Program Mission
Medical Service will be a leader, through education and research, in the delivery of effective quality care.
Program Description
All staff physicians are members of the faculty of the University of Miami School of Medicine. Comprehensive medical care is offered on both the inpatient wards and ambulatory clinics of the Medical Center. Medical Service physicians provide both primary care and highly specialized subspecialty care to our veteran patients.
Medical Sections - Services Provided
The Miami VA Healthcare System Medical Service encompasses all facets of internal medicine. It is composed of the following sections:
Research and Education
Two other major activities of the service are teaching and research. Training is provided to University of Miami medical students at the second (143), third (152), and fourth (149) year levels, to 144 internal medicine residents, and to 100 post-doctoral subspecialty fellows. Medical Service physicians are actively involved in both basic and clinical biomedical research.
All staff physicians are members of the faculty of the University of Miami School of Medicine. Comprehensive medical care is offered on both the inpatient wards and ambulatory clinics of the Medical Center. Medical Service physicians provide both primary care and highly specialized subspecialty care to our veteran patients.
Contact Information
For further information, please contact Medical Service at (305) 575-3160.
Arthritis Section
Section Mission
The Arthritis Section has the mission to improve the care of patients with arthritis and rheumatic diseases through a balanced program of rheumatologic care encompassing arthritic and immune mediated diseases, a strong rheumatology fellowship program, teaching of rheumatology at all levels of medical education, clinical research with a focus on bone and joint diseases, and basic science research with a focus on osteoarthritis and related conditions.
Patient Services
The Arthritis Section provides 2 outpatient clinics per week. The Thursday clinic is attended by all arthritis fellows, rotating medical students and house staff, and 2 faculty. The Wednesday clinic is staffed by 2 faculty members. Inpatient consultations are provided at any time.
Education
Education of physicians is a major goal of the section. Education is provided in the arthritis clinics, along with inpatient consultations and at regularly scheduled conferences.
Clinical Research
The clinical research program has emphasized osteoarthritis and osteoporosis. New approaches to disease modification are under investigation in osteoarthritis and rheumatoid arthritis.
Cardiology Section
The Cardiology Section provides basic and complex cardiac services to veterans in the Miami area. Veterans from the VA Medical Center in Palm Beach are sent to Miami for tertiary cardiac care. Consultations and follow-up care are provided to outpatients in the cardiology clinic. A modern fully equipped 12 bed Coronary Care Unit is operated by the cardiologists and a new four-bed Telemetry Unit has been opened. The noninvasive cardiac laboratories perform ECG, signal averaged ECG, Holter monitoring, echocardiograms and transesophageal echocardiograms. All types of stress testing including treadmill exercise, adenosine, dypridamole and dobutamine stress are done routinely. Both thallium and echo imaging during stress are available.
The two catheterization laboratories perform over 1,000 procedures a year. Over 200 interventional procedures including angioplasty, stent placement, atherectomy and intra-coronary ultrasound are performed yearly. Electrophysiology services are also available. Both diagnostic studies and ablation procedures are performed. When necessary, patients are referred to Cardiac Surgery service, which performs coronary bypass, valve repair or replacement, pacemaker implant and defibrillator implant.
All cardiologists at the Miami VAMC are board certified in Internal Medicine and Cardiology and belong to University of Miami faculty. In affiliation with University of Miami, training is provided to physicians in the specialty of cardiology. An advanced training position in angioplasty in also available.
Clinical Research
The Cardiology Section also participates in research projects involving coronary artery disease and heart failure. Ongoing projects include:
- Comparison of pulse doppler and tissue doppler in the evaluation of diastolic function
- Role of HDL in the prediction of survival
Critical Care Medicine Section
Section Mission
The mission of the Section of Critical Care Medicine is to provide excellence in clinical medical intensive care, critical care research and education.
Program Description
The patient care responsibilities of the section are for the Medical Intensive Care Unit/Intermediate Intensive Care Unit and the Respiratory Therapy Unit.
The intensive care units provide expert, coordinated multidisciplinary care to critically ill medical, cardiac and post-operative patients. In addition to conventional intensive care practice, the section offers advanced ventilator and dialytic therapies as well as approved investigational treatments for a variety of severe conditions.
The Respiratory Therapy Unit provides clinical respiratory care, preoperative respiratory evaluations, home oxygen and ventilator programs as well as operating a STAT blood gas and chemistry laboratory. The Unit's patient education program has received national attention for its innovative and thorough approach.
Endocrinology Diabetes & Metabolism (Edm) Section
Mission
The EDM section has the mission to improve the care of patients with endocrinologic disorders through a balanced program of medical care, teaching, and research endeavors. It consists of a blend of faculty, clinicians, and basic and clinical researchers from the Geriatric Research and Extended Care Center Education (GRECC), headed by Bernard Roos, MD, and Medical Services. The EDM section chief is Jennifer B. Marks, MD.
Patient Services
The EDM section provides for inpatient and outpatient care. It has two outpatient clinics per week, one for patients with diabetes, and one for patients with other endocrinologic disorders. These clinics provide assessment, evaluation, and a comprehensive plan of care for our patients. The clinics are attended by attending physicians (all University of Miami Faculty), all endocrinology fellows, rotating internal medicine residents and medical students. The inpatient consult service is similarly staffed, and cares for the endocrine problems of patients admitted to the VAMC.
Improvement in care and education of our many diabetic patients is a particular priority of the EDM section. A multidisciplinary Diabetes Team has been formulated to provide for the often complex needs of diabetic patients.
Education
Education of physicians is a major goal of the section. The Endocrinology, Diabetes, and Metabolism Division, of which our section is the VAMC component, currently has 6 fellows in endocrinology, and will be expanding to eight over the next few years.
Research
Research is becoming an increasingly important activity in the EDM section. Several areas of clinical and basic research have been developed jointly with the GRECC and with other disciplines. Some of the research areas include bone and mineral metabolism, endocrinology of prostate cancers, and diabetes. This section is actively involved in the VA Cooperative Study CSP#465, Glycemic Control and Complications in Diabetes Type 2. One of the National Co-Chairs of the study is a member of our section, Carlos Abraira, MD. Andrew Taylor, MD, is the local Center PI with Jennifer B. Marks, MD, and Luis Fernando Samos, MD, as Co-Investigators.
Gastroenterology Section
The Gastroenterology Section at the Miami VAMC is staffed by three attending physicians, all of whom are Board Certified in Gastroenterology and have faculty appointments at the University of Miami School of Medicine. Howard Manten, M.D., Chief of the Section is an Associate Professor of Medicine. He is also Board Certified in Geriatrics, and attends in both disciplines. Dr. David Estores (Assistant Professor) is the Director of the Gastroenterology Clinic. Subspecialty residents in Gastroenterology rotate through the section during their 36-month formal training curriculum.
Patient Services
The Gastroenterology Section provides consultative and procedural services on an inpatient and ambulatory care basis. All basic and advanced diagnostic and therapeutic endoscopic procedures are available, including endoscopic ultrasonography (EUS) and photodynamic therapy (PDT).
Research
Research interests include endoscopic therapies of esophageal strictures, pharmacologic therapy of erosive esophagitis and upper gastrointestinal hemorrhage (separate projects), and an exploration of the pathophysiology of gastroenterologic problems in Spinal Cord Injury patients.
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