Darlene

We have 5 PA's and a nurse in our practice.  We have 16 radiologists that utilize the PA's and 4 IR docs that also utilize the nurse.  The nurse works exclusively at the hospital and the PAs rotate between the hospital and one outpatient imaging center.  Here is just a sampling of how valuable these mid-levels have been for our practice and productivity:

• IR Nurse (works 3 days / week)
  • Schedule clinic patients and procedures
  • Takes history and physicals (H&Ps)
  • Pre-procedure planning with patient
  • Insurance authorizations for procedures
  • Schedules follow-up appointments and imaging scans after procedures
  • Educates the patient on the procedure and pre-procedure protocols
  • Facilitates education of hospital staff on procedures and protocols
  • Assists PA's with PICC placements
  •  Mediate with patient's and hospital when issues arise
  • Currently, educating the hospital staff on proper Plurex catheters
  • Answers phone calls from patients / communicate results to referring physicians.
• PAs
  • Cover IR clinic when nurse is not working (so cover all her duties as needed)
  • Provide ancillary support to radiologists
    • Placement of peripherally and centrally inserted central venous catheters and ports
    • Surgical first assistant
    • Conduct minor procedures involving deep and simplified tissue closure, cutting tissue
    • Application of appliances and any other action with conscious sedation under the delegation and direct supervision of radiologist
      • Insertion and removal of centrally inserted tunneled and non-tunneled venous catheters and venous access devices/ports in IR suit and bedside
      • Mediports and Arm Ports, Hickman, Groshong
      • Chest and abdominal tunneled catheter drain placement and removal
      • Chest tube placement and removal for pneumothorax and pleural effusions
    • Involvement with minor procedures
      • Nasogastric and Naso-jejunal tubes;  gastro-jejunal feeding tube placement and exchanges
      • Minor drainage catheter exchanges;  removal of spinal drains
      • Removal of arterial and venous sheaths/catheters
    • Assist in DX studies
      • Pharyngograms, esophagrams, Upper GI studies, Small Bowel follow through, BE, Retrograde urethrogram, Cystogram, Cholangiogram, Neprostogram, Mediport Patency, voiding cystourethrogram, inteavenous pyelogram,
      • Fluoro guided procedures – joint and bursa aspiration / steroid injections, arthrocentesis, lumbar punctures, assist with myelograms, port patency, peg tube evaluation, lumbar drain place and removal, bone marrow biopsy
      • Perform US guided paracentesis, thoracentesis, needle biopsy, chest & abdominal drainage catheter placement
    • Initiate appropriate emergency medical care until arrival of supervising physician.  Provide routine medical management and OP care whenever necessary.
    • Complete appropriate documentation of all consents, evaluations, etc for the patient's medical record
    • Obtain appropriate consultation of specialty services
    • Prescriptions – under direct supervision of radiologist
    • Valuable resource for hospital and referring physician education especially with blood infection rates & PICC placements.  Help to manage this program and communicate data capture for the hospital's QA section

This really does scratch the surface of all the PAs do.  They also work Saturday's and Sunday's but not nights. 

I'm more than happy to have you contact me if you want to discuss further.

Thank you,

Practice Management   Post New Message   Re: Mid Level Providers Reply to Group Reply to Sender Apr 25, 2018 11:31 AM Darlene Molenaar I share interest in the discussion.  We have 3 RPA/RA's who provide fluoro to inpatients only under general supervision.  The group has never billed for their work, but it is seen as very helpful to efficiency.  They are also personally supervised by the Radiologists for outpatient fluoro, and provide considerable assistance to the Rads with needle/catheter procedures and scrub in and assist with some IR.  So, they generate no revenue, but are considered valued team members who make the Radiologists more efficient.  They work out of 4 hospitals.    We also have 2 PA's who work with the IR docs on outpatient IR, and inpatient rounding and they do consults and greatly assist with IR docs.  There is considerable interest in allowing them to perform some of the needle/catheter procedures (done with US or fluoro provided by a Rad Tech) under general supervision, and bill those procedures with the incident to modifier.  One of them has done those procedures in her previous job and is credentialed by the hospital to perform them.  There has also been some discussion as to whether they can be trained to perform fluoro under general supervision.  There is some trepidation about training these mid-levels to provide radiology focused services under general supervision when they little to no radiology experience.  I am curious if anyone has made that leap, and if so, did they hire PA's who were formerly Rad Techs, or did they train them to perform and provide those services?  We do not use mid-levels in imaging centers and are only using them in the hospital setting.  They are employed by the group and not the hospital.  Thanks for further insight.    Darlene Molenaar, COO Colorado Imaging Associates, P.C. Healthcare Business Services, LLC 1819 Denver West Drive Building 26; Suite 101 Lakewood, CO 80401 Office:  303-416-1360 Cell:  860-989-6008 Fax:  303-416-1058     Reply to Group Online   View Thread   Recommend   Forward   Flag as Inappropriate   × New Best Answer This thread already has a best answer. Would you like to mark this message as the new best answer? No Related Content PAs supervising Janice Daniels Added 08-11-2020 Discussion Thread 1 RE: Mid-Level Providers Kimberly Singletary Added 08-03-2020 Library Entry Mid Level Providers Danyle Conner Added 04-25-2018 Discussion Thread 5 PA's for IR service Holly Wallner Added 09-06-2019 Discussion Thread 1 IR PA's E&M billing and PA salaries Christin Crosby Added 07-14-2021 Discussion Thread 13 Contact Us Radiology Business Management Association PO Box 1636 Evansville, IN 47706-0038 Toll Free: 888.224.7262 Local: 703.621.3355 Fax: 703.621.3356 E-mail: info@rbma.org Membership Join Benefits & ROI Free Trial Membership Learn More Privacy & Terms About Us Terms of Use Copyright 2024. All rights reserved. Powered by Higher Logic