Physician  Assistant  Wilford Hall Ambulatory Surgical Center, San Antonio

Time to invest in some new footwear because if you’re San Antonio-bound, you’d better show up in boots! The Alamo City is one of the military’s most envied postings and is often referred to as “Military City USA”. Low cost of living, affordable homes, and the lack of state tax on retirement income are a few financial perks to living and retiring in this Texas city. A robust job market that seems partial to government and defense/security contracting ensures employment opportunities for spouses or transitioning service members. San Antonio is the country’s seventh fastest growing city yet has somehow managed to retain a “small town feel.” Quality schools and friendly locals (most with military ties) are additional  perks to living in San Antonio.

Some things you should know before you get here: trucks are the norm (the bigger, the better), love for The Spurs (NBA) runs deep, the H-E-B obsession is real (it’s a grocery store), rodeos are life, and don’t call it “San Antone”—that’s just wrong. The community boasts a vibrant Hispanic population, and enhances everything from the food, to the music, to community events. You don’t necessarily need to speak Spanish to get around, but you’d better know how to say barbacoa, tamales, and cascarones.

Name brand shopping (IKEA is the latest arrival of note), restaurants, and all variety of entertainment all add to San Antonio’s quality of life. SeaWorld, the San Antonio Zoo, Six Flags Fiesta Texas, and downtown museums are all fun outings for kids and families. Tube or kayak down a river, play or fish in the lakes, or relax by San Antonio’s famous downtown River Walk. Museums, art galleries, and historical landmarks—remember The Alamo?—round out San Antonio’s cultural offerings. Tex-mex cuisine arguably originated here, and some up and coming culinary trendsetters are making a name for themselves in the Pearl District downtown, alongside several notable breweries.

San Antonio has over 300 days of sunshine with some hot summers, mild winters and pleasant spring and fall seasons. San Antonio is in Bexar County (it’s pronounced “BEAR”) in south central Texas, and is just south of the gorgeous Hill Country. It’s only about two hours from Austin, the beach, or the desert.

Working for the Department of Defense comes with an abundance of benefits and perks to include competitive compensation packages, paid-time off, medical benefits, student loan repayments, and retirement package with Thrift Savings Plan to include matching employer contributions.

PURPOSE OF POSITION AND ORGANIZATIONAL LOCATION:

The primary purpose of this position is: To function as a credentialed health care provider, privileged by the facility credentials function, who uses critical judgment to perform comprehensive health assessments, formulate differential diagnoses, and prescribe pharmacologic and non-pharmacologic treatments in direct management of acute and chronic illness and disease to male and female patients of all ages (to include pediatric and geriatric) in small, medium, and large-sized general clinics and hospitals. Promotes wellness and prevents illness and injury.

ORGANIZATIONAL GOALS OR OBJECTIVES:

The organizational goals and objectives of this position are to: to provide comprehensive outpatient medical care to a broad cross section of patients with both common and complex, acute and chronic diseases, to include deployment related medical conditions.

Serves as the Primary Care Manager (PCM)/team leader providing comprehensive outpatient care for both male and female TRICARE Prime enrolled beneficiaries as well as TRICARE for Life and space available beneficiaries, ranging in age from newborn to geriatric, presenting with complex and interdependent, acute and chronic conditions. These conditions include, but are not limited to the management of: insulin & non-insulin requiring diabetes mellitus, hypertension, cardiovascular disease, asthma, inflammatory and non-inflammatory arthritic conditions, cancer diagnosis/management/surveillance, physical and/or extremity injuries, as well as acute and chronic psychiatric/psychological disorders. Provides Pre-and Post Deployment health assessments as well as Preventive Health Assessments (PHA). Addresses, manages, and documents medical issues pertaining to the Personnel Reliability Program (PRP), Security Clearances, Overseas Clearances, Pre-Confinement evaluations, Line of Duty Determination (LOD), and Occupational and fitness for duty medical evaluations -- all of which are performed for active duty, reserve, and National Guard members as well as eligible civilian, DoD, and dependent beneficiaries. Provides direct primary outpatient care to include gynecologic, prenatal, pediatric, and geriatric care. Performs ambulatory surgical procedures including but not limited to: casting/splinting, suturing, excisional and shave skin biopsies, joint aspirations and injections, and colposcopies, as specified in the credential and privilege lists. Orders and interprets diagnostic and testing procedures to include laboratory and radiological examinations. Ensures appropriate follow up and documentation of all clinical and diagnostic procedures IAW the Accreditation Association for Ambulatory Health Care (AAAHC), The Joint Commission (TJC), and Health Services Inspection (HSI) guidelines. Independently and in consultation with named consulting physician formulates full treatment and management regimens based on sound diagnoses consistent with current and/or evidence-based clinical practice guidelines. Due the possible lack of consistent medical specialty support caused by deployment requirements, may be required to provide some sub-specialty services within current granted privileges to patients encountered. Coordinates with facility and community resources to provide multi-disciplinary comprehensive care to all patients, taking into account factors such as new and/or emerging procedures and techniques and the patient’s personal history, as well as information gained through diagnostic tests. Provides advice by telephone and/or in person to other non-physician providers, nursing, and para-professional staff on the care of patients with urgent, emergent, and non-urgent medical problems. Documents clinical encounters and patient instructions into the medical record via current electronic medical record system and prepares appropriate clinical narrative summaries for both civilian and military occupational programs in a timely manner.

Provides direction to other non-physician providers such as Independent Duty Medical Technicians and students assigned to the Military Treatment Facility (MTF) as well as nursing and paraprofessional staff in care of patients with urgent, emergent, and non-urgent medical problems. Evaluates how the team provides care to include participation in peer review proceedings consistent with local and Air Force guidance. Facilitates and manages full spectrum of professional and patient care activities for the PCM team. Evaluates and analyzes how the team provides care through a continuum thereby facilitating the achievement of efficient, high quality, and cost effective healthcare. Guides, counsels, and supervises PCM team personnel to include other Physician Assistants, Nurse Practitioners, medical technicians, and administrative personnel. Provides input and guidance on clinical aspects and/or resolves issues relating to the management of the PCM templates to ensure access-to-care standards are met.

Serves as member of the professional medical staff and complies with hospital plans and policies to meet accrediting agencies’ (AAAHC or TJC) requirements. Participates in continuing education programs to update and maintain skills and knowledge in accordance with Medical Group (MDG) and unit policies including department in-services education. Actively participates and contributes to medical oversight activities to include peer review programs. Serves as clinical preceptor for other professional providers which may include other Physician Assistants, Nurse Practitioners, etc. Participates in hospital/clinic committee work as determined by the Chief of the Medical Staff performing duties (i.e. Credentials, Pharmacy & Therapeutics, Population Health, Occupational Health committees, and other such activities). Provides professional guidance concerning unit/MDG policies and/or operating instructions.

Participates in local disaster training exercises as directed by the Chief of the Medical Staff (SGH) or Medical Group Commander; responds to real-world disaster situations. Participates in local disaster training exercises to maintain preparedness levels. Responds to assigned medical treatment facility in real-world disaster to facilitate primary care delivery in the face of an emergent local situation. Coordinates with local, state, and county medical emergency personnel to execute primary care delivery in accordance with the assigned facility’s Medical Contingency Response Plan (MCRP).

Performs other duties as assigned.