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The Catalyst

By definition, Family Medicine puts patients first

“With views this beautiful, you’ll wish your wait for the doctor was longer.”

By Mikie Hayes
Public Relations

Family Medicine chairman Dr. Terry Steyer is thrilled to again be providing services on the Charleston peninsula. Their new office is located on the 10th floor of Rutledge Tower. photos provided

In January, Terry Steyer, M.D., chairman of the Department of Family Medicine, came back to MUSC to lead and revitalize a department that had recently suffered a great deal of loss.

Beloved team members had retired; others had left, taking positions elsewhere that advanced their careers. Not to mention the loss of the home that had served as True North for the department for 40 years: 295 Calhoun St.  Steyer compared leaving their home on the peninsula to “a death in the family.”

“When I returned to the department after more than four years, there had been a period of mourning in the department — losing 295 Calhoun Street was especially difficult. Then, there was the loss of Bill Hueston as chair, and our longtime residency director accepting a position in Florida. Clive Brock retired after being here for nearly 30 years, and Carolyn Thiedke retired. In 19 months, we lost eight faculty. All for good reasons, but it left the department at a point where it was dealing with a large amount of grief.”

From a practical standpoint, it left the team with the task of establishing a new site while covering all its obligations with eight less faculty members. “We were treading water,” Steyer said. “We were all in the boat, and the boat wasn’t sinking. It just wasn’t moving anywhere. When I came in, I said, ‘We still have a boat — we need to start moving the boat, but before we can move it, we have to have enough people to row the oars.’”

As such, recruitment became a priority for Steyer and he successfully recruited four new family medicine physicians. Three will begin their careers at MUSC in September and the fourth in October. “One is coming from the University of Michigan, another from the University of Cincinnati. All are stellar recruits and have significant academic experience.”

For the department, the commitment to ongoing recruitment has been hugely motivating. But the best news, perhaps, is the reopening of an office on the peninsula. Since Sept. 2, Family Medicine again has a home downtown, located on the 10th floor of Rutledge Tower.  Steyer is in awe about the spectacular views the new space affords.

“When you look out at the Ravenel Bridge and the rooftops and church spires of Charleston, it just doesn’t get much better.” In fact, he created a new slogan for the postcards that are going out notifying patients of the additional clinical location: With views this beautiful, you’ll wish your wait for the doctor was longer.  

Dr. Terry Steyer , from left, joins Family Medicine Rutledge Tower team members physcician assistant Peter Dodge and Dr. Alex Chessman.

Another challenge Steyer had to surmount was bringing back former patients. When 295 Calhoun St. closed and the department was relocated to Ellis Oaks on James Island, it lost approximately 30 percent of its patient base: mostly MUSC employees. The Calhoun Street location had been convenient and employees were able to go in during scheduled breaks or on their lunch hours. Further, access had been far more convenient for downtown residents at 295 Calhoun as well. Employees and many downtown residents were unable to make the Ellis Oaks location work for their needs and left the practice.

Opening the Rutledge Tower location was just what the doctor ordered. In addition to the convenience of the site, the department re-launched the Employee Advantage program. When MUSC employees or their family members call in needing to be seen, they are given an appointment for the same day. If they choose rather to walk in, they are worked into the schedule.

Steyer, in a short nine months, has breathed new life into the department and is pleased he returned. In 2009, after having been an assistant — then associate — professor in the Department of Family Medicine for a decade, he accepted the position of chairman of Clinical Sciences at a new medical school in Athens, Georgia. The University of Georgia - Medical College of Georgia Medical Partnership afforded Steyer an opportunity to have a major impact on the maiden program. He worked with the leadership team to design an innovative new curriculum and played a major role in developing the curriculum for third–and fourth–year medical students.

Returning to a beloved city
As the first class graduated, he was offered the position as chairman at MUSC, and he and wife, Kelly, a high-risk Obstetrics nurse, decided the timing was perfect to return to Charleston with their two sons.

Steyer quickly became recognized as a jovial and enthusiastic leader, passionate about family medicine. Patients adore him and describe him as a “wide-open book.” He has a genuine way of connecting with them because he relates to them as people.

“Obviously I need to lose some weight, like everyone in the world does,” he said laughing heartily. “I do biggest loser contests with my patients. Usually around the first of year, I’ll send out an email and tell them to come in and weigh and we’ll do percentage of body weight lost. It motivates them, and honestly, they motivate me. My patients say, ‘Wow, even my doctor struggles with weight.’”

