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.
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
The Medicine Physician Assistant I is a member of the inpatient Physician Assistant Clinician Educator (PACE) team. The PA I is responsible for assisting attending physicians in the medical management of patients assigned to the PACE service. The PA I position on the PACE team can be quite challenging, requiring both teamwork and individual initiative. A high level of patient care is required while working quickly and often multi-tasking.
The PA works closely with the physician and nursing staff to develop and coordinate a plan of care designed to meet the physical, psychological and social needs of patients and their families. Strong interpersonal, organizational and communication skills are required. Knowledge of current literature and a commitment to continued learning are also required. The mission, vision and cored values of the Brigham and Women's Hospital (BWH) are incorporated into all areas of practice.
As a member of the PACE team, each PA I shall be responsible for the following duties:
Inpatient Clinical Duties
Collaborate with PACE team in admission of patients to BWH
Assist PACE attending physicians on daily patient rounds to monitor patient care and formulate treatment plans
Write daily progress notes
Implement PACE attending physician instructions for patient management in close cooperation with nursing staff
Perform procedures within the PA scope of practice and as directed by the attending
Order and interpret appropriate laboratory testing and other special examinations as requested
Serve as a resource to the health care team for patient care issues
Collaborate with care coordinator for all patient care referrals
Prepare succinct and accurate sign-out to facilitate the smooth transition of patient care from one PA to another PA or physician
Assist in the planning and implementation of discharging patients
Work collaboratively and function as an efficient member of the health care team
Assist in the coordination of consultation of other sub-specialists involved in the care of PACE patients
Provide education to patients and families
Document in the medical record as appropriate and communicate observations/findings with attending physicians
Monitor environment of care and comply with regulatory agency standards
Ensure that his or her clinical practice is consistent with physician assistant policies, procedures and standards
Participate in QA/QI projects as appropriate
Medical knowledge includes an understanding of pathophysiology, patient presentation, differential diagnosis, patient management, surgical principles, health promotion and disease prevention. The PA I must demonstrate core knowledge about established and evolving biomedical and clinical sciences and the application of this knowledge to patient care in their area of practice. In addition, the PA I is expected to demonstrate an investigatory and analytic thinking approach to clinical situations.
The PA I is expected to:
Understand etiologies, risk factors, underlying pathologic process, and epidemiology for medical conditions
Identify signs and symptoms of medical conditions
Select and interpret appropriate diagnostic or lab studies
Manage general medical and surgical conditions to include understanding the indications, agents and other relevant treatment modalities
Identify the appropriate site of care for presenting conditions, including identifying emergent cases and those requiring referral or admission
Identify appropriate interventions for prevention of conditions
Identify the appropriate methods to detect conditions in an asymptomatic individual
Differentiate between the normal and the abnormal in anatomic, physiological, laboratory findings and other diagnostic data
Appropriately use history and physical findings and diagnostic studies to formulate a differential diagnosis
Provide appropriate care to patients with chronic conditions.
Demonstrate proficiency with BWH computer systems as needed to independently perform daily tasks such as order entry, EMAR, lab tests and results, incident reporting, etc.
Consistently provide high quality and timely documentation including admission notes, progress notes, discharge summaries and dictations.
Must have knowledge of billing practices.
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
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