Physician – Emergency Room

The duties include but are not limited to the following:

Responsible for providing emergency medical services to the patients in a Level III Trauma facility. This includes clinical supervision in the trauma room, the Urgent Care, and the Emergency Medicine area. These responsibilities include direct and indirect patient care, clinical supervision of personnel, educational activities, and general clinical operations during the shift. The quality of Emergency Room Physician service will meet or exceed reasonable standards of professional practice for the health care concerned as determined by the authority that governs military medical professionals in the same discipline. Emergency Medicine Physicians shall have sufficient training/experience to be able to perform the required duties which include, but not limited to:

·         Perform full range of emergency room services to include the ability and experience to adequately diagnose and treat diseases and injuries to include, but not limited to, the following: Skin, Head, Eyes, Ears, Nose, Throat/Mouth, Neck, Cardiovascular System, Pulmonary System Gastrointestinal System, Lymphatic System, Musculoskeletal System, Genitourinary System, Reproductive System, Psychiatric Disease, Central Nervous System, Endocrine System, Peripheral Nervous System.

·         Perform medical procedures to include, but not limited to, the following: incision and drainage, nail trephination, sling or swath injuries, bandage, reduce dislocations and fractures when appropriate, stabilize and evaluate cervical spine injuries as appropriate, lumbar puncture, periocardiocenthesis, removal of foreign bodies as appropriate, deliver babies/emergency vaginal deliveries, perform venous punctures for lab studies and interpret

results, draw arterial blood gases for evaluation and interpret results, suture simple lacerations, remove sutures, tube thoracostomy, open thoracotomy, secure and maintain an adequate airway, by such means as:

o   oral airways;

o   oral tracheal intubation;

o   nasal/tracheal intubation;

o   crico-thyrotomy (needle and surgical)

·         Splint and stabilize traumatic injuries to extremities; Administer intravenous, intramuscular and

subcutaneous medications as appropriate; secure and maintain adequate intravenous access by peripheral and by central routes; Diagnostic Peritoneal Lavage (DPL); bladder catheterization; NG/OG tube; local anesthesia; restraints; and conscious sedation. Be able to perform tasks to include, but not limited to, the following: Coordinate with accepting facility & other ER Departments; consult with consultants appropriately; provide medical advice over the telephone; complete all required paperwork; obtain an adequate history, physical, assessment and plan in a timely and appropriate manner on each patient and develop treatment plan; utilize paraprofessional staff as appropriate; respond to cardiopulmonary arrest as appropriate and arrange appropriate backup from the EMS Interpret electrocardiograms; preliminary interpret radiographs to include CAT scans; direct medical care through radio communication with an ambulance and provide discharge instructions.

·         Examine patient, render a medical assessment of their conditions, and take appropriate action.

Provide immediate evaluation and management of emergency patients. Required to perform and supervise bedside ultrasound. Provide definitive medical care to reduce the emergency situation and enable the patient to safely continue care as an outpatient with follow-up care as required. Follow-up of abnormal reports is the responsibility of the ordering physician. However, to assure correct medical follow-up for these patients, all abnormal x-ray and lab reports received on patients seen by the contractor’s physicians shall be reviewed by the contract physician on duty at the time these reports are available for review. Review each report in accordance with established MTF procedures. Provide emergency medical care to both inpatients and outpatients, summon appropriate on-call specialist when deemed necessary, and continue medical management until the arrival of the appropriate specialist. Reassure and treat non-acute conditions as established by medical triage. When necessary, provide emergency care to patients in the holding area.

·         Prepare appropriate narrative summaries and patient profile changes. Prepare and document appropriate history, physical examinations, and preoperative diagnosis. Maintain documentation of all treatment provided in accordance with MTF directives.

·         Respond to a staff nurse’s request for assistance to the emergency needs of hospitalized patients, to carry out procedures, and for writing orders, until the patient’s staff physician arrives. Dispatch and provide medical control for ambulances in accordance with MTF procedures. Accompany emergency room technicians on ambulance runs when indicated by the nature of the emergency and in accordance with MTF procedures. Perform emergency room procedures compatible with the MTF operating capacity and equipment. As workload permits during scheduled duty, attend the Emergency Medical Service’s monthly staff meetings and the Quality Improvement and Risk Management committee meetings as required by the individual MTF. Contract physicians may also attend such meetings scheduled during other than their assigned duty shift.

·         Provide house-staff teaching, prepare and deliver resident lectures, attend department grand rounds and other scheduled academic activities. The contract HCW shall be present for any case being presented for review that involves the contract provider. Become familiar with the hospital formulary. Contract physicians authorized to prescribe pharmaceuticals shall do so according to the availability of drugs listed therein. The pharmacy service will provide instructions to all prescribing practitioners regarding substitutions of generic drugs for prescribed drugs. Complete medical documentation using the approved electronic medical record (EMR) system within a reasonable required time, such as the current hospital policy by 72 hours after the patient visit. Responsible for the completion of individual workload accountability in accordance with clinic, medical treatment facility and program requirements. Maintains inpatient and outpatient medical records IAW DoDM 6025.18. Medical records will be subject to review by the Medical Care evaluation Committee, Quality Assurance Committee, and designated representatives of the Commander, DHA. Only approved medical abbreviations will be used. Charting will follow Army, MTF, or clinic requirements as directed by the provider’s immediate supervisor. The contract service provider is responsible for the content and correctness of all prepared and transcribed reports and shall verify the content and correctness of all prepared and transcribed reports by affixing signature and stamp to all copies of the document and validating its contents the same day as documents are provided by the U.S. Government. All evaluations and other records of patients will remain the property of, and subject to the exclusive control of, the U.S. Government. All reports and documents prepared by the Contactor in fulfillment of this contract will become the property of the U.S. Government. Take part in clinic Quality Assurance Program as required to meet the standards of the Joint Commission on Accreditation of Healthcare Organizations. Responsible for maintenance of the highest standards of professional care.

·         Prepare and document appropriate history and diagnosis. Maintain documentation of all treatment provided in accordance with hospital directives and prepare such records and reports as may be required by the contract. Ensure all documentation and reports are legible. Coordination with other departments of the medical facility staff to provide complete care to patients. Consult with supervisor and/or colleagues, which are normally available, regarding problems either professional or administrative. Responsible for the quality and the timeliness of treatment records and reports required to document procedures performed and care provided. Participates in clinical education programs and in clinical staff quality improvement functions as prescribed by Chief, Emergency Medicine. Comply with the MTF quality control program and the standing operating procedures of the MTF.

·         Participate in clinical and quality review processes as determined by hospital policy. Provide screenings, clinical assessments, treatment, case management, consultation, referral and education according to their professional discipline, Army Medical Departments standards, and the DoD-directed Clinical Practice Guidelines (CPGs). Services shall be provided in accordance with the established principles, practices and ethics of both (1) the contract service provider’s professional (2) Department of the Army (DA) regulations. Services shall be provided in accordance with MTF rules, regulations, bylaws, privileging and within the contract service provider’s scope of practice. Shall be able to read, write, and speak English well enough to effectively communicate with patients and other healthcare providers.