Just call him ‘Jason’

As an undergraduate at Chico State—studying business, of all things—Jason Ruby got a glimpse of his future in the medical profession. During his senior year, Ruby took an emergency-medical-technician (EMT) class at Butte College. His accompanying student job at a local ambulance service more than once included trips to the emergency room at Oroville Hospital.

Little did he expect at the time that he’d wind up working for the hospital—and as a physician assistant, no less.

Ruby recently joined Oroville Family Practice in the office of Dr. Jerry Waters, where he sees patients with a wide range of ailments and, apart from periodic case reviews by Waters, has autonomy to practice medicine.

“Of course, the paycheck is a little different,” Ruby said with a laugh when comparing the life of a physician with a physician assistant. “PAs do require medical supervision; Dr. Waters has to sign off on a certain number of my charts. But there’s not a lot of difference in seeing the doctor versus a PA. They’re essentially my patients.

“Really, we’re more like an associate than an assistant. The scope of practice has expanded. The name doesn’t really fit the profession anymore.”

Whatever the title, Ruby loves his job. He treats patients with acute illnesses as well as chronic conditions. He can refer patients to specialists. He can prescribe medication.

He just doesn’t have the “Dr.” prefix or “M.D.” suffix for his name.

“I go by ‘Jason,’” he said. “‘Mr. Ruby’ is too old for me.”

Why didn’t he become a doctor? He considered it, but the amount of schooling and the off-hours responsibilities of a physician influenced his decision.

“I wanted to start a family early and delve into my career,” Ruby explained. “The [undergrad] prerequisites and [PA] school still take a lot of time, but not as much as med school.”

Ruby’s change in career path added a bit of time to the normal flow. He graduated from Chico State with a bachelor’s degree in business administration; while his additional coursework in science subjects and his experience in ambulatory medicine met the application standards for PA school, he elected to bolster his background with a master’s degree in medical science through St. Francis University. At the same time, he enrolled in the two-year PA program at Stanford University.

“A large majority of the Stanford program is hands-on training,” Ruby said. As a North State native, he elected to get that training in the North State, so he worked in Red Bluff as well as Oroville.

“I guess I’m just a homebody,” he said. “I never wanted to leave.”

He didn’t have to. Paul Robie, physician-assistant manager at Oroville Hospital, and Ken Owen, the hospital’s director of Outpatient Mid-Level Providers, knew Ruby from back in his ambulance days and were happy to recommend his hiring upon his certification.

“When he did some of his training at Oroville Hospital, that kind of gave us a jumpstart,” Robie said, praising Ruby for his care of patients.

Oroville Hospital employs 40 “midlevels”—physician assistants and nurse practitioners. The difference between them, Robie explained, is “nurse practitioners can work independently—they don’t need direct supervision. They come from a nursing background, and their training is longer.”

Robie and Owen, like Ruby, are certified physician assistants. None of the three has an inferiority complex based on his title.

As Owen put it, “To us, it doesn’t matter. We’re just here for the patient.”

“I think people have become more understanding of what we do,” offered Robie.

Ruby noted that while “there may be a lesser perception among some people … Oroville Hospital has had PAs and NPs around for a long time, so I feel like an equal. Some patients come in not knowing the difference.”

Some PAs get training in a specialty, such as dermatology or pain management. Ruby elected to go into the field of primary care. Part of that decision came from the orientation of the Stanford program, which he said “really pushes family practice.” Mainly, he likes the variety of conditions he encounters in a general practice.

“I like being the front runner; I like being the first to diagnose,” Ruby said, adding: “I just enjoy being able to help patients—it’s what I got into this to do. I feel pretty blessed to wind up where I am.”

His practice is growing rapidly, but Ruby still has appointments for new patients. Owen encourages people who are unable to get into a doctor’s office to consider seeing a PA.

“We have a lot of PAs, in all our [Oroville Hospital-operated] clinics,” Owen said. “If people want a long-term relationship with a provider, please don’t hesitate to contact us.”