MARISSA J VILLARREAL

Urgent Care Medicine

• 12 hour shifts, rotating weekends and occasional holidays
• Involved in all aspects of patient care including detailed history and physical exam, development of treatment plans, prescribing of medications, ordering and interpreting laboratory and diagnostic studies, submission of orders, electronic charting,
• Diagnosis and Treatment of common urgent care complaints including, but not limited to, URIs, UTIs, bronchitis, sinusitis, pharyngitis, pneumonia, asthma exacerbations, allergic reactions, bacterial/chemical/allergic conjunctivitis, otitis media and externa, corneal abrasions, DUB, vagina bleeding, STI, gastroenteritis, abdominal pain, nausea/vomiting/diarrhea, sprain, strains, fracture, cellulitis, dental pain/infection, hypertension, hyperglycemia.
• Laboratory/radiology interpretation and assessment
• Minor surgical procedures- suturing, I&D, fracture splinting
• DOT physicals
• School physicals

•VA C&P exams/IMO, SHA/ Gen Comp Exams

•Interpreting diagnostic studies: X-rays, EkG, PFT, laboratory, 2D Echo

Emergency Medicine

• Fast Track ER setting to include assessing and treating ESI level 3, 4 and 5 and collaboration with physician for level 3 and 2 including admissions/transfers. Laceration repair, abscess I & D, joint aspiration/injection,FB removal, interpretation of lab, X-ray, EKG, sonogram, CT, splint application, tenometry, slit lamp, woods lamp, dislocation/fracture reduction.
  
• Attended monthly meeting addressing documentation, patient surveys, improving quality of care, addressing Medicare MIPS and PQRS
• Collaboration with all departments to provide the best patient experience and care.
• Lead APP , also handled scheduling
• Mentoring NP, X-Ray and Nursing students.
• Mentoring for High School Volunteer Program.

Emergency Medicine

• Fast Track ER setting to include assessing and treating ESI level 3, 4 and 5 and collaboration with physician for level 3 and 2 including admissions/transfers. Laceration repair, abscess I & D, joint aspiration/injection,FB removal, interpretation of lab, X-ray, EKG, sonogram, CT, splint application, tenometry, slit lamp, woods lamp, dislocation/fracture reduction.
• Attended monthly meeting addressing documentation, patient surveys, improving quality of care, addressing Medicare MIPS and PQRS
• Collaboration with all departments to providing best patient experience and care.

Occupational/Environmental Health Medicine

Occupational health center with satellite office located on ExxonMobil multi billion dollar plastics manufacturing site. Worked closely with companies in all industries to manage occupational injuries. Managed OSHA records. Maximized return to work and mitigated loss time along with oversight of workplace health and wellness to include Covid-19 workplace response and return to work management.

Clinical Testing

Ordered and administered :

• Lab work
• Vaccinations
• Post-exposure prophylaxis

Drug Screening

Perform urine drug screening and trained in compliance with The Department of Transportation's (DOT)

Early Return to Work Modified Duty Plans

Utilized a combination of modified duty plans, appropriately scheduled follow-up examinations, orthopedic referrals and physical therapy to assist in employee treatment and accelerated case closure.

Electrocardiograms (EKG)

Order/ interpret the EKG along with Supervising physician final read

Fitness for Duty Examination

Performed fitness for duty examination, which helps determine if an employee can return to work in a condition fit for the proper, competent and safe performance of their duties throughout a scheduled shift. Testing both physical and mental ability to perform the assigned tasks.

Hearing Conservation Program

Ordered and interpreted audiometry meeting OSHA standards and then compared to past and future tests to determine if a standard threshold shift (STS) has occurred.

Position-Specific Physical Examinations

Position-specific physical examinations are offered for positions including but not limited to:

• Oil & Gas UK (OGUK)
• Coast Guard/ Merchant Marine
• Department of Public Works
• EMS
• Firefighter
• Police Officers

Post-Offer Physical Examination (POPE)

Performed post-offer physical examination (POPE) to help identify potential concerns after hiring a candidate. These concerns may include the inability to meet the physical and postural demands of the job, such as lifting, pushing, pulling and prolonged standing.

