Physician (Sleep And Pulmonary Medicine)

The W.G.(BILL) Hefner VA Medical Center is seeking a staff physician within the Specialty Care Section. The Physician will operate within Medicine Service under the direction of the Sleep Section Chief and/or the Section Chief of Pulmonary Medicine. The physician is responsible for providing effective delivery of medical care as specified by his/her scope of practice, including but is not limited to Bronchoscopy, Home Oxygen Program, Critical Care, CP AP clinics or Lung Cancer screening program.

All staff physicians assigned to Medicine Service will meet basic requirements and accept and carry out work assignments, including specialty care coverage assignments, when issued by the Service Chief of Medicine and the Chief of Staff.

Duties include but are not limited to:

SLEEP AND PULMONARY MEDICINE:

• Participate in administrative work assignments, including program building as assigned
• Provide guidance and support to the nurse practitioners assigned to Medicine Service in their respective areas of expertise
• Participate in and attend medical center committees as assigned
• Participate in various facility programs designed to enhance and improve the delivery of patient care services, such as Continuous Quality Improvement (CQI) teams
• Give Medicine Grand Rounds and other lectures for staff education.
• Take a sleep and/or pulmonary history and perform physical examination that identifies elements pertinent to sleep and pulmonary diagnoses
• Provide accurate sleep and pulmonary diagnosis for undifferentiated patient symptoms and/or other findings.
• Provide long term treatment and monitoring of patients with a broad range of sleep and pulmonary disorders
• Participate in multidisciplinary activities for optimal care with respect to pulmonary and sleep conditions.
• Order appropriate sleep and pulmonary testing to diagnose and monitor sleep and pulmonary conditions, respectively
• Integrate patient care activities on Medicine Services and other patient care programs at the medical center and in the community such as Social Work, Prosthetics, Home Based Health Care (HBHC), and private nursing homes
• Demonstrate expertise in diagnosing and treating a broad range of pulmonary, critical care and sleep medicine patients
• Demonstrate skill in implementation of clinical practice guidelines and protocols for patients with complex pulmonary and sleep medicine care needs
• Order durable medical equipment therapies routinely used in pulmonary and sleep medicine specialty
• Serve as expert specialist in interpreting pulmonary and sleep tests, including but not limited to home sleep tests, attended in lab sleep studies, pulmonary function tests, and oximetry testing
• Provide pulmonary and sleep care through non face to face encounters, including e-consults, telephone and video clinics
• Provide invasive ventilator management if providing ICU coverage.

SLEEP MEDICINE:

• Identify excessive daytime sleepiness and initiate a basic evaluation of patients with this complaint
• Diagnose, treat, and manage patients longitudinally with sleep disordered breathing
• Identify patients with sleep disordered breathing who have co-existing sleep disorders and manage appropriately
• Order and interpret laboratory tests within the context of a sleep evaluation
• Prescribe medications used to treat patients with sleep disorders, including but not limited to hypnotics, stimulants, as well as Xyrem and Xywav
• Interpret data from CPAP devices and manage appropriately to optimize efficacy and compliance of the therapy
• Counsel, instruct and educate patients on respective risks, indications and limitations, benefits, complications and proper use of therapy
• Prescribe and manage different PAP modalities as appropriate, including but not limited to auto-CPAP, fixed CPAP, BiPAP, BiPAP ST, ASV, and iVAPs
• Consider and prescribe alternative therapies to CPAP when appropriate, including but not limited to the Inspire device, an oral appliance (mandibular advancement device), and oral surgery

VA offers a comprehensive total rewards package. VHA Physician Total Rewards.

Recruitment Incentive (Sign-on Bonus): May be Authorized for Highly Qualified Applicants
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: 7:30am -4:00pm, Mon- Fri

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.

Basic 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.

Preferred Experience: Board eligible/board certified in Internal Medicine, pulmonary medicine, critical care medicine, sleep medicine (as applicable)

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

Physical Requirements: This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires mostly periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations. The incumbent may occasionally be exposed to patients/residents who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be a mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on stakeholder needs. See VA Directive and Handbook 5019.

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 an institution whose accreditation was in place for the year in which the course of study was completed. Approved schools are:

1. Schools of medicine accredited by the Liaison Committee on Medical Education (LCME) for the year in which the degree was granted.
2. Schools of osteopathic medicine approved by the Commission on Osteopathic College Accreditation (COCA) for the year in which the degree was granted.
3. For foreign medical graduates not covered in (1) or (2) above, confirmation must be made that the medical school meets (or met) Educational Commission for Foreign Medical Graduates (ECFMG) eligibility requirement for year graduated.

NOTE: The Under Secretary of Health or designee in the VHA Central Office may approve the appointment under authority of 38 U.S.C. 7405 of a physician graduate of a school of medicine not covered above if the candidate is to be assigned to a research, academic, or administrative position with no patient care responsibilities. The appointment will be made only in exceptional circumstances where the candidate's credentials clearly demonstrate high professional attainment or expertise in the specialty area.