The Department of Medicine has a significant presence at the Milwaukee VA Medical Center, which along with FMLH, constitute the two major adult hospital affiliates of the Medical College. The VA – the largest integrated healthcare system in the USA – has multiple missions, including clinical care for veterans, funding of biomedical research, education and back-up to the Department of Defense (indeed, the entire community) in a time of war or domestic disaster. Specifically, the Milwaukee VA is included in the category of most complex VA hospitals (a so-called 1A facility) based on size and the range of clinical services (the Hines VA in Chicago is similarly characterized). The Milwaukee VA serves about 60,000 enrolled veteran patients (10% are women) at the main hospital facility and its four affiliated VA community clinics.
The Department of Medicine at the Milwaukee VA is represented by the Medicine Chief Resident, an Associate Program Director (Dr. Susan Davids) and a Vice Chair of Medicine (me). We work closely together on a wide variety of issues related to the Department’s personnel and activities at the VA involving physician faculty, Ph.D. faculty, students, residents and Fellows. In turn, the Chief Residents, Dr. Davids and I have a close working relationship with the Department’s leadership – Drs. Ann Nattinger (interim Department Chair), David Marks, Michael Frank and Michael Dunn – the last three being my Department of Medicine Vice Chair counterparts. Needless to say, the Department’s VA clinical Section Chiefs (including all the subspecialties and GIM) play a vital role in the day-to-day activities at the VA. The Department’s administrative staff, working on the FMLH/MCW campus, is responsible to support the professional activities of all MCW programs that take place at the VA. Their commitment is indispensable.
Several members of the Milwaukee VA’s leadership are internists: the Chief of Staff (Dr. Erdmann), to whom I report at the VA and two of the Associate Chiefs of Staff (Dr. Van Ruiswyk [Education] and Dr. John Hayes [Clinical Affairs]) are general internists in the College’s Department of Medicine.
The VA as a healthcare system has transformed itself over the past several years. The implementation of a single, system-wide integrated inpatient/outpatient electronic medical record, accountability for patient safety, implementation of quality measures, access and peer review program, expanding telehealth services and ongoing renovation to medical centers (including new inpatient wards and acquisition of the latest equipment) have contributed to the VA’s being viewed as a model of healthcare transformation in the USA.
Over the next several months, the Department of Medicine’s VA-based physicians will be called upon to meet new demands, including an expansion of inpatient beds as a result of the 5C and 6C renovations, and staffing of growing hospitalist, telehealth and urgent care center programs - to name a few. It will be an exciting – though challenging time ahead.
Written by Ralph M. Schapira, MD, Professor, Vice Chair for Veterans Affairs Medical Center