Wounds unfortunately impact our frail elder population at large and seeking proper treatment with a skilled and experienced professional is imperative. When it come to our clients, Dr. Roger Schechter has always been our dedicated wound care specialist. After reading this interview it will be no surprise why. He is truly best-in-class and over the years we have witnessed just how much of a difference he can make in even a single visit. We thank Dr. Schechter for taking the time to help answer some important questions regarding his practice and wound care in this featured interview.
Dr. Schechter is board-certified in Emergency Medicine and Undersea and Hyperbaric Medicine. He is also a certified wound specialist. Dr. Schechter earned a Bachelor of Arts degree from UCSD’s Revelle College and received his Medical Degree at UCSD School of Medicine. He underwent post-graduate training as an Emergency Medicine Resident at Kern Medical Center in Bakersfield and achieved board certification from the American Board of Emergency Medicine in 1998. Dr. Schechter is a Fellow of the American College of Emergency Physicians and a Fellow of the College of Certified Wound Care Specialists.
Dr. Schechter serves as the Wound Care Medical Director for Kindred Hospital and Promise Hospital, as well as the Palomar Pomerado Health System as a whole. He is active in conducting clinical trials in both the acute care and wound care fields. He has been a speaker on the national level regarding wound care and has spoken internationally about clinical research.
In November of 2010, Dr. Schechter was voted Palomar Pomerado’s Physician of the Year for Outpatient Services. Below we feature his personal interview with Grace Care.
We have seen the wonderful work you have done with our geriatric clients and how much of a difference proper wound treatment can make. What would you like our audience to know most about wound care that they may not be aware of?
Not all wound care is alike. The centers at Palomar Health follow evidence based clinical practice guidelines for optimal healing. We also track every wound on every patient in a database and use it to identify those wounds that are not progressing to healing. The reports we generate from our database prompt us to reassess and change our care if someone is not on the road to complete resolution of their wound problem. We also try to make sure that underlying health problems such as diabetes and malnutrition are managed to promote wound closure.
We treat the WHOLE patient and not just the HOLE in the patient.
When is best to come and see a wound care physician, such as yourself, over a primary care doctor?
Ideally, the primary care doctor should refer to us so we can work as a team with them to get their patient healed quickly. The guidelines we use to advise both primary doctors and patients who self-refer, is that a wound that is not 50% healed in 4 weeks, or completely healed in 8 weeks, is a problem wound and will benefit from our services.
We learned that Palomar’s Inpatient Program has recently added a dedicated wound doctor program several days a week. Can you tell us more about this?
We have been performing inpatient wound care since the inception of the wound care centers in 1997. We have come to realize, however, that in a large and comprehensive system like Palomar Health, we needed to provide a doctor dedicated solely to wound care for the entire day, several days per week. In July, we started the dedicated wound doctor program on Mondays, Wednesdays and Fridays to assist in the care of inpatients with complex wounds and to enhance the transition of wound care from the acute setting to the long-term care or outpatient environment.
Our goal is to reduce readmission of patients with wounds to the acute care hospital, reduce amputation rates in patients with diabetes and arterial disease, and to promote best practices in wound management in the inpatient setting. We are working as a team with the current wound care nurse specialists and our synergy has already led to improved and more timely outcomes for several patients with wounds.
What benefit do you find in working with Grace Care’s Care Management Team?
For many of our patients, navigation of the bewildering world of post-acute care is daunting and leads to sub-optimal management and stress. Grace Care’s private care management can help lead to better outcomes and peace of mind for our patients and their families. Private care management can serve to ably “plug the holes” in the sometimes leaky ship of post-acute support of dependent adults with significant health problems, thereby keeping the patient afloat.
What advice would you give new patients, to be sure they are given top wound care upon arrival?
At the Palomar Health Wound Care Centers in Poway and San Marcos patients can expect top wound care from all of our providers and nurses, since they are specially trained to manage complex and chronic wounds with cheerful and individualized attention to their wounds. Still, it is always smart for patients and their family members to remember to bring a complete list of medications to each visit and to inform the staff of any changes in health or medications from visit to visit. Also, it is important to be diligent about control of chronic illnesses, especially diabetes and nutritional deficits, to bring about healing.
The primary care doctor, the patient, and the wound doctor must work together as a team to optimize care. With respect to the acute care setting at the Palomar Health Hospitals and Villa Pomerado, skilled nursing patients with wounds and their family members should feel free to ask the primary admitting physician to request consultation from the wound physicians. Consultation is not automatic and it never hurts to provide a reminder to the often busy hospital care specialists.
To find out more about the Palomar Health Wound Care Centers, please visit their website at https://www.palomarhealth.org/ContentPage.aspx?nd=186.
