Bridging the Healthcare Generation Gapmed.und.edu/nd-medicine/_files/docs/spring-2015.pdf ·...

Bridging the HealthcareGeneration GapParkinson’s Disease Research

Brushing Up on Dental Care in North Dakota

Rural Surgery Support Program

Bridging the HealthcareGeneration GapParkinson’s Disease Research

Brushing Up on Dental Care in North Dakota

Rural Surgery Support Program

Spring 2015VOLUME 40, NUMBER 1

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2 NORTH DAKOTA MEDICINE Spring 20152 NORTH DAKOTA MEDICINE Spring 2015

NORTH DAKOTA MEDICINE Spring 2015 3

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POSTMASTER: Send address corrections to:ND Medicine Address Correction UND School of Medicine and Health SciencesOffice of Alumni and Community Relations, Attn: Kristen Peterson501 North Columbia Rd. Stop 9037, Grand Forks, ND 58202-9037 E-mail: [email protected]: 701-777-4305

NORTH DAKOTA MEDICINE is available online at www.ndmedicine.org

UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE AND HEALTH SCIENCES

ROBERT O. KELLEY, President, University of North Dakota

JOSHUA WYNNE, Vice President for Health Affairs and Dean, School of Medicine and Health Sciences

EDITOR Denis MacLeodWRITERS Morgan Goulding, Alyssa Konickson, Stacy Kusler, Claire Lenard, Lonnie Laffen, Denis MacLeod, Nikki Massmann, Dave Miedema, Juan Pedraza, Jessica SobolikCONTRIBUTORS Kristen PetersonGRAPHIC DESIGN Laura Cory, John Lee, Victoria Swift PHOTOGRAPHY Nicole Pape, Wanda Weber

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FEATURESBridging the Healthcare Generation Gap 10 The founding chairs of new departments at the SMHS will work to

improve and extend care to all people and across all generations inNorth Dakota.

Parkinson’s Disease Research 14 An old technology may be the means to a new treatment to help

alleviate one of the unseen effects of the disease.

Brushing Up on Dental Care in North Dakota 20 The Center for Rural Health makes recommendations based on a study of ways to improve North Dakotans’ oral health.

Rural Surgery Support Program 30 This novel SMHS program serves as a national model in providing

surgical care to rural patients.

DEPARTMENTS Dean’s Letter 4 News Briefs 6 Building Progress - Lonnie Laffen 16 Workforce 17 Student Profile - Marc Granrud 22 Alumni Profile - Glenn Thoreson 24 Alumni Notes 27 In Memoriam 28 Philanthropy 32 Parting Shots 34

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4 NORTH DAKOTA MEDICINE Spring 2015

My “Dean’s Letter” in the last edition ofNorth Dakota Medicine (Holiday 2014)stressed the importance of philanthropy inreducing educational debt, which can besubstantial for medical, graduate, andhealth sciences students. Mitigatingstudent debt is the School’s highestphilanthropic priority. Other benefits ofenhanced giving include supportingnamed professorships and endowed chairsthat are of great help as we compete forfaculty recruits on a national stage;additionally, other philanthropic dollarsare directed at programmatic support andprogram development. So how are wedoing in growing the School’sphilanthropic giving base? Actually, we aremaking good progress. One of the moregratifying recentmanifestations of this isthe fall—that is, theimprovement—in theSchool’s percentileranking of averagemedical student debtwhen compared withother medical schools. Inone short year, thecumulative debt of our medical studentsplummeted from the 75th percentile to the50th; that is, the debt burden of ourstudents was as much or more than thedebt level at 75 percent of the medicalschools in the United States, and itimproved so that it currently is the same orless than that at half the schools. And weaim to do better. This impressiveimprovement is substantially the result ofan increase in scholarships awarded by theSchool made possible by increased givingby our generous benefactors. Philanthropy also has helped usrecruit several top-notch educators andresearchers to the School. Jau-Shin Lou,MD, PhD, MBA, a prominent neurologist,was named the founding chair of the Dr.Roger Gilbertson Endowed Chair ofNeurology at the University of North

