E-mail Address:
HL@jemsekclinic.com
Service Provisions:
Heidi is at the site 2-3 days/week; Wednesday, Thursday and every other
Monday.
Funding Source:
Self funded. Fifty percent of Ms. Lichtner's salary is covered by a pharmaceutical
RD program and 50% is funded by the clinic.
Population Served:
Heidi notes, "We serve approximately 1,000 adult clients well mixed with
regards to gender (60% male, 40% female) and race (equally Caucasian/African
American). Our Latino population is increasing."
Patient Referral Source:
Jemsek clinic gets referrals from MDs, their web site <http://www.JemsekClinic.com>,
ads, or word-of-mouth. It is also affiliated with the Ryan White
Care Act via Metrolina AIDS Program (MAP).
How often are patients
seen? Patients are seen as needed for medical purposes. Visits are
scheduled at least every quarter for BIAs, DEXAs, and wasting monitoring.
Ms. Lichtner sees patients in the wasting program every 4-6 weeks to monitor
labs, diet records, the effectiveness of any anabolics, etc.
Are all patients screened
for nutritional risk? Yes
How often do you provide
nutritional assessments and follow-ups? Assessments and follow-ups
depend on the patient's stability, reaction with meds, etc. If a patient
is on anabolics, then BIAs and labs are done more frequently. Diet records/recalls
are taken at least twice a year. If a patient is using supplements, we
ask for a 24-hr food recall every time the patient is seen. Diet records/recalls
are used to determine if patients are in fact not eating well and relying
on supplements for calories. It also helps us to determine if there are
other reasons a patient isn't eating well - fatigue, access to services
or foods, etc.
Other Provided Nutritional
Services: The Jemsek Clinic provides BIA testing, DEXA, on-site visits,
and clinical studies. An in-house nutrition education periodical - via
the web site - features an article every quarter.
Patient Education Materials:
According to Heidi, "I don't like to re-invent the wheel so I rely on educational
pieces provided by pharmaceutical companies as well as publications specific
to HIV for patients to review. I use some ADA educational materials
for more general things such as diabetes, cholesterol/triglyceride and
low fat information. I use information from the National Cancer Institute
as well. To address alternative and complementary medicine we are now in
the process of making up Nutraceutical Cards for our patients so that they
have some sort of a guide to use for supplements that have some science-based
evidence behind their use."
What was the most difficult
issue you had to deal with when you started? The most difficult issue
for Ms. Lichtner was the realization that there are almost no follow-up
services to refer patients to once they leave the office - no food pantries,
no supplements.
"More and more patients
seem to become less eligible for support these days and it is a difficult
and slow process to obtain food stamps, meal support services, etc. In
a hospital setting, it was easy to send a patient home with a case of Ensure.
But here at the clinic we don't have access to supplements like that. Not
all patients have caseworkers to help network them into the system and
even if they do, the system here in Charlotte seems weak. Ryan White money
is spread out
