DRops of Wisdom

Today we are officially launching Chapters Health System doctors’ blog titled “DRops of Wisdom.” Twice a month we will bring you posts by our physicians about a variety of medical topics, in a sense, their medical drops of wisdom.

Kicking Off DRops of Wisdom

We kick off “DRops of Wisdom” with Dr. Ronald Schonwetter, who is the Chief Medical Officer for Chapters Health System.

Mission-Driven Service: Open Access

At Chapters Health including our affiliates—Good Shepherd Hospice, HPH Hospice  and LifePath Hospice, we are driven by our mission to be able to provide support and care for people in our community with or affected by advanced illness . We are dedicated to offering services and programs that improve quality of life for our patients.

This is why we offer an Open Access therapeutic approach so patients don’t have to choose between receiving hospice services that help improve their quality of life or palliative care that brings them comfort from pain and symptoms. Open Access prevents re-hospitalizations, and patients and families both benefit.

Chapters Health has offered this model for 20 years, and we are among the few hospice programs across the country that do. With our Open Access, palliative measures may include chemotherapy, radiation therapy, cardiovascular infusion, intravenous antibiotics, and even ventilators for a short period of time. Traditional hospice organizations do not offer these palliative interventions, which many view as aggressive.

Some of these interventions are offered in home settings. Vitals are not monitored like they might be in a hospital setting. These measures are in place to provide comfort. Our Open Access approach simply supports our philosophy of maximizing and focusing on quality of life and patient comfort.

As long as patients have a prognosis of 6 months or less, we will work with their family physician or specialist in facilitating an educated decision as to the best approach. Patients do NOT need to make a choice to stop treatment as there’s another viable option for them—Open Access.

Prognosis Crystal Ball

It is challenging for physicians to predict prognosis, especially for patients with chronic and often times debilitating illnesses and diseases, like Alzheimer’s disease. Prognosis is almost like having a crystal ball and trying to foretell the future. However, the guidelines that Medicare sets for hospice eligibility do a pretty good job. If physicians follow these guidelines in order to refer patients, they are 90 percent accurate in their assessment.

Unfortunately, patients wait too long to be referred to hospice. Many only access services when they only have days to live instead of the 6 months from the time they might have been first referred to hospice. We often hear that patients do not opt for hospice out of fear. They wrongly believe that they aren’t ready for hospice and equate this care option with giving up.

Hospice is not a death sentence, and research supports this statement. In a 2016 study published in Cancer, the group’s findings suggest that choosing to die at home actually helps terminal cancer patients live longer. In fact, this observation was also reported back in 2010 by the New England Journal of Medicine.

At Chapters Health, we have lengthy discussions with patients about what they want to achieve. We focus on what is valuable to them and their families. With hospice, often times, patients and families discover that they still have ample time to make life meaningful. We want to lessen the instances where we hear patients and families say that they wish they would have known about hospice earlier. We’d like to replace that feedback with “we are glad that we were able to make the most of life thanks to Chapters Health.”

What You’d Like to Read about in Future Posts

On “DRops of Wisdom,” we want to feature posts with subject matter that would be of interest to you. Please leave a comment or drop us an email with your ideas.

At Chapters Health System, every day is devoted to educating our patients and keeping them in the place they call home. We are dedicated to ensuring that patients, young and old alike, and their families are able to make educated decisions about important healthcare matters. For more information, please call our helpful Chapters Health team at 1.866.204.8611 or send an email to info@chaptershealth.org. 

More about Our Drops of Wisdom Author

Ronald S. Schonwetter, MD, FACP, AGSF, FAAHPM, is certified in Internal Medicine and Hospice and Palliative Medicine by the American Board of Internal Medicine. He also previously earned certification as a medical director, a hospice administrator and in geriatric medicine.

Dr. Schonwetter earned his medical degree from the University of South Florida (USF) College of Medicine. He completed his internship and residency programs in the area of Internal Medicine at the Baylor College of Medicine in Houston. In addition, Dr. Schonwetter completed a two-year fellowship in geriatric medicine at Baylor College of Medicine and The Veterans Administration Medical Center in Houston. He previously served as professor and division director of Geriatric Medicine at the USF College of Medicine as well as director of the Geriatric Medicine Fellowship Program.

Dr. Schonwetter has held various positions with the American Board of Hospice and Palliative Medicine including serving as the board’s chair, and the American Academy of Hospice and Palliative Medicine, serving as the academy’s president in 2006.