Job Title

The Emergency Medicine Physician provides urgent and emergency care services to patients within the scope of their license. This role involves performing rapid medical examinations, diagnostic testing, assessments and screenings, managing acute treatment plans, and coordinating care with other healthcare professionals. The Emergency Medicine Physician also instructs patients and family members on emergency conditions and treatment options during their stay in the emergency department, as well as other duties as assigned. Minimum Requirements: + Graduate from an accredited medical school in the United States or Canada. Successful completion of an internship and residency program to become Board certified by Emergency Medicine (American Board of Emergency Medicine (ABEM) or American Board of Osteopathic Emergency Medicine (ABOEM) only. + Current, full, active, and unrestricted license (MD or DO) to practice medicine and able to obtain clinical privileges to practice medicine at the MTF where services are provided and have an active DEA registration. + Board certified by Emergency Medicine (American Board of Emergency Medicine (ABEM) or American Board of Osteopathic Emergency Medicine (ABOEM) only. + Minimum (1) one year of experience in the last two years as an Emergency Medicine Physician required. + Current BLS, ACLS and PALS certifications + TB questionnaire, PPD or chest x-ray as requested + Current Immunization/Vaccination records as requested + Current Health certificate (per contract or state regulation) + Must meet all federal, state and local requirements + Must be a U.S. Citizen + Must be at least 18 years of age + Complies with all relevant professional standards of practice under licensure and scope Shift Requirements: + The work schedule includes nights, weekends, and holidays. All health care workers may be scheduled anytime 24 hours a day, 7 days a week, 365 days a year to meet mission requirements. Shifts will be scheduled in advance and consist of days, evenings, and nights, to include weekend coverage (Saturday through Sunday), Federal holidays, and training holidays. + Possible Duty Hours: + Fast Track (10 hours): 0700-1700, 0900-1900, 1200-2200, 1400-2400 + Vertical Split Flow Area (9 hours): 1000-1900 + Main Emergency Department (9 hours): 0645-1545, 0700-1600, 1445-2345, 1600-0100, 2245-0745 + Shifts may be adjusted/scheduled anytime 24 hours a day, 7 days a week, 365 days a year to meet mission requirements. Compliance and Professional Standards: + Adhere to CDC universal precautions and Madigan Infection Control Program + Meet all Joint Commission standards. + Review monthly staff meeting minutes for updates. + Become familiar with the hospital formulary and prescribe pharmaceuticals, accordingly, following pharmacy guidance on generic substitutions. + Optionally attend meetings and CME offerings outside assigned shifts at no cost to the Government. Requirements for All Positions + Ability to read, write, and speak English well enough to effectively communicate with all parties and other health care providers. + Possess basic computer skills, knowledge, and abilities required for the labor (i.e., medical terminology, basic computer skills, customer service expectations, telephone etiquette, and basic typing) + Possess sufficient initiative, interpersonal relationship skills and social sensitivity such that he/she can relate constructively to a variety of patients from diverse backgrounds. Clinical Duties (to include by not limited to): + Clinically supervise and teach emergency medicine residents, PAs, PA fellows, interns, medical students, and house staff during assigned ED shifts; complete teaching attestation and co-sign charts within 72 hours; when clinically supervising residents, provide verbal feedback on performance at end of shift and one written teaching evaluation per emergency medicine residency policy. + Ensure accurate, complete, and timely (within 72 hours) documentation in the electronic health record (EHR); respond to coding queries and correct deficiencies promptly; maintain records per hospital directives. + Provide expert guidance to Government Service PAs in ED Fast Track as needed. + Stabilize and manage patients requiring transfer beyond MAMC capabilities, coordinating with the Patient Logistics Center, discussing with the accepting physician, and completing necessary documentation per COBRA and EMTALA regulations. + On day shifts, review abnormal microbiology results and culture sensitivity reports in the electronic medical record and counsel/treat patients as appropriate. + Intermittently prepare, deliver, and proctor