Emergency Room Physician

Emergency Room Physician

The Emergency Room Physician shall be available to provide services within the Emergency Room Department at Fort Leonard Wood, MO Medical Treatment Facility, to provide services in that role.

Responsibilities

• Collect and record, in proper format, medical and social historical data appropriate to the patient's condition.
• Provide emergency medical care to both inpatients, if part of code team response, and outpatients, summon appropriate on-call specialists as necessary, and continue medical management until the arrival of the appropriate specialist.
• Respond to "Code Blue" (cardiac or respiratory arrest) medical emergency alerts within the hospital and provide resuscitation treatment until more specialized treatment arrives. Should resuscitation efforts be unsuccessful, the physician shall pronounce the patient dead, complete necessary records, and notify the next-of-kin, if the next-of-kin is physically present.
• Patients presenting themselves with non-acute conditions will be reassured and treated in priority as established by medical triage.
• Provide emergency care to patients in the holding area when necessary.
• Prepare appropriate narrative summaries and patient profile changes. Document history, physical examinations, and preoperative diagnosis. Maintain documentation of treatment IAW established procedures.
• Use an electronic medical record system for keeping records, ordering of ancillary procedures, ordering of medications, writing doctor's orders, and performing other required patient record functions.
• As required by MTF, respond to a staff nurse's request for assistance to the emergency needs of hospitalized patients, to carry out procedures, and for writing orders, until the patient's staff physician arrives.
• Dispatch and provide medical control for ambulances IAW MTF procedures.
• If staffing permits, accompany emergency room technicians on ambulance runs when indicated by the nature of the emergency. This includes initial response for disaster-type situations. Remain on the scene until relieved by a staff physician.
• Perform emergency room procedures compatible with the medical facility's operating capacity and equipment.
• Respond to mass casualty situations in accordance with hospital procedures.
• As workload permits during scheduled duty, contract providers shall attend meetings as required by the MTF. The Chief, Emergency Department (ED) may require contract providers to attend a one-hour staff meeting with all contract providers once a quarter. The Chief, ED will schedule the meeting at least 30 days in advance. The meeting will be coordinated through the COR and the contractor.
• Prescribe pharmaceuticals according to the availability of drugs listed therein. Use only prescription forms DA 1289, which have been stamped: "To be filled only at (Name of MTF)." Only a physician can dispense medication to emergency room patients. Contract physicians prescribing medications for patients after the MTF pharmacy has closed must dispense the medications themselves.
• Remain in the emergency room or immediately available to the emergency room throughout the tour of duty, except in response to emergencies and/or disaster ambulance runs. Remain on tour of duty until appropriate replacement is on site.
• Maintain medical records IAW DHA-AI 5015.01. Medical records completed by the contract physician shall be subject to review by the Chief, Emergency Medical Services, and a medical records review committee established by the MTF. The contract physician shall be notified of deficiencies in his/her entries and shall be instructed to correct the deficiencies. All records generated in the performance of the contract will remain the property of and subject to exclusive control of the government.
• At the discretion of the individual MTF, contract physicians shall utilize standardized, templated patient encounter sheets as supplements to the SF 558, in order to facilitate documentation of patient care.
• Verify the content and correctness of all prepared and transcribed reports by affixing his/her own signature and stamp to all copies of the document and validating its contents.
• Document appropriate history, physical examination, required laboratory and x-ray examinations, and preliminary diagnosis (as appropriate) prior to healthcare treatment.
• Patient referrals to civilian practitioners shall be done only after providing notification to the MTF staff in accordance with emergency room procedures at the MTF.
• Provide house staff teaching, prepare and deliver lectures, attend department grand rounds and other scheduled academic activities.
• Provide assistance and training to PA students, special force's members and students on rotations in the clinic.
• Treat patients from other provider panels.
• Perform a general physical examination.
• Record the findings in proper format and determine medical qualifications for various purposes.
• Plan and initiate proper treatment within the contract physician defined privileges and the scope of practice of the facility.
• Provide limited general medical care, diagnosis, treatment and prescription as described in HSC Pam 40-7-7.
• Identify and report those situations and individual cases that have public health significance and carry out effective control measures.
• Obtain an adequate history, physical assessment & develop a treatment plan in a timely & appropriate manner for each patient
• Utilize paraprofessionals as appropriate
• Respond to and provide initial management of cardiopulmonary arrests and arrange backup from the Emergency Medical Services (EMS) as appropriate
• Make preliminary interpretation of radiographic films to include CAT scans
• Perform initial interpretation of electrocardiograms
• Perform documentation and patient care IAW JC guidelines
• Clearly communicate with other health personnel either orally or in writing the findings, diagnosis and planned treatment regimen.
• Code all patient encounters utilizing the Electronic Medical Record. Codes will be based on HCPCS, ICD, and CPT, and all encounters must be closed or transferred prior to the contract physician leaving their shift.
• Follow up on lab and radiology orders they request including contacting the patients and primary care manager with the results. Check results while on shift addressing all abnormal labs and proper documentation.
• Stabilize and manage a patient in a medical or surgical emergency and/or transfer to physician care.
• Facilitate patient access to medical care by recommending appropriate referrals to other health care providers' IAW policies and regulations of the MTF.
• Determine appropriate means of evacuation of emergency patients, prepare patients for evacuation and arrange for evacuation support.
• Maintain inpatient and outpatient medical records in accordance with IAW DHA-AI 5015.01 Records Management. Medical records will be subject to review by the Medical Care Evaluation Committee, Quality Assurance Committee, and designated representatives of the Commander, GLWACH.
• Take part in clinics or programs as required to meet the JC standards.
• Attend and participate in patient care reports, patient care conferences, team conferences, professional staff conferences and other appropriate professional activities only to the extent that such attendance and participation is relative to his/her assigned cases and/or performance of the contract services as determined by the COR or Chief, Emergency Room Department, or his/her designated representative at each location.
• Once a quarter or as required by department SOP, review a percentage of another ER physician's charts. The Chief, ED will randomly pull the charts and assign them to the contract physician for review and provide the physician with a checklist for each chart. The checklist will contain such areas as legibility, documentation, results of labs, x- rays, etc. The contract physician shall return the checklists to the Chief, ED citing the deficiencies found and corrective actions taken.
• Other duties as assigned

Qualifications

• Graduation from a medical school in the United States, Canada, or approved by the Liaison Committee on Medical Education of the American Medical Association (AMA), graduation from a college of osteopathy approved by the American Osteopathic Association (AOA), or graduation from a medical school with evidence of Educational Commission for Foreign Medical Graduates (ECFMG) certification.
• Completion of an accredited emergency medicine residency approved by the Accreditation Council for Graduate Medical Education (ACGME).
• Board certified in emergency medicine by the American Board of Emergency Medicine. OR
• Completion of an emergency medicine accredited residency approved by the Accreditation Council for Graduate Medical Education (ACGME)
• Board eligible in emergency medicine
• Minimum 2,000 hours of ER experience post residency OR
• Completion of an accredited family practice or pediatrics with internal medicine residency approved by the Accreditation Council for Graduate Medical Education (ACGME)
• Board certified in Family Practice or Pediatrics with Internal Medicine Minimum 20 hours per week for the past 12 consecutive months in a similar or higher level III emergency care institution after board certification. Minimum two (2) years' experience within the last three (3) years post residency