UW Health in Appleton Follows Guideline to Help Patients Quit

If UW-CTRI Outreach Specialist Roger Dier could rub a magic lamp and make all Wisconsin clinics handle tobacco treatment like UW Health Fox Valley of Appleton, the state smoking rate would likely decrease.

UW Health asks every patient about smoking status as a vital sign and attempts to treat each person who smokes or chews at every visit. That's a basic textbook recommendation from the U.S. Public Health Service Clinical Practice Guideline. Unfortunately, not all clinics follow it.

But that's why UW Health in Appleton is a super clinic for treating tobacco use among its patients. Nurses ask about quit readiness and document involuntary smoke exposure. Doctors then follow up with advice to quit, relate smoking to current health conditions, offer tips on quitting and prescribe medications such as the patch, gum, Zyban or Chantix. Then they have an option to refer them to the clinic health educator/counselor Shawn Boogaard, who further assists patients with cessation. Boogaard follows up with patients and helps them every step of the way throughout each quitting process.

“I tell them, ‘If this doesn’t work, please come back,’” Boogaard said. “We will find a way to quit smoking. That’s our job.” Boogaard is an excellent example of the advantage of having a tobacco cessation “champion” at a clinic, another standard recommendation.

From Left: Roger Dier provides assistance to Educator/Counselor Shawn Boogaard, Dr. Jessica Johnston and Dr. Drew Villamagna of UW Health Fox Valley Clinic in Appleton.

UW-CTRI works with clinics and systems throughout the state in an effort to offer assistance to every patient who wants to quit smoking. And, while Dier has no magic lamp, he has provided training, materials and technical assistance to clinics like UW Health Fox Valley, which has 7,000 patients. About 23 percent of patients at UW Health Fox Valley smoke. Eighteen residents and four to six attending physicians handle more than 20,000 visits a year. More than 90 percent of patient visits are accurately charted for tobacco status, demonstrating a commitment to excellence.

Dr. Jessica Johnston has helped many patients quit with wit, passion and verve. She treated a 40-year-old man after his routine physical revealed lung damage from smoking. He was impressed that she could tell he smoked from a routine exam. He listened when she told him he could recover from much of the damage. He quit.

Johnston said she looks at tobacco treatment as part of her job to help her patients be as healthy as possible, not a burden. “You should never say you didn’t have time,” she said. “You just didn’t prioritize. This is a priority.”  In fact, she enjoys relating cigarette damage to teens. “I tell them their teeth will stain,” she said.

Dr. Drew Villamagna agrees. He runs the Framingham calculator in his hand-held data device to show patients their 10-year risk for coronary heart disease. That usually encourages patients to quit smoking. “If I’ve gotten one patient to quit,” Villamagna said, “then as a family physician, I feel I’ve done the best I can do for that patient’s preventive care.”