We're looking for a primary care provider to serve home bound older adults in the Kent, WA area.
"A New Approach to an Age-Old Need" - Pathway Geriatrics is a Nurse Practitioner owned medical startup headquartered in Redmond, WA, and currently serving the Greater Seattle area. We provide in-home primary care services for homebound older adults. Said differently, we bring our medical services to our clients, who often can't leave their homes to get the kind of specialized care they need.
We have a uniquely deep background in technology (and tech startups), which heavily influences our workflows and culture. Our vision is to build a new kind of medical practice that melds the latest technologies and best practices with the caring hearts of top-tier providers.
We are looking for a certified Geriatric Nurse Practitioner with at least three years of experience to serve as a primary care provider in our Kent, WA region. The position is fully field based, although we do have occasional team meetings at our Redmond office. Typical business hours are 9:00 AM to 5:00 PM, Monday - Friday.
We think our performance-based pay model is one of the best out there. We don't make the details public for competitive reasons, but a solid provider with a full panel should earn between $140K to $175K annually. There isn't a cap, though, so hard workers can make more so long as they maintain the highest standard of care for our clients.
New providers also get one-time bonuses to hit specific milestones (e.g., # of new clients in the first six months).
You will serve as the PCP for a panel of 250 to 350 homebound older adults that reside within your region. Most of our clients live in Adult Family Homes (AFH), with a portion residing in assisted living facilities. We often have several clients at each home. We aim to visit each facility every five to six weeks, and clients are seen based on medical necessity.
Our providers also facilitate each client's medication and chronic care management between in-person appointments.
We do our best to keep clients out of the emergency room. While we don't provide in-home urgent care, we can often manage urgent situations remotely with help from our local network of in-home diagnostic services. Some of these include mobile imaging, ultrasound, phlebotomy, and urinalysis/urine cultures.
The nature of our services means we often work with multiple parties when coordinating patient care. We typically have at least three clients per patient; the patient (aka. the client), their medical power of attorney, and their caregiver (typically an Adult Family Homeowner).
A typical client is 75+ years old and often in their final few years of life. Most clients are homebound due to advanced dementia, but many also have other chronic diseases like osteoarthritis with contractures and pain, Parkinson's disease, heart failure, and diabetes. That said, we also work with younger adults who are homebound due to traumatic brain injuries, strokes, or mental health conditions.
The family members and powers of attorney for our clients have varying levels of engagement and knowledge. We are transparent and communicative with them and aim to serve as a resource for them and their loved ones.
The job is 100% "work from homes." :) On a given day, you will visit clients at anywhere from one to five different locations. Each Adult Family Home is someone's actual house in a regular neighborhood that the state has licensed to care for (around six) homebound adults.
Be prepared to pull out your laptop and perform your visits on the family couch, at the dining room table, or perched on a client's bedside. Adult Family Homes are unique settings that genuinely feel like family for these older adults, where they live in a small and compassionate environment, and their caregivers know them well. Their intimate knowledge of each client's habits and expressions often helps us fill in the gaps when clients cannot speak for themselves. We develop a rapport and work together with the caregivers since they have the knowledge that allows us to target the root of a person's "agitation" and find the right fit for a client's treatment.
Our practice approaches issues from a palliative care perspective. Our primary goal is to improve client comfort and quality of life while reducing unnecessary medications. We monitor as diseases progress and consider when they should transition onto hospice services. We usually remain as the client's PCP while on hospice, managing their end-of-life care.
We see many routine problems day-to-day, but we are also frequently surprised by things we've never seen before.
· We often work with dementia-related behavioral concerns expressed through tearfulness, restlessness, physical aggression, combativeness, and sleep difficulty.
· As our clients grow weaker, they will transition from walker to wheelchair to hospital bed and require our assessments and orders to coordinate that equipment.
· We partner with local home health care teams when our client needs skilled nursing, physical and occupational therapy, speech therapy, and psych nursing.
· Adult family homes also have special state regulations, so they need us to provide specific orders and permissions for their inspection requirements.
Many dementia behaviors are managed with psychotropic medications. As such, we need you to be comfortable weighing the risks and benefits of applying antidepressants, antipsychotics, anticonvulsants, and others to help our clients with their quality of life.
We also strive to reduce or stop unnecessary medications. Standard "adult" guidelines often don't apply to a geriatric population. You will also need to be comfortable managing specialty medications, including those for cardiac issues and diabetes.
Personal Vehicle: You will need one.
On-call: We are available to our clients 24/7 for urgent needs, including holidays, weekends, and nights. We rotate being on-call evenly between our providers, answering urgent calls and messages. It won't require physically going to a facility after hours, just triaging over the phone. For your reference, most nights, we don't have any calls.
Giving Back: We try to give back to our community in many ways, and we ask all our employees to participate. Contribution examples might include writing an article for our (upcoming) blog, precepting a nursing student, or teaching a class at the local senior center.
Software Feedback: We're developing a proprietary healthcare tech platform designed explicitly for in-home patient care. Our engineers will work with you from time to time while designing and testing our software platform to streamline operations (i.e., make your life easier).
In addition to your compensation, we provide each provider with:
· Malpractice insurance
· PTO (vacation + sick leave)
· Nine paid holidays (six are set, three you get to pick)
· Top-notch low deductible Health Insurance (Medical, Dental, Vision) with an FSA
· 401K with company matching (up to 4%)
· Life & Disability Insurance
· Workers Comp
$107,500 - $175,000 per year