PA-Orthopedics-3

Job Description Summary

Under the medical direction of the MD Chair of Orthopedics as well as the Executive Director of APCs, the PA will evaluate, treat and manage patients with orthopedic conditions.

Job Description

Receiving general direction from the Medical Director - Surgical Services, Chairman - Orthopedic Services, Executive Director - APC’s, Lead Orthopedic Physician Assistant and Executive Director – Musculoskeletal Service Line.  The position will assess, diagnose and treat health problems of patients who suffer from a range of musculoskeletal conditions from time of admission to discharge. Patients include but are not limited to: adult and pediatric inpatient trauma, joint replacement, Fragile Fracture Program patients and General Orthopedic patients.  As a highly skilled clinician, the incumbent will participate with other members of the Orthopedic and Hospital Medicine Care Team in the Emergency Department, Orthopedic Inpatient Unit(s) and serve as first assist in the Operating Room.

Minimum Education – Preferred

•   Bachelor’s degree

•   Completion of Advanced Physician Assistant training program from an accredited institution approved by the AMA.

•   Recertification, as required, to maintain licensure.

Minimum Work Experience

Acute Medicine and/or Orthopedic experience preferred

Required Licenses / Registrations

PA - Physician Assistant

Required Classes/Skills -

ACLS - Advanced Cardiac Life Support

Required additional Knowledge, and Abilities

• Possess the ability to care for patients with musculoskeletal conditions who may also have any range of medical problems.
• Possess the maturity, self-confidence, and ability to follow complex patient management plans as directed by the attending physician.
• Eligible for state and federally controlled substances registration.
• Demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served on his/her assigned unit.
• Time Management: Exceptional organizational skills and ability to organize time and priorities effectively, asking for direction when appropriate. Flexibility to handle multiple tasks and deadline pressures. 
• Quality Improvement: Skills to work efficiently and effectively and strive to do so in all aspects of the position.
• Knowledge and competence of basic radiation safety during fluoroscopic procedures; required to attend at least one radiation safety training session per year.
• Must have broad knowledge of medical environment, surgical practices and performance goals of the orthopedic Services
• Must exercise the highest degree of professional judgement under the direction and guidance of a licensed physician.
• Must be able to accept instruction and guidance and assume graded responsibility in complex teamwork.
• Must be able to administer such care and treatment and exercise such independent originality in solving problems not covered by existing guidelines, within legal limits, to meet the needs of the patients.
• Must maintain a professional attitude toward patients at all times and an excellent and collegial working relationship with other personnel involved in patient care.

Working Conditions

Position Hours:  Typically Monday through Friday with potential for rotating weekend days.  Additional Weekend and Holiday coverage as determined based on the needs of the department.

Clinical Responsibilities

Provides direct care to orthopedic patients in collaboration with the Orthopedic Attending Physician.  The duties and responsibilities of the Orthopedic Physician Assistant involved in in-patient care will include, but are not limited to:

• Obtains a detailed and accurate medical history and performs a comprehensive physical exam for patients admitted for elective, non-elective and trauma orthopedic procedures.
• Implementation of all Orthopedic Surgery care plans including writing orders, transfer orders, wound care, dressing changes, application of casts/splints, and fracture reductions.
• Collaborates with hospitalist team on co-managed patients
• Discharge orders and planning, writes discharge orders, dictate formal discharge summary, prescription writing, VNA care plan, etc.
• Obtain, review and interpret radiology and laboratory studies and implement appropriate care plan based on the results in accordance with attending physician instructions.
• Orders necessary diagnostic tests, consultations and procedures as indicated or requested by the attending physician.
• Performs or assists in routine and complex procedures, as necessary.
• Serves as first or second assist in the Operating Room, as necessary.
• Identifies and manages chronic medical conditions and provides continuous care to hospitalized inpatients.  Proactively manage patient to prevent complications.
• Has familiarity with current guidelines regarding the assessment of the risk of a perioperative cardiovascular event for pre-operative patients (such as RCRI, and ACS-NSQIP) and pre-operative medical optimization. 
• Writes orders and prescribes medications in accordance with current practice guidelines.
• Writes complete and comprehensive notes on all patients using appropriate electronic systems consistent with Hospital policy.
• Facilitates timely care, including scheduling of procedures, for patients in the Geriatric Fracture Program.
• Actively participates in the South Shore Health System readmission reduction efforts.
• Collaborates with the patient care team (physicians, nurses, PT/OT, case management) to develop and facilitate care plan.
• Provides urgent evaluation to patients with changes in clinical status.
• Safe and effective operation of fluoroscopy equipment; certification within 1 year of hire date.

Situations That Require Referral or Consultation

• Referrals and/or consultations may be obtained by the Orthopedics Physician Assistant when the attending physician deems necessary, and need to be obtained for any medical or surgical problem that does not fall within the scope of practice of the supervising physician.

Delegation of Supervising Physician Responsibilities

• The direct supervision of work performed by the Orthopedic Physician Assistant is the responsibility of the supervising physician or his/her designee (who must be another MD) in accordance with all state and national guidelines.  
• An MD may delegate to his/her Orthopedic Physician Assistant only duties and responsibilities that fall within the scope of practice of the supervising physician.
• Orthopedic Physician Assistant will follow all state and national mandates and guidelines as they pertain to the emergency management of patients.

Scope of Prescriptive Practice

The scope of prescriptive practice will conform to the Massachusetts State Controlled Substance Act, all Department of Public Health, and Massachusetts Board of Registration for Physician Assistants, Massachusetts Board of Registration in Medicine and other applicable statutes and regulations.

•   The prescriptive practice of the Orthopedic Physician Assistant will be reviewed by the supervising physician in an ongoing format, at least quarterly.

•  The Orthopedic Physician Assistant may prescribe the following classes of medications:  Class II-Class V.

Other Responsibilities

Actively participates in meetings, including:

• Monthly Orthopedic Staff Meeting
• Joint/Geriatric Fracture Program Team Meetings.
• Participate in continuing education activities to maintain or enhance knowledge and skills.
• Ensures that patient billing is submitted accurately and consistent with Hospital policy.
• Other duties and projects as assigned.