Clinical Component

Clinical Component

This will be a blend of clinical and administrative time to complete the duties below.

Michael and Dr. Gibbons and elaborate on the percentages of each. The administrative time coincides with your leadership responsibilities and is protected time. For your clinical responsibilities, this is a 100% outpatient position.

In speaking with Dr. Gibbons, he shared the following: 
“TGNB kind of care is something that we expect to all providers to do. So the Medical Director will be creating the standard and stewarding that care, taking it to the next level and get us to be a center of excellence for TGNB care.

We need someone who will help providers lean-in to best practices, seeing opportunities to improve our model for patients. Howard Brown is known for being on the forefront of this care and was one of the first organizations (and FQHC’s) to deliver hormone therapy to patients.

This position will also require involvement in research and education on new surgical options that are being approved by insurance companies so we can educate our staff and patients, since a lot of TGNB care is not FDA approved.
• Lots of Patients will come in asking for different treatments that they’ve learned through their LGBTQ+ community. Some are reasonable and some carry more significant risk.
• The Powers Method of Hormonal Transitioning
• WPATH
• UCSF

We’d like to create an evidenced-based, approach using some of the same standards and best practices that the groups above have followed/created.

We already have some great referral pathways in place with surgeons and other specialists but continuing to nurture relationships in the community and healthcare world.

The Medical Director’s role will act as a liaison to help with education, onboarding, and the evolution of protocols/best practices, and will have the latitude to create programs for and around TGNB care. Howard Brown is seeking someone who has existing experience in TGNB care.” 

How will I be supported? 

There are patient care coordinators in place to help patients navigate the many resources and services that Howard Brown has to offer to get the best level of care.

  • Behavioral Health
  • Support Groups for Patients
  • Specialists that Deliver Hormone Therapy Care
  • Surgical Navigation Team
  • Case Management Team
  • Insurance Enrollment Assistance
  • Linkage to Care
  • …And any other programs you feel will be beneficial to create for TGNB care. 

Trans & Nonbinary Health 

We affirm who you are.

Howard Brown Health is committed to improving the health of trans and nonbinary communities. We offer programs that address the unique barriers faced by trans and gender non-conforming clients as well as medical, behavioral health, and case management staff who are sensitive to your needs.

Hormone Therapy
Drop-in Nights and Support Groups
Trans and Nonbinary Surgical Navigation
Syringe Service Program 

Our clinical staff has expertise in

  • Alternative insemination
  • Breast/chest cancer screenings
  • Immunizations for COVID-19, flu, HPV, and hepatitis, including most travel vaccines
  • Infectious disease care, including HIV and hepatitis
  • OB/GYN care, including birth control, all-options pregnancy testing/counseling, and cervical cancer screenings
  • Post-Exposure Prophylaxis (PEP)
  • Pre-Exposure Prophylaxis (PrEP)
  • Preventive care and routine physicals
  • Primary care
  • Services for survivors of sexual harm through In Power
  • STI/HIV prevention and treatment
  • Transgender and nonbinary health services, including hormone therapy and gender-affirming surgery navigation 

What can you expect

The Medical Director of TGNC Care provides clinical and integrative leadership for delivering services for patients who identify as transgender, non-binary, or gender nonconforming at Howard Brown Health. The Medical Director of TGNC Care is responsible for the quality of care provided to TGNC patients for peri surgical, wellness, and routine integrative services. The Medical Director of TGNC Care will promote the current policy and procedures for Howard Brown Health Center in alignment with the clinical management. The Medical Director of TGNC Care is a partner to all site clinical and office managers and collaborates with leadership initiatives. The Medical Director of TGNC Care is a licensed clinical professional and can be from the following training backgrounds- nurse practitioner, physician assistant, or physician.

How you will make an impact as a clinical administrative leader

  1. Participate in the development and ongoing refresh of the Howard Brown’s strategy for TGNC health.
  2. Participate in the build-out and coordination of the delivery network needed to support the TGNC health solutions, with particular emphasis on how providers in our network fit into the broader spectrum of solutions
  3. Be a resource to the external teams in the solution development process
  4. Represent the clinical point of view on decisions related to the identification, build-out and management of technology needed to support TGNC visits
  5. Serve as an ambassador for Howard Brown Health in the roll-out of our TGNC health models.
  6. Work in concert with IT, practice management, and other departments to monitor ongoing effectiveness of TGNC service delivery solutions.
  7. Develop and implement a multidisciplinary TGNC team to support patients across the continuum of care.
  8. Lead a team of clinicians and non-clinicians successfully delivering TGNC care across the agency
  9. Represent Howard Brown at local and national TGNC care events
  10. Streamline perisurgical services to create efficient collaborative primary care-surgical team communication
  11. Develop TGNC virtual care services support convenient quality care for TGNC patients within the HBHC virtual catchment area 

