Internist Job at Defense Health Agency Medical Civilian Corps in Washington

Serves as a direct primary health care provider in the capacity of a credentialed Nurse Practitioner to provide primary care services to patients ranging in ages from 18 years old through geriatric for the Madigan Army Medical Center at Joint Base Lewis-McChord, Washington. Duties include health management for a DOD beneficiary patient population with responsibility for the independent examination, diagnosis, and treatment within personal credentials and privileges delineated by the Military Treatment Facility (MTF). The Nurse Practitioner provides comprehensive primary care services and auxiliary practices in general medicine to the military and their family members.MAJOR DUTIES 1. The incumbent performs varied duties requiring many different and unrelated processes and methods applied to a broad range of general medicine in the adult and geriatric patients in specialty areas. The Nurse Practitioner makes independent decisions regarding the medical care required and in the interpretation and evaluation of processes resulting from continuing changes in the medical field due to new technological developments or conflicting requirements. The Nurse Practitioner performs a variety of complex duties involving the full range of medical care that consists of isolating and defining unknown medical conditions. Assignments include a wide range of activities including assessing, planning, evaluating and modifying the treatment of patients in various locations throughout the MTF. Duties are typical of, but not limited to, the following: a. Secures health and medical history from the patients or family member, record findings and makes a clinical evaluation. Examines patient and performs initial patient workup and assessment of patient's care and treatment; and determines the need for and orders laboratory tests, X-rays and other procedures necessary to complete evaluation of the patient. Discriminates between normal and abnormal findings to recognize early stages of serious physical, emotional or mental problems. Provides surveillance of adherence to medical and primary care practices and procedures to stabilize chronically ill patients; adjusts regimens within established protocols recognizing when to refer the patient to the physician or other primary care members. Makes decisions concerning primary care needs of patients that impacts the care of other healthcare professionals and ancillary staff; works independently and collaboratively with physicians in patient management, evaluation, and revision of therapeutic plans; and refers extremely or selected complex medical problems to medical management by subspecialist. b. Diagnoses disease, illness, disorder, or injury, institutes treatment of patients. Prescribes for and treats a variety of diseases, disorders and injuries, treats patients returning for routine or directed follow-up and treatment of chronic illnesses previously documented in patients’ medical records; writes routine orders on outpatients, performs medical histories; and document encounters appropriately in the electronic medical records. Provides a full range of emergency services or crises interventions in the absence of the physician, including life-saving emergency procedures to stabilize a patient within the scope of practice and approved protocols. Writes prescriptions, orders the administration of medications, dispenses medications, and prescribes controlled substance per scope of practice. The Nurse Practitioners performs a variety of physical examinations including but not limited to: school, employment, sports, retirement, discharge, reenlistment, disability separation, or retirement, annual and other special physicals, health certificate employment and other related physical examinations. Orders laboratory tests, X-rays, etc. and arranges for physician consultation if required. Records entries into patient's charts including progress notes, treatment rendered, tests, or procedures ordered, and notations of prescriptions or orders, and drugs dispensed or administered per approved protocols including computer-based progress notes. In a timely fashion, evaluates the primary care aspects of patient care recognizing when reassessment by a physician or other staff professionals is required. The Nurse Practitioners provides primary care and preventive services to healthy individuals and evaluates the total health care needs of patients and develops plans to meet clients' needs. Participates in disease management of typical internal medicine patients, which includes the following conditions: hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, etc. The individual may be asked to train mid-level students and residents. 2. The Nurse Practitioner independently develops new techniques and establishes criteria for providing improved, quality patient health care to clients and family members of the Medical Center. Plans with other professionals, and agencies involved in providing primary care services to patients and their family members, and coordinates the primary care provided. Develops and recommends new approaches for providing improved, quality primary care for military and their family members and other clients of the hospital. The Nurse Practitioner provides consultation, teaching, and coordination with patients and their family members regarding treatment and medical care.Perform other duties as assigned.