Pre-Employment Physical Examinations

Performed pre-employment physical examinations designed to screen prospective employees for conditions that could potentially interfere with the ability to perform essential job functions safely. Modifications made based on the job description and any issues uncovered throughout the process

• Medical history examination
• Comprehensive head-to-toe assessment
• Snellen vision test
• Ishihara color vision test, if indicated
• CDL medical examination as promulgated by the Department of Transportation (DOT)
• Respirator clearance examination as per OSHA guidelines

Pulmonary Function Testing

Ordered and interpreted pulmonary function tests as they relate to the employee, respiratory exposure and the respirator.

Respiratory Clearance Program

Reviewed OSHA standards medical questionnaire and determined if employee is clear to use a respirator without restrictions.

Screening for Tuberculosis

Performed and interpreted Mantoux tuberculin skin test (TST) when required. Ordered/ interpreted QuantiFERON-TB (QFT) and Chest X-ray.

Breath Alcohol Test (BAT) Certified

Workers Compensation: Injury Treatment, Initial Visit and Follow-Up Visits

Provided medical evaluation and ongoing treatment to employees who sustain on-the-job injuries or illnesses to safely return employees to work as soon as possible, and prescribed modified or temporary alternate duties.

• Full review of medical history to identify pre-existing medical conditions that may have contributed to the injury or illness
  
• Evaluating and treating the injury, illness or wound
• Recommended status on the ability to return to work
• Develop and implement health promotion programs.
• Provide guidance for case management of employees who have prolonged or complex illnesses and injuries.

Occupational/Environmental Health Medicine

• Located in a beef packing plant
• Pre employment physicals
• Primary care services, order/interpret labs, diagnostic testing, vaccination, acute care visits, prescribe medication.
• Managed on site work related injury.

Urgent Care Medicine

• 12 hour shifts, rotating weekends and occasional holidays
  
• Involved in all aspects of patient care including detailed history and physical exam, development of treatment plans, prescribing of medications, ordering and interpreting laboratory and diagnostic studies, submission of orders, electronic charting,
  
• Diagnosis and Treatment of common urgent care complaints including, but not limited to, URIs, UTIs, bronchitis, sinusitis, pharyngitis, pneumonia, asthma exacerbations, allergic reactions, bacterial/chemical/allergic conjunctivitis, otitis media and externa, corneal abrasions, DUB, vagina bleeding, STI, gastroenteritis, abdominal pain, nausea/vomiting/diarrhea, sprain, strains, fracture, cellulitis, dental pain/infection, hypertension, hyperglycemia.
  
• Laboratory/radiology interpretation and assessment
  
• Minor surgical procedures- suturing, I&D, fracture splinting

Emergency Medicine

• Fast Track ER setting to include assessment, diagnosing/treatment of ESI level 3, 4 and 5/collaboration with physician for level 3 and 2, admissions/transfers. Laceration repair, abscess I & D, joint aspiration/injection,FB removal, interpretation of lab, X-ray, EKG, sonogram, CT, splint application, tenometry, slit lamp, woods lamp, dislocation/fracture reduction.
  
• Attended monthly meeting addressing documentation, patient surveys, improving quality of care, addressing Medicare MIPS and PQRS
• Collaboration with all departments to provide the best patient experience and care.
• NP and nursing/x-ray student mentoring/shadowing.
• High School Volunteer Program mentoring.

Federally Qualified Health Center

• Managed a wide variety of chronic health problems including hypertension, diabetes, hyperlidedemia, COPD, CHF, endocrine disorders and psychiatric illness and others in a clinical setting with minimal supervision on site but always available by telecommication. Complex patient with multiple medical illness who were uninsured / underinsured and loamy times unable to afford specialty referral. Relied on daily communication when needed with specialties to help care for patients. Close communication with local community ER Dept /Hospital to provide continuity of care post ER and Hospital Discharge. Worked closely with various home health agencies to provide much needed health care services to mitigate return to ER Dept/ Hospital. Worked closely with Medicaid Women’s Health Program: The Breast and Cervical Cancer Services program to help women receive quality and accessible cancer screening and health services. Administrative duties such as supply ordering, quality assurance, completing various home health /Medicare forms such as DME and many others.

