A Team Approach

For­mer Quin­cy May­or Chuck Scholz has encoun­tered a series of health chal­lenges over the past two decades, requir­ing the metic­u­lous man­age­ment of numer­ous appoint­ments and pre­scrip­tions. The addi­tion of Quin­cy Med­ical Group (QMG) RN Care Man­ag­er Leslie Koet­ters to his care team marked a trans­for­ma­tive shift in his health­care journey.

Scholz’s health issues began in 2004 with a diag­no­sis of intesti­nal ischemia, a con­di­tion that near­ly claimed his life. Sub­se­quent­ly, he under­went surgery to remove 28 inch­es of his intes­tine. Express­ing con­cerns about weak­ness to his then-pri­ma­ry care provider, retired QMG Physi­cian Dr. John Scott, Scholz was referred to retired QMG Gas­troen­terol­o­gist Dr. John Bozdech.

Notic­ing changes in Scholz’s appear­ance, Dr. Bozdech real­ized he might be fac­ing a seri­ous health issue. He prompt­ly arranged an appoint­ment for him at Barnes-Jew­ish Hos­pi­tal in St. Louis the fol­low­ing day.

Dr. Bozdech called me at 10:30 at night and informed me I had an appoint­ment at Barnes the next morn­ing. I asked, Well, what’s going on?’ And he replied, I’ve been Googling pic­tures of you from the news­pa­per, and I looked at your fore­head right above your glass­es, and you don’t have any fat there. I can see that you’re wast­ing, you’ve got liv­er dis­ease,’” Scholz recalled.

At Barnes the next day, Scholz was diag­nosed with non­al­co­holic steato­hep­ati­tis (NASH), a pre­cur­sor to liv­er can­cer. He con­tin­ued mul­ti­ple doc­tors’ vis­its to man­age the con­di­tion while await­ing a liv­er trans­plant. Dur­ing a vis­it to Barnes Hos­pi­tal in 2014, his doc­tor informed him that a can­cer­ous tumor had been detect­ed in the liv­er, which ulti­mate­ly moved him up the list for a trans­plant. He received a trans­plant on Feb. 13, 2015.

Over the next decade, Scholz con­tin­ued to man­age his health. Giv­en the com­plex­i­ty of his med­ical his­to­ry and ongo­ing care, a cohe­sive approach was need­ed. After mul­ti­ple vis­its to the emer­gency room in recent months, they met Koet­ters, who is the Care Man­ag­er Coor­di­na­tor at QMG and spoke to Scholz and his wife, Becky, about the Tran­si­tion­al Care Man­age­ment Program.

Koet­ters recalls her ini­tial encoun­ters with Scholz in the hos­pi­tal. Despite his uncer­tain­ty about need­ing her ser­vices, Koet­ters rec­og­nized the poten­tial to stream­line his care and alle­vi­ate some of the bur­den placed on him and Becky.

I see prob­a­bly half a dozen dif­fer­ent doc­tors, and you want some­body that knows that you’re with each one and that it’s all cen­tral­ized and coor­di­nat­ed,” Scholz explained. I think it has helped me tremen­dous­ly because I have a coor­di­nat­ed plan of care now with all the var­i­ous physi­cians, and Leslie can coor­di­nate all that,” he added.

As part of the pro­gram, Koet­ters over­sees patients of Dr. Adam Rey­burn, QMG Inter­nal Med­i­cine Physi­cian, Scholz’s new pri­ma­ry care provider. She sup­ports patients admit­ted to the hos­pi­tal or those with mul­ti­ple emer­gency room vis­its in the last 90 days. Scholz had over a dozen ER vis­its and three inpa­tient admis­sions over recent months; Koet­ters played a piv­otal role in help­ing man­age his health.

Her efforts includ­ed man­ag­ing med­ica­tions, sched­ul­ing doc­tor vis­its, and act­ing as a bridge between Scholz and Dr. Reyburn’s office, ensur­ing seam­less com­mu­ni­ca­tion and con­ti­nu­ity of care.

I’m on the side­lines try­ing to get that all orga­nized for him. That’s exact­ly what the nurs­es in care man­age­ment do dai­ly — we sift through appoint­ments, answer ques­tions, and get extra sup­port involved if need­ed. We aim to be the link between our patients and their providers.”

Although Koet­ters sees her­self on the side­lines of his care, Scholz calls her the quar­ter­back.” He express­es grat­i­tude for Koetters’s sup­port, empha­siz­ing the pro­found impact on his well-being.

Even dur­ing Scholz’s recent trav­els to Ire­land and Geor­gia, Koetters’s sup­port remained, offer­ing reas­sur­ance and assis­tance across continents.

His fam­i­ly went to Ire­land and had a great time and recent­ly returned from Geor­gia. When I spoke with them recent­ly after their trip to Geor­gia, Becky expressed to me, I can’t tell you how impor­tant that was.’ They were gone, maybe three or four weeks, but were able to enjoy their time with­out the added stress. That made me so hap­py to hear,” said Koetters.

Scholz added, I can’t imag­ine liv­ing in a big city and it’s like­ly you wouldn’t you don’t even know who you’re talk­ing to. But I know Leslie. Leslie’s become a friend.”

Over the years, his health has had many ups and downs, yet Scholz has found respite in the care of Koet­ters and his ded­i­cat­ed physi­cians includ­ing Dr. Scott, Dr. Bozdech, Dr. Rey­burn, QMG Sur­geon Dr. Todd Pet­ty, QMG Gas­troen­terol­o­gist Dr. Karthik Tri­pathi, and QMG Dietit­ian Brit­tany Winship.

Koet­ters is hum­ble about her impact, shar­ing that the rewards she receives from see­ing her patients thrive are worth more than anything.

This is my most favorite job. I’ve been a nurse for 26 years and worked here at QMG just shy of eight years, and this is hands down my most favorite job. I think it’s because it fills my cup. One of the things I’m most proud of is that we are mak­ing a dif­fer­ence. I see it every sin­gle day in our patients,” said Koetters.

For more infor­ma­tion on the Care Man­age­ment ser­vices at QMG, vis­it quin​cymed​group​.com.

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