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nma Medical Director - Intraoperative Neurophysiological Monitoring in Las Vegas, Nevada

Title: Intraoperative Neurophysiological Monitoring Medical Director

Department: Operations

Reports To: Chief Operating Officer

Summary: The Medical Director is a provider of real-time remote technological supervision, clinical data interpretation, and interventional suggestions or recommendations during intraoperative neuromonitoring (IONM). The Director leads a team of IOM reading physicians and is responsible for the organization?s oversight program including but not limited to: peer-review, approval of medical staff privileging, development of clinical protocols, and implementing quality initiatives and reporting

Scope: Intraoperative neuromonitoring is provided by an on-site neuromonitoring technologist who is under the direct supervision of an off-site reading physician. The reading physician is responsible for real-time and retrospective interpretation of IONM data. The reading physician will use his/her utmost and best skill to accurately interpret changes in waveform data, immediately report any threat to neural integrity, differentially diagnose within the procedural context, and suggests specific interventions to redress evolving neural injury or threat of injury. The physician shall not engage in other clinical or other distracting activities during IONM supervision.

Essential Duties:

  • Provide direct supervision to all employed and contracted IOM reading physicians and audiologists

  • Assist in the development and implementation of clinical monitoring protocols

  • Implement and oversee a physician peer-review process

  • Approve requests for new and renewed privileges

  • Report to the executive board on quality metrics, credentialing applications, and other key performance indicators

  • Evaluate the intraoperative neuromonitoring patient care plan based on planned procedure, neural structures at risk, and clinical presentation, physical exam, medical history and radiologic findings

  • Recommend appropriate anesthetic regimen to optimize the likelihood of obtaining high-quality recording

  • Direct neuromonitoring technologists on data acquisition, recording and stimulus parameter optimization and troubleshooting

  • Direct neuromonitoring technologist on necessary communication related to monitoring status

  • Evaluate and confirm baseline data quality

  • Evaluate and confirm responses obtained from topographical studies in real time

  • Evaluate and interpret all significant intraoperative monitoring data changes from baseline recording

  • Recommend therapeutic interventions as indicated:

  • procedure related changes should be reported to the surgeon as soon as possible

  • intraoperative changes related to ambiguous origin should be reported to the surgeon as needed and appropriate

  • communicate concerns that suggest a neurologic compromise that could be related to patient positioning

  • suggest an alteration to anesthetic regimens and/or physiologic measures when these appear to compromise neural integrity and/or efficacy of intraoperative monitoring

  • Provide a report of each intraoperative monitoring session, which includes information on the surgical procedure, types of modalities performed, description of baseline and intraoperative signals and description of significant changes in the recording and interventional measures.

Other duties:

  • Assist in the generation of appropriate quality assurance and quality improvement reports and formulation of outcome measures.

  • Provide intraoperative education and mentoring regarding basic and applied intraoperative physiology to neuromonitoring technologists

  • Strengthen collegiality among team members

  • Transfer professional responsibility to another reading physician when evolving case acuity no longer permits adequate simultaneous evaluation or unforeseen external factors affect remote real-time monitoring

  • Pertinent information such as preoperative evaluation, baseline studies, intraoperative findings and changes, etc. must be communicated before completion of the responsibility transfer

Education/Experience Requirements:

  • Hold an advanced academic degree such as MD or DO

  • Hold a medical license in the state which surgery is being performed

  • Hold clinical neurology or clinical neurophysiology credentials by any one of the following Boards: American Board of Neurophysiologic Monitoring, American Board of Clinical Neurophysiology, American Board of Electroneurodiagnostic Medicine, American Board of Psychiatry and Neurology (with added in Clinical Neurophysiology)

  • Comply with all continuing education, state licensure, and credentialing requirements

  • Participate in M&M conferences as required

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