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: Indicate key areas of responsibility, major job duties, special projects and key objectives for this position. These items should be evaluated throughout the year and included in the written annual evaluation.
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
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
Additional duties and responsibilities as required by the department/division
For all positions that include direct patient care, indicate with an "X" the age(s) of all patient populations served
No Direct Patient Care
All age groups
Adolescence (13 to 17 years)
Neonates (birth to 1 month)
Young Adult (18 to 25 years)
Infant (1 month to1year)
Adult (26 to 54 years)
Early Childhood (12 months to 5 years)
Senior Adult (55 to 64 years)
Late Childhood (6 to 12 years)
Geriatric (65 years and up)
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
Assists the surgeon in the OR, acting as first or second assistant during the following phases:
prepare and drape patient, make skin incisions, use staplers, fascial closure devices, set up retractors, close fascia, subcutaneous tissue and skin, dress surgical incisions,
Inserts nasogastric tubes and maintains suction decompression of the stomach as well as irrigation of the same tubes
Catheterizes and maintains indwelling urinary drainage tubes.
Removes chest tubes.
Cleans, debrides and sutures minor lacerations. Cares for wounds including debridement, I&D's dressings, VAC sponge applications/removal, removal of drains and tubes and suture removal.
Performs EKG's when technician is unavailable and reviews tracing for arrhythmias and ischemia.
Performs cardiac resuscitation and ATLS as indicated
Performs and records complete history and physical examination.
Makes daily rounds by him or herself or with surgical team on patients with a variety of surgical conditions and reports findings to the Attending Surgeon. Manages patient care, evaluates change in patient status, writes orders, obtains consultations, and interprets lab values and x-rays with assistance of physicians as necessary. Gives special instructions to patients prior to discharge.
Writes daily progress notes and completes discharge summaries.
Collects data from charts or interviews with patients for clinical studies being performed under the direction of the Attending Surgeon.
Assists the surgeon in highly specialized procedures in approved protocol of clinical investigation in patients and experimental surgery in animals.
Must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served on his/her assigned unit.
Other duties as assigned.
Physical and mental abilities required.
Must be quality driven and have proven ability to be a productive member of a cohesive team of peers, dedicated to providing optimum patient care.
Must exercise the highest degree of professional judgment under the direct supervision and guidance of a licensed physician.
Must maintain a professional attitude towards patients and exercise such mature independent originality in solving problems not covered by existing guidelines, within legal limits, to meet the needs of the patients.
Must maintain a professional attitude towards patients at all times and an excellent and collegial working relationship with other personnel involved in patient care.
Must demonstrate understanding of procedures, policies and documentation required to ensure compliance with hospital standards of care.
Each PA II shall demonstrate the following clinical knowledge, skills and competencies:
For the most common diagnoses admitted to the general surgery service, demonstrate competency to effectively diagnose, formulate appropriate treatment plan, and efficiently implement the plan without much direction, and with a greater level of independence, from the attending physician.
Clinical skills and knowledge as well as professionalism of the PA II candidate are assessed by chief physician assistant of the department under the direction of the division chief.
Candidates with two or more years of relevant PA experience prior to joining the general surgery service become eligible for a preliminary evaluation of competencies approximately 3 months after joining the service. The purpose of the preliminary evaluation is to provide feedback to the candidate on progress towards level of competency required and provide guidance on additional development needs. After approximately 6 months, after joining the (service), the candidate then becomes eligible to complete the assessment and, if successful advances to a PAII.
If a candidate does not pass the competency assessment, the chief physician assistant will provide feedback on additional development needs. Re-assessment is possible after 6 months of focused development.
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