the profession in Oregon, and at OHSU is admirable, and the outcomes of his efforts have impacted 10s of 1000s of applicants, and 1000s of PA educators as well. Ted is yet another example of the people who serve our profession with a perfect service minded heart and mindset. Tune in next week, as we speak to another nationally renowned leader Dr. John Morton Riaz, President and CEO of the National Commission on certification of Physician Assistants. Dr. Martin Ryan shares her path to becoming a PA, a PA educator, a PA leader, and the first PA and woman of color to lead one of the four national organizations that represent the profession. Until next time, I wish you success with whatever path you are walking in life. And thank you for joining us. The purpose of this podcast is to provide news and information on the PA profession and is for informational purposes only. The views and opinions expressed in this podcast are those of the speakers and guests and do not necessarily reflect the official position or policy of the University of Southern California.
Associate Professor Emeritus
Ted Ruback is a 1979 graduate of the University of Colorado PA Program (CHA/PA). Ted started his PA career practicing pediatrics in a small rural community in Washington State. He then moved his family to Atlanta, Georgia to continue his clinical practice as a member of the pediatric staff of a local group practice. During that time, Ted was invited to guest lecture for the Emory PA Program. He joined their faculty in 1990, serving one year as a Clinical Coordinator and then as Associate Director and Director of Admissions. In 1994, Ted was recruited to Oregon Health & Science University (OHSU) to develop and serve as the founding director for the first PA Program in the state. He served as director and Head of the Division of PA Education in the School of Medicine at OHSU for 22 years before retiring from the program in August 2016. He then served a year on special assignment to the Provost, advising the Provost on the potential expansion of health care education at OHSU. Upon his retirement a year later, Ruback was named Associate Professor Emeritus in the School of Medicine at OHSU.
Ted’s service nationally has included 4 years as a member of the Board of Directors of the PA Education Association (PAEA), serving as President in 2010. His service to PAEA included participating in the design and development of the Central Application Service for Physician Assistants (CASPA). He served 10 years on the CASPA Advisory Committee and as its chair for eight of those years. In 2006, PAEA awarded Ruback the Master Faculty Award for his contributions to PA education. Nationally, Ted also served as Chair of the Education Council of the AAPA and as a site visitor for the Accreditation Review Commission on Education for the PA (ARC-PA) for ten years. Ted represented Oregon in the AAPA House of Delegates for 18 years.
In his home state, Ted served as President of Oregon Society of PAs and served on OSPA’s Government Affairs Committee for more than 20 years, contributing to several bills improving the practice of PAs in the state. In 2002, OSPA recognized him as PA of the Year. Ted also served as a member and Chair of the PA Committee of the Oregon Medical Board.
In 2019, Ted’s service to the profession was recognized by the American Academy of PAs (AAPA) when he was awarded the Eugene A. Stead Jr. Lifetime Achievement Award. Ted was only the 7th PA so honored with AAPA’s most prestigious honor.