| Course | PA 624 Clinical Clerkship: Underserved Population |
|---|---|
| Week | 2 |
| Paper type | Treatment alternative memo |
| Length | About 460 words, 4 pages |
| Format | Memo with APA 7 citations |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 624 Week 2
Memorandum
To: Supervising physician, Eastside Community Health Center
From: PA student, underserved care clerkship
Date: September 15, 2026
Re: Glucose-lowering plan for J.P.: the plan another clinic might write, why it cannot work here yet, and what replaces it
The Goal, Stated Before the Plan
Bring J.P.'s A1C from 9.4 percent toward under 7 percent over six months, without hypoglycemia on a roof.
The Plan Another Clinic Might Write
Metformin, increased to 2,000 mg a day, plus an SGLT2 inhibitor such as empagliflozin, which current standards favor for its heart and kidney benefits in people with or at risk of those conditions (ElSayed et al., 2024).
The Obstacle, Named Exactly
J.P. has no insurance. The retail price quoted by the nearest pharmacy on September 14 for a month of empagliflozin was about $560. Metformin costs about $8 a month at the same pharmacy. The manufacturer's assistance program requires an application that takes three to six weeks.
The Replacement and Its Price
Metformin extended release, titrated to 2,000 mg daily over four weeks, plus glipizide 2.5 mg each morning, about $12 a month in total. The price of this choice: glipizide can cause low blood sugar, which is dangerous for someone working at height, and it lacks the heart and kidney benefits. To limit that, J.P. starts at the lowest dose, takes it with breakfast, carries glucose tablets at work and checks blood sugar before climbing. Cost is a real barrier: in a national sample of low-income older adults with diabetes, about one in eight reported skipping or delaying medicines because of cost in the past year (Pooler & Srinivasan, 2019).
The Trigger to Revisit
Revisit when any of these happens: the assistance program approves empagliflozin; J.P. gains insurance; a low glucose below 70 mg/dL occurs; or A1C is above 8 percent at three months.
Who the Memo Is Written To
The supervising physician, who signs the prescription, and the next clinician who sees J.P., so the reasons are in the chart.
What the Physician Is Asked to Weigh
The real question for the signer is whether a sulfonylurea's lows are an acceptable risk for a man who climbs ladders for a living. Three safeguards make the answer yes for now: the lowest dose, a glucose check before climbing and tablets in the truck. Without them, the memo would recommend metformin alone and accept a slower fall in A1C. The physician should also know J.P. was offered that slower route and chose the faster one after hearing about the lows.
Request
Approve metformin plus glipizide today; the enrollment counselor will start the assistance application this week.
J.P. has agreed to both medicines and to the glucose checks, and has the tablets for the truck.
References
ElSayed, N. A., McCoy, R. G., Aleppo, G., Bajaj, M., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., Ekhlaspour, L., Gaglia, J. L., Garg, R., Girotra, M., Khunti, K., Lal, R., Lingvay, I., Matfin, G., Neumiller, J. J., Pandya, N., . . . Bannuru, R. R. (2024). 9. Pharmacologic approaches to glycemic treatment: Standards of care in diabetes-2025. Diabetes Care, 48(Suppl. 1), S181-S206. https://doi.org/10.2337/dc25-S009
Pooler, J. A., & Srinivasan, M. (2019). Association between supplemental nutrition assistance program participation and cost-related medication nonadherence among older adults with diabetes. JAMA Internal Medicine, 179(1), 63-70. https://doi.org/10.1001/jamainternmed.2018.5011
The Chamberlain PA 624 Week 2 instructions
The second week asks for a one-page memo, headed like a note, that explains a plan chosen because the usual plan cannot work for this patient yet. Open with the goal, then the plan another clinic might write, with its source. Name the obstacle exactly, with numbers if it is cost. Describe the replacement and its price, including any added risk, and how that risk will be limited. Set the triggers that would send you back to the usual plan. Say who the memo is written to. Some sections call this a plan justification; the structure is the same. The memo should recommend specific drugs or tests, since the argument is about a particular choice. Cite the standard behind the usual plan and evidence on the obstacle.
How this PA 624 Week 2 example is built
The memo goes to the supervising physician at Eastside Community Health Center on September 15, 2026. The goal is an A1C under 7 percent over six months without hypoglycemia at work. The usual plan pairs metformin with an SGLT2 inhibitor such as empagliflozin, citing ElSayed et al. (2024). The obstacle section gives a $560 monthly cash price, metformin at about $8 and an assistance application that takes three to six weeks. The replacement uses metformin extended release titrated to 2,000 mg and glipizide 2.5 mg each morning for about $12, names the hypoglycemia risk on a roof and lists glucose tablets and pre-climb checks, citing Pooler & Srinivasan (2019). Four triggers follow, then the readers and a request for approval.
Where the points sit in the PA 624 Week 2 rubric
The memo loses the most when the replacement is presented as just as good, hiding what it gives up. Next comes an obstacle described vaguely, such as "cost concerns," without numbers. Faculty deduct when no trigger to revisit is set, since a next best option should be temporary when circumstances change. Credit goes to the goal stated first, the usual plan sourced, the replacement priced and its risks managed. Naming the readers shows the memo will survive in the chart. Memo format and APA citations for the standard and the obstacle complete the rubric.
Common PA 624 Week 2 mistakes, and how to avoid them
Next best option memos commonly read as defenses of a cheaper drug, without ever stating what the better plan would have been. Another frequent problem is ignoring the new risk the replacement brings for this patient's work or life. Some memos also have no point at which the decision is revisited. If your patient's obstacle is different, such as transport, a language barrier or a prior authorization delay, send the usual plan and the obstacle in numbers; we would state the goal, source the usual plan, name the obstacle exactly, price the replacement and its risk and set triggers to revisit. If your section uses a set template, the memo would follow its headings.
Get a PA-624 Week 2 example written to your instructions
Send the memo wording, the rubric rows and the case your section set, and a model memo written to those rows comes back the same way every sample here does: free the first time, inside 24-48h. If your template has headings of its own, send those too and the example will sit inside them rather than beside them.
More PA 624 papers and MPAS samples
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PA 624 Week 2 questions, answered
What if my section calls it a plan justification instead?
Names differ by section and the marked object does not. Whatever the heading, the rows ask for a purpose, an obstacle with a name on it, a replacement with its price stated and a condition that would reverse the decision. Give us the heading your section uses along with its rows, and the model arrives sitting under that heading rather than under a generic one.
Should the memo recommend a specific drug or test?
The examples here name plan elements the way an assignment does, as objects in a decision, and they stop short of telling anybody what to give a patient. Clinical choices sit with you and your preceptor. What the sample demonstrates is the shape of the reasoning and the level of detail the rows reward, which is the part writers ask about.
How long is the finished memo?
Short enough that the decision is visible on the first screen. Sections that publish a limit tend to set a modest one, and the examples respect whatever you send. Where no length is given, the model runs to the point where the four moves are complete and stops, since padding a memo is the fastest way to bury the sentence a reader needs.
Where can I find a free PA 624 Week 2 sample paper?
A complete PA 624 Week 2 next best option memo for an uninsured patient's diabetes plan is on this page.
What risk does the replacement add in the PA 624 Week 2 sample?
Glipizide can cause low blood sugar, which is dangerous for someone working on a roof, so the patient carries glucose tablets and checks before climbing.