| Major Duties:
Provides care as required, by interviewing (if possible) and examining patients with traumatic injuries and patients with difficult to diagnose illnesses; reviews past medical history, and immediately requests and/or performs diagnostic tests and examinations deemed necessary to obtain all possible information related to each case. Makes preliminary diagnosis, directs, prescribes or provides treatment, or arranges for specialized care or patient referral as required. Bases decisions upon information obtained, professional medical knowledge and skills and prescribes policies and procedures. Makes notes of observations to be incorporated into clinical records.Provides definitive management in all medical categories for cases that do not require referral. Gives total patient care including prevention, health maintenance, early diagnosis, treatment, and follow-up services to patients under his/her care.
Assures preparation of appropriate medical records for all patients seen to assure the accumulation and organization of all pertinent clinical data needed to provide comprehensive medical care. Dictates clinical reports and interfaces and consults with outside hospitals, and other individuals and facilities in the provision of health care services.
Conducts outpatient clinics making observations appropriate to the outpatient's underlying disease and treatment plan, including current symptoms. Reviews the patient's medications, diet, therapy course, adherence to management plan and patient observations. Modifies regimen as indicated. Instructs and counsels patients and family members as required.
Performs or assists other physicians in the performance of minor surgery.
Refers patients to appropriate contracted medical (or other) facilities, providing full clinical information for care and diagnostic procedures that cannot be adequately provided at local WRFCHC facilities. Coordinates and integrates information obtained into the ongoing Health Care Program at the WRFCHC and assures timely follow-up care as required.
Works closely with allied health professionals (i.e. Community Health Nurse, Social Workers, Health Educator, etc.) to utilize and coordinate the services of Health Care Professionals in the management of the patient's medical, psychological and social problems.
Responsible for training medical students, interns or residents in their specialty. Assists in the provision on continuing education, on-the-job training, and evaluate medical procedures and processes relative to assurance of quality patient care. As required, performs medically related or patient care assignments that fall outside the designated area of specialization or experience, and involves working in clinics or facilities on an emergency or other contingency basis.
Must participate in at least two or more of the following committee activities or functions which assures compliance with AAAHC Standards: Surgery medical staff coordinator/participant; Lab X-ray Director and PT/Drug Utilization; Medical Staff Infection Control representative and Blood Usage medical staff coordinator/participant; ER Director and EMS medical staff coordinator/participant; Infant Death Review medical staff coordinator/participant; Mortality Review medical staff coordinator/participant; Child Protection Team (CPT) representative/Participant; Medical Staff Credentialing coordinator/participant; Medical Staff Diabetes Team representative/participant; Surgery medical staff coordinator/participant; Quality Assurance/Joint Commission on Accreditation of Hospitals and Organizations medical staff coordinator/participant; and Health Promotion/Disease Prevention medical staff coordinator/participant.
Routine duties shall include providing medical care and public health services to individuals eligible for services provided by the homes, schools, clinics, job sites, and other community locations within the WRFCHC.
Factor 2. Supervisory Controls
The Chief Medical Officer or designee provides primarily administrative supervision and limited technical supervision. Incumbent is recognized as a senior specialist in the Emergency Medicine specialization. Contract consultants in the specialty area of Emergency Medicine medical specialty provide expert technical guidance. Work which involves out-of-the ordinary diagnostic decisions or treatment is discussed with supervisor who keeps aware of the condition of such patients and all aspects of treatment regimen. Work performance is reviewed for conformance to IHS policy, procedures and accepted emergency medicine professional practices; and the Quality Assurance (improvement) Program of the Medical Staff of the Service Unit.
Factor 3. Guidelines
Guidelines available include DHHS, PHS, IHS, Billings Area, WRFCHC, and Medical Staff regulations, policies, procedures, and by-laws. In addition, traditional and currently accepted medical practices are available in the form of specialty consultation, medical journals, and textbooks. In nearly all cases, however, the medical officer's judgment is the key factor in determining whether guidelines are to be adhered to or deviated or whether new guides need to be developed to protect the interests of the patient.
Factor 4. Complexity
Assignments include very difficult decisions in the Internal Medicine specialty, with very little technical guidance. The incumbent may serve as a consultant on the most difficult cases in the specialty, and performs advanced diagnostic and treatment procedures without professional direction. Recognizes difficult-to-identify symptoms or signs, and is fully responsible for developing a full treatment regimen involving a knowledge of new techniques or the use of advanced skills. Cases are routinely critical and require immediate decisions or are complicated because patients fail to respond to previously-tried treatment regimens. Considerable weight is given to the medical officer's recommendations in their technical specialties, by their supervisor and colleagues.
In addition to the work being very difficult, the work also consists of broad general practice of medicine, involving diagnosis and treatment of inpatients and outpatients with an extremely wide variety of physical and emotional problems and includes the broad functions of medicine to include, education, prevention, cure, and rehabilitation, in addition to the internal medicine practice specialty. Assignments are characterized by breadth and intensity of effort and generally involve the simultaneous application of multiple distinct skills, knowledge, and abilities in the care of one or more patients. The work is often difficult and further complicated by the fear and skepticism of patients, undefined or ill-defined problems presented in advanced stages, and conflicting data.
The work requires continued efforts to establish programs to resolve chronic medical problems among the population served.
Factor 5. Scope and Effect
The work of this position directly affects the health and well being of individuals with severe, traumatic injuries and highly unusual illnesses on an immediate basis; and impacts the health status of families and the community on a broad basis.
Factor 6. Personal Contacts
Personal Contacts of the incumbent are with patients with severe traumatic injuries, patients with highly unusual illnesses, their families, other employees, representatives of other federal, state and tribal health organizations, and administrators and physicians from the private sector. These contacts are made with individuals and occasionally groups in moderately unstructured settings.
Factor 7. Purpose of Contacts
The purpose of contacts is to exchange information, resolve problems, educating, influencing, and motivating individuals and groups to understand and accept recommended medical information, diagnosis, treatment, and therapies.
Factor 8. Physical Demands
The work requires some physical exertion and stamina, and extensive walking, standing, bending, and similar activities. Patients may be required to be lifted from time to time. The incumbent may be required to remain awake on duty for periods from twenty-four to thirty-six hours in duration.
Factor 9. Work Environment
The work is performed in a hospital or clinical setting, with continual exposure to patients having a variety of illnesses and communicable diseases. Occasionally, the incumbent may be subjected to adverse weather and hostile patients and/or families. Works in a regularly assigned, rotation or call back basis to provide continuity of medical services during evenings, nights, holidays, and weekends. Required to work at outlying reservation communities. This position has been designated as an essential position.
Personal Attributes:
The incumbent must maintain strict confidentiality and high ethical standards in performing the position. The incumbent needs to be respectful, possess cultural awareness and sensitivity, be flexible, and demonstrate sound work ethics. |
