Dr. Troy Bishop Helps Patient End Inconsistent Care with House Calls

Jan 13, 2020

Gail Pittman wanted to end her mother Marie Davis’ debilitating cycle of landing in the emergency room, being admitted to the hospital and then on to a nursing home, something that many older adults can relate to. 

Data from the National Hospital Ambulatory Medical Care Survey revealed that 511 out of 1,000 adults age 65 and older visited an emergency department in the span of one year. 

Pittman’s 92-year-old mother suffered from tuberculosis as a child, and the illness scarred her corneas and caused lung damage. 

Over the years, and despite these setbacks, Davis had maintained her health. But infections have always spread easily in her body, and several years ago she began getting chronic urinary tract infections. Side effects in the older population can include poor motor skills, dizziness and confusion. 

“Mom was dragging her foot,” Pittman says. “I didn’t realize she was exhibiting extreme weakness and that is a symptom. The doctor wanted to rule out a stroke.”

Davis also went to the emergency room for gallbladder issues, but doctors hesitated to treat her immediately because of her heart, lung and other medical issues related to her case of tuberculous as a child.

“It’s a miracle she made it through,” says Pittman. The surgery was delayed while waiting for a cardiologist causing her mother to get sepsis, which can lead to malfunctioning organs and even death. She spent 26 hours in the post-anesthesia care unit under constant care. 

“After each hospital visit, she ended up in a nursing home,” Pittman shares, stating that Davis, who lives with her, could not thrive in that environment. 

She knew there had to be a better way for her mother to live. Eventually, Pittman and Davis were introduced to Unity Health Network’s High-Risk Care Management Program, headed by Dr. Troy Bishop, medical director of care delivery transformation. 

The goal of the program is to increase patients’ access to physicians, nurses and testing supplies, and to help facilitate home therapies to reduce hospitalization. A physician or nurse practitioner makes home visits, if necessary. Caregivers and patients are given education and tools to monitor vitals, and to identify and treat common issues like chronic obstructive pulmonary disease urinary tract infections. 

“We identify high-risk patients and visit them in their home environment several times a year,” Bishop says, adding that there is a specific hotline so patients and caregivers can directly access the team.

“We treat mom’s infections in a more proactive manner by doing tests three times a week and looking out for other signs and symptoms,” Pittman says. “If tests are positive, we can treat here, and this has kept her from getting more serious infections and kept her out of the hospital.”

A handful of times, Davis came down with lung infections and was treated at home by Bishop. 

“This has made a huge difference in her quality of life,” says Pittman, who maintains a log of her mother’s medications and daily vital signs, such as blood pressure. 

If Pittman sees any changes in Davis’ health, she writes it down and also monitors her mom’s diet with a careful eye on sodium intake. 

“If I have any questions, I call the high-risk line and we talk frequently,” Pittman adds.

Davis says this personalized care has made all the difference for her, and she’s happy to be rid of the emergency room, hospital bed, nursing home cycle. 

“Dr. Bishop has come here to the house and checked on me, and he keeps me out of the hospital,” she says. “I can’t find the words — he is just really great.” 

Pittman notes that sometimes perseverance is all it takes. 

“You have to be an advocate and keep searching for the right health care team to help you through,” she says.