GENERAL SUMMARY/ OVERVIEW STATEMENT:
The physician assistant (PA) is a licensed provider who has acquired a broad range of knowledge and skills through the successful completion of a physician assistant program. The PA is responsible for the assessment and management of various populations of patients, medical and/or surgical, including diagnostic and therapeutic interventions, development of appropriate plans of care and ongoing evaluation. The physician assistant works under the supervision of an attending physician and reports directly to the department administrator or chief physician assistant administratively.
The PA will perform in accordance with all state and federal regulations and institutional policies including but not limited to the BWH PA Scope of Practice, Prescriptive Guidelines, approved clinical privileges, and BWH PA policy.
The PA II position is designed for those physician assistants who have advanced clinical skills and who are experienced enough to take on additional clinical, administrative, and/or leadership responsibilities above that of a PA I. The PA II position entails those responsibilities defined by the department/division that will become part of the performance evaluation process.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Principle Clinical Duties and Responsibilities:
- Provides direct care, counseling, and teaching to a designated patient population in the ambulatory, inpatient, operative, and/or procedural setting
- Performs complete histories and physical examinations
- Orders, interprets, and evaluates appropriate laboratory and diagnostic tests
- Develops appropriate plans of care and follow-up based on the outcomes of diagnostic, laboratory, and physical examination findings
- Orders medications and writes prescriptions according to organizational and regulatory policies and procedures
- Consistently provides high quality and timely documentation including admission and progress notes, procedure notes, operative notes and discharge summaries
- Performs bedside procedures as are appropriate to the patient population
- In some settings, the PA may first assist in the operating room or procedural areas
- Practices cost effective medicine in an efficient manner, maximizing available resources
- Discusses patient data with other physicians and professionals as appropriate in a multidisciplinary setting
- Demonstrates expert clinical judgment skills to function in an independent role
- Additional duties and responsibilities as required by the department/division
Non-Clinical Duties and Responsibilities:
- Demonstrates professional collaborative and consultative relationships with other providers
- Follows all designated prescriptive practices and monitoring requirements with the designated supervising physician and administrative report
- Participates in departmental and organizational committees and programs as appropriate and attends all required meetings, in-services, and professional trainings
- Maintains superior interpersonal and communication skills as a member of the healthcare team in order to collaborate effectively with patients, families, staff, and community health workers
- Remains actively involved in continuing education with a commitment to self and departmental growth
- Adheres to all established safety policies, procedures, and precautions; identifies potential or actual unsafe situations in the environment and takes measures to rectify the situation
- Demonstrates understanding of procedures, policies, and documentation required to ensure compliance with hospital standards of care
- The PA II shall be responsible for precepting PA students each year and/or managing the department/division PA student program.
- Additional duties and responsibilities as required by the department/division
The colorectal physician assistant (PA) will be an integral part of the interdisciplinary team approach for overall care and evaluation of primarily colorectal surgery patients in the Division of General and GI Surgery (GGI). Under direction of the supervising physician, the PA will be involved in all aspects of patient care. Responsibilities will include care of surgical patients primarily in the outpatient setting, but may also include work as a surgical assist in the OR. The PA will see and evaluate patients both pre- and postoperatively, as well as in long-term follow-up. The PA will also be responsible for triaging patient issues/concerns via phone. The PA will be primarily responsible for seeing colorectal patients at the Brigham and Women’s Hospital campus, Brigham and Women’s Faulkner Hospital campus, and Foxborough campuses with the possibility of additional locations as the service expands.
The PA II will practice according to the scope of practice outlined in the Physician Assistant Colorectal Clinical Privileges document.
The PA II can expect a daytime schedule, but occasional evenings and weekends are necessary, as well as variation in schedule when needed to cover clinics and clinical needs.
Usual responsibilities include the following:
- Performs and documents medical, physical and psychosocial assessment on both new and established patients. This may be performed either in conjunction with the surgeon during the surgeon’s clinic, or independently during PA clinic. Documentation requirements include electronic medical record documentation, dictations, medication reconciliation and bariatric database entry.
- Evaluates potential colorectal patients according to NIH criteria to establish candidacy for surgical procedures.
- Educates patients regarding a variety of surgical, endoscopic and clinical procedures including but not limited to colonoscopy, anoscopy, sigmoidoscopy, colectomy, proctocolectomy, ileostomy, hemorrhoid banding, hemorrhoidectomy, botox injections and laparoscopic surgery.
- Educates patients on pre and post-surgical care in accordance with their condition. This may include teaching around ERAS protocol, ostomy creation and reversal if applicable, diet and exercise, expectations around going back to work and other lifestyle factors that may be impacted by their surgery.
- Gathers and interprets data collected from patient exams as well as diagnostic studies to formulate and implement plans of care in conjunction with supervisory staff, as well as follow patients and evaluate and document response to plan.
- Evaluates for and initiates consults with specialists on an as need basis.
- Triages patient calls/questions related to post-operative care, medication, dietary concerns/issues, and evaluates for post-operative complications.
- Diagnoses and treats surgical complications in conjunction with attending physician.
- Coordinates follow-up care, such as prescriptions, medication prior authorizations, and FMLA paperwork.
- Assists with and/or perform various surgical and medical procedures, i.e. dressing changes, wound packing and irrigations, debridements, staple and drain removal.
- Provide accurate billing charges for services provided.
- Participate as an active member of the colorectal surgery team. This will include identifying areas in need of improvement and collaborating with other members to achieve a solution.
- All other duties as assigned by manager and supervising MD.
- The appropriate candidate will have successfully completed a graduate level physician assistant program (Masters degree) accredited by the Accreditation and Review Committee for Physician Assistants (ARC-PA) or such other accrediting agency as may qualify a graduate to sit for the NCCPA certifying examination
- BS/MS joint programs and those candidates with a BS and PA certificate are eligible, but ONLY for those who graduated BEFORE 1995
- Must have at least two years of experience practicing as a PA to qualify for the PA II position
- Certification by the National Commission on Certification of Physician Assistants (NCCPA) must be obtained prior to first day of employment
- Must hold a current valid license or be eligible for licensure as a physician assistant in the Commonwealth of Massachusetts
- Must have or eligible for, and maintain, a current DEA registration and Massachusetts Controlled Substance Registration
- Must complete 100 hours of CME according to national and state regulations during each two year period of employment
- Must complete the BWH Professionalism Program within three months of date of hire
- Must complete the BWH Procedural Sedation Training if deemed necessary
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
- Must have the ability to work in a high stress, dynamic, busy clinical setting with changing organizational climate
- Must have the ability to be self-directive and to demonstrate initiative in addressing the responsibilities of the position
- Must have the ability to utilize appropriate problem-solving and conflict resolution skills
- Must be energetic and quality driven and have a proven ability to be a productive member of a team dedicated to providing optimal patient care
- Must be proficient with BWH computer systems as needed to independently perform daily tasks (EMR, Epic preferred)
- Must maintain the highest degree of professional judgment under the supervision and guidance of a licensed physician