Physician Extender II - Clinic

PHYSICIAN EXTENDER II



CLINIC



HEALTH DEPARTMENT


General Statement of Duties:


This is an advanced level of professional work augmenting the medical director physician in making medical diagnosis, practicing medical acts, ordering therapy and dispensing medical treatment. The physician extender will provide nursing and medical services within the health department programs, which are family and community oriented.


This position functions as a Physician Extender in clinical areas by delivering traditional and public health services and primary care. The Physician Extender obtains a thorough patient history and physical examination, performs appropriate diagnostic and therapeutic procedures, and records the information in the patient's medical record. The Extender also develops and maintains health care plans and counsels patients. The Extender provides medical services under the supervision of a physician who is ultimately responsible for the Extenders medical practice. Supervision of the physician includes a set of mutually agreed upon patient care protocols, medical resources and guidelines with the physician immediately available by telephone or in person, if needed for consultation. In addition, the Extender may also function under the direction of administration, while performing non-medical acts.


The Physician Extender will report to the clinic nursing supervisor and medical director and may occasionally supervise other staff such as RN's, MOA's/Interpreters, Aides etc.


"Public Health is a first responder agency for natural disasters (e.g. hurricanes, tornadoes, floods, winter storms), naturally occurring infectious disease outbreaks (e.g. influenza, SARS), technological hazards (hazardous materials releases, critical infrastructure disruptions), and terrorist incidents. This position, like all other positions within the Department, may be required to participate in any emergency response activities as deemed necessary by the Health Director or his/her designee. Availability during emergencies and exercises is required". Appropriate ICS courses will be completed as assigned for position.


Examples of Duties Performed:

• Patients present with a broad variety of conditions. The Physician Extender has the ability and delegated authority from the supervising physician to make independent and varied decisions affecting the patient's treatment plan and total care. The Physician Extender must interpret the accepted patient care protocols and medical guidelines to cover the various conditions and determine the appropriate course of action. The Physician Extender may also supervise other examiners, serve on agency committees, formulate/review policies and procedures, precept students and be a consultant to the medical staff.
• The Physician Extender must have a complete understanding of public health concepts, patient care protocols, and medical guidelines used in the areas of work, agency policies, procedures, reference manuals, program guidelines and standards.
• Daily work is self planned and performed with considerable independence. Short range plans and changes can usually be implemented. Significant or long range plans are initiated by the supervising physician and coordinated with the clinic nursing director and other members of the health care team, such as pharmacists, nutritionists, etc. Result of the work demonstrates concern for the individual, family and the outcome of the illness and its impact on the patient population served.
• Services include, but are not limited to ordering, conducting, supervising, and interpreting diagnostic and laboratory tests, and prescription of pharmacologic agents and non pharmacologic therapies. Teaching and counseling individuals, families and groups are a major part of Physician Extender practice.
• Physician Extenders practice in collaboration with health care professionals and other individuals to diagnose, treat and manage the patient's health problems. The Physician Extender is also a patient advocate.

Clinical Activities:



Identify the health status of the individual by:

• Recognizing normal and abnormal findings.
• Performing appropriate diagnostic procedures.
• Counseling patients and making proper referrals.
• Obtaining a thorough patient health history through knowledge of interviewing techniques.
• Performing physical exams with skill.
• Accurately recording findings in the record.
• Presenting information to the physician accurately and thoroughly.
• Providing health maintenance teaching, counseling, guidance to individuals, families or groups.
• Prescribing the correct medications and treatment.
• Referring to available resources in county, as needed.
• Assuming the responsibility of ongoing health maintenance and clinical management of stable and chronically ill patients.
• Assuming responsibility for provision of services in family planning, geriatrics, pediatrics, obstetrics, communicable diseases, bioterrorism, and primary care illness.
• Serving as a consultant to the staff, participating as in-service education leaders, and serving as a preceptor to students.
• Participating in a broad variety of duties and responsibilities which may include evaluations, development and implementation of agency policies, procedures, goals and objectives and other administration functions.
• Functioning within OSHA Standards and implementing these in work areas.

Recruitment Standards:

• Academic preparation enables the Physician Extender to assume the responsibilities formerly assumed solely by the physician. Extenders can solve problems, situations and evaluate patient's total needs. They can provide comprehensive care to patients. Encountering all levels of education from time to time, the Extender can interpret proper treatment for the patient. The Extender can move and work in other clinic sites with expertise, competence of care and adapt to different working conditions. Dynamics of work scope range from simple procedures i.e. heights and weights to complex histories and diagnosis, treatment plans and follow-up.
• The Physician Extender must be able to perform accurate and comprehensive patient histories, physical exams, arrive at an appropriate diagnosis and order appropriate treatment plans including counseling instructions. Physician Extenders must possess the ability to detect situations where referrals are appropriate for consultations and treatment. Accuracy in work, medicines and quality of care is a must.
• The autonomous nature of Physician Extender's advanced clinical practice requires accountability for health care outcomes. Ensuring the highest quality of care requires certification, periodic peer review, clinical outcome evaluations, a code for ethical practice, evidence of continuing professional development and maintenance of clinical skills. Physician Extenders are committed to seeking and sharing knowledge and promoting quality health care and improved clinical outcomes.
• Medical/clinical supervision and consultation is received from the clinic physician. Administrative supervision is from the clinic nursing supervisor.

Minimum Education and Experience:

• The Family Nurse Practitioner (FNP) must be currently registered as an RN in North Carolina, have national certification accredited by a national credentialing body, and be licensed and certified to practice through the North Carolina Board of Nursing. Application for supervising physician is through the NC Medical Board.
• The Physicians Assistant (PA) must be currently licensed and approved to practice through the NC Board of Medical Examiners and have certification through the National Council of Certification of Physician Assistants (NCCPA).