Physician (SLEEP MEDICINE AND PULMONARY SPECIALIST)

Summary

The physician is accountable to the Sleep Section Chief and is responsible for providing the most effective delivery ofmedical care as specified by his/her scope of practice while meeting and exceeding compliance standards.

Qualifications

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 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 Accreditation Council for Graduate Medical Education (ACGME) - b) OR [(2) Those approved by the American Osteopathic Association (AOA) -OR (3) Other residencies (non-US residency training programs followed by a minimum of five years of verified practice in the United States) - 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
• 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 or fee-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
• Proficiency in spoken and written English
• Reference: For more information on this qualification standard - please visit https://www.va.gov/ohrm/QualificationStandards/
• Physical Requirements: The Physical Requirements of this position are concerned with the mental and physical ability of the applicant to satisfactorily perform the duties of the proposed assignment and may include requisite laboratory and other screening as required by Federal regulatory agencies
• See VA Directive and Handbook 5019.

Duties

• The physician will work without direct supervision but is administratively and clinically responsible to the Chief - Medicine Service
• The physician is expected to perform the following: Participate in administrative work assignments - including program building as assigned by the Section Chief of Pulmonary Medicine and The Chief of Medicine Service
• Operate as a director of one of the major functions within the Pulmonary Section under the direction of the Chief of Pulmonary Medicine
• This may include but is not limited to Bronchoscopy - Home Oxygen Program - Critical Care - CP AP clinics - or Lung Cancer screening program
• Serve as acting chief of the section (if appropriate) - as needed
• Provide guidance and support to the nurse practitioners assigned to Medicine Service in their respective areas of expertise
• The physician is expected to perform the following specific Sleep Medicine duties: 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 (narcolepsy/idiopathic hypersomnia - restless leg syndrome - chronic insomnia etc.) and manage appropriately
• Identify patients with sleep disordered breathing who have co-existing sleep related hypoxemia and manage appropriately
• Order and interpret laboratory tests within the context of a sleep evaluation
• Complete QA forms for technical evaluation and integrity of the sleep studies
• Prescribe medications used to treat patients with sleep disorders - including but not limited to hypnotics - stimulants - as well as Xyrem and Xywav
• Counsel patients with respect to the risks of in adequate/poor quality sleep and excessive daytime sleepiness
• Instruct patients on the indications and limitations of home sleep studies
• Place appropriate orders with respect to positive airway pressure devices
• Initiate health promotion - disease prevention - education - and counseling in relation to sleep issues
• Interpret data from CPAP devices and manage appropriately to optimize efficacy and compliance of the therapy
• Collaborate with and provide medical guidance to the respiratory therapists as they conduct positive airway pressure (PAP) clinics and home sleep test clinics
• Educate patients on the indications - benefits - contra-indications - proper use - and complications of PAP 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.