Physician Lead - Post Discharge Service Physician

This position will be located at the Duke Primary Care Riverview clinic in Durham, North Carolina.

The Duke Primary Care Physician Lead - Post Discharge Service Physician works in collaboration and continuous partnership with patients discharged from Duke University Hospital and Duke Regional Hospital, their family/caregiver(s), clinic/hospital/skilled nursing facility providers and staff, and community resources in a team approach. The intent is to provide timely access to appropriate care and reduce emergency room utilization and hospital readmissions. As part of Post Discharge Physician’s (PDP) regular duties, the physician will be responsible for acting as the supervising physician for at least one mid-level provider, as directed by Duke Primary Care. The Post Discharge Physician may also see same day appointments for the DPC Riverview clinic if the post discharge appointments slots are not fully utilized. The minimum required total FTE for the position is .8. The Post Discharge Physician (PDP) will be compensated with a base salary plus incentive.

Goals:

• Create and promote adherence to a care plan, developed in coordination with the patient and family/caregiver(s).
• Increase continuity of care by managing relationships with hospitalists, specialists, and those managing transitions of care.
• Partner with Pharmacist and Population Health Resource to perform a thorough medication reconciliation and identify any barriers to maintaining and improving health; Refer to other members of the care team that can connect patients to relevant community resources with the goal of enhancing patient health and well-being, increasing patient satisfaction, and reducing health care cost.
• Connect the patient to a Duke Primary Care Provider for ongoing care.

Reporting Relationships

The PDP reports to the ACMO of Innovation & Improvement and works collaboratively with the practice Health Center Administrator (HCA), Nurse Manager (NM) to achieve practice goals that are in alignment with the Duke Primary Care and Duke University Health System.

ESSENTIAL JOB FUNCTIONS

• Effectively manages both medical and mental health chronic and acute conditions, during the patient's transition between healthcare settings.
• Functions independently to perform a history and physical for acute and chronically ill patients during a transition of care period. 
• Facilitates the implementation of the patient's plan of care by engaging the patient and family and connecting to primary care providers and specialists as needed.
• Evaluates the effectiveness, necessity, and efficiency of the patient's plan of care, making revisions as needed.
• Prescribes appropriate pharmacologic and nonpharmacological treatment modalities.
• Provides primary care services to patients after a transition of care until care can be effectively transferred to the patient's PCP.
• Participates in readmission efforts to identify interventions to better support patients and their families. Refers to other members of the care team, as appropriate, in order to meet the needs of the patient.
• Orders, interprets, and evaluates diagnostic tests to identify and assess patient's clinical problems and health care needs. Records physical findings, and formulates plan based on patient's condition. Attends required meetings and participates in committees as requested.
• Participates in professional development activities and maintains professional affiliations.
• Maintains patient confidentiality.
• Functions independently and responsibly with minimal need for supervision, within the requirements of the licensing board.
• Interacts harmoniously and effectively with others, focusing upon the attainment of organizational goals and objectives through a commitment to teamwork.
• Conforms to acceptable attendance and punctuality standards, as expressed in the Employee Handbook.
• Complies with all safety rules and protocols. Reports all accidents, regardless of severity, immediately to supervisor and completes incident/injury report and investigation form, which will be forwarded to Human Resources within 24 hours of incident.
• Abides by the organization's compliance program and requirements.
• Current on all required training for current year.
• Performs all other duties, as assigned by VPMA and/or supervising physician.

KNOWLEDGE, SKILLS, AND ABILITIES

• Adaptable to change.
• Proficient computer skills including the ability to document medical information within the electronic medical records.
• Ability to work collaboratively in a team and manage multiple priorities, utilize effective time management skills, and exercise sound administrative and clinical judgment.
• Strong interpersonal communication skills, both verbal and written.
• Ability to provide patient, compassionate care.

EDUCATION AND EXPERIENCE

• Medical degree required; board certified in Family Medicine, Internal Medicine, or Medicine/Pediatrics. Physician must be able to obtain faculty of through Duke University School of Medicine and privileges at Duke University Hospital.
• Proven experience functioning in complex delivery systems with demonstrated results.