GENERAL SUMMARY/ OVERVIEW STATEMENT:
The Ambulatory Physician Assistant (PA) in Pulmonary and Critical Care Medicine is an advanced practice provider responsible for assisting physicians practicing in the BWH Lung Center caring for patients with Interstitial Lung Disease. The 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 practitioner has responsibility for assessment and management of patients, including diagnostic and therapeutic interventions, implementation, and evaluation of an appropriate plan of care, and ongoing evaluation. The PA works in collaboration with the attending physicians and is responsible to both the Ambulatory Director and department administrator or chief physician assistant administratively. The PA participates and assists with management, coordination, and transition of care of the patient in the outpatient setting.
In this role, the PA sees ambulatory patients independently. The PA is expected to have three and a half (3.5), four (4) hour clinic sessions per week
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.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Principle Clinical Duties and Responsibilities -ILD:

• Provides direct care, counseling, and teaching to a designated patient population in the Pulmonary ambulatory practice.
• 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 in collaboration with supervising physician.
• Records pertinent patient care findings in the medical record.
• Orders medications and writes prescriptions according to organizational and regulatory policies and procedures.
• Communicates any abnormal findings to attending physician.
• Assists with triage of patient communications related to clinical status. Communicates acute clinical issues to attending physician, as appropriate.
• Serves as a resource to the health care team for patient care issues.
• Consistently provides high quality and timely documentation for both new and established patients in the ambulatory practice. Performs procedures as are appropriate to the patient population.
• 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.
• Incorporates the concepts of health maintenance, prevention, and promotion into daily practice through patient education and counseling.
• Works collaboratively and functions as an effective member of the health care team.
• Demonstrates awareness of community resources and assists staff, patients, and families to effectively utilize them.
• Participates in Divisional and Hospital initiatives such as virtual patient evaluation and meaningful use of the electronic medical record.
• Practices at main campus in The Lung Center, as well as, at satellite locations, as appropriate.

• Serve as a patient advocate and use teamwork to achieve excellent patient outcomes.
• Participate as a learner and/or teacher in educational activities including participation in any CME and non-CME courses run by the Division of Pulmonary and Critical Care Medicine.
• Additional duties and responsibilities as required by the department/division.

Coordination

• Facilitates continuity of care and transition of care via multiple platforms including but not limited to communication with referring providers and consultants.
• Demonstrates appropriate collaborative and consultative relationships with other providers within the institution and community.
• Ensures patient charts are complete before their first appointment and that patients are knowledgeable about next steps in care and future appointments.
• Collaborates with Patient Program Manager to follow patient progress to ensure they are on the correct path and track patient throughout the patient journey.

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 quality improvement initiatives, as appropriate.
• 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 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.
• Contribute to the development, design, and writing of research studies, grant proposals, and IRB protocols, and recruit patients for clinical trials.
• Additional duties and responsibilities as required by the department/division.

Education and Planning
Education

• Acts as preceptor for staff as requested.
• Acts as an educational resource for other trainees including medical students, residents and fellows, as well as nursing and other members of the ambulatory team.
• Participates in orientation of new staff.
• Participates in Departmental and organization continuing education programs.
• Identifies own learning needs and updates clinical knowledge and skills through formal and informal education and review of current literature.
• Educates lay and/or professional groups through lectures, papers, publications, and educational materials.
• Remains actively involved in continuing education with a commitment to self and departmental growth.

Planning

• Develops annual objectives and reviews with PA Director and collaborating MD at time of performance review and at appropriate intervals. Completes annual credentialing process through the PA credentialing program.
• Assists in determining, evaluating, and/or implementing clinical area goals and objectives.
• Maintains interdisciplinary approach for planning and communicating information for patient care and operation of practice.
• Maintains current knowledge of legislation that may affect the health care delivery system.
• The PA shall participate in selected organizational committees, councils, and initiatives (may also add those outside BWH such as AAPA, PAEA, MAPA, etc.).

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 group
Adolescence (13 to 17 years)
X
Neonates (birth to 1 month)
Young Adult (18 to 25 years)
X
Infant (1 month to1year)
Adult (26 to 54 years)
X
Early Childhood (12 months to 5 years)
Senior Adult (55 to 64 years)
X
Late Childhood (6 to 12 years)
Geriatric (65 years and up)
X
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.
• 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.

WORKING CONDITIONS:
Describe the conditions in which the work is performed.
Work settings will include ambulatory clinics. There may be loud noises, noxious odors, and temperature extremes. A large portion of the workday may be spent either standing or walking and the position may require heavy lifting of equipment and patients.
The PA may be exposed to radiation, potentially infectious bodily fluids, and sharp instruments such as needles and scalpels. Knowledge of Universal Precautions and proper use of surgical sharp instruments may be required. The consequences of contamination from bodily fluids or from being stuck with a sharp instrument include the possibility of physical harm to the employee or others. BWH is a fast paced, dynamic environment with a very large and complex patient volume; exposure to stress in the workplace is expected.
While the PA can expect a relatively predictable work schedule planned in advance whenever possible, scheduling variations may occur in order to cover clinical needs as they become apparent to the department/division/clinic. The PA may be asked to pick up additional shifts, work variable hours, and/or provide backup coverage as needed.
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
(MUST be realistic, neither overstated nor understated, and related to the essential functions of the job.)
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.
SUPERVISORY RESPONSIBILITY:
The Physician Assistant I does not have any supervisory responsibility.
FISCAL RESPONSIBILITY:
The Physician Assistant I does not have any fiscal responsibility.
EEO Statement
Brigham and Women's 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.