Description

Housecall Providers is a Portland area nonprofit organization and one of the largest providers of medical care exclusively in the home in the Western United States. We are proving every day that in home medical services for homebound and chronically ill patients can improve health outcomes, increase patient comfort, reduce health care costs and increase provider satisfaction. We are a proud part of the CareOregon family of health organizations.

Our Mission
Improving lives by bringing health care home

Our Vision
To sustainably transform home-based medicine so all homebound adults and those living with serious illness have access to care that improves their quality of life.

Our Values
Compassion and respect, authentic relationships, collaboration, courage, social justice

Job Summary
The physician provides professional, comprehensive medical care and treatment services with emphasis on hospice for the purpose of improving patient medical care and symptom palliation. Care may be provided directly, through visits to the patient’s place of residence/facility or indirectly by advising and directing members of the interdisciplinary team. The hospice physician will also identify opportunities to improve care delivery, use resources effectively, and comply with legal, regulatory and clinical policies and procedures.

Essential Responsibilities
Clinical Services and Care

Certifies that patients are medically eligible for hospice services, using available diagnostic and prognostic indicators, related diagnoses if any, current subjective and objective medical findings, current medication and treatment orders, and information about the medical management of any of the patient’s medical conditions unrelated to the terminal illness.
Recertifies patients as appropriate, using information from face-to-face evaluations where required, for continuation of the Medicare Hospice Benefit at the appropriate level of care.
Collaborates with the interdisciplinary team and patient’s attending physician to create, implement, and revise care plans which reflect the patient’s goals, values, and mental, spiritual, and physical needs to assure overall continuity of hospice services.
Attends IDG/IDT meetings, acting as a medical resource for the team, guiding the work of those who provide direct medical services (RN, NP, PA, LPN, CNA), and assuring compliance with medical standards of care for hospice. 
Provides consultation, support, and education to the hospice IDG, attending physicians, and other colleagues regarding medical eligibility, symptom management, and any other issues related to the medical care of hospice patients.  Ensures that medical services and support are available to hospice patients and the IDG 24/7, either directly or through arrangements.
Documents care provided in the patient’s clinical record, including evidence of end-stage-disease progression and need for opioids to meet CMS/DEA requirements.
Reviews, prescribes and dispenses medications to ensure adequate symptom management; initiates and/or continues medical regimes for new patients; reviews medication to ensure they are medically necessary and cost effective.
Provides compassionate anticipatory guidance through decline due to chronic disease and provides high quality palliative care focused on the goals of the patient and family. This includes participation in family meetings to educate patients and families on medical conditions and the pros and cons of treatments or medications. 
Assesses and counsels’ patients regarding hospice care needs; determines need for specialty and rehabilitative services and makes appropriate referrals.
Performs the most difficult assignments (including management of the most complex, at-risk patients), requiring a higher level of responsibility, applying advanced subject knowledge, and exercising significant independent judgment and initiative. 
Delivers quality care while maintaining all company metrics pertaining to productivity.
As directed by Medical Director, may provide oversight of care delivered by Nurse Practitioner.
Provides coverage for clinical colleagues in their absence.
Participates in 24/7 consultation and care support including overnight and on weekends.

Administration

Participates in collaborative treatment with other medical and mental health professionals and technical staff.
Participates in staff and professional conferences; consults on and assists in the development of in-service training and orientation activities in areas of treatment and care of the patient population; participate in peer review.
Attends and participates in all required staff meetings and other ad hoc committees as assigned.
Participates in quality improvement activities as assigned.
Completes and maintains medical records according to agency protocols and in support of quality metrics.
As assigned by the Medical Director, may train and assess performance of other providers.
Assures overall continuity of hospice medical services.
Participates in the development and updating of patient care policies and emergency procedures.
Participates in resolution of interpersonal conflict and issues of clinical and ethical concerns.
Maintains current knowledge of the latest research and trends in hospice care and pain/symptom management.

Requirements

Required

Licensed physician (MD or DO) in the State of Oregon
Certification by the American Board of Medical Specialties with additional board certification or board eligibility in hospice and palliative care
Drug Enforcement Administration (DEA) license
Valid driver’s license, acceptable driving record, and automobile liability coverage or access to an insured vehicle
CPR certification at hire or within 6 months in position
Preferred

Experience in Internal Medicine or Family Medicine
Experience in geriatrics.
Experience providing primary care for hospice patients
Experience in performing medical home visits
Experience with the mental health, substance abuse and behavioral health issues of a safety net population
Experience with medical ethics and quality improvement methodology
 

Knowledge

Knowledge of the ethical and medico-legal aspects of medical practice
Knowledge of the principles and practices of public health, including familiarity with epidemiology, health services delivery and financing systems, and environmental health
Knowledge of the population served in adult health, including culture, demographics, patterns of disease, barriers to care and other unique features or special needs
Knowledge of available interventions and medications, the expected palliative benefits in the hospice population, and the likely ability to meet the needs of an individual patient
Knowledge of Federal, State and Local regulations, Hospice Medicare Conditions of Participation, and HIPAA privacy rules and regulations Ability to assist in the development and implementation of appropriate outcome tools, metrics, and assessment strategies to inform quality outcome, safety, and performance improvement