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PA Graduates Take the Road Less Traveled

October 08, 2021
2018 graduates Sylvia Brandenberg and Dan McGuire
Sylvia Brandenberg and Dan McGuire celebrate their recent marriage at Grant Teton National Park in front of their Airstream trailer.

Sylvia Brandenberg and Dan McGuire are taking a unique approach to working as physician assistants. 

The 2018 graduates are traveling the country, living in an Airstream trailer after deciding that spending their lives in one place was not for them. Currently in the Rocky Mountains, the couple is taking the road less traveled to their PA careers—literally. 

Brandenberg, who spent her first three years after graduation working in the emergency department at the University of Maryland Baltimore Washington Medical Center, now also works remotely for Cityblock Health, a Brooklyn start-up that provides primary and emergent care via telehealth. McGuire has kept his job treating medical and surgical critical care patients for MedStar at Washington (D.C.) Hospital Center, with a twist—he drives or flies to the hospital to pick up a week’s worth of shifts every month or two.  

Their Airstream is decked out with solar panels and two propane tanks, and can carry 40 gallons of fresh water. After stocking up with groceries, they can stay on the road for about a week. And while the trailer may have a very small living area, it gives the couple a freedom that was largely impossible before COVID-19. 

“We’re in a time when there’s a lot more flexibility,” said McGuire. “The pandemic opened avenues for telehealth, making remote work more available.” 
 
“We have no map or plan for where we’re going. We’re learning what works for us as we drive around the country,” added Brandenberg. “We don’t have a date where we have to be anywhere specific, and it’s been great.”  

Still, life isn’t all hiking trails, watching sunsets, and being on the road. Brandenberg spends hours hot spotting on the phone and computer, practicing emergency medicine virtually with patients in Massachusetts, Connecticut, New York, DC, and North Carolina where she is licensed. Some cases she can handle by phone, sending in prescriptions or ordering lab work and other procedures; other times she will deploy paramedics to the patient’s home to assess the patient in person while she joins in virtually and oversees the visit. She can give orders to start IVs, draw labs, and give medications while also being able to schedule in-home X-ray imaging.  

With a patient population that primarily is older, whose health coverage is with Medicare and Medicaid, that live in historically marginalized communities, and are high risk because of multiple co-morbidities, Brandenberg said the goal is to prevent them from having to use the emergency department while improving access to preventive and follow up care. “Most have stopped believing in the health care system, although once we get a chance to visit them and keep our promises, I have found that we gradually earn their trust again,” she said. “And that’s a great place to be as a PA.”  

This being PA Week (October 6-12), McGuire has some advice for new PAs as they prepare to enter their careers. “The first year after graduation is going to be a steep learning curve, no matter what you do or where you end up working,” he said, noting the extreme stress he experienced working on the front lines during the pandemic. “If you choose a high-acuity specialty, consider a residency or fellowship, or make sure you’re taking a job in a place where there’s good mentoring and on-boarding.” 

The couple, who married in September under the majestic peaks in Grand Teton National Park, is planning to continue exploring the West with visits to Glacier National Park in Montana and Banff National Park in Alberta, Canada on the horizon. After that? Their future is an open road. 

Follow the adventures of Sylvia and Dan on Instagram.