Physician Assistant - Endocrine

Physician Assistant - Endocrinology, Diabetes, and Hypertension

The Division of Endocrinology, Diabetes, and Hypertension (Division) general endocrinology Physician Assistant (PA) will be an integral part of the interdisciplinary team approach for overall care and evaluation of patients seeking endocrine care at the Brigham and Women's Hospital. Under direction of the supervising physician(s), the PA will be involved in all aspects of endocrine patient care. The PA functions as a clinical team member, delivering care to a panel of patients for whom s/he has responsibility for the planning, implementation, coordination, and evaluation of endocrine care related outcomes. The PA works in partnership with the patient care team and other practice leaders to ensure the effective delivery of care, and actively supports the achievement of patient, departmental, and organizational goals.

In this role, the PA sees ambulatory patients independently. The PA is expected to have eight (8) four (4) hour clinic sessions per week. While the PA can expect a relatively predictable daytime (four days at 10 hours per day) work schedule planned 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 take call, pick up additional shifts, work variable hours, and/or provide backup coverage as needed.

Usual responsibilities include the following:

• Patient Care Organization
• Performs in the role of direct care provider and is responsible to work both independently and in collaboration with other providers to maintain a panel of patients.
• Provides direct care, counseling, and teaching to patients.
• Performs physical examinations and provides preventive health measures appropriate to patient needs.
• Orders, interprets, and evaluates appropriate lab and diagnostic tests to assess patients' clinical problems and health care needs.
• Arranges for appropriate plan of care and follow-up based on outcome of diagnostic, lab, and physical assessment findings. Seeks consultation as appropriate.
• Orders medications and writes prescriptions according to organizational and regulatory policies and procedures.
• Records pertinent patient care findings in the electronic medical record.
• Sets priorities for appropriate and efficient management of patient care that reflects evidence-based practice and cost-effective management of time, available human resources, supplies and equipment.
• Maintains an interdisciplinary approach to planning and communicating patient care information by discussing patient data with appropriate providers, the clinical team and other health care professionals.
• Incorporates the concepts of health maintenance, prevention, and promotion into daily practice through patient education and counseling. Assists patients and families in self-care management through the provision of information, tools, and resources.
• Demonstrates awareness of community and hospital resources and assists staff, patients, and families to effectively utilize them.
• Quality Monitoring
• Engages in regular performance improvement activities. Uses performance and patient outcome data for continuous quality improvement.
• Collaborates with physicians, physician assistants and the interdisciplinary team to refine team goals and objectives and further ensures ongoing continuous improvements to the care delivery model.
• Analyzes, interprets and presents team-based care results to various audiences as appropriate including senior organizational leaders, departmental and practice leaders, nursing leadership, colleagues, and staff.
• Translates themes uncovered through ongoing quality monitoring and evaluation into the care model and the clinical practice of the interdisciplinary team.
• Job Specific Tasks
• Thyroid
• Seeing patients with hypothyroidism to monitor responses to treatment and adjust doses of thyroid hormone.
• Conducting virtual visits with pregnant patients with hypothyroidism during each trimester to monitor responses to treatment and adjust doses of thyroid hormone.
• Seeing patients with hyperthyroidism who have been treated with radioactive iodine to monitor post-treatment changes in thyroid hormone levels.
• Seeing patients with low-risk thyroid cancer to review imaging studies and blood tests checked to monitor for recurrence.
• Assessing thyroid ultrasound results to determine which patients with nodular thyroid disease require initial or repeat fine needle aspiration biopsies.
• Bone and Mineral Metabolism
• Seeing patients with osteoporosis who have started treatment with bisphosphonates to assess adherence and check for side effects.
• Conducting virtual visits with patients with osteoporosis treated with bisphosphonates and other antiresorptive agents to monitor status, assess adherence, and check for side effects.
• Seeing patients with primary hyperparathyroidism who have undergone parathyroidectomy to monitor post-treatment changes in calcium and PTH levels.
• Adrenal
• Seeing patients with primary adrenal insufficiency treated with stable glucocorticoid and mineralocorticoid replacement to monitor responses to treatment.
• Seeing patients with steroid-induced adrenal insufficiency to monitor status while tapering glucocorticoids.
• Hypertension
• Seeing patients with hypertension for blood pressure checks after antihypertensive regimens have been modified or adjusted.
• Reproductive
• Seeing patients who have started estrogen replacement therapy for vasomotor symptoms of menopause to monitor status and check for side effects and appropriate dynamic endocrine testing.
• Other
• Seeing patients with other endocrine disorders as appropriate.

Qualifications

• Master's degree from an accredited Physician Assistant program required; doctoral degree (DMSc or equivalent) preferred.
• Current, valid Massachusetts Physician Assistant license required.
• National Certification: Current NCCPA certification (PA-C) required.
• Certified Diabetes Educator preferred.

Skills/Abilities/Competencies Required:

• Expert clinical knowledge, leadership, and technical skills to achieve all aspects of the role
• Strong organizational skills
• Project management ability and skills
• Ability to manage meetings to encourage participation and achieve results
• Excellent written and oral communication/presentation skills
• Demonstrated effectiveness as a team leader, member, and facilitator
• Ability to manage time and resources effectively to meet program deadlines and objectives
• Problem-solving ability, data management and analysis
• Ability to perform in fast-paced office, clinical and patient home settings
• Demonstrates knowledge of evidence-based practice and assures clinical practice within the program is evidence-based
• Must possess the ability to function clinically both as an autonomous provider and as a member of an interdisciplinary team
• Demonstrated ability to work collaboratively with a variety of clinical and administrative staff, forming strong partnerships
• Ability to function at the highest level professionally and clinically, must possess excellent interpersonal skills

Working Conditions:

Work settings will include ambulatory clinics, but could at some point include treatment rooms, inpatient areas, intensive care units, operating rooms, and/or procedural areas. 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.