Pulmonary Outpatient

Services

Service

Pulmonary Outpatient Services

The VA Foreign Medical Services pulmonary out-patient includes the workup, evaluation, and management of patients with pulmonary disorders in the outpatient setting.  The Veteran patient population is a unique patient population.  Patients seen during this rotation have a number of common pulmonary diseases, particularly obstructive lung disease, interstitial lung disease, and neoplastic lung disease.  Uncommon pulmonary diseases are also seen.  The Veteran patient population typically has a number of medical comorbidities.

1. Patient Care  that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.

To recognize the following:

2. Medical Knowledge  about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.

To recognize the following:

Obstructive lung diseases
Pathophysiology, natural history, treatment, and management of obstructive lung disease

1. Asthma-diagnosis and management
2. Chronic bronchitis-diagnosis and management
3. Emphysema-diagnosis and management
Bronchiectasis
Bronchoscopy, diagnostic-indications, contraindications, techniques, management of complications
Cystic fibrosis-diagnosis, management, genetics, family counseling
Chronic cough
Dyspnea
Cardiopulmonary exercise testing
Methacholine challenge testing and exercise bronchoprovocation testing
Disability evaluation
Eosinophilic lung disease
HIV: infectious and non-infectious pulmonary complications

Inherited lung disease including alpha-1 antitrypsin deficiency-diagnosis and management
Lung Transplantation-indications for lung transplantation, evaluation for transplant, pharmacology of transplantation, and post-transplant management
Preoperative assessment of the surgical patient with lung disease.
Pregnancy-effect on pulmonary conditions such as asthma, management of pulmonary problems during pregnancy
Pulmonary malignancy, primary
1. Diagnosis, staging, and management of lung cancer, including multimodality therapy
2. Screening methods for lung cancer
3. Basic understanding of histopathology
Pulmonary malignancy, metastatic
Pulmonary infections, bacterial, fungal and viral
Pulmonary infections, Mycobacterium tuberculosis
Pulmonary infections, atypical mycobacterial
Pulmonary infections, atypical
Pulmonary infections in the immunocompromised host
Diffuse interstitial lung disease

Pulmonary vasculitis/pulmonary hemorrhage syndromes
Pulmonary hypertension, idiopathic: diagnosis and management
Pulmonary hypertension, secondary: diagnosis and management
Occupational and environmental lung disease
Drug-induced lung disease
Acute lung injury due to radiation, inhalation, or trauma
Pulmonary manifestations of systemic disease, including the collagen vascular diseases
Sarcoidosis
Solid organ transplantation: pulmonary and non-pulmonary complications
Thromboembolic disease, including pulmonary embolus
Interpretation of diagnostic studies including CT angiography
Disorders of pleura
Disorders of mediastinum
Genetic and developmental disorders
Sleep disorders, including diagnosis and management of obstructive and central sleep apnea

3.  Practice-Based Learning and Improvement     that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care

To recognize the following:

The effective utilization of educational and evidence-based resources to seek answers to scientific and clinical questions.
Identification of perceived deficiencies in knowledge or experience and actively seek opportunities for correction.
Appropriate response to faculty direction and criticism and demonstrate learning from faculty/fellow interactions
Proficiency at using the electronic medical record and the use of electronic resources to look up medical information
Commitment to self-education by attending Divisional educational activities including conferences and journal clubs
Facilitate the learning of students, residents, and other healthcare professionals as well as colleagues

4. Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals.

To recognize the following:

The role of a consultant in assisting a referring physician with the care of a patient.
The skills needed to interact with patients and their families in a manner that demonstrates compassion, competence and professionalism.
Education to the residents and students working with their patients.
Appropriate relationships and communication skills with staff including nurses, respiratory therapists, cardiopulmonary technologists, and all other support personnel

5. Professionalism as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.

To recognize the following:

The skills needed to interact with patients and their families in a manner that demonstrates compassion, competence and professionalism.
The role of consultant always keeping the patient’s best interest as the primary goal and performing these duties in a professional and courteous manner.
Communication skills with patients and their families with attention not just to the medical aspects of patient care, but also to the psychological, social and spiritual dimensions as well.
High standards of ethical / moral behavior
Need for Reliability / Responsibility
Commitment to on-going professional development and lifelong learning
Attention to documentation in the medical record and communication with other treating physicians
6. Systems-Based Practice  as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.

6. Systems-Based Practice  as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.

To recognize the following:

The skills needed to interact with patients and their families in a manner that demonstrates compassion, competence and professionalism.
The role of consultant always keeping the patient’s best interest as the primary goal and performing these duties in a professional and courteous manner.
Communication skills with patients and their families with attention not just to the medical aspects of patient care, but also to the psychological, social and spiritual dimensions as well.
Coordination the care of patients in the outpatient setting and thus learn the complexities of our health-care delivery system.
Importance of leadership within a healthcare team.
Practice of cost-effective health care that does not compromise patient care
Appropriate utilization of consultants and diagnostic testing information to provide effective patient care
Awareness of community resources available for patient care
Knowledge about home care nursing services, home care respiratory services, and patient support services and how to refer patients to these programs
Awareness of hospice and end-of-life resources available for patients and families
Adequate recordkeeping skills that:
1. Provides appropriate documentation of effort for reimbursement
2. Demonstrates knowledge of and behavior consistent with strict Medicare compliance

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We are the largest Medical Facility in the Caribbean taking care of the Men and Women who served our Country! Providing top notch Medical & Mental Health along with physical therapy and medication to Veterans.

Services

Pulmonary Outpatient

Service

Pulmonary Outpatient Services

1. Patient Care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.

To recognize the following:

2. Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.

To recognize the following:

3. Practice-Based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care

To recognize the following:

4. Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals.

To recognize the following:

5. Professionalism as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.

To recognize the following:

6. Systems-Based Practice as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.

To recognize the following:

Need Help?

We are the largest Medical Facility in the Caribbean taking care of the Men and Women who served our Country! Providing top notch Medical & Mental Health along with physical therapy and medication to Veterans.

1. Patient Care  that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.

2. Medical Knowledge  about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.

3.  Practice-Based Learning and Improvement     that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care

6. Systems-Based Practice  as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.