Urology

Urology

• Hospital / Urology Surgical Procedures-
  

Rounded and discharged post-operative patients.

Performed hospital inpatient rounds and new patient consultations.

• Urology Ambulatory Surgery-
  

Engaged in the execution of several outpatient procedures to include TRUS prostate biopsies, cystoscopy, ureteral stent removal.

• Ambulatory patient clinic 5 days per week treating all urological illness/disease, to include new patient consultation, follow ups, post surgical procedure, follow ups.

Urology

• Hospital / Urology Surgical Procedures-
  

First assist in the performance of daVinci robotic prostatectomy/partial nephrectomy/pyeloplasty, radical cystectomy/nephrectomy, and lap partial nephrectomy as of 2007. Rounded and discharged post-operative patients at the 5 various inner city hospitals.

Performed hospital inpatient rounds and new patient consultations. Familiar with robotic sacrocolpopexy.

• Urology Ambulatory Surgery-
  

Engaged in the execution of several outpatient procedures in an ambulatory surgery center to include TRUS prostate biopsies, fiducial seed placement, cystoscopy, ureteral stent removal, and male/female urethral dilations, transurethral resection of bladder tumors. Familiar with Interstim, IPP, male/female urethral slings.

• Ambulatory patient clinic three days per week treating all urological illness/disease, to include new patient consultation, follow ups, post surgical procedure, follow ups.
• Facilitated bi-weekly public relations conferences to local family practice, internal medicine, and urgent care offices presenting services and promoting anticholinergic therapy in collaboration with pharmaceutical representatives.

Urology - University Teaching Hospital Setting

• Hospital / Urology Surgical Procedures-
  

First assist in the performance of daVinci robotic prostatectomy. Rounded and discharged post-operative patients at the various inner city hospitals.

Performed hospital inpatient rounds and new patient consultations.

• Urology Ambulatory Surgery-
  

Engaged in the execution of several outpatient procedures in an ambulatory surgery center to include TRUS prostate biopsies, cystoscopy, ureteral stent removal.

• Ambulatory patient clinic 4 days a week treating all Urological illness/disease.

Family Practice Clinic and School Based Rural Health Clinic

• Performed history, physical exams, assessed and treated high school students in public schools. Provided patient education. Administrative tasks.

Allergy, Asthma & Immunology

• Conduct history and physical examination, order and interpret diagnostic testing, and prescribing medications and immunotherapy for treatment.
• Administration of immunotherapy
• Order and interpret pulmonary function testing

Family Medicine- Rural Health

• Provided primary care services to uninsured and under-insured patients in rural health clinic. Preventative services, routine physical/adult - pediatric wellness exams, appropriate screening examinations, vaccinations and health education to geriatric/adult/pediatric patients. Provided services in clinic and home visits and nursing homes.
• Managed a wide variety of chronic health problems including hypertension, diabetes, endocrine disorders, psychiatric illness, GI, COPD, CHF, urinary disorders, and dermatological conditions. Monitored patient health and treatment plan progress to make necessary adjustments in care.
• Referred to and consulted with physicians and other healthcare providers on patient care.
• Ordered and interpreted diagnostic testing to include labs, X-ray, EKG to confirm diagnosis and implement accurate treatment plans.
• Recorded patient history to accurately track conditions, progress and diagnosis for comprehensive medical records.
• Ordered and executed various lab tests/analyses, and diagnostic images to provide information on patient condition.
• Prescribed medications to patients to treat conditions and alleviate symptoms.
• Educated patients to improve overall health and wellness.
• Implemented therapeutic regimens involving medications and other interventions to mitigate symptoms and prevent reoccurrence.
• Conducted rounds in nursing homes and performed in home visits.
• Rapidly analyzed and responded to critical situations such as cardiovascular, abdominal, and neurological in emergency situations.
• Maintained patient confidentiality and adhered to HIPAA regulations.
• Performed therapeutic procedures such as injections, laceration repair, abscess I&D, immunizations and infection management.
• Established continuity of care by completing patient management plans such as but not limited to home health , DME, nursing home orders and successfully completed paperwork by deadlines.
• Completed in-depth physical evaluations and gathered patient medical data to complete speedy, successful office visits.
• Provided counseling on emotional problems of daily living while promoting wellness and health maintenance.