Dakota School of Medicine and HealthSciences, and joined us about a year ago.Dr. Lou came to us from the Departmentof Neurology at the Oregon Health andScience University School of Medicine.And joining us this year is Donald Jurivich,DO, who has been named the foundingEva L. Gilbertson, MD, DistinguishedChair of Geriatrics at the University ofNorth Dakota School of Medicine andHealth Sciences. He is a nationally knownand respected clinician who has conductedextensive research on aging and age-relateddiseases and their treatment. Since 1997,Don was the Vitoux Endowed Chair andAssociate Professor of Geriatric Medicineas well as chief of the Division of GeriatricMedicine at the University of Illinois

College of Medicine at Chicago.He also was chief of GeriatricMedicine at the Jesse BrownVeterans Affairs MedicalCenter in Chicago. And it is apleasure to announce therecruitment of Gary Schwartz,PhD, MPH, PhD, to head theSchool’s new Department ofPopulation Health.

It is with mixed emotions I announcethe retirements of Drs. Julie Blehm andWilliam Newman. Why mixed emotions?Because I and the School will miss themany talents and contributions of Julie andBill, while at the same time I respect theirdecisions to do what they really want to doin the next phases of their lives. Dr. Blehmhas served as the School’s Southeast(Fargo) Campus dean since October 2007.She learned medicine at the SMHS,provided superior care for countlesspatients through her many years ofdedicated practice, and was honored tohave the privilege and pleasure ofconveying to students and residents thehealing art and science of medicine. Dr. Newman has functioned asassistant dean for Veterans Affairs sinceJuly of 1998 as well as professor and chair

DEAN’S LETTER

Philanthropy and

Mitigating student debt isthe School’s highest

philanthropic priority.“

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Public Supportof the Department of Internal Medicinesince November 2003. He has decided toretire from those positions so that he candevote all of his time to patient care, toteach UND SMHS students and residents,as well as to conduct clinical researchprojects at the Veterans Affairs MedicalCenter in Fargo. We realize that you never can replacethe talent of these two valued facultymembers and leaders, but the School hassearches underway to identify individualswho can apply their unique abilities inassuming the positions. And while philanthropy is criticallyimportant as a major component of ourrecruitment strategy, the bedrock of theSchool’s overall financial underpinnings isthe strong support we get from the peopleof North Dakota (mainly throughlegislatively directed appropriated dollarsand to a limited degree from a one-millproperty tax levy). We derive about a thirdof our annual budget of $100 million fromstate support; that is a higher fraction thanalmost any other medical school in theUnited States. So we follow thedevelopments in the current 64thLegislative Assembly closely, since we areso critically dependent on state support.And while we won’t know the final, officialbudget numbers until May, thus far we arevery pleased with how things are progressing.The Healthcare Workforce Initiativecontinues to be fully funded at the levelthat we have requested. Importantly, theamount of funding that we requested forthe upcoming biennium is exactly what wesaid we’d need when we first proposed itduring the last legislative session.Assuming that there are no surprisescoming down the road, we continue to begratified by the extraordinary level ofsupport that the Legislature hasdemonstrated. The School’s leadershipteam works hard each and every day tojustify the phenomenal confidence that theLegislature has vested in us.

Perhaps the most dramaticmanifestation of that confidence andsupport is the new SMHS building thatrapidly is rising at the corner of NorthColumbia Road and Gateway Drive inGrand Forks. We now are a mere year awayfrom the opening of the building, and theproject continues to be on time—and onbudget! PCL Construction, ourconstruction manager at risk, puts apriority on worksite safety, and we’ve nowgone over 100,000 worker-hours without asingle lost day from employee injury.That—along with the project being ontime and on budget—are remarkableaccomplishments. But the real payoff willoccur when we start using the building andreaping the benefits of the many state-of-the-art features that have beenincorporated into the new facility. It’sgoing to be fantastic!

Joshua Wynne, MD, MBA, MPHUND Vice President for Health Affairs and Dean

”

“The bedrock of the

School’s overall financialunderpinnings is the strong support we get

from the people of North Dakota.


