Physician Assistant (Home Based Primary Care)

Full Job Description

A PA is a credentialed health care professional who provides patient-centered medical care to assigned patients as a member of a health care team and who is authorized to practice with defined levels of autonomy and to exercise independent medical decision making within their scope of practice.

This vacancy will be filled with either a Nurse Practitioner or a Physician Assistant.

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.

Physician Assistant Basic Requirements United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.

Education or Training.

The candidate must meet the following: (1) Graduate of a PA training program which is accredited by the Accreditation Review Commission on Education of PA (ARC-PA) or one of its predecessor organizations.

Additionally, candidates must meet one of the following: Master's degree in any discipline; Bachelor's degree in any discipline with on year of experience as a PA. Certification.

Must have successfully passed the PA National Certifying Exam (PANCE). Licensure.

Must possess an active, current, full, and unrestricted license to practice in a State, Territory, or commonwealth of the United States, or in the District of Columbia.

PAs must maintain current registration in the State of licensure if this is a requirement for continuing active and current licensure in that State OR be a graduate physician assistant pending licensure.

English Language Proficiency. PAs appointed to direct patient-care positions must be proficient in spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d).

Preferred Experience: Physician Assistant-I. a. Experience and Education. None beyond the basic requirements. b. Demonstrated Knowledge, Skills, and Abilities.

The following list of knowledge, skills, and abilities (KSA) present the minimum skill set expected of an Entry Level PA.

This practice may include, but is not limited to: Ability to utilize the principles of PA practice in the care of assigned patients to provide appropriate care.

Ability to perform patient history and physical. Ability to formulate a plan and provide treatment to the patient.

Ability to provide patient care that is abreast of changing concepts and advancements in the profession. Physician Assistant-II. a. Experience and Education.

The PA at this grade is at the intermediate grade level and has had progressively increasing responsibility and experiences as indicated in the KSAs listed below.

Individuals will have demonstrated the ability to analyze and solve more complex medical problems than at the entry level grade and can utilize their training in the successful practice of patient care and participate in team problem solving.

Individuals demonstrate the KSAs of PA-II intermediate level by: Two years of successful practice as a PA; OR Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S.

Armed Forces, or another accrediting agency; OR A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education b.

Demonstrated Knowledge, Skills, and Abilities (KSAs).

PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-II: Skills to analyze and solve complex medical problems.

Ability to function autonomously and make independent medical decisions. Skill to incorporate training and experience into the successful practice of patient care including telehealth medical care.

Ability to work effectively in an interdisciplinary environment for improvement of services for patient care. Ability to practice with colleagues and peers collaboratively. Physician Assistant III. a.

Experience and Education.

PAs at the PA-III grade are at the full performance level and lead and organize patient care independently, practice within multi-disciplinary teams, and coordinate all aspects of patient care across the health care system.

They utilize advanced clinical knowledge and judgment in decision-making and evaluating outcomes.

They function as experts in clinical practice and/or in areas related to the assigned roles and responsibilities, may serve as mentors for transitioning PAs, and may provide training for health care students.

Individuals can demonstrate the KSAs for the full performance level by: Three years of successful practice as a PA; OR Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S.

Armed Forces, or another accrediting agency and one year of professional practice as a PA; OR A doctoral degree in a health-related field from an accredited college or university recognized by the U.S.

Department of Education and one year of professional practice as a PA. (b) Demonstrated Knowledge, Skills, and Abilities.

PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-III: Ability to clinically evaluate facility patient care delivery systems and validate or identify barriers to safe and effective patient care.

Skill to consistently demonstrate an elevated level of expertise and autonomy in diagnosing and treating seriously ill, multi-symptomatic patients through facility Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE).

Ability to present clinical findings and recommendations to appropriate management officials.

Ability to clinically facilitate the delivery of patient care in collaboration with health professionals, health managers, and other health care personnel.

Ability to implement and initiate clinical changes to established treatment protocols based upon new medical literature research findings to enhance patient delivery care for improved patient outcomes.