• Urgent Care - Rural Health
• Provided primary care and acute urgent care services under minimal supervision as a physician assistant in a culturally diverse rural community health setting.
• Complete urgent care evaluation and treatment of injuries common ailments including evaluation of x-rays and minor surgical procedures and suturing responsibility.
• Performed many procedures including: incision and drainage, simple/complex suturing, joint injections/aspiration, dislocation/fracture reductions.

Family Medicine - Rural Health

• Provided primary care services to uninsured and under-insured patients in rural health clinic. Preventative services, routine physical/adult - pediatric wellness exams, appropriate screening examinations, vaccinations and health education to geriatric/adult/pediatric patients.
• Managed a wide variety of chronic health problems including hypertension, diabetes, endocrine disorders, psychiatric illness, GI, COPD, CHF, urinary disorders, and dermatological conditions. Monitored patient health and treatment plan progress to make necessary adjustments in care.
• Referred to and consulted with physicians and other healthcare providers on patient care.
• Ordered and interpreted diagnostic testing to include labs, X-ray, EKG to confirm diagnosis and implement accurate treatment plans.
• Recorded patient history to accurately track conditions, progress and diagnosis for comprehensive medical records.
• Ordered and executed various lab tests/analyses, and diagnostic images to provide information on patient condition.
• Prescribed medications to patients to treat conditions and alleviate symptoms.
• Educated patients to improve overall health and wellness.
• Implemented therapeutic regimens involving medications and other interventions to mitigate symptoms and prevent reoccurrence.
• Conducted rounds in nursing homes and performed in home visits.
• Rapidly analyzed and responded to critical situations such as cardiovascular, abdominal, and neurological in emergency situations.
• Maintained patient confidentiality and adhered to HIPAA regulations.
• Performed therapeutic procedures such as injections, laceration repair, abscess I&D, immunizations and infection management.
• Established continuity of care by completing patient management plans such as but not limited to home health , DME, nursing home orders and successfully completed paperwork by deadlines.
• Completed in-depth physical evaluations and gathered patient medical data to complete speedy, successful office visits.
• Provided counseling on emotional problems of daily living while promoting wellness and health maintenance.

• Use sonographic equipment to identify and observe the area(s) of concern

• Prepare the exam room for examinations and assist Radiologists with ultrasound-guided biopsies

• Report to the appropriate medical staff of any abnormalities that require immediate attention

• Maintain sonography equipment and report machinery failure

• Conduct scan tests and write reports based on the results

• Manage several patients and priorities and be able to adapt to a fast-paced work environment

• Work under minimal supervision and cooperate with other team members

• Performed ultrasound scans and provided direct patient care after proper confirmation of study and patient identification.
• Educated patients on procedure details, provided instructions, and answered questions to minimize anxiety and improve cooperation.
• Communicated differentials to interpreting physicians to consider possible causes of clinical findings before final diagnoses.
• Assisted in executing optimum quality ultrasound exams while obtaining images to support diagnosis documented by interpreting physician.
• Promoted effective working relationships to meet the mission/goals and objectives of Ultrasonography Dept.
• Sought consultation collaboration for complex issues or when unsure

Radiology Department

• Operated radiologic equipment to produce diagnostic images and films.
• Captured images using mobile equipment in operating rooms, emergency rooms, and patients' bedsides.
• Handled private and confidential information in compliance with hospital policies and procedures.
• Facilitated positive care experience for patients by establishing rapport and applying interpersonal skills to reduce anxiety and promote cooperation.
• Minimized patients' exposure to radiation during x-ray imaging through application of shielding techniques and careful positioning of patients, equipment and restrictive devices.
• Served as informational resource for patients and families by educating about imaging processes and addressing questions and concerns.
• Supported radiologists with performing high-quality interventional procedures.
• Monitored and adjusted imaging equipment for optimal quality standards.
• Applied contrast media and monitored patient reactions to contrast agents.
• Collaborated with wider healthcare teams to provide comprehensive patient care.
• Performed diagnostic breast mammograms and ultrasounds.