University of North Dakota scientists warn that all of thevariables for contracting Lyme disease are now present andestablished in Grand Forks County. Although eastern NorthDakota borders Minnesota counties where the risk ofcontracting the tick-borne Lyme disease is moderate to highbased on confirmed human cases, few studies have been doneon the migration of the disease farther west. Lyme disease is the most common tick-borne illness ofhumans in the United States, causing an estimated 300,000 casesper year. Lyme disease is a debilitating and significant publichealth problem that can result in arthritis, heart problems, andneurological impairment and disability. While Lyme disease canbe treated effectively with antibiotics, some people continue tosuffer with pain, fatigue, and memory problems called post-treatment Lyme disease syndrome.

Now, a joint research team, led byProfessor Jefferson Vaughan, PhD, fromthe UND Department of Biology, andAssistant Professor Catherine Brissette,PhD, a biomedical scientist in theDepartment of Basic Sciences at theUniversity of North Dakota School ofMedicine and Health Sciences, reportsthey have verified that Lyme disease hasspread to Grand Forks County.Brissette’s laboratory works on thecausative agent of Lyme disease, the bacterium Borrelia burgdorferi.The full article is available at http://tinyurl.com/m6kewgc.

UND scientists prove Lyme disease is in Grand Forks County

NEWS BRIEFS

A total of $371,705 in scholarships has been awarded to 135medical students at the University of North Dakota School ofMedicine and Health Sciences for the 2014–2015 academic year.Funds for the scholarships come from various private sources,endowments and scholarship funds. For a complete list of scholarship recipients and theirscholarships, please read more online athttp://tinyurl.com/n3mpmjk.

Catherine Brissette

UND medical students receivescholarships for 2014–2015

The Annual Civic Engagement Awards were presented at theStone Soup Awards Program and Reception hosted by theCenter for Community Engagement on November 20 at theGorecki Alumni Center. The awards recognize excellence incommunity partnerships, service learning, and community-based research. The Department of Occupational Therapy received theEngaged Department Award. The award recognized thepartnership role Occupational Therapy (OT) participated inwith Global Friends Coalition, a local nonprofit helping newAmericans in the Greater Grand Forks Community. OTstudents helped with job-readiness skills. In keeping with thegoal of OT, students helped new Americans in other valuedoccupations such as home management, cooking, shopping,participating in the community, accessing the library, andbecoming an active part of the Grand Forks community. The Department of Occupational Therapy started theireffort last spring through the Department’s OT 451Multicultural Competency course that was taught by AssociateProfessor and Chair Janet S. Jedlicka, PhD, OTR/L, FAOTA; and

Associate Professor LaVonne Fox, PhD, OTR/L. The work ofstudents in the course was further expanded by AssistantProfessor Sarah Nielsen, PhD, OTR/L; Associate Professor DebHanson, PhD, OTR/L; Instructor Cherie Graves, MOT, OTR/L;and Dr. Fox to serve as a level I fieldwork site for the program’scurriculum. In August of 2014, Global Friends Coalition andthe Occupational Therapy Department entered into a clinicalaffiliation agreement. Developing the agreement took a teameffort on the part of the OT faculty. The experience workingwith new Americans has helped students develop moreconfidence and the ability to adapt interventions to moreeffectively work with clients from various cultures. Cynthia Shabb, executive director of the Global FriendsCoalition wrote the nomination letter. Occupational therapy isabout preventing “occupational deprivation.” Many newAmericans are deprived of the work or career or job that theyonce knew in their own countries. According to Shabb, “OTstudents help to ease the transition so that new Americans cangain the skills they need to thrive.”

