Physician Assistant- Pulmonary Vascular Disease

The PVD PA inpatient responsibilities include but not limited to rounding and assisting in the assessment and management of pulmonary/heart/vascular diseases patients with the inpatient PVD consult service attending physicians and fellows.

The PVD PA will independently see ambulatory patients in the PVD PA clinic 1 (4-hour blocks) every 3 weeks and assist in the attending clinics as needed. In the PVD PA clinic, the PA will see established and occasionally new pulmonary vascular, dyspnea and general pulmonary patients. Some visits may be virtual when appropriate.

The PVD PA procedural responsibilities include but not limited to assisting the attending physicians, fellows and exercise physiologists in the advanced Cardiopulmonary Exercise Testing (aCPET) Program with pre-procedure, peri-procedure and post-procedure assessment, management, and discharge education/planning/coordination.

The PVD PA will have an opportunity to be involved in our clinical research programs as sub-investigators and assist the principal investigator and research coordinator/assistants in medication administration, device management and patient assessments.

The PA will always have the support of attending physicians and the senior PA to discuss and manage patients with complex pulmonary heart and pulmonary disorders.

1. Inpatient Clinical Duties

Works as an independent provider and supports interdependent relationships with members of the care team Collaborates with PVD consult service attending physician and fellow on daily patient rounds to formulate treatment plans and care coordination. Performs and documents histories and physical examinations on hospitalized PVD patients.

Implements attending physician's instructions for patient management in close cooperation with PVD fellow, the nursing staff, primary care team and floor pharmacists. Works closely with inpatient case managers in discharge planning and establishes a continuum of care between inpatient care and outpatient care. Communicates and coordinates patient plan with other hospital department such as Pharmacy, Vascular Radiology, and Patient Care Services within BWH. Provides post-procedural device care (e.g. Hickman catheter), care of implantable pumps (including programming and refilling), and general care of patients with mechanical circulatory support devices and ECMO. Performs routine preoperative and postoperative procedures e.g. insertion/removal of tubes, lines, sutures; performs postoperative wound care. Orders and interprets appropriate laboratory testing and informs physician and patients of results as necessary. Participates in quality improvement and research efforts as directed by the service leadership. He/she should also initiate quality improvement and research efforts as appropriate.

2. CPET Duties

For all pending invasive and non-invasive cardiopulmonary exercise test (CPET), the PA is responsible for ordering appropriate labs, reviewing and familiarizing themselves with the patient's medical history, physical examination, pre-procedure work-up and indication for the CPET. On the day of the CPET, the PA will consent the patient for any procedures including radial and/or pulmonary arterial catheter placement, the exercise test, and for appropriate research protocols. The PA will be available to assist in the placement of radial and/or pulmonary artery catheters in the cath lab During the CPET, in cooperation with the exercise physiologists, CPET attending, and/or physiologist fellow, the PA will assist in test set-up, hemodynamics monitoring, pulmonary artery catheter management, patient monitoring, and performing testing protocols as documented in the BWH CPET program policies Post-CPET, in collaboration with the cath lab attending, stress lab attending, and recovery nursing staff, the PA will be responsible for all post-procedure care including but not limited to patient transport with continuous hemodynamic monitoring, post-procedure orders, pulmonary artery catheter removal, radial artery catheter removal, discharge documentation/coordination and discussion of test results with patients and family members. The PA will be available via pager for any procedure related questions or problems. The PA will assist in the compilation of test data, interpretation of invasive exercise test results, and be available for patient questions regarding test results

3. Outpatient Clinical Duties

Assisting the attending physicians in the management of selected patients by the attending physicians. This would include performing and documenting histories and physical examinations as well as developing a collaborative assessment and plan with the attending physician. Providing valuable verbal and written patient education to those newly diagnosed patients with pulmonary vascular disease. Ordering further lab, imaging, and diagnostic testing. Prescribe medications and other therapies. Coordinating post clinic visit care and referrals as needed. If needed, can assist patients in noninvasive tests in clinic

4. Clinical Research Duties

Participates in PVD studies in conjunction with the Principal Investigators, Study Coordinator and research staffs. Performs clinically related duties for research patients including physical examinations, answering patient's clinical questions, medication administration, device management, non-drug related research consenting, and any other duties deemed appropriate by the Principal Investigator and the Study Coordinator.

5. Follow Up/Outpatient Care Coordination Duties

Serves as a liaison between the patient and specialty drug distributors in managing therapeutic options. Prescribe new medications and renew medications by phone, fax, or electronically. Maintains a healthy relationship with patient insurers and follows through with prior authorization for medications. Responds to all inquiries and questions from patients and others involved in the care of the patient's care received by our office by phone, fax, email, or any other form of communication. Insures that policy and procedures are properly followed and data collected.

6. General Duties

Works collaboratively and functions as an effective member of the health care team. Provides education to patients and families. Documents in 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. Participates in QA/QI projects as appropriate.

Teaching-Coaching Function

Develops patient, family and caregiver educational materials. Reinforces positive health care behaviors. Serves as a consult to hospital staff. Develops lectures within and outside BWH for the purpose of increasing awareness concerning the care of patients with PVD.

Ensuring Quality of Care

Participate in Hospital-wide and Departmental committees as requested Utilizes internal and external resources to facilitate the resolution of moral, patient advocacy and ethical issues Promotes an environment of ethical decision-making and patient advocacy Maintains awareness of the most current practices in the care of patients with PVD Identifies own learning needs and goals and develop a plan to meet them.

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 Medicine. Participates in committees at the divisional, departmental, and organizational levels.

Maintain BLS and ACLS certification

Education
Master's Degree Physician Assistant required

Can this role accept experience in lieu of a degree?
No

Licenses and Credentials
Massachusetts Physician Assistant License

Experience
Experience as a licensed Physician Assistant preferred

Knowledge, Skills and Abilities
- Skilled in taking medical histories to assess medical condition and interpret findings.
- Ability to maintain quality control standards.
- Ability to react calmly and effectively in emergency situations.
- Ability to interpret, adapt and apply guidelines and procedures.
- Ability to communicate clearly and establish/maintain effective working relationships with patients, medical staff and the public.