His office is filled with photos of his family and he enjoys sharing both the pictures, as well as the stories behind them, with his patients. He has a way of making them feel comfortable and understood. “I relate to them as people. I know what it’s like to have a child with a chronic illness — my youngest son has juvenile idiopathic arthritis. So I understand them and their apprehension.”

Steyer’s mantra is “Put patients first,” and that attitude pervades everything he does as a physician as well as the direction in which he is steering the department.

“The principle behind family medicine is all about the patient. I couldn’t survive as a physician if I didn’t put the patient first,” he said. “If you constantly think to yourself, ‘What would I want if I were in the patient’s chair?’ you will never make the wrong decision. Some people have an attitude that putting the patient first means doing whatever the patient wants. It doesn’t.

It means doing what’s best for that patient. Putting the patient first means taking care of them.”

He also believes that evidence–based, cost-effective care is superior care. “If you put evidence before cost, you will never
go wrong.” He explained, “For instance, evidence has proved that routine CT scans are not effective in the diagnosis of chronic headaches. Instead, it is both better care for the patient, as well as more cost-effective, to refer the patient to a neurologist instead of putting them through repeated testing.”

A department at the forefront
During his time in Georgia, he was never out of touch with his former colleagues at MUSC, and his respect for the department’s history played a role in his decision to return.

In 1969 family practice became a true specialty. After completing a three-year residency and passing boards, a doctor can then be considered a specialist in family medicine. In 1970, MUSC was on the forefront when it was among the first five in the country to create a university-affiliated family medicine department. Since that time, the department has always remained on the cutting edge, said Steyer.

“In the early 80s, we were literally one of the first in the country to put medical records on computers — far before the dawn of electronic records being introduced. That led to PPRNet, the Primary Care Practice Research network which is one of the oldest practice-based research networks in the country. The PPRNet team pulled together patient information from medical practices around the country to study the aggregated information. Now this is the trend in medicine throughout the world.”

Another source of pride is the fact that Family Medicine was the first department on campus to be awarded a Level 3 Patient–Centered Medical Home status. This is a designation given by the American College of Medical Quality. The department received a perfect score: 100 out of 100 points, on its first submission. Steyer credits Bill Hueston, the former chairman, for being forward thinking, and gives credit to Allison McCutcheon, patient-centered medical home coordinator, for the accomplishment. “She did a great job of making sure we got there,” he said.

When asked what he is most proud of in his short time back at MUSC, he didn’t have to pause to think. “The things I’m most proud of to date are our recruitment and diversity efforts and getting back on the peninsula.”

Of the four new faculty members recruited, three are women, and one is an African-American woman. “I am also excited that one does OB as we haven’t had a physician practicing OB in a long time,” he said. “This allows us to place new emphasis on primary care women’s health.”

He explained of the newest location, “Despite our main office being on James Island, we are again here on the peninsula to serve the needs of people downtown. This is truly home.”  We have to go where the areas of greatest need are and it’s tough for a lot of people downtown to get to Ellis Oaks.”

Not one to rest on any laurels, Steyer and his team are working toward the development of a strategic plan for the department that will define the direction for the next several years.

Two items in particular are high on his list of priorities. First is to develop the patient-centered medical home, neighborhood and system. His initial goal is to ensure that patients understand what it means to have a medical home – a place where a family doctor can provide a “single window clearance” to manage all the health care needs of an individual or family. This model is said to promote a higher level of coordination and communication, and ultimately, a more patient-focused experience.  

By establishing a patient–centered medical neighborhood, in cases when a specialist’s care is needed, Steyer and his team will serve as advocates, helping to coordinate with the specialist and ensuring the patient understands the new information and recommendations. “Family Medicine is home base,” he explained. “But if a patient is suffering with chest pains, you call your neighbor in for help. We’re all part of one big team. ”

Finally, recognizing the importance of a patient–centered medical community is critical to the future of academic health centers. “The health care environment is changing. Government regulations are changing. The needs of the patient are changing. In an ever–evolving industry where expectations at every level have increased, health systems will need to effectively collaborate with other health systems,” he said.

His second priority is population management. The average family medical doctor, according to Steyer, manages 2,100 patients. “We have to continually ask ourselves, ‘How do we manage the care of our population?’” he said. “What are you doing to make sure they are staying healthy? Are they getting their colonoscopies? Are they up to date on their flu and tetanus shots?

Everyone needs a family doc to coordinate their care and to put the ‘care’ in health care.”

Steyer is unequivocal in his support of MUSC. He cannot imagine a patient going anywhere else to receive his or her care. “From the best providers to the latest and greatest technology and research, it’s all here at MUSC,” he said

September 12, 2014



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