As Clinician

  1. Facilitates entry of the patient into the health care system, either at a HBHC clinic site, Perisurgical or virtual setting by assessing the care needs, including eliciting comprehensive health histories, performing physical examinations, ordering and/or performing pertinent diagnostic tests, analyzing collected data to determine client health status and formulating a problem list (diagnosis.)
  2. Provides coordinated, continuous and culturally competent primary health care to clients that span the health continuum through mutual goal setting and planning delivery of care.
  3. Prescribes a variety of treatment modalities to meet health and illness needs.
  4. Meets provider productivity standard including but not limited to number of visits per week
  5. Collaborates with advanced practice nurses and community health nurses to assure that health teaching and counseling is provided.
  6. Will follow role assignments that are in alignment with the Patient Centered Medical Home Standards, and participate in all Patient Centered Medical Home efforts.
  7. Meets productivity standards including but not limited to number of visits per week
  8. Manages and evaluates the plan of care, process and outcome and then modifies the plan as needed. 
  9. Adheres to collaborative practice principles of respect and joint decision making when: ◦Providing clinical supervision of the medical care delivered by the advanced practice nurses.
  10. Consults with health team members about managing the client treatment plan.
  11. Follows clinical practice standards (protocols) related to each health care providers role and responsibilities.
  12. Assures access and continuity of care by providing call for after-hours coverage.  Assures continuity by obtaining hospital privileges at designated hospitals and by making home visits when appropriate.
  13. Collaborates with other multidisciplinary professionals and community agencies to provide high quality care.
  14. Seeks opportunities for community and professional outreach to maintain and increase patient referral base.  Outreach activities can include, but are not limited to:
  15. Provides training and presentations on TGNC health care issues to multi-disciplinary professionals and community agencies.
  16. Attends community health fairs.
  17. Disseminate information about health center and services provided to other agencies or health care professionals.
  18. Coordinates services in conjunction with other team members to meet patient’s primary health care needs and to ensure the continuity of care.
  19. Participates in quality improvement activities through protocol development and collaborative peer review by:
    • Developing medical and joint practice protocols and identifying appropriate evaluative criteria for utilization review activities.
  20. Evaluates care based on clinical standards through the quality improvement process.  Implements recommended changes and/or improvements to guarantee quality care based on the evaluative process.
  21. Assumes the responsibility for professional development and contributes to the professional growth of others by: 
    1. Developing in-depth knowledge of daily program operations, policies and procedures.
    2. Acting as a preceptor in the orientation of new health care personnel, interns, residents and volunteers. 3. Serving as a consultant in specialized populations to other health care providers and community agencies.
    4. Incorporates and disseminates research findings as a basis for practice and to improve health care outcomes.
    5. Identifies clinical questions to be researched. 
  22. Assumes the responsibility for maintaining competence in clinical practice by: 
    1. Engaging in mentor relationships with experienced mid-level providers and physicians to gain clinical expertise.
    2. Developing and maintaining a patient panel as clinical competence is achieved to enhance continuity of care and meet Organization productivity standards. 
    3. Participating in appropriate educational activities in order to maintain Board certification and continue professional growth. 
  23. Provides cost effective Organization productivity requirements by practicing collaboratively with the advanced practice nurses and the community health nurses to prevent the duplication of services.
  24. Practices within the legal and ethical guidelines established by the Medical Practice Act, the Physicians Code of Ethics and the Specialty Standards of Practice.
  25. Documents comprehensive, accurate and continual data on clients’ records and program reports according to Organization standards.
  26. Prepares the appropriate program reports to fulfill finding requirements as assigned.
  27. Adheres to professional standards as outlined by governmental bodies, American Medical Association (AMA), American College of Obstetrics and Gynecology (ACOG), American College of Physicians, American Academy of Pediatrics, and American Academy of Family Physicians, private funding sources, Organization plans/policies and Unit guidelines. 
  28. Participates in periodic evaluative reviews and/or in-house and external staff training to ensure that he/she understands and continues to adhere to such standards.  Initiates requests for assistance or guidance from Manager to address new issues or complex concepts affecting adherence to professional standards.
  29. Performs other duties as necessary. 

SUPERVISORY RESPONSIBILITIES

  1. The Assistant Medical Director of TGNC Care and other staff as assigned for their clinical location. 

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