Robotic Surgery Physician Assistant, Surgical Oncology

Brigham and Women's Hospital, an affiliate of Mass General Brigham, is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve. At Mass General Brigham, we believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity : race, gender identity, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression that make us better able to provide innovative and cutting-edge healthcare and research.

The physician assistant (PA) is a licensed provider who has acquired a broad range of knowledge and skills through the successful completion of a physician assistant program. The PA is responsible for the assessment and management of various populations of patients, medical and / or surgical, including diagnostic and therapeutic interventions, development of appropriate plans of care and ongoing evaluation. The physician assistant works under the supervision of an attending physician and reports directly to the department administrator or chief physician assistant administratively.

The PA will perform in accordance with all state and federal regulations and institutional policies including but not limited to the BWH PA Scope of Practice, Prescriptive Guidelines, approved clinical privileges, and BWH PA policy.

This PA role helps provide the highest level of preoperative, intraoperative, postoperative and outpatient care of surgical patients treated at Brigham and Women's Hospital, as well as the Dana Farber Cancer Institute (DFCI) Gastrointestinal (GCC), Melanoma (MEL), and Sarcoma (SAC) Disease Centers under the direction of the supervising physicians. Participates in the ongoing clinical research activities within the Division of Surgical Oncology and the related Disease Center at DFCI.

Non-Clinical Duties :

Team Work, Interpersonal & Communication Skills

Professionalism / Professional Development

Continuing Education

Professional behavior

Course attendance

Growth of self, growth of department

PRINCIPAL DUTIES AND RESPONSIBILITIES : PERIOPERATIVE CARE

Perioperatively

Prior to the operation, the PA serves to assist with a wide variety of preparations including but not limited to :

Verify correct patient information, operative procedure and surgical site and check the patient's chart for any abnormalities

Verify that the correct equipment and instrumentation is prepared and ready to use.

Carry out the surgeon's request for exact positioning for surgical procedure. Assist with patient positioning, including helping transfer of patients from stretcher / bed to OR table, ensuring that the bed is locked and secure during transfer, and application of patient safety measures, i.e., safety strap application, protective padding and arm board placement

Assists circulator and anesthesia provider in preparation of patient to include but not limited to foley catheter placement, tourniquet application, placement of IVs, cricoid pressure application, sterile prep and drape, and other procedures as needed.

Check availability of imaging studies Work with director of robotic surgery to ensure availability of robotic instruments for current and upcoming case

Intraoperatively :

During the operation, at certain points of the procedure the PA may be scrubbed at the bedside with the attending surgeon. During much of the procedure, the PA may be scrubbed alone at the bedside as the attending surgeon performs the procedure on the robotic console. Roles include the following :

Make incisions and place ports at discretion of attending surgeon

Visualization of the operative site by digitally manipulating tissue, suctioning, irrigating, or placing sponges

Manipulating suture materials.

Change robotic instruments (remove and reintroduce instruments)

Administering subcutaneous postoperative injections of local anesthetics when directed by the surgeon

Postoperatively

Closing skin incisions, secure drains, and apply wound dressings

Handles all surgical specimens according to procedure, assist with specimen reconciliation as needed

Transfer patient to stretcher

Accompany patient to recovery room to assist with report to staff in post-anesthesia care unit (PACU)

Professional Development :

With assistance of robotic surgical coordinator, must become familiar with mechanics of the DaVinci system including details of port placement, camera targeting, robotic docking, emergency undocking and troubleshooting procedures

In addition :

Works with Lead Surgeons, other Pas, and OR leadership to help grow and develop the Robotic Surgery and Robotic PA programs

Trains bedside personnel (residents, fellows, and other PAs) in robotic procedures

Keeps current regarding developments in technical instrumentation, trends and techniques through internal and external programs, particularly regarding the DaVinci Surgical System.

Serves on appropriate nursing and hospital committees as requested.

Works closely with OR Nursing to ensure best practices in perioperative patient care. Participates in staff meetings.

Assists with quality improvement projects as applicable

Assists in evaluation of products, equipment and systems which may have an impact on planning and implementing the budget.

Keeps informed of personnel policies and incorporates them in behavior as indicated.

Seek out new learning experiences as staffing numbers allow.

PRINCIPAL DUTIES AND RESPONSIBILITIES : OUTPATIENT

The Robotic Surgical PA will be called on periodically to substitute for other physician assistants in the Division of Surgical Oncology for clinical duties during periods of vacation or illness. Roles may include the following :

Serves as a point of contact for patients with GI / Hepatobiliary / Pancreatic cancer Melanoma and Sarcoma treated in the Division of Surgical Oncology.

Chart review and documentation for clinic patients. Works together with providers in other subspecialties to ensure a smooth transition of care for patients receiving multimodality treatment at DF / BWCC.

Performs surgical oncology consultations at BWH and DFCI as requested by the attending physician.

Performs assessment and sharp debridement of wounds as necessary, recommends wound management options, performs follow up visits and communicates with attending surgeons regarding patient status.

Performs routine surveillance follow-up assessments of patients after surgery, including history, physical exam, and radiographic evaluation of patients scheduled in a physician-supervised clinic at DFCI.

Performs inpatient and outpatient wound management for acute incisions and chronic wounds, including sharp debridement, dressing applications, suturing and removal of drains, sutures, and staples.

Writes orders and interprets lab values and radiological tests with the assistance of physicians as necessary.

Facilitates referral of surgical patients to the DFCI GCC, MEL, and SAC Service by consultation with referring providers. Performs access and evaluation of indwelling venous catheters.

Assists study coordinators for ongoing clinical research involving surgical oncology, including performing and recording research histories and physicals, data collection and recording, obtaining tissue specimens for research analyses, and wound care according to specific study guidelines.

Other duties as assigned.

PRINCIPAL DUTIES AND RESPONSIBILITIES : RESEARCH

1. Assists with data collection and maintenance of research databases and quality improvement databases

2. Assist with ongoing clinical research and quality initiatives related to robotic surgery through follow-up of patients involved in clinical trials or clinical outcomes studies

2. Attend research meetings as applicable

3. Obtain informed consent for research protocols if applicable

Education

Master's Degree Physician Assistant required

Can this role accept experience in lieu of a degree?

Licenses and Credentials :

Physician Assistant MA State License

Experience

2 years of experience as a PA required

• Must have successfully completed a Graduate Level, accredited Physician Assistant Program approved by AMA Board of Approval and Certification of PA programs.
• Must have 4 years of college level education and bachelors degree or equivalent. (BS / MS joint programs are also acceptable; BS with PA certificates are acceptable for graduates before 1995).
• 2 years of surgical experience preferred, one year of either dedicated robotic surgical experience or completion of an APPAP-accredited PA surgical residency program.
• Board Certification by the National Commission on Certification of PAs is required prior to start date
• License as a Physician Assistant in Massachusetts prior to start date
• Maintain current DEA and Massachusetts Controlled Substance Licenses
• Complete 100 hours of CME according to national and state regulations during each 2 year period of employment.
• Maintain current BLS / ACLS certification
• Complete BWH Professionalism Program within 3 months of date of hire.
• Complete BWH Procedural Sedation Training, if determined necessary.

Knowledge, Skills and Abilities

Physical Requirements

Brigham and Women's Physicians Organization, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and / or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.