Physician Assistant (PA) – Orthopaedics

Mass General Brigham

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Description

GENERAL SUMMARY/ OVERVIEW STATEMENT:

Under the supervision and direction of the Physician Chief of the Hand and Arm Service, immediate supervising physician, APP Clinical Director, and the Administrative Manager, the Physician Assistant (PA) is responsible for the care of the orthopaedic hand and arm population in the outpatient setting. The PA coordinates all aspects of care to enhance the patient/family surgical experience, which includes preop optimization, intraop first assist, postop care, symptom management and surveillance. The PA will conduct independent clinics for new, established, postop and add-on/urgent visits, as well as assist surgeons in their high-volume clinics.

The PA will practice in accordance with the rules, regulations and standards issued by the state and federal governing boards, including the American Academy of Physician Assistants (PAs) and the National Commission on Certification of PAs.

PRINCIPAL DUTIES AND RESPONSIBILITIES: 

  • Provides direct care, counseling, and teaching for the orthopedic hand and arm patient population.
  • Functions independently in own clinic (15-20 pts/day), and manages/coordinates all aspects of patient care.
  • Assists supervising physician with overall management of his/her patients, including organization/workflow of clinics and all non-revenue generating tasks associated with patient care, and assists other surgeons in the service when necessary.
  • Assists APP colleagues with clinic coverage during vacations, sick or FMLA absences.
  • Performs complete histories and physical examinations on new, established, preop, and postop patients.
  • Handles urgent add-on or walk-in patient visits.
  • 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.
  • Consults with supervising physician/other orthopaedic hand and arm surgeons regarding abnormal findings outside PA scope of practice.
  • Prescribes medications and narcotics as necessary according to organizational and state/federal regulatory policies and procedures.
  • Initiates consultations and referrals for patients.
  • Obtains preoperative surgical consents; confirms laterality and abides by all hospital consent guidelines.
  • Performs surgical optimization/education for patient and family, reinforcing the surgical plan presented by the attending physician.
  • Orders necessary preop diagnostic tests (MRSA/MSSA for implants), labs, imaging, consultations, and procedures as indicated or requested by the attending physician to prevent delay/cancellation of the surgical procedure, which also includes obtaining medical clearance and instruction regarding medications (anticoagulation/DMARDs/ DM) prior to surgery from PCP or specialists.
  • Provides symptom management for hand and arm patients; surgical and nonoperative.
  • Manages high volume of patient calls, Patient Gateway messages, emails and completes all outpatient clinical forms (FMLA, insurance disability, hardship needs).
  • Obtains prior authorizations for surgery, scans, medications, or DME when peer-to-peer calls are necessary (insurance MD-PA calls). 
  • Consistently provides high quality and timely documentation of clinic visits (within 72 hrs), admission note from office, outpatient progress notes, procedure notes, and e-mail/phone conversations.
  • Contributes to patient presentation in clinic, weekly indications conference, and multi-disciplinary meeting/conferences as necessary.
  • Identifies patients appropriate for division research studies and obtains consents after completion of Insight training. May conduct independent research and/or quality improvement studies.
  • 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.
  • Maintains communication with all inpatient staff, if necessary (APPs, case management, OT/PT, consults if necessary), off-site staff (Danvers, Waltham, Boston) and all involved in the transition of patient care (skilled facility, VNA, PCP, referring physicians). 
  • Demonstrates excellent interpersonal and communication skills to provide quality patient/family centric care.
  • Demonstrates expert clinical judgment skills to function in an independent role.
  • Performs other responsibilities required by the Hand and arm service (injections).
  • Demonstrates professional collaborative and consultative relationships with all orthopedic hand and arm service staff and other multidisciplinary providers.
  • Participates in departmental and organizational committees and programs as appropriate and attends all required departmental meetings, in-services, and professional trainings.
  • Remains actively involved in continuing education with a commitment to self and departmental growth.
  • Adheres to all established safety policies, clinical policy and procedures, and infection control precautions; identifies potential or actual unsafe situations in the environment and takes measures to rectify the situation. Documents and complies with hospital standards of care.

SKILLS/ ABILITIES/ COMPETENCIES REQUIRED: 

  • Able to work in a high stress, dynamic, fluid, outpatient clinical setting with a changing organizational climate and high-volume clinics.
  • Has the ability to travel to all off-site locations (Waltham, Danvers, Boston) to support the overall function of the Hand and Arm service.
  • Is self-directed, proactive and demonstrates initiative in addressing the responsibilities of the position.
  • Demonstrates problem-solving and conflict resolution skills.
  • Has excellent interpersonal and communications skills to care for the hand and arm population; provide patient-family centric care and interact with multidisciplinary providers involved in the specialized care of hand and arm patients. 
  • Demonstrates an energetic, positive drive to be a productive member of a team dedicated to providing optimal patient care.
  • Proficient with electronic medical record systems to independently perform daily clinical tasks (Epic preferred).
  • Holds self and colleagues accountable to learn, develop and achieve the best and highest quality results.
  • Treats all colleagues with respect.
  • Maintains the highest degree of professional judgment under the collaborating supervising physician, director of APPs and administrative manager.

WORKING CONDITIONS: 

Work may require contact with needles and other sharp instruments or division specific technology. Prolonged standing and fast-paced environment can be expected. Will require travel to off-site facilities (Boston, Danvers, Waltham).

Qualifications

QUALIFICATIONS: 

  • The appropriate candidate will have successfully completed a graduate level physician assistant program (Master’s 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.
  • 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.
  • In addition, PA must demonstrate continued competence by passing a re-certification exam every ten years.

EEO Statement Massachusetts General Hospital is an Affirmative Action Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.

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