Physician (Hospice Palliative Care)

Full Job Description

The role of the Hospice Palliative Care (HPC) Physician will be to provide clinical care and goal planning in an interdisciplinary approach to Veterans and family members.

The goal is to provide care that enhances the Veteran's rights and wellbeing.

The duties include specific responsibilities for the HPC Physician functioning as a Licensed Practitioner of the Department of Veterans Affairs.

The physician will meet credentialing requirements of the VA specific to the discipline.

To qualify for this position, you must meet the basic requirements as well as any additional requirements (if applicable) listed in the job announcement.

Applicants pending the completion of training or license requirements may be referred and tentatively selected but may not be hired until all requirements are met.

Currently employed physician(s) in VA who met the requirements for appointment under the previous qualification standard at the time of their initial appointment are deemed to have met the basic requirements of the occupation.

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.

Degree of doctor of medicine or an equivalent degree resulting from a course of education in medicine or osteopathic medicine.

The degree must have been obtained from one of the schools approved by the Department of Veterans Affairs for the year in which the course of study was completed.

Current, full and unrestricted license to practice medicine or surgery in a State, Territory, or Commonwealth of the United States, or in the District of Columbia.

Residency Training: Physicians must have completed residency training, approved by the Secretary of Veterans Affairs in an accredited core specialty training program leading to eligibility for board certification.

(NOTE: VA physicians involved in academic training programs may be required to be board certified for faculty status.) Approved residencies are: (1) Those approved by the Accreditation Council for Graduate Medical Education (ACGME), b) OR [(2) Those approved by the American Osteopathic Association (AOA),OR (3) Other residencies (non-US residency training programs followed by a minimum of five years of verified practice in the United States), which the local Medical Staff Executive Committee deems to have provided the applicant with appropriate professional training and believes has exposed the physician to an appropriate range of patient care experiences.

Residents currently enrolled in ACGME/AOA accredited residency training programs and who would otherwise meet the basic requirements for appointment are eligible to be appointed as "Physician Resident Providers" (PRPs).

PRPs must be fully licensed physicians (i.e., not a training license) and may only be appointed on an intermittent or fee-basis.

PRPs are not considered independent practitioners and will not be privileged; rather, they are to have a "scope of practice" that allows them to perform certain restricted duties under supervision.

Additionally, surgery residents in gap years may also be appointed as PRPs. Proficiency in spoken and written English. Preferred Experience: Hospice experience required.

Reference: See VA Handbook 5005, Part II, Appendix G-2. For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

Physical Requirements: Must be able to physically and mentally perform the duties of Physician under normal and emergent conditions.

Moderate lifting 15-44 lbs and over with assistive devices, heavy carrying of 15-44 lbs and over with assistive devices; reaching above shoulder; use of fingers, both hands required, walking or standing up to 4 hours per day; repeated bending up to 1-2 hours per day; ability for rapid mental and muscular coordination; near vision correctable; hearing aid permitted.

See VA Directive and Handbook 5019. Major Duties:

The duties and responsibilities of the HPC Physician include, but are not limited to the following: Responds to all Palliative Care consults within 72 hours (excluding holiday weekends), some within 24 hours depending on urgency.

Initiates outpatient consults for Hospice care as needed.

Provides goal setting with Veteran and family by initiating and chairing Veteran/family meetings and recording the outcome of the meeting in the medical record to communicate Veteran/family goals for all involved staff to understand.

These meetings may be in the inpatient or outpatient setting. The Veteran's attending health care provider is encouraged to attend these family meetings.

Some issues of discussion may include code status, advanced directives, and identification of resource needs.

These meetings will include the other members of the Palliative Care Consult Team (PCCT) to be in attendance as much as able.

Collaborates with Veteran and physicians caring for the Veteran at the time (i.e., Emergency Department (ED) physician, Primary Care, or hospitalist) to be informed of the history and prognosis of the patient.

Will be available to the ED as needed to assist with case-finding and goal setting.

Provides direct interaction with the Veteran and family in various venues, such as attending primary care visits at the time of the Veteran's appointment, being able to participate in home visits, if deemed necessary, and willing to visit the Veteran at the Veteran's location.

Responsible for ongoing pain and symptom management with evaluation and adjustments as needed.

Requires special interest/skill in malignant acute pain management with availability to other medical providers for consultation.

Fills prescriptions for narcotics, palliative care medications, and durable medical equipment requests as needed.

Will attend weekly Interdisciplinary Team (IDT) meetings with HPC, other IDT meetings or MICU/SICU rounds as needed, monthly HPC meetings, VISN 6 and National Palliative Care meetings if scheduled, GEC meetings and memorial services as requested, and daily rounds to acute inpatients.

Contributes to the VISN 6 HPC Task Force and VISN 6 HPC staff as needed. Participates in conference calls as scheduled. Works to strengthen and progress the overall HPC Service in VISN 6.

Serves as a member of the facility's Ethics Committee, meeting quarterly or as needed Works closely with PCCT for a facility-unified strong program and available to Community Based Outpatient Centers (CBOC) and Home Based Primary Care (HBPC) physicians for consultative services as needed.

Assists case managers with evaluating requests for inpatient palliative care admissions.

Contributes to educational needs of others by providing education for: facility grand rounds; teaching offerings for medical residents; teaching sessions as requested from PCCT; consider community requests and contribute as able; available to visit CBOCs to provide direct education with medical site practitioners; assist the HPC RN with introduction of palliative care services to various specialties and types of care related to the VA (i.e., Acute Care, Primary Care, Chronic Disease Management, Mental Health, or Urgent Care, etc.).

Demonstrates continued ongoing education in the field. Provides cross-coverage for other physicians in GEC.

Collaborates with Research staff in pursuing research options in palliative care and is involved in National, regional, or local palliative care research as able.

Maintains a team mindset and pictures PCCT as a unification of care, with a cooperative mindset of a culture of working together with the HPC RN, Social Worker, Chaplain, Psychologist, and other staff who are part of the team process to deliver care.

Links the team with other members of the VA facility by inclusion of the Service line with other existing programs.

Sensitive to cultural diversification and teaches respect for other people, groups, and faiths as indicated. Looks for ways to bring palliative care into existing programs, promoting bridge-building.

Collaborates with VA community Hospice partners. Will remain proactive in suggestions of how to evaluate and improve services.

Reviews monthly and quarterly quality measures, making any necessary adjustments.

Determines business decisions with the input of other stakeholders for the improvement of care for the Veteran and family.

Ability to brainstorm and be open to suggestions for ways of delivering improved care.

Contributes to the annual report and maintains running list of items learned that may benefit the PCCT or other Palliative Care teams and tracks value-added benefits to the care of the Veteran and family.

Will continue to expand HPC services to all end-stage conditions and disciplines.

Collaborates with other VISN 6 facilities to assist in sharing information that may be helpful in promotion and growth of the program. And, other duties as assigned by Supervisor.