Managing Hypertension and Reducing Readmissions in Purple Hearts | Cardiology Magazine
Profile | For someone who has never clocked a minute of military service, Richard Schofield, MD, FACC, spends an inordinate amount of time among the men and women of the armed forces. As a professor of medicine in the division of cardiovascular medicine at the University of Florida College of Medicine in Gainesville, Schofield currently serves as the vice chair for Veterans Affairs (VA) within the department of medicine at the University of Florida and is chief of the medical service for the North Florida/South Georgia Veterans Health System, one of the largest integrated health systems in the Veterans Health Administration.
“I’m very proud of everything our service members do,” says Schofield. “To have a chance to help them with their health care, it’s honestly a privilege to go to work every day.”
While a mental health physician or physical therapist must contend with the results of more contemporary military campaigns, respectively addressing soldiers with post-traumatic stress disorder or a traumatic improvised explosive device wound, as a cardiologist Schofield’s population of patients are of a much older guard.
“There are still some of the World War II era patients, who have always been my favorites,” says Schofield. “They are just extraordinary people. I’m not sure America will ever have another generation like that. They are just incredibly patriotic individuals and all of them are very proud of their service and extremely grateful for anything you can do to help them with their medical problems. Those are the kind of patients that tend to stand out and there are not a whole lot of them left. However, the patients I take care of the most have hypertension, diabetes, coronary heart disease, valvular heart disease, arrhythmia and heart failure. That’s really what I spend a lot of my time working on. It wouldn’t be a whole lot different than what any cardiologist would treat out in the community or in an academic setting.”
Though specializing in heart failure and heart transplantation, Schofield and his colleagues throughout the Veterans Health Administration were recently recognized as champions for hypertension control by Million Hearts, a national initiative seeking to prevent one million heart attacks and strokes by 2017 by improving access to effective care, and identifying new prevention and detection strategies.
With approximately 8 million patients eligible for care through the VA, and with many of them suffering from heart failure, Schofield’s next project is reducing the number of readmissions for heart failure patients. “In the private sector it’s a concern because Medicare now is going to impose penalties for frequent readmissions to the hospital,” says Schofield. “While on the VA side we don’t have penalties, readmissions account for more in-patient bedtime, which costs an incredible amount of money to the system. So it’s to our advantage to take care of patients in such a way that they don’t need to be frequently readmitted,” he adds.
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