Ed Friedmann, PA-C, has been the sole health care provider at the Redfield Rural Health Clinic in his Iowa community, Redfield, Iowa (population 835), for the past 36 years. His patients appreciate and praise his neighborly medical care, after-hours and weekend availability, and house calls. He also has served as one of the leaders in scores of PA legislative and regulatory achievements at the national, state, local, and rural health clinic levels during his 44 year medical career.
Born in Waterloo, Iowa, in the spring of 1946, Ed grew up milking cows on a dairy farm outside of the small town of Luxemburg, Iowa. His dad, a farmer who could grow and fix anything, and his mom, a nurse who knew what to do when someone was sick or injured, exemplified strong and caring work ethics.
In 1967, at the height of the Vietnam War, Ed volunteered for the US Army and qualified for the Green Berets, choosing to specialize as a Special Forces medic. After serving as a combat medic with the Fifth Special Forces in Vietnam (1968-69), Ed attended the University of Iowa in Iowa City, graduating in 1971 with a BA degree in Political Science. Medicine was in his blood, so in 1977 he graduated from the College of Medicine, University of Iowa (Iowa City) PA Program. Ed’s early career was in medical education, serving as staff PA in the Family Physician Residency Program in Mason City and Sioux City, and later helping to establish the first PA program in an osteopathic medical school at the University of Osteopathic Medicine and Health Sciences in Des Moines, where he served as Clinical Instructor and Coordinator (1982-85).
In 1985, Ed moved to Redfield, Iowa and began serving the medical needs of the residents of that medically underserved small town. In 1988, when the previous owner closed the only medical clinic in Redfield, Ed (with his wife, Libby Coyte, PA-C) reopened the clinic by agreeing to serve as its owner and converting it into a federally certified Rural Health Clinic (RHC). This method of keeping a clinic open was possible because the 1977 RHC law was the first federal legislation to recognize PA ability to see patients without physician presence, own a medical clinic, and authorize Medicare and Medicaid to cover PA medical services at 100% of the physician rate. Ed became the clinic’s sole medical care provider. Using sliding income scale charges for patients with no insurance, he continues to provide affordable, accessible health care at the clinic while also serving as a clinical preceptor of PA students.
Knowing that many more patients can receive timely needed medical care with better laws, Ed’s volunteer activities have centered on improving health care legislation. Putting his political science education skills to work, Ed has been a tireless leader in the Iowa PA Society, serving as its Public Education Committee chair (1978-87), President (1983-84, 2013-14), Legislative Coordinator (1984-2001), and Legislative Committee member (2001- present). During this time, achievements have been many by Iowa PAs – PA drug dispensing; PA membership on the Medical Board; establishment of an Independent PA Regulatory Board with a PA majority; PA prescribing; PA inclusion in Iowa’s Emergency Medicine Law; mandatory third party reimbursement for PA medical services; PA hospital privileges; Medicaid 100% cost reimbursement for Rural Health Clinics and Community Health Clinics; and PA profession corporations membership. He has also served in multiple leadership positions on the Iowa Rural Health Association, the Iowa Association of Rural Health Clinics, the PA Advisory Committee to the Iowa Board of Medical Examiners, the Iowa PA Regulatory/Licensing Board, and the Dallas County Iowa Board of Health.
The American Academy of Physician Assistants has benefited from Ed’s energy and service. He was a member of the AAPA Public Education Committee (1979-81); member and chair of the AAPA State Legislative Subcommittee (1984-87); chair of the AAPA Government Affairs Committee (1997-1999); and AAPA President (2001-2002). During his years of service, he worked tirelessly with his wife Libby, other PAs, and former Senate Finance Chair U.S. Senator Charles Grassley (R-IA) to achieve partial Medicare reimbursement for PAs services (1985), expanded Medicare coverage for PAs (1997), Medicare Hospice and Skilled Nursing coverage for PAs, Medicare Home Health coverage for PAs (2020), and Medicare Direct Payment for PAs (2020). Having served for many years as Iowa AAPA House of Delegate representative, Ed currently serves as Vice President and Chief AAPA delegate for the PAs for Rural Health Caucus.
Ed’s other national volunteer work has been with the National Rural Health Association (NRHA) and the National Association of Rural Health Clinics. He worked with former AAPA Government Relations Director Bill Finerfrock and others to achieve improved payment for independent Rural Health Clinics (2020), and helped to save the National Rural Health Clinics program (1996). Redfield Mayor Dave Griffith stated, “Ed regularly attends the NRHA’s annual Policy Meeting in Washington DC – and is the Iowa lead when it comes to making annual appointments with members of the Iowa Congressional delegation. U.S. House and Senate staff know Ed, appreciate his insights, and value his policy knowledge.”
Ed’s advocacy and leadership skills have been recognized throughout the years through national and state awards. Those include the Iowa PA of the Year Award (1988), the AAPA Presidential Award (1989), AAPA Public Education Achievement Award (1993), the Iowa Association of Rural Health Clinics Service Award (1996), the Iowa PA Examiners Outstanding Service Award (2010), and the most recent Iowa Rural Health Association Rural Advocacy Award (2020).
When asked of which accomplishments he thinks made the most difference, his response was:
“…LOCAL — serving as the sole source of medical care in Redfield for the past 36 years after the previous owner had closed the only medical clinic in town. And now better payment for independent Rural Health Clinics will significantly improve chances of keeping medical care in small towns like Redfield – well worth the long effort.
STATE — working as Iowa PA Society’s Legislative Coordinator with a small group of committed PAs and a few visionary physicians to establish an independent PA Regulatory Board in Iowa with a PA majority, when there were fewer than 150 PAs in Iowa and medical board over-regulation was driving PAs from the state.
NATIONAL – working with Senator Charles Grassley and others for many years to gain initial and ever-improving Medicare coverage for PAs, and, finally, PA direct Medicare payment in 2020. There is little in life as good as the feeling one gets when succeeding against long odds to secure better care for many more people through persistent effort.”
One thing is for certain, Ed had crucial help from dedicated PAs and a few insightful physicians. And none of these improvements would have been possible without his wife and partner PA, Libby Coyte’s incredible hard work in skillfully running the rural clinic while practicing as a full time PA at the Des Moines Community Health Center. Her advice, encouragement and reality checks, including timely visits to legislators with their constituent PAs, gaining essential physician support, and her mastery of electronic health records were essential to these achievements. PAs and patients nationwide are the beneficiaries.
Acknowledgments: This Biographical Sketch was prepared by Marilyn H. Fitzgerald with assistance from Ed Friedmann. It was submitted to the Society in March 2021. The photographs were donated to the Society by Ed Friedmann.