22
Theresa M Lavoie, RN
Chief, Executive Medicine
CDR
|
NC
|
USN
|
Ret
WRB
Walter Reed National Military Medical
Center’s Executive Medicine Service is the
largest of its kind in the Department of
Defense, offering our nation’s leaders a wide-
ranging health program that encompasses the
latest innovations and technologies in
healthcare. Our government and military
leaders face numerous time, privacy and
security demands required of their positions
that c
an cause them to put their health on the
back burner. Keeping our senior leaders
healthy is critical to the success of our nation.
To ensure our senior leaders have their health
at the forefront,
the Executive Medicine
Service provides all of a patient’s healthcare
needs and/or arranges care with other
qualified professionals. While emphasizing
preventive care, our physicians are skilled in
the diagnosis and management of acute and
chronic illnesses. Our unique blend of cutting-
edge medical technology with old-fashioned
family medicine values allows our physicians
to practice medicine the way it was meant to
be practiced—with diligence, compassion and
individualized care.
Because we are an integrated part of the
Military
Healthcare
System,
we
have
incredible resources at hand—clinics in many
locations, specialists in every discipline, as well
as medical records instantly available.
We serve members of the President’s cabinet;
members of Congress; Supreme Court justices;
active duty and retired flag/general officers
and their beneficiaries; Senior Executive
Service (SES) staff who are retired military;
Secretary, Deputy Secretary and Assistant
Secretary of Department of Defense; foreign
dignitaries; foreign military flag/general
officers on orders or with letters of secretarial
designation; and Medal of Honor recipients.
Our three physicians are board-certified in
either family medicine or internal medicine
and several are faculty at the Uniformed
Services University. We believe every patient
benefits by having a physician with the
training and experience to be a “medical
quarterback,” coordinate care, anticipate
problems and respond to the first sign of an
illness as promptly as possible.
Our medical team consists of the following:
Susan C Brunsell, MD
Medical Director
Kim F Gibson, MD
Staff Internal Medicine
Mary B Heathcote, MD
Staff Family Medicine
Cherron D Boswell, NP
Staff Family Nurse Practitioner
This year, we have grown our relationships
with executive medicine teams in the United
States and overseas. Our Executive Medicine
team works closely with Fort Belvoir
Community Hospital and other executive
medicine clinics to ensure seamless care to
our beneficiaries.
Ex
ec
utiv
e Medicin
e
23
This past year marked the second year since
the establishment of the Service of Geriatric
Medicine and Palliative Care at WRB. Now
firmly established, the Service continues to
grow in both its scope of clinical services and
influence throughout the Command. Long
dedicated to improving the care of elderly
beneficiaries, a robust consultative service has
been developed which offers patients and
their providers access to unique clinical
expertise regarding common disorders of
aging. Similarly, as a focus on patient-centered
goals of care is increasingly emphasized, the
palliative care section continues to be a leader
and advocate for a holistic and patient-
centered approach to medical care.
As This Critical Field of Expertise Blossoms,
Geriatric and Palliative Patients Experience a
New, In-Depth Spectrum of Care
With an emphasis on geriatric medicine
consultation, referrals from primary care,
subspecialists and surgical colleagues continue
to increase as these providers realize how
geriatric specialists can provide expertise and
assistance with care of their complex elderly
patients. Service to our patients is enhanced
as referrals from the entire National Capitol
Region are increasingly requested. The Falls
Prevention Clinic, under the leadership of our
Geriatric Nurse Practitioner, Theresa Miles,
DNP,
is
an
exemplary
model
of
multidisciplinary
collaboration
among
Geriatrics, Optometry, Physical Therapy and
Pharmacy. Miles has served as an expert
advisor and contributor to the Command’s
policies and Joint Commission preparations
regarding falls, as well as quality improvement
projects aimed at reducing falls risk
throughout the medical center.
The palliative care section continues to see
accelerated
growth
in
requests
for
consultation. Under the leadership of Valencia
Clay, MD, regular attendance by palliative care
staff on the inpatient medicine wards and at
various tumor boards has enhanced exposure
regarding availability of palliative care services
across
the
Command.
Our
program
administrator for palliative care, Jerry
Waddell, PhD, again led and organized the
annual well-received Murtha Cancer Center
memorial service to commemorate men and
women who were lost to cancer during the
preceding year.
Laying a Strong Foundation for Specialized
Care through Graduate Medical Education
Education and teaching the next generation of
providers continues to be a major priority for
Geriatric Medicine and Palliative Care. The
internal medicine residents’ rotation in
geriatric medicine provides the necessary skills
and lays the foundation for improved quality
of care for elderly patients. Both supervised
one-on-one instruction during the focused
geriatrics rotation and longitudinal supervision
in the resident continuity clinic ensure that
our residents are well-prepared to manage the
health problems of the elderly. A strong
collaboration
with
a
local,
nationally-
renowned hospice program augments and
enhances
our
residents’
educational
experience. Local education highlights over
the past year include our palliative care staff
leading a highly successful Palliative Care
Communication Skills Training seminar for
registered nurses this past year. Additionally,
Waddell was an invited speaker at the annual
Lung Cancer Summit held on campus.
Looking Forward
Realizing that the care of elderly and palliative
care patients is complex by nature, we
continue to further liaise with other disciplines
and local institutions in order to best serve our
patients. We seek to lead the way with
development of unique clinical programs and
models of care as well as spreading our
knowledge and expertise through innovative
teaching. In summary, as the newest service in
the Department of Medicine, the Geriatrics
and Palliative Care Service at Walter Reed
Bethesda enthusiastically looks forward to
even greater accomplishments in 2017.
Kenneth G Pugh, MD
Chief, Geriatric Medicine
and Palliative Care
CAPT
|
MC
|
USN
WRB
Geria
tric M
edicine
and
P
allia
tiv
e Ca
re
Geriatric Nurse
Practitioner Theresa
Miles, DNP, provides
compassionate care to
Walter Reed Bethesda
geriatric patients.
She has served as expert
advisor and contributor to
the medical center’s
policies and Joint
Commission preparations
regarding falls.