Susan came to LMG Family Medicine to provide additional Nurse Case Management to those patients who need the extra help of understanding their health and disease. Susan has been following those extra patients weekly by calling them and asking them how they are doing, making sure they are taking their medicines correctly, checking on their blood pressure readings, and etc. She has done a tremendous job with our clinic and we have noticed a decreased amount of patients being confused about their health and decrease in concerned phone calls. They know that Susan will call them and they will be able to ask her at their next conversation.

Susan's panel has been growing day by day since her start here, but through all the difficulties, she continues to have a smile on her face and takes on the responsibilities. Susan comes around and chats with each and every one of us to see how things are going and whether there have been any concerns. She also communicates with providers and MA's regarding the status of our patients.

Susan exceeded our expectations and not only has it helped our providers out, she took a step forward for our future changes for Medical Home which consists of 8 themes: Critical Thinking, Active Part of Patient's Care Team, Quality of Care, Patient Experience, Health Literacy, Communication, Health Maintenance, and most of all: Chronic Disease Management.