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Emergency Medicine Physician Services - 3032
Job Opportunity at
Eskridge & Associates
Posted on Aug 22
6 BC ER Physicians needed in Emergency Room department of the new Las Vegas VA Medical Center
“What to expect”-
1. The new facility’s ED has 8 rooms; they all have single beds, except for the “resuscitation” room which has 2 beds.
2. We are expected to provide 24/7 coverage for VA patients. The VHA directive that we have to follow specifies that there has to be a provider in the ED at all times, so we have to have 2 providers in the ED at all times to respond to in house emergencies (Code Blues/RRTs)- one provider can respond to the floor emergency, and the other once stays in the ED area to ensure that all patients have access to a provider in that area.
3. Resources/ancillary services: When it opens, the new facility will have a radiology technician in house 24/7 to do plain films. CT tech will be on call for after hours studies. Lab services will be available 24/7. When the facility initially opens, surgery will not yet be open due to construction/modification of the OR suites. Patients requiring surgical evaluation or if there is a concern that the patient may have a surgical problem will need to be transferred to another hospital. We also will not have dialysis/cardiac cath lab/ interventional radiology/endoscopy after hours; patients presenting with medical problems requiring this support will also need to be transferred out. The VA’s facility activation plan for bringing up additional services indicates that the ICU/dialysis will be open 5/1/13, the OR on 5/15/13, interventional radiology 6/1/13, and the cath lab (diagnostic only, initially) 7/1/13. Subspecialty consultation with pulmonary/CCM, cardiology, and nephrology is available 24/7.
4. There will usually be a hospitalist in house 24/7. Since the patients that will initially be admitted to the planned 12 bed unit will be of necessity very low acuity given the limited resources that we are opening with, there will initially not be a hospitalist in house. However, I anticipate moving one of the hospitalists over to the new facility within the first 4 weeks of opening, assuming that other services come up as planned. The hospitalist typically manages admissions and responds to calls on the floor and in the ICU. There is an expectation that the ED physician will come to assist with Code Blues/RRTs and may be asked to perform emergent procedures (intubation/line placement in emergencies). We do not have in house anesthesia after hours. Nursing service indicates that they are working on a 24/7 PICC line service, but I am presently unsure as to what its status will be at the time that the facility opens.
5. Shifts: the physicians at the MOFH presently are working all 10 hour shifts. I think having a mix of 12 hour and 10 hour shifts would work. From my standpoint, as long as the 24 hours are covered, I don’t have strong feelings either way. The current VA ED providers do not want to work 8 hour shifts, and would probably not tolerate working 12 hour shifts. Again, I think a mix of 12/10 hour shifts would work. We have some tentative schedules based on the workload data from the MOFH (numbers of patients presenting, times during the day, etc).
6. Census/work load is difficult to predict, since we are opening a new facility. Based on MOFH work load data, we see anywhere from between 24 to up to 60 patients per day. Average is around 45/day. Based on data from the MOFH, about 60-70% of those are considered nonacute, with an ESI of 3 or less. About 30% of the VA patients that present to the MOFH end up being admitted. However, there is a strong possibility that more veterans will come to the VA ED, since they do not have to go through base security.
7. The VA uses an electronic medical record, CPRS, for orders and documentation.
Personnel assigned by the Contractor to perform services covered by this contract shall hold an unrestricted license in a State, Territory, or Commonwealth of the United States or the District of Columbia. The qualifications of such personnel shall be subject to review by the VASNHS Chief of Staff (COS) and approval by the VASNHS Director. Emergency Department Physicians shall:
Be Board Certified, or eligible to take boards, in Emergency Medicine by the American Board of Emergency Medicine (ABEM) or American Osteopathic Board of Emergency Medicine (AOBEM) OR, be Certified Internal Medicine or Family Practice and meet all other requirements stated below.
Have completed an Emergency Medicine, Internal Medicine or Family Practice residency program.
Be credentialed by the appropriate civilian American Medical Association specialty and indemnified by an appropriate/legal third party corporate entity for their professional activities.
Have a minimum of two (2) years of experience in emergency department care within the last three (3) years. Time spent in an emergency department setting as a physician intern or in a residency program shall count toward the two (2) years of experience.
Be certified in American Heart Association Basic Life Support and Advanced Cardiac Life Support.
Have a valid/certified Drug Enforcement Agency (DEA) license.
Be a U.S. citizen.
Not have had a medical license revoked or limited by a State, Territory, Commonwealth or the District of Columbia.
Not be pending or have had past felony charges against him/her.
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