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Citizen-Warrior: Idaho Guard member keeps patients healthy in air, on ground

By Army 2nd Lt. Crystal Farris | Idaho Army National Guard | Jan. 1, 2018

BOISE, Idaho - As an undergraduate student, Army Capt. Derek Derkacs, an aeromedical physician assistant with the Idaho Army National Guard's 1st Battalion, 183d Aviation Regiment, was studying to become a registered dietician. But in his junior year of school, he began feeling as if he wanted to do something more, he said.

His father suggested looking into becoming a physician assistant. Initially, Derkacs said he didn't put much thought into it. A year later he found himself in the emergency room at the local hospital and the idea came back to him.

"I got a sizable cut on my head and a physician assistant took care of me at the ER," said Derkacs. "I remember asking him, 'you're a PA, and you're going to staple me up?' That's when I knew I wanted to be one."

That interaction made Derkacs change his course of study and he graduated from the physician assistant program at the University of Utah in 2006. He later moved to Idaho and today he's a physician assistant at the Boise Veterans Affairs Medical Center, working in the surgical department and providing care for veterans from all branches of the military.

It's not too different from his military job with the aviation regiment.

"When it comes to caring for a Soldier and completing the mission, I will find any gap that needs to be filled," said Derkacs. "I'll sit out on a firing range, give vaccinations, splint an injured limb, suture a laceration, place a chest tube, read an [electrocardiogram] or write a prescription."

Derkacs is one of 11 physician assistants serving in the Idaho Army Guard. As commissioned officers, they handle a wide array of healthcare responsibilities in addition to their common Soldier tasks, such as weapons qualification and land navigation.

"In the combat [arms] units, the physician assistant's focus is on conserving the strength of the force in wartime through individual medical readiness, sick call and trauma care, to include life saving measures," said Army Lt. Col. Heidi Munro, physician assistant for the Idaho National Guard's state surgeon's office. "Everything we do in training should be focused on preparation for that."

Physician assistants are versatile with the skills they bring and are often able to easily bond with troops in the field, said Munro.

"Physician assistants are very multi-faceted because they are mid-level practitioners," she said. "Many of them have been medics, so the enlisted troops really relate to them as far as working and training with them. It is always a special relationship between medics and physician assistants."

While Derkacs had no prior military service before becoming a physician assistant, it was two Army medics and a Navy corpsman, who, in part, led his decision to join the Idaho Army Guard.

"I had students that I was a clinical preceptor for and three of them had prior service," Derkacs said. "Just hearing about what they did as medics, taking care of Soldiers as kind of a first-line intervention really stuck with me and impressed me. I felt it was something I needed to do before I got too old."

Derkacs entered the Idaho Army National Guard in 2011 as a physician assistant assigned to the 145th Brigade Support Battalion. There he first learned what it meant to be a military physician assistant and how to work with other medical providers within the Guard.

He was reassigned to 1st Battalion, 183rd Aviation Regiment in 2012 and sent to flight surgeon school at Fort Rucker, Alabama. There he received training in aviation survival, flight physiology, aviation medicine programs and aviation operations and mishaps.

After graduating, Derkacs returned home to his unit as a certified aeromedical physician assistant, where he is responsible for managing the healthcare of the unit's pilots and flight crews.

"The best part about being a flight surgeon is that you make a big impact with medical readiness and that's pretty cool," he said, adding that medical readiness is instrumental in keeping both pilots and crews fit to fly.

In addition to performing medical screenings and other tasks, Derkacs must log at least 12 flight hours every six months, like all flight crew members. That allows the aeromedical physician assistant to build trust with those in the unit, while also gaining a better understanding of what aviation Soldiers are exposed to inflight, said Derkacs.

"Having a physician assistant as an active crew member in the aircraft benefits our organization because it gives him a real perspective of the environment crew members operate in," said Army Capt. Thomas Westall, commander of Headquarters and Headquarters Company, 1st Battalion, 183rd Aviation Regiment. "This ultimately leads to improved aviation medical care."

For Derkacs, his time in uniform has been rewarding and filled with memorable experiences, one of which was traveling to Cambodia for a training event as part of the National Guard's State Partnership Program.

"I've been thinking lately about stuff I've done with the Guard," said Derkacs. "I've had some really cool experiences and neat opportunities presented to me lately that I've taken advantage of. [I] really appreciate the ability to do [that], because I'm a physician assistant in the Guard."