Remembering Ruth Milligan Ballweg, MPA, PA-C Emeritus

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Ruth M. Ballweg, February 29, 1944-November 20, 2022Photograph courtesy of the PA History Society

We remember the remarkable life and legacy of Ruth M. Ballweg, a trailblazing PA, student-turned-educator, and influential leader. Ruth spent her life in the Pacific Northwest, from her early days in Southern Oregon to a distinguished faculty career at the University of Washington in Seattle; however, her work had a global effect on healthcare and the PA profession. Her professional accolades and accomplishments are many, but we remember her most as a loyal friend, proud parent, dedicated teacher and mentor, global ambassador for the PA profession, and fearless change maker. Ruth was many things to many people, and there is no way we can, or wish, to define her in so few words. Drawing from our collective experiences with Ruth, we share three key lessons we each learned from her with our PA colleagues as a starting point for a professional life well lived.

Ruth Ballweg retired in 2016 as professor emeritus of family medicine at the University of Washington after leading its MEDEX Northwest PA program and its regional campuses for many years. During her career, Ruth drove effective change in healthcare workforce issues across Washington, Wyoming, Montana, Idaho, Nevada, and Alaska. Her work included chairing the Group Health Cooperative of the Puget Sound Board of Directors and partnering with the Alaska Native Tribal Health Consortium to develop the dental health aide therapist program to ensure routine dental healthcare in rural Alaska.

Beyond the Pacific Northwest, Ruth served the National Commission on Certification of Physician Assistants as a board member, founding member of the nccPA Health Foundation, and director of international relations. Ruth traveled the globe, helping expand the PA profession internationally while learning from her experiences abroad and bringing back insights and new innovations to share with PAs in the United States.

Wherever Ruth was in the world, she always made time to connect with her colleagues, family, and friends. This inspired Ruth's first lesson: Build and nurture relationships. She availed herself to offer advice, share a caring ear with a friend in need, coach a new mentee, encourage a colleague, or help others make important connections. Nurturing relationships is an indelible part of her legacy as a leader, clinician, educator, scholar, and friend. With an open heart and tactful but sometimes unfiltered mouth, she was the best of friends and cherished getting to know others from diverse backgrounds and interests. Ruth developed professional and personal relationships with leaders, innovators, and thinkers inside and outside the PA profession and across the globe. At conferences and meetings, she prioritized her time to find those who could effect change. Her ability to drive change was supported by an expansive network she cultivated during her life and career and was influenced by thoughtfully listening to and learning from the people and communities she served. Her dominant professional identity was as an educator. She strived to create the next generation of clinicians, educators, scholars, leaders, and global citizens. Like many exceptional teachers, Ruth had a remarkable sense of humor and talent for storytelling. Ruth always had an opinion to share, but one endearing trait was her openness to and curiosity about others' points of view, perspectives, suggestions, and ideas.

When Ruth encountered need, such as a gap in healthcare for vulnerable populations, she acted. One word that Ruth rarely spoke was “no.” This inspired Ruth's second lesson: Never say no. In fairness, it wasn't that she never said no; rather, she rarely turned down any opportunity to help a friend or colleague, support a meaningful cause, expand her professional network, or advocate for and support the PA profession or PA educators in the United States and beyond. If she could not be there herself, she was quick to help find someone who could or help make connections among interested colleagues. Testament to this quality is her role in supporting the expansion of PA education and practice in other countries, including India, Ireland, and Israel. The Dentex program is a prime example of how Ruth never said no to acting when she observed a community in need. When the dental therapist movement was started in Alaska to serve Iñupiat, Yupik, Aleut, Eyak, Tlingit, Haida, Tsimshian, and Northern Athabaskan tribes and communities, the American Dental Association objected to the creation of this lesser-trained clinician, regardless of the service provided and in the absence of dentists. Ruth moved the nascent Dental Therapist Association into her department to offer an academic sanctuary and promoted dental therapists as a national asset. Today the dental therapist movement thrives across several states, serving many remote and underserved communities.

Many will remember Ruth for her tenacity and skill in working through the complexities of PA leadership in an academic health center and among the national PA organizations as well as the groundbreaking advancements she achieved for the profession through her service. We also note that Ruth rarely encountered a rule she couldn't bend, break, or rewrite if the situation called for it. These qualities and her track record of trailblazing inspired Ruth's third lesson: Never take no for an answer. Ruth overcame numerous hurdles to document our profession in the book Physician Assistant: A Guide to Clinical Practice. This seminal text for PA education now bears her name and is in its seventh edition, with each chapter written by notable scholars in the field. Ruth had a vision for the future of the PA profession and was an early promoter of PAs' potential to make a substantial effect on domestic and global healthcare. Her record of accomplishment in policy and social change as well as the global expansion of PAs stemmed from her unwillingness to accept no for an answer. Her perseverance as a leader and later president of the PA Education Association also drove important policies and practices that are the mainstays of PA education. As any successful researcher knows, failure is part of the process. Ruth never gave up as a grant writer and scholar and, through her collaboration on grants and fellowships, produced an impressive record of extramurally funded research projects and peer-reviewed scholarship.

We all asked Ruth at one time or another about the secret to her seemingly endless supply of energy and determination in the face of significant resistance. Her answer was: “It's all about the students.” In particular, it was the experiences she shared with students of the MEDEX Northwest PA program that inspired her work and fueled her drive to advance the PA profession. She often quoted her colleague, friend, and founder of MEDEX, Richard “Dick” Smith, MD, who said that shifting his own career from clinical practice to education was like multiplying his hands 10,000-fold. Ruth said, “Being a PA faculty person and a director especially, you get the chance to do that, and nothing will take that energy away from you.” Ruth recalled the experiences of her MEDEX students, who often were older and embarking on new careers; they faced different challenges than other PA students in balancing their personal lives and education. “Sometimes you get involved in the most wonderful and incredibly sad aspects of their lives,” Ruth recalled, “and the bonds that are created through those experiences will never dissolve.”

As Ruth and her colleagues who founded the PA History Society knew, the preservation of our history is critically important. Looking back and seeking to understand our choices and the effect PAs have made can help us face the future and take action. Ruth remains an inspirational force for PAs across the world, and she will be missed. To honor her legacy and learn from her life and work, we share Ruth's three lessons for a professional life well lived to those who aspire to be their own force of change in the world.

For more on Ruth Ballweg's extraordinary contributions to the PA profession, please visit her biography on the PA History Society website: https://bit.ly/3UgZlJT.

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