Psychiatric Physician Assistant (PA)

• JourneyPure at the River
• Position Title: Psychiatric Physician Assistant (PA)
• Department: Medical Services
• Location: JourneyPure at the River – Murfreesboro, Tennessee
• Reports To: Medical Director / Medical Leadership
• Position Type: Full-Time

Clinical Setting: Medical Detoxification, Residential Substance Use Disorder Treatment, and Co-Occurring Behavioral Health Services

Position Summary

The Physician Assistant (PA) provides comprehensive medical care to patients receiving treatment at JourneyPure at the River. The PA works collaboratively with physicians, nurse practitioners, psychiatric providers, nursing staff, therapists, utilization review, admissions, and other members of the interdisciplinary treatment team.

The PA is responsible for evaluating and managing the medical needs of patients receiving treatment for substance use disorders, withdrawal management, and co-occurring conditions. Responsibilities include admission histories and physical examinations, ongoing medical follow-up, withdrawal management, medication management, laboratory review, coordination of care, assessment of changes in medical condition, and determination of when a patient requires a higher level of medical care.

The PA practices within the scope permitted by Tennessee law, applicable facility policies, credentialing requirements, and established clinical protocols.

Essential Duties and Responsibilities

Admission & Medical Assessment

• Complete comprehensive History and Physical (H&P) examinations on newly admitted patients within required facility and regulatory timeframes.
• Review pre-admission assessments, medical histories, substance use histories, current medications, allergies, recent hospitalizations, laboratory results, and other available medical records.
• Perform appropriate physical examinations and document pertinent findings.
• Identify medical conditions that may affect a patient's ability to safely participate in detoxification or residential treatment.
• Determine whether additional medical evaluation, laboratory testing, specialty consultation, or hospital-level evaluation is indicated.
• Collaborate with Admissions and medical leadership regarding patients with significant medical complexity or potential exclusionary conditions.
• Assist with determination of medical appropriateness for admission when requested.

Withdrawal Management & Addiction Medicine

• Evaluate patients experiencing withdrawal from alcohol, opioids, benzodiazepines, stimulants, and other substances.
• Utilize established withdrawal assessment protocols and clinical findings to guide treatment.
• Initiate, continue, modify, and discontinue withdrawal-management medications within scope of practice and established facility protocols.
• Monitor response to detoxification protocols and modify treatment plans when clinically indicated.
• Evaluate patients for complications of withdrawal, including seizures, delirium, significant autonomic instability, dehydration, altered mental status, or other conditions requiring escalation of care.
• Provide evidence-based treatment for substance use disorders.
• Participate in medication-assisted treatment (MAT) when clinically appropriate, including management of buprenorphine and naltrexone products within the provider's scope, credentials, and facility protocols.
• Provide patient education regarding withdrawal, medications, MAT, overdose prevention, and recovery.

Ongoing Medical Management

• Conduct follow-up visits for patients with acute and chronic medical conditions.
• Evaluate common medical complaints occurring during treatment, including gastrointestinal symptoms, respiratory complaints, infections, pain, wounds, hypertension, diabetes, and other routine medical conditions.
• Manage chronic medical conditions when appropriate within the treatment setting.
• Prescribe, discontinue, and adjust medications based on clinical assessment and within scope of practice.
• Order and interpret laboratory testing and other diagnostic studies when clinically appropriate.
• Review abnormal laboratory results promptly and initiate appropriate follow-up.
• Monitor medication effectiveness, adverse effects, contraindications, and clinically significant drug interactions.
• Complete medication reconciliation and address discrepancies identified during admission or treatment.
• Coordinate specialty and primary care follow-up when necessary.

Emergency & Higher-Level-of-Care Assessment

• Evaluate patients experiencing acute changes in medical condition.
• Determine when patients require emergency department evaluation, hospitalization, specialty consultation, or another higher level of care.
• Provide appropriate stabilization within the capabilities of the facility while arranging transfer when indicated.
• Communicate relevant clinical information to receiving hospitals, emergency departments, EMS, or other healthcare providers.
• Participate in decisions regarding medical discharge when a patient's needs exceed the capabilities of the facility.
• Document the clinical rationale for transfers and medical discharges.

