Breaking Down Barriers and Establishing Trust

By:   February 26, 2019

33-year-old Eric Svendsen is working out of a mobile health van on the edges of Coeur D’Alene, Idaho. Turns out this is familiar territory for him.

“I came from emergency medicine, working on an ambulance, being out in the community and working with similar populations,” he says. “That was in Sacramento, with homeless people and lots of others who didn’t have access to healthcare.”

At that time, the ambulance team typically took patients to an emergency room. “That’s the only way a lot of these people would find healthcare, even for little stuff like blood pressure medication refills or follow-ups after hospitalization. There’s a huge population out there that doesn’t have access to a continuum of care.”

A member of MEDEX Spokane Class 21, Eric is fulfilling his 4-month primary care family practice preceptorship under longtime MEDEX classroom lecturer TJ Byrne, PA-C. The mobile van belongs to Heritage Health, a federally qualified health center that provides services across North Idaho. Today, the van is parked on a lot outside of Lake City Community Church. It’s a chilly Wednesday morning, and the church is servicing individuals and families in need with a simple breakfast, access to a food bank and employment counseling. Both TJ and Eric are on hand to address any medical needs of this group.

The Heritage Health mobile health van.

“Our program has evolved,” says TJ Byrne, PA-C and Eric’s preceptor during this 4-month period. Initially, his main mission under Heritage Health was to treat the chronically homeless. But the focus has progressed now to the point where the mobile van goes weekly to several churches in the Coeur D’Alene area. “The reason we’ve changed is that we encounter the homeless in our community that aren’t necessarily the typical appearing homeless. They are families, they’re the working poor.”

Over the past several years, TJ has found that the churches are huge supporters of his mobile health services. “In fact, we have buy-in from the churches far more than we do from city and county government. We rely heavily on our churches.”

One factor that’s driving people to seek out free social and medical services is the high cost of housing. Coeur D’Alene is known for its lakeside location and many resorts, but this has left a lot of people behind in an otherwise thriving local economy.

“I’m from California, so I’m used to the inflated costs of buying a house,” says Eric. Since moving from Hawaii to nearby Spokane in order to start his physician assistant education at MEDEX, he’s seen housing prices rise by 20% to 30%. “Rent is going up and there’s low inventory for available rental properties. It’s just harder and harder to get into a place. And especially if you’re in financial trouble or out of work. Or if you have a criminal record, it’s almost impossible to secure a place to reside.”

MEDEX student ERic Svensden and preceptor TJ Byrnes in front of the Heritage Health mobile health van.
During his 4-month primary care family practice preceptorship, Eric works under longtime MEDEX classroom lecturer TJ Byrne, PA-C.
The Mobile Clinic van parks outside Lake City Church in the Coeur D'Alene area to service local residents.

previous arrow
next arrow

previous arrownext arrow


Eric first connected with TJ Byrne and the idea of the Heritage Health mobile van when TJ lectured to the Spokane 21 class. TJ brought some of his homeless patients to the classroom in order to expose the MEDEX students to this population in need of care. “With the mobile medical van, TJ is addressing these problems and seeing people that don’t have access to care.”

Eric on his first day of PA studies in Spokane.

Eric continues. “I was inspired by some of the people TJ brought to class. Some of them are the homeless that you see here today.” He’s painfully aware of the conditions that a lot of people would suffer without TJ’s help and that of Heritage Health. Eric knows this from being out in the community with the van. “A lot of these people will not seek out healthcare until they absolutely have to. We can improve the entire system just by going out and essentially finding those people.”

In order to make this work, TJ and Eric take steps to break down barriers and establish trust. To start, they’re not wearing the traditional medical white coats.

“Whether we approach people or they come into the van, they want to feel comfortable,” says Eric. “There’s a stigma for people who are experiencing homelessness. They might be more fearful of being judged. Being able to develop a rapport with this population is very important in building trust. We take extra steps to make them comfortable and hear their story.”

Even with his earlier ambulance experiences, Eric was amazed to learn just how many people are not getting their basic healthcare needs met due to lack of access. “There’s a lot of mental health issues out here,” he says. “We see a lot of that on the mobile medical unit. But the resources are not in place for people that need those types of services.”

Eric and TJ talk with a homeless patient, Kevin, inside the mobile clinic.
Eric runs down his medical complaints for the team.
TJ Byrnes, PA-C listens intently to the patient.
Eric beings the physical exam.
Eric confers with his preceptor, TJ, about his findings and diagnosis.

previous arrow
next arrow

previous arrownext arrow


Before he entered the medical field, Eric Svendsen worked in the construction trades. Right out of high school, he saw that his path forward was that of a tile setter.

“I come from a family full of contractors, so every summer I’d go to work for them and learn as much of the trade as I could.”

In time Eric learned about an opportunity with the local fire department which required EMT training. “Right away, I loved the EMT part of the job, which I was not expecting. I felt like it was both fun and challenging.”

Eric on the Seattle UW campus with sons Cody and Cole.

A move to Tennessee followed. For employment, Eric resorted to his old standby—the construction trades. He worked as a roofer in part because employment with a fire department required upgrading to a paramedic license. Finally, his wife encouraged him to get the necessary training and certification. “You’re not very happy on the roof,” she told him.

He entered paramedic school in Nashville and “absolutely loved it.”