Department of Occupational Therapy garners Community Engagement Award


NEWS BRIEFS

In a time of reduced research funding, the National Institutes ofHealth granted $1.45 million to Chester Fritz DistinguishedProfessor Jonathan Geiger, PhD, and his colleague andcollaborator Assistant Professor Xuesong Chen, MD, PhD, inthe Department of Basic Sciences at the University of NorthDakota School of Medicine and Health Sciences. This is thesecond, five-year R01 grant—the NIH’s top-ranking—awardedto Geiger and Chen in the last half of 2014. The grant from theNIH’s National Institute of Mental Health funds research onnovel mechanisms that regulate intracellular levels of calciumand how drugs used to treat HIV-1 infection affect these levelsof calcium and interact with HIV-1 proteins to affect themechanisms that control the levels of calcium inside of neurons. In August 2014, the Geiger and Chen laboratory received a$1.6 million 5-year NIH R01 grant for similar work that wasfocused on the effects of HIV-1 proteins on intraneuronalcalcium control mechanisms. The novelty of both applicationswas recognized by the NIH grant review study sectionmembers. Geiger and Chen’s unique insights and approachesresulted in their receiving these two R01 grants in one year. “This is a huge achievement because it is so hard to get evenone NIH R01 grant, let alone two,” said Malak Kotb, PhD, thechair of the Department of Basic Sciences at the UND SMHS. A part of the U.S. Department of Health and HumanServices, the NIH is the nation’s medical research agency. The

NIH is the largest source of funding formedical research in the world. Themission of the NIH is to seekfundamental knowledge about thenature and behavior of living systemsand the application of that knowledgeto enhance health, lengthen life, andreduce illness and disability.

“This further distinguishes Drs.Geiger and Chen from most otherresearchers because only the top 10percent of grants are currently beingfunded by the NIH,” said JoshuaWynne, MD, MBA, MPH, UND vicepresident for health affairs and dean ofthe UND School of Medicine andHealth Sciences. “To receive two suchgrants probably puts them in the top 2percent nationally.”

Geiger and Chen are currently theonly faculty members at UND that holdtwo NIH R01 grants.

The full article is available online at http://tinyurl.com/pq5753v.

UND scientists garner second top-level NIH grant to study HIV-1/AIDS neurological complications

Jonathan Geiger

Xuesong Chen

Thirty-three health professionals beganthe clinical portion of their studies inJanuary to earn the Master of PhysicianAssistant Studies degree at theUniversity of North Dakota School ofMedicine and Health Sciences.

The White Coat Ceremony was heldon Friday, Jan. 16, in the Reed T. KellerAuditorium at the UND School ofMedicine and Health Sciences. KateLarson, PA-C, presented the keynote

address, focusing on the role of the physician assistant inprimary care. Larson, a UND PA alumna of the Class of 1995, isa practicing primary care physician assistant in Garrison,N.Dak. She also serves as treasurer for the North Dakota Boardof Medical Examiners. Welcome remarks were given by SMHSSenior Associate Dean for Education Gwen W. Halaas, MD,MBA; and Wayne Swisher, PhD, interim dean of the UNDSchool of Graduate Studies. “The presentation of the white coat is symbolic of the newprofession the students are entering,” said Department ChairJeanie McHugo, PhD. The coats will be worn by studentsthrough the clinical phase of their training and denote theirinvolvement with the Physician Assistant Program at UND. The individuals in this class come from a wide variety of

professional healthcare disciplines, which through classinteraction will strengthen each student’s ability to return to his orher rural clinical site as a well-rounded primary care provider. The PA Program admits health professionals who haveyears of experience working as nurses, respiratory therapists,radiology technologists, paramedics, military healthcareproviders and related professions. This group averages nineyears of previous professional healthcare experience uponmatriculation into the program. Enrolled students come from throughout the United States,from Idaho to Florida, but this particular class is very regional,with almost 50 percent of the students from the tristate area ofNorth Dakota, South Dakota and Minnesota. Students range inage from 26 to 52 years, with an average age of 35; the classincludes 18 men and 15 women. The students have completed their first two semesters ofbasic sciences and spent their first four weeks in Grand Forksbefore returning to their home communities, where most oftheir training will take place under the supervision of physicianand physician assistant preceptors. Over the next 18 months,they will return to UND for several weeks at different juncturesfor education and training. For a list of students and their hometowns, please read thefull article online at http://tinyurl.com/n9b7tnw.

