Clinical Component

Clinical Component 

This position is going to be a true Emergency Medicine position, in a fast-paced environment seeing patients of all acuity. This job offers high acuity patients due to the area's underserved primary care population resulting in many patients presenting at advanced stages of illness or injury requiring more complex treatment plans than usual for their ESI levels

  • 10-99
  • BC required 
  • About 20 patients a day
  • Fast track vs true care : 4-5 
  • Abilities needed: airways, central lines, fractures, pacemakers
  • Transfers out: interventional radiology, stroke, brain bleeds
  • Meditech EMR 

There's a lot of pathology in the area. It's an underserved area in terms of primary care. So people, when they come to the hospital, they have not been doing preventive care, they have not been seeing patients or of physicians, so they are very complex patients.  

The hospital sees around 150 patients per day and takes transfers from smaller facilities in the area. The patient panel is about twenty to twenty five percent ESI 4/5. ESI 3 is going to be the largest component of patients, which comprise of 60-70% of the patients and ESI 1/2 is relatively small. We do have an outstanding team of APPs that see virtually all 4 & 5s, in addition to vertical 3s.  

Being a level II trauma, we treat basically everything that comes through the door. Exceptions would be night level brain bleeds and Neurosurgical cases as the current team does not do coils. Outside of that, we are expected to see and treat everyone.  

Physicians are expected to work 12-hour shifts that may include both day and night shifts.

Schedule

The facility operates 7 days a week with four shifts per day. 

  • We have one provider on from 7am to 7pm
  • We have one provider on from 8am to 8pm
  • We have one provider on from 7pm to 7am
  • We have one provider on from 8pm to 8am 
Additional there are swing shifts during the weekdays. Mondays are normally from 2pm to10pm, with Tuesday through Thursday being more flexible between 6 & 8 hour shifts. If the census is high then the hours will be longer, if the census is down the hours will be shorter for those days.   

Although physicians work primarily twelve-hour shifts rotating between days/nights depending on patient volumes each month; they must also cover The Women's & Children's Hospital Level II Trauma Center across the street. “This only happens three-six times per year” but requires two physicians present at all times during those events. 

Overall, the requirement for full-time is 120 hours a month between Nights, Weekends & Swing shifts. All nights and holidays are equally divided between the team and everyone does their share.  

Job Specifics

Required procedural strengths: tracheal intubation; central venous line (catheter); complex lacerations

Providers are expected to do obviously the airway and we do come across some very difficult airways. So, the physician needs to be very competent with the airways. Obviously, centralized chest tubes, fracture reductions, dislocation reductions, shoulder reduction. Providers should be comfortable with difficult airways as well as external pacing but not float their own pacemakers or perform coiling procedures for brain bleeds.

In terms of medical staff there, I would not classify this medical staff any different than any other hospital. Some of them are very good. Some of them are very good to work with. Some of them are difficult to work with, so that's normal. Normal for any, you know, medical staff.  

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