After paramedic school, Eric had no desire to return to the fire department. As a working paramedic in Nashville, he spent time with physician assistants and MDs at Vanderbilt Medical Center, sometimes attending lectures together. One of these professional acquaintances was a former Army medic who became a civilian PA. He recognized Eric’s enthusiasm for medicine and encouraged him to follow the PA path.

However, there were obstacles. Eric didn’t have a bachelor’s degree, so he would have to start down that road to qualify for a masters-level PA program.

Twenty-six at the time and with a wife and young child, Eric started taking college courses and never gave up on the goal, despite some challenges. “We did a lot of moving around during that time,” he says. “So, for my application to get into PA school, I had transcripts from 11 different colleges.”

Eric announces his entrance to the exam room with a knock.
Scott sits patiently in the mobile van waiting to be seen.
Together, Eric and Scott discuss Scott's symptoms of COPD.
Eric listens to Scott's lungs for signs of breathing irregularities.

previous arrow
next arrow

previous arrownext arrow


The process of applying to PA school was intimidating from the get-go. Eric didn’t have an early history of good grades. The fire academy was a pass/fail certificate program, so academic achievement had not been a priority. The thinking was, “Just get through the class and you can be on the fire department.” Still, Eric believed that it was his larger life experience that tipped the balance in his favor for a PA career.

But anyone coming up against the prospects of a 2-year PA program understands that the admissions criteria are fierce. “Going forward, I knew that I had to have perfect grades if I was even going to measure up against the competition,” Eric says.

On Maui with wife Laura, sons Cody and Cole.

Eric and his wife were living in Hawaii when MEDEX came up for consideration because of its proximity to the islands. “I started looking into MEDEX and it just seemed like it would be a perfect fit with my background.” He got interviews at a couple PA programs, but it was MEDEX Northwest that recognized his potential.

Upon learning of his acceptance to the Spokane 21 Class, Eric was “blown away. Honestly, I didn’t expect to get into a program like MEDEX,” he tells us. “I’d been all over the place in employment and geography, so it took resourcefulness and pulling everything together that allowed me to be here today.”

After observing Eric interact with several homeless patients on the mobile medical unit, it’s clear that his empathetic qualities helped open the doors to MEDEX. Michael Smith, PA-C, and the MEDEX Spokane Site Director recalls all the considerations behind Eric’s admission to the program.

Eric kayaking with son Cole at Davis Lake, north of Spokane.

“While Eric may have struggled early in his academic career, his more recent GPA was near 4.0,” says Michael. “As a paramedic, the scope of his clinical experience was above average, as were his total patient contact hours. He had glowing letters of reference and his essays displayed compassion and his commitment to providing care for the underserved. Simply stated, Eric embodies the ‘whole person’ concept. His strong application package combined with a stellar interview made the decision to select him very easy.”

We asked Eric what’s behind his huge heart for the homeless.

He explains that there are two things that really engage his conscience: seeing somebody who needs help, and lack of access. “I see this as a way to make a difference, and it’s attractive to me.”

There was also Eric’s time in Tennessee. As a paramedic there he encountered a sizable underserved population. Tennesseans rank above the national averages for adults with diabetes, poor mental health, and obesity, as well as low-birth-weight babies. “Seeing that there was such a huge need early in my career stimulated my interest in the underserved.”

It takes a special person to work with this population, and Eric also attributes much to his time with TJ Byrne.

“TJ is a blessing for a lot of people,” he says, citing his preceptor’s patience. Eric recalls when TJ came to lecture at Spokane Class 21 and brought some homeless men with him. They all sung his praises. “He’s done so much for us and gone beyond what we could ever imagine just to help us find a way through the maze of healthcare,” they’d say.

Witnessing TJ’s good works in person, Eric has nothing but accolades. “He meets a lot of other needs far beyond healthcare, making sure people have sleeping bags and enough food. Just anything and everything you can think of pretty much.”

Eric Svensden undertakes a full HEENT exam with the patient, checking head, ears, eyes nose and throat.

previous arrow
next arrow

previous arrownext arrow


Now in the midst of his clinical year rotations, Eric looks back fondly on his didactic year with Spokane Class 21. At the close of classroom instruction, everybody in the class was so happy.

“This was kind of sad for me because we were all about to go our separate ways,” he says. “I was trying to enjoy every moment of those last couple months being in class, with these people, with our instructors.”

“There a lot of people in Spokane Class 21 that also come from unconventional backgrounds, like me. Our class was exceptional in how everybody got along and meshed. We all became great friends throughout our program and we still are.”

Ahead are several 1-month rotations that will expose Eric to a wide range of specialties, including behavioral medicine, general surgery and inpatient. Eric is open to what lies ahead after graduation in August 2019.

“I’ve been pretty much just open to everything because I really enjoy all the different aspects of medicine so far,” he says. “It’s like going into EMT school. I was convinced that I wouldn’t like it, and then I loved it. Right now, I’m not closing myself off into any one area of medicine until I have a better idea and see everything. But, right now it seems like there’s a lot to learn in primary care and family medicine. This gives me a broad knowledge base that I need.”

Eric (in the center) with MEDEX classmates Russ Evans (left) and Hershell Cummings (right).

Dennis Raymond is the Communications Manager for MEDEX Northwest in Seattle, Washington. He can be reached at