UND Physician Assistant Program presented new class with white coats

Jeanie McHugo


NEWS BRIEFS

Associate Professor Scott Garrett, PhD,in the Department of Pathology, wasrecently chosen to be the editor of theAmericas and Japan for thejournal Toxicology Letters, published byElsevier. This journal has a total of threeco-editors-in-chief, handles over 1,000submissions, publishes just over 300papers per year, has an Impact Factor of3.355, and is the official journal ofEUROTOX (Federation of European

Toxicologists & European Societies of Toxicology). Toxicology Letters serves as a multidisciplinary forum forresearch in toxicology, an aspect of Garrett’s research thatinvolves the toxicology of arsenic and cadmium. The journal’saudience consists of toxicologists, pharmacologists, cancerresearchers, and epidemiologists. The prime aim is the rapidpublication of research studies that are novel and advance theunderstanding of a broad range of topics in toxicology fromclinical, occupational, and safety evaluation to legal, risk, andhazard assessment, with an enhanced focus on mechanisms ofmammalian toxicology. The journal also publishes mini-reviews,editorials, commentaries, and contemporary issues in toxicology.

Scott Garrett

Garrett new editor of the Americas andJapan for Toxicology Letters

The Bush Foundation’sNative Nation RebuildersProgram named itsRebuilders for 2015. ChelseyLuger of Grand Forks wasnamed among theseRebuilders. Luger is aproject coordinator for theSeven Generations Center ofExcellence within the Centerfor Rural Health at theUniversity of North DakotaSchool of Medicine andHealth Sciences.

Each year, the BushFoundation selects a cohortof approximately 30Rebuilders to participate in a

two-year program. This is the sixth cohort of Rebuilders. In thefirst year, the Bush Foundation and its partner, the Native

Nations Institute, provide access to ideas and information,expanded networks, leadership training, and other resources fornation building. In the second year, Rebuilders use the tools andskills to implement action plans in which they engage inpractical nation-building projects within their communities.Rebuilders are chosen through a selection committee composedof individuals with expertise in nation building. The committeeevaluates each Rebuilder candidate according to his or hercommitment to Native self-governance, knowledge of the issuesfacing his or her nation, and potential to help his or her nation. Luger is an advocate for indigenous health and wellness.She is Ojibwe (Turtle Mountain Band of Chippewa) and Lakota(Standing Rock Sioux Tribe and Cheyenne River Sioux Tribe).Luger grew up in Fort Yates and Grand Forks, North Dakota.She has a BA in Native American studies and history fromDartmouth College, and her master’s in journalism fromColumbia University. She is currently working on designing aninformation source and online community for young Nativepeople who are committed to decolonizing foods andindigenizing fitness.

Chelsey Luger named Native Nation Rebuilder

Chelsey Luger

All students in Grades Five and Six are invited to “Science Day” on Saturday, May 2, at the University of North Dakota School of Medicine and Health Sciences in Grand Forks. The free event features hands-on learning experiences organized by medical students. Science Day isdesigned to stimulate children’s interest in science. Children willconduct science projects and learn about human anatomy andvarious health issues, such as the dangers of tobacco use, amongother topics. Two sessions, morning (9 a.m.–noon) and afternoon (1–4p.m.) will be offered. The event is FREE. Parents are welcome, but they are notrequired to attend since medical students supervise all events.For more information and a registration form, visithttp://med.und.edu/events/science-day.pdf or call (701) 777-4305.

Children in Grades Five and Six invited toparticipate in Science Day at UND Schoolof Medicine and Health Sciences


NEWS BRIEFS

UND Master of Public Health studentsreceive training awards

Three University of North Dakota Master of Public Healthstudents received stipend awards from the Rocky MountainPublic Health Training Center for projects they will becompleting this spring. The MPH Program is part of the UNDSchool of Medicine and Health Sciences. Each of the students received a stipend of $1,500 thatsupports field placements and collaborative learning projects.The UND students, among 20 from several other colleges in theregion, were selected because they proposed projects in ruralareas, work with underserved populations, or work to supporttribal health on a reservation or urban Indian health. Studentsreceive an initial $1,000 and the remaining $500 in July,following the submission of a brief final report describing theirfield placement. The UND recipients are the following students: Michael Dulitz, from Webster, S.Dak., will organize andhelp with cooperative learning and sharing sessions to assistwith the implementation of electronic health records in theeight local public health units that make up the Northeast NorthDakota Public Health Collaboration. Gaurav Mehta, a physician from Mumbai, India, will beperforming clinical outcomes research with data from NativeAmericans regarding vascular surgery and amputation rates. Kalee Werner, from Bismarck, N.Dak., will be implementingan exercise and diet intervention among pregnant women inGrand Forks. The full article is available online athttp://tinyurl.com/po2obgx.

