Core Skills


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Core Skills

  1. 1. Scope Of Practice Name License # Supervising Physician ______________________ ________________ Additional Supervising Physician(s) ______________________ ________________ ______________________ ________________ ______________________ ________________ ______________________ ________________ ______________________ ________________ Physician Assistant ______________________ ________________ Practice Site ______________________ ______________________ ______________________ Office Address ______________________ ______________________ Hospital Affiliation ______________________ ______________________ ______________________
  2. 2. Date ______________________ Core Skills 1. A physician assistant may only provide those medical services which he or she is competent to perform and which are consistent with the physician assistant’s education, training and experience and which are delegated in writing by a supervising physician (or alternate) who is responsible for the patients cared for by the physician assistant. 2. The physician assistant may perform his/her duties only in the principal offices of the physician, public or private places or health facilities where the physician regularly sees patients; and is not precluded from making house calls, hospital rounds, serving as an ambulance attendant, or performing any functions performed by the supervising physician (or alternates) for which the physician assistant is qualified and are delegated by the supervising physician (or alternates). 3. Supervision means overseeing the activities of, and accepting the responsibility for, the medical services rendered by a physician assistant. The supervising physician need not be physically present at the time of the services but shall be immediately available by telecommunications and within reasonable travel distance to assume personal care. 4. The physician and physician assistant are expected to understand and comply with all current laws, rules and regulations which govern the practice of physician assistants in the State of South Carolina and will be acknowledging this by affixing their signature on the physician assistants practice application. 5. A physician assistant may gather a data base on all new patients or established patients with new or existing problems which may include a complete medical history and physical examination, medical record review, and he/she may order the appropriate initial diagnostic studies and initiate a treatment plan. The physician assistant will be responsible for transmitting that information orally, or through notation in the patient’s record or to the supervising physician for review. 6. The physician assistant, if qualified by training and experience as determined by the supervising physician, may perform medical treatments, diagnostic procedures, or tasks as delegated by the supervising physician which fall within the normal scope of practice of the supervising physician. 7. A physician assistant may instruct and counsel patients and their families, and involve them in informed decision making, with regards to their illness or injury, therapeutic and diagnostic procedures, treatment regimens, normal growth and development, family planning advanced directives, emotional problems of daily living and health maintenance. He/she may also facilitate referrals of patients to other medical providers, medical facilities, or other health/social service agencies when appropriate as per the delegation of the supervising physician. 8. In a life threatening emergency situation, when the supervising physician is not present, the physician assistant may initiate appropriate evaluation and treatment. 9. The physician assistant shall be at all times properly identified as a physician assistant and shall wear clearly legible identification name tag. 10. A physician assistant may carry out a prescription drug or device order in any health care setting excluding controlled substances in Class II medications, ophthalmic steroids, MAO inhibitor, anabolic steroids and sublingual Nifedipine for blood pressure control.
