Physician- Home Based Primary Care

To qualify for this position, you must meet the basic requirements as well as any additional requirements (if applicable) listed in the job announcement. Applicants pending the completion of training or license requirements may be referred and tentatively selected but may not be hired until all requirements are met.

Currently employed physician(s) in VA who met the requirements for appointment under the previous qualification standard at the time of their initial appointment are deemed to have met the basic requirements of the occupation.

01Basic Requirements

United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Degree of doctor of medicine or an equivalent degree resulting from a course of education in allopathic medicine or osteopathic medicine. The degree must have been obtained from one of the schools approved by the Department of Veterans Affairs for the year in which the course of study was completed.

Current, full and unrestricted license to practice medicine or surgery in a State, Territory, or Commonwealth of the United States, or in the District of Columbia.

Residency Training: Physicians must have completed residency training, approved by the Secretary of Veterans Affairs in an accredited core specialty training program leading to eligibility for board certification. (NOTE: VA physicians involved in academic training programs may be required to be board certified for faculty status.) Approved residencies are: (1) Those approved by the accrediting bodies for graduate medical education, the Accreditation Council for Graduate Medical Education (ACGME) or American Osteopathic Association (AOA), in the list published for the year the residency, or fellowship if applicable, was completed; OR (2) One year of post medical school training (internship, first year of residency, or transitional year residency) approved by ACGME or AOA followed by two years of post-training independent practice (performing under a full and unrestricted license) in the United States; OR (3) Non-US residency training programs followed by a minimum of three years of verified independent practice in the United States (performing under a full and unrestricted license) performing duties related to the position they are applying for (United States fellowships would be creditable towards this requirement), which the local Medical Staff Executive Committee deems to have provided the applicant with appropriate professional training and believes has exposed the Physician to an appropriate range of patient care experiences.

Exceptions: Residents currently enrolled in ACGME/AOA accredited residency training programs and who would otherwise meet the basic requirements for appointment are eligible to be appointed as "Physician Resident Providers" (PRPs). PRPs must be fully licensed physicians (i.e., not a training license) and may only be appointed on an intermittent basis.

PRPs are not considered independent practitioners and will not be privileged; rather, they are to have a "scope of practice" that allows them to perform certain restricted duties under supervision. Additionally, surgery residents in gap years may also be appointed as PRPs.

In rare and unusual circumstances, the Facility Director can submit a memo to the VISN Director through the VISN Chief Medical Officer, who may approve requests for reasonable exceptions to the residency training requirement for Physicians whose composite record of experience, accomplishments, performance, and qualifications warrant such action. Proficiency in spoken and written English.

02Preferred Experience

Board certification in: Internal Medicine, Family Medicine, or Geriatric Medicine certification preferred. Experience collaborating with and mentoring advanced practice providers. Primary care experience with older adults and Veterans with multiple chronic conditions, ideally in home based primary care, house calls, long-term care, or geriatrics. Management of complex multimorbidity, including heart failure, COPD, diabetes, chronic kidney disease, and dementia.

Transitions of care: timely follow-up after emergency department visits and hospital discharges, with medication reconciliation and a documented plan. Polypharmacy management and deprescribing (for example, Beers Criteria), in partnership with clinical pharmacy. Goals-of-care and life-sustaining treatment conversations; palliative care and hospice referral. Leading an interdisciplinary team and giving clear clinical direction to RN care managers and other disciplines.

Documentation that shows assessment and medical decision-making for each problem addressed. Telehealth, including VA Video Connect, paired with in-person nursing visits. Rural practice and comfort covering a large geographic area by government vehicle, including in winter conditions. Accurate coding for home and telehealth visits. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

03Physical Requirements

Moderate lifting (15-44 pounds and over), Moderate carrying (15-44 pounds), Reaching above shoulder, Use of fingers, Both hands required, Walking (2 hours), Standing (2 hours), Kneeling (1 hours), Repeated bending (1 hours), Both legs required, Operation of crane, truck, tractor, or motor vehicle, Ability for rapid mental and muscular coordination simultaneously, Near vision correctable at 13'' to 16'' to Jaeger 1 to 4, Far vision correctable in one eye to 20/20 and to 20/40 in the other, Ability to distinguish basic colors, Hearing (aid permitted). Environmental Factors: Outside and inside, Excessive heat, Excessive cold, Slippery or uneven walking surfaces, Working around moving objects or vehicles, Working closely with others, Working alone, Home settings: pets, smoke, sanitation, Winter and night driving

Duties include but are not limited to: Provide patient care directly or through the supervision of residents in either the home or institutional settings, such as assisted living. Perform administrative responsibilities for leadership and direction of GEC development and programs for HBPC, as well as effective interface with the GEC staff. Participate in accreditation processes, reviews, and site visits. Perform assessments, diagnosis, treatment, and outcome measures of healthcare problems.

Initiate and adjust therapeutic regimens. Perform histories and physicals. Order diagnostic and therapeutic tests/studies. Initiate consults and referrals. Prescribe medications/supplies in accordance with VA policy, VA formulary, Federal & state regulations, and scope of practice. Execute position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex patient care. Responsible for medical care delivered by the HBPC team.

Work in collaboration with the HBPC Medical Director, the GEC Section Chief and the HBPC Program Coordinator to meet the requirements of the programs. Maintain a faculty appointment and be involved in academic activities with affiliated Medical Schools or residency program when applicable. Provide clinical input and oversight for all patient treatment plans for HBPC. Be readily available to HBPC team members for collaboration when medical or other problems arise. Participate in HBPC interdisciplinary team meetings.

Keep the HBPC team apprised of medical care advances and practice standards. Arrange Physician coverage and communicating the plan of coverage to the HBPC team. Collaborate with other HBPC physicians, VISN leadership, and VA Central Office staff on program development issues. Serve as acting Medical Director upon the absence of the Medical Director. Determine the need for, and facilitating, admission to the hospital. Comply with Medical Center and VHA regulations regarding the use of government vehicles.

Demonstrate work practices that include adherence to Infection Control standards and the safe use and operation of equipment. VA offers a comprehensive total rewards package. VHA Physician Total Rewards. Education Debt Reduction Program (Student Loan Repayment): Authorized Learn more. EDRP Authorized: Former EDRP participants ineligible to apply for incentive.

Contact , [email protected] the EDRP Coordinator for questions/assistance Pay: Competitive salary, annual performance bonus, regular salary increases Paid Time Off: 50-55 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year and possible 5 day paid absence for CME) Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Licensure: 1 full and unrestricted license from any US State or territory CME: Possible $1,000 per year reimbursement (must be full-time with board certification) Malpractice: Free liability protection with tail coverage provided Contract: No Physician Employment Contract and no significant restriction on moonlighting Work Schedule: Monday-Friday 8:00am-4:30pm