ASTS Advanced Transplant Provider Bio Corner  

Humberto_Monge

Name: Humberto Monge, PA-C, MPAS
Title: Senior Physician Assistant, Adult & Pediatric Solid Organ Transplant Program 
Institution: Stanford University
Director of Transplant: Carlos Esquivel, MD, PhD
Years in current position: 25 years

How many faculty and ATP colleagues are on your team?:

7 Transplant Surgeons
5 Surgical ATPs 

Patient population:

Adult and pediatric patients

Brief Job description:

  • Assists in the management of pediatric and adult small bowel, liver transplant, and general surgery patients in the ICU, ward, and outpatient setting
  • Precepts and mentors junior ATPs
  • Lectures and precepts PA students
  • First and second assists in the OR

How has being an ATP impacted your institution? 

In 1995, I was the first in-hospital APP hired and credentialed at both Stanford Hospital and Lucile Packard Children’s Hospital at Stanford, and it was quite a challenge getting approval from the medical board to be credentialed. In less than 25 years, we now have over 500 APPs working at Stanford Hospital, Lucile Packard Children’s Hospital, and their respective satellite clinics throughout the Bay Area, along with the Palo Alto VA. Also, we have APPs in administrative positions and we have an Interdisciplinary Practice Committee of the Medical Board that is specifically for reviewing, hiring, and approving practice guidelines for APPs, along with an APP Council that promotes APP advancement. 

How has being a member of ASTS impacted your practice?

With new and updated advances in surgical technique, immunosupression, and medical management that have been presented in the meetings have improved  the way we practice.

Also, ASTS has made great strides in embracing and and including ATPs and recognizing ATPs for their achievements. I was honored in being the inaugural recipient of the ASTS Advanced Transplant Provider Award in 2011. 

What’s the most interesting thing about you? 

I am proud to say that I served in the Navy for 27 years. I enlisted as a sailor, rose through the ranks as a Hospital Corpsman to Senior Chief, and became a Mustang, which means that I was an enlisted sailor that became an officer and retired as a Lieutenant Commander. I am a Persian Gulf and Iraq War veteran and a ShellBack, which means I crossed the equator onboard the aircraft carrier USS Midway (now a floating museum in San Diego) and on the supply ship USS Acadia.

What’s the most impactful thing to you about being an ATP?

  • I provide not just bedside care to critically ill patients, but I take the time to know them and their families. This allows me to know them better and helps me have a better bedside manner.
  • The surgeons trust me and ask my advice and assistance on difficult cases.
  • We, the surgeons, fellows, and ATPs work as a team.

thumbnail (14)Name: Eliana Z. Agudelo, PA-C
Title: Senior PA, Division of Liver Transplant
Institution: University of California, San Francisco
Years in current position: I have worked in Transplant Hepatology and Liver Transplant at UCSF for 15 years. I am currently a post liver transplant provider and have been in this role for 11 years. 

How many faculty and ATP colleagues are on your team?:

In Liver Transplant we work with nine surgeons and collaborate with eight transplant hepatologists. There are currently thirteen ATPs in the Division of Liver Transplant (pediatric, inpatient, outpatient, and pre LT). This number does not include kidney, pancreas, and heart/lung ATPs. There are about 30 ATPs working at UCSF Transplant. 

Patient population:

Post liver transplant patients, including LDLT and SLK patients.

Brief Job description:

I started my career in liver transplant in 2007. As an Outpatient Liver Transplant PA, I am responsible for the care of liver transplant patients starting at the time of discharge. The liver transplant ATPs provide the first line care of the patient by managing medical issues, coordinating care with referring providers, interacting with community providers, and consulting with collaborating physicians as needed. We provide long-term follow-up care of the post-transplant patients, which includes diagnosis, treatment, and management of post liver transplant complications, immunosuppressive management, ongoing clinical assessment, preventive care, and patient education. As a post liver transplant ATP, I also participate in outreach clinics, which allows for bringing care and education to locations that are hours away from the medical center. My position allows me to be a resource to other health care team members and to the community regarding the special concerns of liver transplant patients and their families. As a requirement for my position, I participate in the development of policies, procedures, and protocols and participate in continual quality improvement.   

It is gratifying to be part of an extraordinary interdisciplinary team and an honor to develop patient relationships that have spanned for over a decade now. 

How long have you been a member of ASTS?

10 years. I became a member when Dr. Roberts was ASTS President. 

How has the ASTS impacted your practice?

As a member of ASTS, I started attending meetings and later became a member of the ATP committee. This participation has brought forth opportunities for leadership development and educational growth. ASTS has impacted my clinical practice by providing ongoing opportunities to learn. The modules and meetings present clinically relevant information that impacts my clinical practice. Through involvement in ASTS, I have participated in expanding ATP recognition and awareness in the transplant community. I have been fortunate to work with an exceptional committee of ATPs in developing the ATP Certificate Program and job description, expanding membership, and planning our Winter Symposium sessions. 

In the next 5 years, what kinds of opportunities for ATPs would you like to see at your institution?

I hope to see ongoing programs and opportunities at the institutional and national level that continue to promote the growth of the ATP professional development. The expansion of leadership, educational, and clinical roles for ATPs is needed to promote professional satisfaction and retention, and therefore allow for exceptional patient care and contribute to the success of the transplant center. My hope is that in the next five years, both UCSF and ASTS will continue to increase opportunities for ATP growth and advancement.

professional pic Hoy_AName: Haley Hoy PhD, NP
Title: Nurse Practitioner
Institution: Vanderbilt Medical Center/ University of Alabama Huntsville
Years in current position: 17 years

How many faculty and ATP colleagues are on your team?:

On the lung transplant team, we have four ATPs. In the transplant center as a whole, we have over fifty faculty and twenty-two ATPs.

Patient population:

Lung transplantation

Brief Job description:

I have worked as a nurse practitioner for twenty-two years, the last seventeen of which have been in lung transplantation. For the first six years, I worked as an inpatient and outpatient nurse practitioner in both the pre-transplant and post-transplant arenas. The job description included the evaluation of new candidates for lung transplantation, inpatient rounds, outpatient urgent and annual clinic visits as well research and patient/staff education. As the program has grown, these tasks have been divided among multiple ATPs and additional team members. The following ten years I ran an NP-led waitlist clinic for lung transplant patients who were listed, and now I primarily work as a nurse practitioner in transplant outreach clinics in an effort to bring tertiary care services to underserved populations. I have been fortunate throughout my work in transplantation to work with an interdisciplinary team that functions with mutual respect and excellent communication.

How long have you been a member of ASTS?

I have been a member of ASTS for seven years.

How has the ASTS impacted your practice?

ASTS membership has enhanced my practice in many ways. I have been exposed to practitioners functioning as ATPs in different transplant organ groups, bringing to my conscious awareness the commonalities and differences of our individual successes and struggles.  The ATP educational opportunities within ASTS, both module-based and live conferences, have provided clinically relevant information that I have then brought back to my center for implementation into practice. Finally, ASTS has afforded me multiple opportunities for professional growth. I participated in the development of the ATP certificate program, had to opportunity to chair a very active ATP committee, and have had the pleasure of working with a dynamic committee that has significantly increased ATP involvement in ASTS.

In the next 5 years, what kinds of opportunities for ATPs would you like to see at your institution? Within ASTS?

Both at my institution and within ASTS I would like to see further opportunities for professional development and research grant opportunities for ATPs.