a 30-minute oral board clinical case for the emergency medicine residents. + When assigned to shifts in the main ED, review charts of patients who Left Without Being Seen, contacting high-risk patients or those with abnormal labs per ED policy. + Regularly review the ED tracking board (LaunchPoint) and monitor the waiting room to enhance efficiency and patient safety. + Obtain clinical consultations as needed. + Respond to Pierce County Base Station calls, directing pre-hospital care per Washington State, Pierce County, and Madigan guidelines. + Respond to mass casualty situations per hospital procedures. + As part of the Coordinating Team (charge RN, medic shift leads, nursing supervisor, and administrator on duty), address workflow issues, staffing shortages, supply deficiencies, or equipment failures on shift. + Remain in or immediately available to the ED throughout the shift; do not leave without a privileged replacement; receive a safe and effective handoff from a designated staff member before assuming duties. At the end of the shift, ensure a safe and effective transition of care to the oncoming privileged provider. + Clinical management and supervision of mass casualty and triage + Clinical supervision of prehospital and other emergency medical technician (EMT)-provided care Electrocardiogram (EKG) interpretation + Mechanical ventilatory management (invasive and noninvasive) + Tonometry + Slit lamp examination + Central venous pressure monitoring + Treatment of dental fractures + Treatment of priapism Procedures Endotracheal intubation + Use of laryngeal mask airway Cricothyrotomy + Rapid sequence intubation + Laryngoscopy; direct, indirect + Flexible / rigid nasopharyngoscopy Removal of upper airway foreign body + Pacemaker insertion, temporary - transvenous, epicardial + Pericardiocentesis + Emergency resuscitative thoracotomy including internal cardiac massage + Thoracentesis + Tube thoracostomy + Needle thoracostomy + Repair of cutaneous lacerations, single or multilayer Wound care / debridement + Paracentesis + Thrombosed hemorrhoid incision and drainage (I&D Suprapubic bladder aspiration + Reduction of paraphimosis / phimosis + Emergency retrograde urethrogram + Emergency vaginal delivery + Lumbar puncture + Nasal cautery and packing / balloon placement, anterior and posterior + Reduction of simple closed fractures and dislocations + Arthrocentesis + Complete / partial nail removal with or without destruction of nail matrix + Nail trephination + Repair of cardiac trauma Incision and drainage of cysts and minor abscesses + Caesarean section, maternal perimortem + Central venous catheter insertion Emergency needle cricothyrotomy + Resuscitation and management of burn injuries + Thrombolytic therapy + Suprapubic catheter + Defibrillation and synchronized cardioversion + Compartment pressure testing, needle transducer + Cardioesophageal balloon tamponade + Anoscopy + Treatment of testicular torsion + Tooth reimplantation + Arterial catheter placement + Dialysis catheter placement + Removal of nasal foreign body + Soft tissue injections + Joint aspiration and injection + Bedside ultrasound + Placement of alternative airway devices + Percutaneous transtracheal jet ventilation + Needle aspiration and incision & drainage of peritonsillar/intraoral abscess + Gastric tube replacement + Tracheostomy tube replacement + Removal of ocular foreign body and rust ring + Topical and local infiltration anesthesia + Peripheral nerve block anesthesia + Moderate sedation + Deep sedation Administrative Duties (to include by not limited to): + Submit schedule requests on time via the electronic system; shifts may be in main ED, ED Fast Track, or Vertical Split Flow based on need and availability; provide intermittent ED coverage during Grand Rounds (Wednesdays 0700-1600) or staff-only days. + Perform monthly peer reviews for ED providers using the electronic chart review system (CQA). + Complete all required paperwork, computer-based training, and face-to-face training per Madigan policies. + Prepare additional records/reports as required of Army Medical Department officers or physicians in routine patient care. + Complete Washington State Labor and Industry and civilian employee injury forms for on the-job incidents and respond to quality improvement or patient complaint inquiries. + Refer patient/hospital information requests to the Administrative Officer of the Day (AOD); do not release medical information without AOD coordination. + Use only approved abbreviations from AR 40-66, Appendix B; document history, physical exam, labs, x-rays, and preliminary diagnosis before treatment.