Patient Advisor and Advocate: Richard Scholtz
 |
Richard Scholtz |
In 1987, when he was almost 40, Richard Scholtz fainted while playing soccer in a recreation league. As a result, he learned that he needed open-heart surgery to implant an artificial aortic valve, which he had eight weeks later. He felt his care went beyond treating his medical condition and wanted a way, beyond payment for services, to give back on a personal level for the gift of his care. As a musician, he offered to play music in the waiting room of his physicians' practice. The physicians were happy to give this novel idea a try, and suggested that Richard play on Friday afternoons, thinking that by the end of the week when the staff might be most tired, they would appreciate it the most. The first time Richard played, several doctors told him how surprised they were at the difference they could see in their patients, as well as the difference they perceived in the staff. Richard continued playing in their waiting room most Fridays for the next two years, feeling grateful that he could "give back." In addition, this experience taught him "a lot about the human context and how having music in the waiting room actually changed the relationships amongst patients and families and healthcare providers and how music works outside the formal structure of a stage and performance." Without planning to, Richard served as a catalyst to change and to improve the delivery of health care.
Since his surgery, Richard has continued to work to change the health care system. For the past twelve years, he has been the "medical companion" to his 93-year-old mother, and also assisted his mother-in-law in the five years before her recent death.
As a result of Richard's mother's participation in the Robert Wood Johnson (RWJ) funded project, Pursuing Perfection: Raising the Bar for Health care Performance, Richard served on the Pursuing Perfection Patient and Family Advisory Council. He also helped to develop the Shared Care Plan-a secure web-based, patient-owned medical record that lets patients share up-to-date information with their health care teams: spouses, children, neighbors and friends, Doctors, Pharmacists, and other health care practitioners. This helps manage their chronic conditions and promote the flow of information between the patient and health care team members. The RWJ grant-implemented in Bellingham, WA by a coalition of Peace Health and some of the local medical practices-supported the development of patient-centered care.
The Whatcom County organizations participating in "Pursuing Perfection" also initiated an effort to map the "Health System" in Whatcom County. They realized that the map couldn't stop at the hospital door or the doctor's office. Patients were active participants and needed to be on the map. Richard was asked to be the chair of the committee, made up of patients and healthcare professionals, building the patient's part of the map. With Richard's leadership, the committee resisted the idea of looking at the patient as a distant piece of a large health care system and, instead, focused on the understanding how people understood illness and the resources that could help them: to really make the patient the center of the map.
 |
Richard and Helen Scholtz |
In order to find out what was important, over 200 community members have been asked to draw maps of their "health neighborhood." These maps begin to give new insight into questions like "What is health?" and "Where does health come from?" and reveal a wealth of information that informs the process to improve the delivery of health services.
Over time, this committee grew into an unusual coalition of community members, doctors, administrators, and professors from Western Washington University. Western Washington University and St. Joseph Hospital joined forces to form the Critical Junctures Institute to study ways in which communities can work together to improve the health of the residents. It focuses on community health and outreach. Initial goals include four main areas: (1) patient activation (2) social network engagement (3) information technology and (4) management of chronic diseases. The Institute's first research project, funded by The Robert Wood Johnson Foundation, is the pilot-mapping project that Richard now co-directs.
Richard describes part of the project: "To better understand what elements patients believe are important, we developed a simple exercise in which people are asked to draw a map of their 'health neighborhood' that includes people, services, and information sources-even putting in one or two-way connectors. We collected about 200 maps and each one is unique."
Mapping changes the perspective of the patient. Richard believes that the participants in the Mapping Project learn something about themselves because the map makes health-not illness or the health care delivery system-the focal point. People with multiple illnesses often deal with a number of specialists, and can easily end up with a fragmented understanding of their own situation. As a result of the mapping process, patients can see the connections in their life, their health, and community. They learn to view their health and health resources in a different way.
Richard finds this work to be quite energizing and his experience is an excellent example of how advisory roles can evolve.
Richard lives in Bellingham, WA with his wife, Helen, and they have two adult sons. Richard is self-employed, and works primarily in music and education, as well as in computer consulting, project administration, and financial management. He's worked with pre-schools and elder hostels, a youth orchestra and youth choir, organized adult camps, and taught university and community college classes. Richard released multiple CDs of his own music: instrumental duets, traditional American songs, and improvised music to accompany the telling of traditional stories. Richard has shared his music in formal and informal settings, ranging from concerts and festivals to doctor's offices, hospitals, and university offices. Richard has a long history of participating community activities including serving on the board of Artist's Trust. He is a founding board member and past Chair of the Washington State Folklife Council-a project of the NEA and the Washington State Arts Commission. A graduate of Antioch College in Yellow Spring, OH and was one of the founders of Antioch College West.