Physician Assistant Orthopaedic Surgery

Boston’s Brigham and Women’s Hospital (BWH) is an international leader in virtually every area of medicine and has been the site of pioneering breakthroughs that have improved lives around the world. A major teaching hospital of Harvard Medical School, BWH has a legacy of excellence that continues to grow year after year.

The Physician Assistant will work with two Hand and Upper Extremity Surgeons as well as various Fellows and Residents on the Service. Time will be divided between the outpatient clinic, operating room, and administrative tasks centered on patient care. Time devoted to each setting may vary by week and the operating room time is minimal.

**Principal Duties and Responsibilities:** The Physician Assistant will work with an Orthopedic Spine physician as well as various Fellows and Residents on the Service. Time will be divided between the outpatient clinic, operating room, and administrative tasks centered on patient care. Time devoted to each setting may vary by week. **Clinical Duties:** * Collaborates with attending physician to diagnose and treat hand and upper extremity, and related illnesses in the ambulatory setting. Clinic setting would include both shared clinic with opportunity for growth into an autonomous clinic. * Assist in preoperative evaluation and education. * Perform initial interview and assessment of patient. * Perform history and physical examination. * Review diagnostic data * May obtain preoperative surgical consents. * Prepare preoperative data sheets. * Present preoperative patients at team meetings. * Liaison with the Pre-Admission Testing Center (PATC), surgical scheduling areas and nursing units. * Track and obtain radiographic studies required preoperatively for patients. * Manage prescription medications for practice * Perform therapeutic and diagnostic injections of shoulder and elbow * Assist in data collection and therapeutic treatments for multiple research studies * Perform pre-operative consultation/education and complete surgical procedure forms and coding * Complete FMLA, Disability and Letters of Medical Necessity Forms * Act as liaison for surgical pre-authorization and insurance peer to peer consultations * Participate as preceptor for medical and physician assistant students * Coordinate Physical Therapy care * Performs procedures within the PA scope of practice and as directed by the attending. * Operating room responsibilities will be minimal and will include first and second assisting responsibilities. * Administrative tasks include triaging and returning patient phone calls under the direction of the supervising physician, and assisting with various other tasks related to patient care. * Inpatient duties are limited and may include admission orders, post-op orders, and rare floor consultations. **General Duties:** * Works collaboratively and functions as an effective member of the health care team. * Provides education to patients and families. * Documents in a timely manner, the medical record as appropriate and communicates observations/findings with attending physicians. * Monitors environment of care and complies with regulatory agency standards. * Clinical practice is consistent with physician assistant policies, procedures and standards. **Professional Development:** * Identifies areas for professional growth. * Formulates professional goals, objectives and methods for accomplishing these. * Supports initiatives within the BWH and the Department of Orthopedics. * Participates in committees at the divisional, departmental, and organizational levels. **Clinic:** * Obtains complete history and physical examination and presents to attending physician * Orders and interprets diagnostic tests (radiological studies, EMG/nerve conduction, noninvasive vascular studies, lab work) * Writes prescriptions for medication, physical therapy, braces, orthotics, and medical appliances (wheelchairs, crutches, walkers) * Educates patients regarding pre and post op instructions, wound care, home exercises * Assists supervising physician with injections, superficial debridement, dressing application * Writes admission H&P and orders for patients admitted to hospital directly from clinic **Operating Room:** * Assists in gathering and completing pre-op paperwork, which includes history and physical, consent, and site verification form * Assists in positioning, preparing, and draping patient for procedure * Acts as first/second assistant on surgical cases * Assists in wound closure and splint/dressing application * Writes brief operative note, post-op orders, and discharge orders/instructions **Office:** * Telephone triage * Deals with patient’s questions, concerns, problems * Refills patient’s medication * Coordinates home services and outpatient services **Independently performs:** * Splint and cast, application and/ or removal * Injection of local anesthetic and/or corticosteroids * Removal of sutures, staples, percutaneous pins, and PICC lines * Superficial debridement and wound closure in clinic and Emergency Department setting * VAC dressing application. * Reduction of fractures and dislocations **Supervisory Responsibility:** * No responsibility for the work of others **Fiscal Responsibility:** * No fiscal responsibilities but timely completion and documentation of medical records is necessary.

**Qualifications:** * The candidate must posses the following formal education in order to perform the essential functions of the job: * Must have successfully completed a Graduate Level, accredited Physician Assistant Program approved by AMA Board of Approval and Certification of PA programs. * Must have 4 years of college level education and bachelor’s degree or equivalent. (BS/MS joint programs are also acceptable). * Board Certification by the National Commission on Certification of PA’s is required. * The minimum year(s) and type of work experience required is as follows: * Experience as a PA preferred. * Specified license/certification/registration required to perform the job are as follows: * NCCPA certified * License as a Physician Assistant in Massachusetts * Maintain current DEA and Massachusetts Controlled Substance Licenses * Complete 100 hours of CME according to national and state regulations during each 2 year period of employment. * Maintain current BLS/ACLS certification * Complete BWH Professionalism Program within 3 months of date of hire. * Complete BWH Procedural Sedation Training, if determined necessary. * Specific Additional Qualifications required for this PA position. * NA **Skills / Abilities / Competencies Required:** Each PA shall demonstrate the following professional Knowledge and skills: * Strong interpersonal, organizational, and communication skills are required. * Knowledge of current literature and a commitment to continued learning are also required * Proficient with BWH computer systems as needed to independently perform daily tasks such as order entry, EMAR, lab tests and results, incident reporting, BICS, etc. * Consistently provide high quality and timely documentation including admission notes, progress notes, discharge summaries and dictations. The physical and mental abilities that are required are: * Must be energetic, quality driven and have proven ability to be a productive member of a cohesive team of peers, dedicated to providing optimum patient care. * Must exercise the highest degree of professional judgment under the direct supervision and guidance of a licensed physician. * Must maintain a professional attitude towards patients and exercise such mature 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 towards patients at all times and an excellent and collegial working relationship with other personnel involved in patient care. * Must demonstrate understanding of procedures, policies and documentation required to ensure compliance with hospital standards of care. **Working Conditions:** Due to the size and complexity of the Department and the Spine Service, the pace of work is sometimes hectic and quite challenging. Workload could necessitate working evenings. The candidate will work in an office setting shared with other staff members. In the office and the clinical area where patients are seen there is minimal exposure to noise, dust, chemicals, or extreme temperatures. The candidate: * May be exposed to infectious disease processes * May include unknown/undiagnosed infectious and/or communicable diseases * Will be required to wear personal protective gear This position requires: * Full range of body motion including handling and lifting patients, manual and finger dexterity and hand-eye coordination. * Requires standing and walking for prolonged periods of time. * Occasional lifting and carrying items weighing up to 50 pounds. * Requires normal visual acuity and hearing. * Requires exposures to communicable diseases and bodily fluids. * Requires working under stress in emergency situations or during irregular hours. * Frequent exposure to communicable diseases, toxic substances, ionizing radiation, medicinal preparations and other conditions common to a clinic environment.