Psychiatric & Co-Occurring Conditions

• Recognize psychiatric symptoms that may affect medical treatment or patient safety.
• Screen for changes in mental status, suicidal or homicidal ideation, psychosis, severe agitation, or other acute behavioral health concerns.
• Coordinate psychiatric concerns and medication-management needs with the psychiatric mental health provider and treatment team.
• Maintain clear communication between medical and psychiatric providers when patients have co-occurring medical, psychiatric, and substance use disorders.
• Facilitate transfer to a higher psychiatric level of care when clinically indicated.

Interdisciplinary Collaboration

• Participate as an active member of the interdisciplinary treatment team.
• Collaborate with physicians, psychiatric providers, nurses, therapists, case managers, utilization review, admissions, and leadership.
• Communicate significant changes in patient condition promptly to appropriate team members.
• Participate in treatment planning and case consultation as appropriate.
• Coordinate care with outside hospitals, pharmacies, primary care providers, specialists, and other treatment facilities when necessary.
• Provide clinical guidance and education to nursing staff within the PA's scope of practice.

Documentation & Compliance

• Complete accurate, thorough, and timely documentation in the electronic medical record.
• Document H&Ps, follow-up visits, medication changes, patient education, clinical decision-making, transfers, and discharge recommendations.
• Maintain documentation consistent with JourneyPure policies, professional standards, regulatory requirements, and payer expectations.
• Complete required orders, medication reconciliations, prescriptions, and discharge medications within established timeframes.
• Participate in chart review, quality improvement, utilization management, and compliance activities when requested.
• Maintain patient confidentiality and comply with HIPAA and applicable substance use disorder confidentiality requirements.

Required Qualifications

• Graduation from an accredited Physician Assistant program.
• Current and unrestricted Physician Assistant license in the State of Tennessee.
• Current NCCPA certification, as applicable.
• Current DEA registration when required for assigned prescribing responsibilities.
• Current BLS/CPR certification.
• Ability to prescribe medications within applicable Tennessee requirements and the provider's authorized scope of practice.
• Ability to work effectively within a multidisciplinary behavioral health and addiction-treatment environment.
• Strong clinical assessment, communication, documentation, and decision-making skills.

Preferred Qualifications

• Previous experience in addiction medicine, substance use disorder treatment, medical detoxification, behavioral health, emergency medicine, internal medicine, family medicine, or residential treatment.
• Experience managing alcohol, opioid, and benzodiazepine withdrawal.
• Experience with medication-assisted treatment for opioid and alcohol use disorders.
• Experience treating patients with co-occurring medical and psychiatric conditions.
• Familiarity with CIWA-Ar, COWS, suicide-risk assessment, and other behavioral health/addiction treatment assessment tools.
• Experience working within an interdisciplinary residential treatment environment.

Knowledge, Skills & Abilities

The Successful PA Should Demonstrate

• Strong medical assessment and clinical decision-making skills.
• Understanding of substance use disorders as chronic, treatable medical conditions.
• Knowledge of withdrawal syndromes and potential medical complications.
• Ability to identify when a patient's condition exceeds the capabilities of the facility.
• Ability to manage multiple clinical priorities in a fast-paced environment.
• Strong written and verbal communication skills.
• Professional and respectful interaction with patients experiencing substance use and mental health disorders.
• Ability to maintain appropriate professional boundaries.
• Ability to collaborate effectively with medical, psychiatric, nursing, clinical, and administrative leadership.
• Reliable follow-through regarding abnormal findings, medication issues, laboratory results, and changes in patient condition.

Patient Safety Expectations

The Physician Assistant is expected to prioritize patient safety and promptly escalate concerns involving:

• Significant or unstable vital signs
• Severe or complicated withdrawal
• Withdrawal seizures or seizure activity
• Altered mental status or delirium
• Respiratory distress
• Chest pain or suspected cardiovascular emergencies
• Severe hypo/hyperglycemia or other diabetic emergencies
• Acute neurological changes
• Significant medication reactions
• Falls or injuries requiring further evaluation
• Acute suicidal/homicidal risk