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Back in the early 1990s, in what I like to refer to as my first life, I was a paramedic in the Fargo-Moorhead area.

It was a challenging, exciting and often hair-raising job for a 20-year-old kid from a small-town in northern Minnesota. At that time, we worked 24-hour shifts.

Let me just say that a lot can happen in 24 hours. Each shift threw us into a wide range of unpredictable and dynamic situations, demanding quick thinking, adaptability and a steady hand.

That experience continues to influence how I approach health care to this day. It taught me the importance of staying calm under pressure, adapting to whatever comes next and relying on the strength of a dependable team.

One moment, you may be extracting a trauma patient from a vehicle after a collision. The next, a frantic mother is placing a struggling infant in your arms. Soon after, you’re offering a steady hand and calm reassurance to a confused, hurting elderly patient.

Providing health care in such a diverse and unpredictable environment demands adaptability, compassion and a willingness to do whatever it takes to ensure patients receive the care they need.

When someone sustains major trauma injuries, it sets off a large, coordinated response within the hospital. Care teams from multiple specialties and departments mobilize to be ready the moment that patient arrives in the ER.

I will never forget one shift early in my career, when we brought in a trauma patient into the trauma center. Among the many providers in the room, one person stood out to me. He wasn’t a physician or a nurse, but he played a significant role in the patient’s care.

I later came to learn that he was a PA, a Physician Assistant. That was my first introduction to what we now refer to as APPs, Advanced Practice Providers.

At Sanford Health of Northern Minnesota, nearly half of our clinical team is made up of APPs, working alongside our physician colleagues, and they are a vital part of our care delivery team.

Our APP staff includes nurse practitioners (NP), physician assistants (PA), certified registered nurse anesthetists (CRNA), audiologists (AuD) and geneticists (CGC).

This group of talented individuals brings to the table a broad variety of educational backgrounds, clinical training and work and life experience, as the varying array of titles may suggest.

Many of these professionals have a prior career in another area of health care before settling into their spot as an APP. It is not unusual for patients to assume we are still in training. While further education could be an option, many already hold a master’s or doctoral degree.

On the flip side, we are also often mistaken for physicians, which we are not. We deeply value our partnership with physicians, whose training includes medical school, residency and often specialty training beyond our own six to ten years of training that APPs typically complete.

One of the unique strengths of APPs is our versatility. Many of us can work across multiple specialties or transition into new clinical areas as needs arise. We prescribe medications, diagnose and treat a broad range of acute and chronic conditions and provide both primary and specialty care.

In some cases, APPs are the only clinician serving in a rural ER, primary care clinic or specialty session. Some APPs function with a high degree of independence, while others work closely within a physician-led team.

If you have accessed health care anywhere across the U.S., you have most certainly received care from an APP.

Whether you visited a walk-in clinic, were hospitalized, had surgery, received a hearing aid or sleep apnea diagnosis, underwent genetic counseling or got a refill for your high blood pressure medication, it’s likely an APP helped you.

Just like paramedics must adapt to the unpredictability of every call, APPs must respond to the evolving needs of our patient populations and organization’s staffing needs.

At Sanford Health, we've relied on APPs to help maintain services through staffing transitions and to help launch new offerings across our region. Today, nearly 100 APPs serve patients throughout Sanford Health of Northern Minnesota, providing critical roles in the delivery of health care.

As our population grows and ages, the demand for providers will continue to increase. According to the Association of American Medical Colleges, the U.S. population is estimated to increase by 8.4% by 2036, but the 65+ age group is projected to increase by a staggering 34%.

At the same time, one in five physicians today is at or near retirement age. These trends point a clear need for both physicians and APPs to meet our increasing demand for care.

We are fortunate to have such a dedicated, skilled and compassionate group of APPs serving our communities and playing such an integral role in our health care system.

Every day, I am inspired by the knowledge, skill and work ethic our APPs and physicians bring to their work. As health care continues to evolve, one thing remains constant: the commitment, expertise and heart our clinicians bring to every patient interaction. It’s an honor to work beside them.

Brad Smith, PA-C, is a physician assistant in general surgery at Sanford Bemidji Main Clinic and an outgoing chair of Sanford Bemidji’s regional Advanced Practice Provider Council and an outgoing council member of Sanford Bemidji’s regional Physician Executive Council.