Physician - Hospice/Palliative Provider

The Tomah VA Medical Center is recruiting for one experienced and highly qualified physician to provide Palliative and Hospice Care services to Veterans served by the Tomah VA Health Care System. The physician will provide comprehensive, Veteran-centered care for patients with serious, advanced, chronic, and life-limiting illnesses. This will include inpatient admissions as well as inpatient and out patient consultations.

*This position is eligible for the Physician Contract Buy Out Program

The physician will provide inpatient and outpatient palliative care consultation and work collaboratively with an interdisciplinary team to improve symptom management, clarify patient and family goals of care, support informed health care decision-making, and improve access to appropriate palliative, hospice, and supportive care services. Depending on patient-care needs, workload, physician expertise, and organizational priorities, the physician may also support outpatient geriatric services and other Geriatrics and Extended Care programs.

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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

Some Specific Duties and Responsibilities:

• Function as an active member of the interdisciplinary team serving Veterans with serious, advanced, chronic, and life-limiting illnesses
• Provide inpatient and outpatient consultation services in Palliative and Hospice Care
• Provide expert evaluation and management of pain and other symptoms associated with advanced and serious illness
• Facilitate patient and family goals-of-care discussions, advance care planning, and treatment decision-making as clinically appropriate
• Provide compassionate care for advanced illness, including dementia, chronic obstructive pulmonary disease (COPD), cancer, heart disease, frailty, functional decline, and other serious or life-limiting conditions
• Assess and manage concerns commonly associated with serious illness and aging, including pain, cognitive decline, weakness, immobility, incontinence, infection, and psychological or emotional effects of illness and aging.
• Provide appropriate referrals and coordinate care with specialists, other VA facilities, home-based services, hospice providers, and community health care partners when clinically indicated.
• Collaborate with Veterans and families or caregivers and advocate for care reflecting informed preferences, goals, values, beliefs, and clinical needs
• Provide consultation and professional guidance to Community Living Center leadership regarding Palliative and Hospice Care process improvement, program development, and related clinical policy considerations
• Perform other duties consistent with qualifications, privileges, scope of practice, and organizational needs as assigned

Work Schedule: Full-time (1 FTE); 0800 - 1630, depending on the needs of the facility.

This is a multidisciplinary announcement and may be filled by either a Physician or Nurse Practitioner.

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:

• Experience providing inpatient and outpatient Palliative and Hospice Care
• Experience caring for geriatric patients
• Board Certification in Hospice and Palliative Medicine

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

Physical Requirements: Eligible applicants must be physically and mentally able to perform efficiently the essential functions of the position, with or without reasonable accommodation, without hazard to themselves or others. Depending on the essential duties of a specific position, usable vision, color vision, hearing or speech may be required. however, in most cases, a specific physical condition or impairment of a specific function may be compensated for by the satisfactory use of a prosthesis or mechanical aid.

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.

Contract Buy Out Program: This position may be eligible for the Physician / Provider Contract Buy Out Program (CBOP), which authorizes VHA to buy out service contracts (Locum agreements, loan repayments, sign-on bonus contracts, Physician-owned practices) in exchange for employment at certain rural or highly rural facilities for a period of obligated service (minimum 4 years). For additional information and eligibility requirements, contact the VHA Contract Buy Out Program Manager at vacontractbuyoutprog@va.gov.