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State-of-the-Art Health Care for Veterans in the Lowcountry and Beyond

Ralph H. Johnson VA Medical Group
Department and Section Leadership of the Medicine Service at the Ralph H. Johnson VAMC 

Clinical Care 

The Department of Medicine is a primary partner of the Ralph H. Johnson Veterans Affairs Medical Center (VAMC) which provides a full range of patient care services, as well as educational and research opportunities. As a premier teaching hospital, the VAMC is a 152-bed tertiary care facility that serves over 80,000 veterans along the South Carolina and Georgia coasts. As a level 1A facility, the Charleston VAMC is one of the fastest-growing VAMC’s in the nation. It is consistently ranked in the top 10th percentile for quality according to the Healthcare Effectiveness Data and Information Set (HEDIS) and has sustained a high level of performance on the VA's Strategic Analytics for Improvement and Learning (SAIL) rating system for the past several years.

The VA Medical Center is a leader in cardiac care, cardiothoracic surgery, and mental health care, and provides a range of comprehensive specialty health care services in cardiology, dermatology, endocrinology, gastroenterology, hematology/oncology, infectious diseases, nephrology, pulmonary, rheumatology, and women’s health. The facility is the site of the VA’s first National Tele-Mental Health Hub, providing evidence-based psychotherapies for PTSD, as well as an extensive Homeless Veterans program, including services such as the Compensated Work Therapy program and the Housing and Urban Development-VA Supported Housing (HUD-VASH) program.

Serving those “who shall have borne the battle” continues to be a privilege that comes with great responsibility. The Medicine Service at the Ralph H. Johnson VAMC in partnership with the Medical University of South Carolina is proud to take on this responsibility and looks forward to continuing to find new and better ways to meet the health care needs of veterans across the Lowcountry and beyond.

Research

Veterans receiving care at the Ralph H. Johnson VA Medical Center benefit from an extensive research program directed by R. Amanda LaRue, Ph.D., Associate Chief of Staff, Research & Development. The VAMC's robust research program has more than 90 investigators involved in 280+ projects funded at $28.8M annually. In 2018, cutting-edge research efforts in the Medicine Service focused on novel therapies in heart failure, including cell therapy, the diagnosis and treatment of fatty liver disease, and access to the National Cancer Institute (NCI) infrastructure offering cancer patients access to NCI-sponsored clinical trials.

Complementing the Ralph H. Johnson VAMC world-class cardiac care is cutting edge research led by Department of Medicine investigators Michael Zile, M.D., Valerian Fernandes, M.D., and Sheldon Litwin, M.D., who have been instrumental in a Department of Defense-sponsored cell therapy study for HFpEF (Heart Failure with preserved Ejection Fraction); and the work of Terrence O’Brien, M.D., in the “PARADISE-MI” trial evaluating the benefits of sacubitril/valsartan in the treatment of heart failure patients. Extending this expertise into clinical care, the VAMC’s Cardiology Service now offers complex electrophysiologic services, including atrial and ventricular arrhythmia ablations, cardiac catheter treatments for total coronary occlusions and refractory angina, and a novel home cardiac rehabilitation program.

In 2018, under the direction of Wing Syn, Ph.D., the VAMC’s Gastroenterology Service was named one of five sites to be part of the National Steering Committee for the VA Non-Alcoholic Fatty Liver Disease (NAFLD) Research Consortium. The Ralph H. Johnson VAMC offers four NAFLD clinics per week, including transient elastography in addition to the new services of capsule endoscopy, “smart pill” motility studies, inbody composition analysis and others.

As one of 11 VA sites in the nation participating in the National Cancer Institutes and VA Interagency Group to Accelerate Trials Enrollment (NAVIGATE) initiative, the Ralph H. Johnson VAMC is at the forefront of cancer care for veterans. This infrastructure allows veterans to participate in NCI trials such as precision-medicine therapies based on genetic profiles and cures using the patient’s own immune system. Tying into the patient-centered focus of the VAMC’s Hematology and Oncology Service is the 2018 expansion of the Nurse Navigator program led by Rinah Shopnick, D.O. Under this new program, all veteran cancer patients treated at the VAMC are now followed by a nurse navigator, resulting in improved continuity and better health outcomes.

Education 

Medical training continues to be a fundamental activity for over 300 medical students, residents, and fellows who rotate through the Medicine Service each academic year. Dedication to training future generations of health care providers is at the core of the VAMC’s Emergency Medicine Service directed by Lancer Scott, M.D. In 2018, the service completed an expansion and renovation of the Emergency Department which now includes a state-of-the-art mental health emergency assessment and treatment area. Continued recruitment of VAMC faculty with board-certified emergency medicine physicians has expanded emergency medicine teaching rotations to physician assistant students and residents in emergency medicine and internal medicine at MUSC.