Ability to participate clinically in the development of the PA patient care audit processes involving in-depth review and analysis of medical records.

The full performance level of this vacancy is PA-III. The actual grade at which an applicant may be selected for this vacancy is in the range of PA-I to PA-III.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

Physical Requirements: This work is mostly sedentary and requires some standing, bending and carrying light items.

The incumbent must have the ability to stand and walk for prolonged periods of time to interact with the patients and other services. Major Duties:

Duties include but not limited to: The Home Based Primary Care (HBPC) Physician Assistant (PA) is a position located in the Geriatrics and Extended Care Service (GECS) and functions as a Primary Care Provider in the HBPC Program.

The Home Based Primary Care (HBPC) Physician Assistant (PA) is a licensed practitioner who has demonstrated a high level of proficiency in patient assessment including performing physical diagnosis, developing a comprehensive treatment plan, prescribing medications, evaluating laboratory data, and assessing patients' and families' psychosocial functioning.

The PA functions as the HBPC provider for his/her HBPC patients and coordinates their care among all members of the health care team, including other HBPC staff, outpatient primary and specialty physicians, inpatient services, ancillary hospital services, and community organizations.

The PA also promotes preventative health care and facilitates patient and staff education. The PA will provide daily support for the activities of the HBPC Team.

The incumbent will function autonomously as guided by approved clinical protocols and privileges, practicing to the full extent of their education, training, and their scope of practice.

Given the interdisciplinary team structure of the clinic, collaboration with other interdisciplinary team members is expected.

Clinical duties: The core elements for a PA Scope of Practice may include, but are not limited to: I. Obtaining medical histories and performing physical examinations. II.

Providing and coordinating medical care for assigned patients in any care setting, including establishing diagnoses, formulating and implementing care plans, and providing follow-up care. III.

Evaluating outpatients to determine the need for further health care. IV.

Ordering diagnostic studies and other special tests, such as Magnetic Resonance Imaging (MRI), Computerized Tomography (CT) scans, etc. V.

Carrying out health promotion, disease prevention, and patient education activities. VI. Ordering or obtaining laboratory specimens. VII.

Ordering ancillary services, such as, pharmacy, social services, physical medicine and rehabilitation therapies, prosthetic services, etc. VIII.

Ordering VA specialty service consults and initiating requests for non-VA medical care and consults in accordance with VHA and local facility policy and procedures. IX. Ordering patient care supplies.

X. Writing orders for or prescribing medications. XI.

Admitting and discharging patients in consultation with, and on behalf of, the collaborating physician, obtaining admission history and performing physical examinations, conducting patient rounds, documenting progress notes and summaries in the patient record, and writing patient orders on assigned patients.

The PA may be delegated the responsibility of documenting operative notes if present for the procedure, but the operative surgeon must review and co-sign the note.

They may also be delegated the task of documenting the discharge summary, but the collaborating physician must write a discharge note, or co-sign the discharge summary written by the PA in accordance with The Joint Commission standards that are applicable.

XII.

Other patient record entries by PAs, including medical histories, physical examinations, progress notes, service consults, Compensation and Pension evaluations, and patient orders do not require physician co-signature unless specifically required by Federal law, VA policy, or the standards of applicable external accrediting bodies.

XIII. Obtaining and documenting informed consent for treatments and procedures for which the PA is responsible. XIV.

Providing education and counseling of patients and families in preventive care, medical conditions, and the use of prescribed treatments and drugs.

Administrative Responsibilities: There is minimal administrative responsibility.

The incumbent will enter their time and leave in the VA Time and Leave System (VATAS) and ensure timely completion of TMS and CME. Occasional meeting attendance may be required, as indicated.

The incumbent will assist with onboarding and mentoring new staff as requested. Completion of peer-review evaluations and infrequent protected peer reviews will be required.

Additional administrative duties may be assigned as needed. Still, they will be kept to a minimum due to the known administrative burden associated with PACT panel management.

Work Schedule: 07:30 - 16:00, or depending on service needs