  3. 3. Scope Of Practice Treatment Plans To be discussed by the physician and physician assistant. Included but not limited to: Abdominal Aortic Aneurysm Diarrhea Alcohol Withdrawal Diastolic Dysfunction Allergic Reaction Diverticulosis/Diverticulits Angina Dizziness Amurosis Fugax Dyspnea Anemia Electrolyte Disturbances Angina Pectoris (stable & unstable) Empyema Aortic Dissection Type I and II Endocarditis Aortic Valve Disease Erectile Dysfunction Arterial Occlusive Disease Failure To Thrive Ascending Aortic Aneurysm Fatigue Arthritis Fever Of Unknown Origin Asthma Fluid Management Atrial Fibrillation Flu Atrial Flutter Fungal Infections Atrial Myxoma Gastroenteritis Atrial Septal Defect Gastroesophageal Reflux Disease Bacteremia Genitourinary Tract Infections Bacterial Infections GI bleeding Benign Prostatic Hypertrophy Gout Biventricular Pacemakers Headaches Bronchitis Heart Block (1st, 2nd and 3rd degree) Cardiac Arrest Heart Murmurs Cardiac Dysrhythmias Hematoma Cardiac Pacemakers Hemoptysis Carotid Artery Stenosis Hemorrhoids Cancer Hematuria Candidiasis Hepatitis Cardiac Shock Hiatal Hernia Cardiac Tamponade Hypercoagulable States Cardiomyopathy Hyperkalemia Cellulitis Hyperlipidemia Cholecystitis Hypernatremia Cholelithiasis Hypertension Chronic Obstructive Pulmonary Disease Hypertriglyceridemia Common Dermatoses Hypoglycemia Common Psychiatric Disorders Hypokalemia Conduction Disturbances Hyponatremia Congenital Heart Disease Hypotension Congestive Heart Failure Hypoxia Constipation Idiopathic Hypertrophic Subaortic Stenosis Coronary Artery Disease Irritable Bowel Syndrome Cor Pulmonale Indeterminate Lung Nodules or Masses Cough Implantable Cardiodefibrillators Decubitus Ulcers Lung Malignancies Deep Venous Thrombosis Management Of Prosthetic Heart Valves Dehydration Medication Reactions Dementia Mitral Valve Disease Diabetes Musculoskeletal Pain Diabetic Foot Ulcers Myocardial Infarction
  4. 4. Myocardial Ischemia Tricuspid Valve Disease Myocarditis Thrombocytopenia Nephrotic Syndrome Thrombophlebitis Non Healing Wounds Thyroid Disorders Obesity Transient Ischemic Attack Orthostatic Hypotension Urinary Retention Osteoarthritis Valvular Heart Disease Palpitations Ventricular Septal Defect Pancreatitis Venous Insufficiency Pain Venous Stasis Ulcers Peptic Ulcer Disease Vertigo Pericardial Disease Viral Infections Pericarditis Wound Infections Peripheral Neuropathy Weakness Peripheral Vascular Disease Weight Loss Pleural Effusion Pleurisy Pneumonia Pneumothorax Postcardiotomy Syndrome Pre/Post Operative Management Pulmonary Edema Pulmonary Embolus Pulmonary Hypertension Pulmonary Infections Renal Artery Stenosis Renal Failure Renal Insufficiency Rheumatic Heart Disease Rhythm Disturbances Septic Shock Sinusitis Sleep Apnea Soft Tissue Injuries Stroke Subclavian Steal Subdural Hematoma Substance Abuse Syncope Tobacco Abuse Thoracic Aneurysm Specific Job Description The physician assistant’s job duties to include but not limited to taking patient history and performing a complete physical examination and make an assessment and diagnosis therefrom. Conduct and record daily rounds in the hospital setting including admissions, referrals and discharge summaries. Initiate review and revise treatment and therapy plans and record/present data in a manner meaningful to the supervising physician. Explain cardiology procedures and perform site checks after placement of catheters or pacemakers. The physician assistant will also see patients in the office setting for interval follow up for possible revision of initial treatment as outlined by the supervising physician (or alternate). Coordinate and manage the development of a Lipid Management Center. Enhance the identification and optimal treatment of lipid disorders and other risk parameters related to the development of vascular disease. Direct the ongoing management of patients in conjunction with a physician supervisor. Emphasize patient education in the areas of pathophysiology of vascular disease, how various risk markers affect atherosclerosis and provide
  5. 5. understanding of how various treatment modalities affect long term outcomes. Initiate, compile and analyze computer database for the evaluation of treatment modalities. Coordinate and manage an established Coumadin Clinic. Identify and outline therapeutic goals regarding various cardiac entities whereby Coumadin is warranted (ie. chronic atrial fibrillation, mechanical valves, etc…) and structure a course of therapy to achieve and maintain these goals. This is to include initial prescribing amounts and serial follow up appointments for medication adjustments. Administration and interpretation of maximal graded exercise tests for normal and cardiac impaired populations. Administration of maximal graded exercise echocardiography tests. Administration of maximal graded exercise nuclear tests and persantine/adenosine resting nuclear tests. Interrogate and program cardiac devices including permanent pacemakers and implantable cardiodefibrillators Coordinate and manage an established Congestive Heart Failure Clinic. Identify and monitor parameters to measure patient volume status. Structure a course of therapy to achieve and maintain a euvolemic state.