Kalee Werner, Michael Dulitz, and Gaurav Mehta

Beverly Johnson, PT, DSc, GCS,CEEAA, was recently appointed to theCommission on Accreditation inPhysical Therapy Education (CAPTE)Physical Therapy Panel. Johnson isassistant director of clinical educationand an associate professor in theDepartment of Physical Therapy at theUniversity of North Dakota School ofMedicine and Health Sciences.

The Commission on Accreditationin Physical Therapy Education is an accrediting agency that isnationally recognized by the U.S. Department of Education andthe Council for Higher Education Accreditation. CAPTE grantsspecialized accreditation status to qualified entry-leveleducation programs for physical therapists and physicaltherapist assistants. Johnson serves on the PT Panel as the academicadministrator. The commission is a group of 31 individuals withvaried backgrounds who are charged with determining whethera program meets the standards of quality in physical therapyeducation, developing the evaluative criteria for quality, andsetting policy and procedure for the physical therapyaccreditation process. Members of the commission must haveserved as on-site reviewers to be eligible for appointment.Johnson has been an on-site visitor for physical therapistprograms since 1997. As a commissioner, Johnson reviews physical therapyeducation programs to assure the programs meet qualityeducation standards developed by the commission. “Dr. Johnson is recognized nationally as a leader in physicaltherapy clinical education,” said David Relling, PT, PhD,associate professor of physical therapy and chair of theDepartment of Physical Therapy at the UND School ofMedicine and Health Sciences. “As a member of on-site reviewteams, Bev visited developing and established physical therapyprograms. She employed substantial knowledge and skill inevaluating program policies, clinical experiences, and coursecontent. Appointment to the commission is a great honor,recognizing Dr. Johnson’s dedicated and exceptional serviceto CAPTE and the physical therapy profession.”

Johnson appointed to national physical therapy commission

Beverly Johnson


Bridging the Healthcare


Generation Gaponald Jurivich, DO, the recently named founding

Eva L. Gilbertson, MD, Distinguished Chair of Geriatrics at the University of North Dakota School

of Medicine and Health Sciences, is an avid reader—when hefinds the time. Quoting American poet T. S. Eliot and adjusting his tie forthe photographer, the nationally known clinician and expert onthe elderly chats easily about his vision for his new job in abrand new department at the SMHS. “The key to an effective geriatric program is wide diversityof expertise,” said Jurivich. “You may even include, perhaps, apediatrician, because of the aspects of grandparenting. Suchpartnerships are far-reaching in their contributions to the careof an older adult.” Jurivich recollects a recent casewhere two social workers notified himabout one of his senior citizen patientswho was in crisis. “They were part of a team thatcomanaged his case, and they alerted methat time,” he said. “Good teamwork likethat is what really makes healthcareclick—it’s all evidence-based, but it’scoming from people who really care and who are advocates for older patients.The point is to improve outcomes, and in the elderly, that means improvingoverall function.” The challenge Jurivich see as ageriatrician is to encourage healthcaresystems to take note of and care for older patients. “I’ve seen many changes in geriatric care,” Jurivich said. “It’sa mosaic of wins and losses, with creative programs in somehospital systems, but regression in others.” For example, a big metro health system may focus onpatients with commercial insurance rather than Medicare—sothey de-emphasize the older adult population, even though thepopulation in their area is aging. Some other institution mayfocus on organ transplant patients and therefore doesn’t put anyof its resources into geriatric care. However, some systemsprovide excellent geriatric care, supporting a broad range ofprograms that attend to the needs of older patients. Jurivich would like to see geriatric medicine fully integratedinto the healthcare system. He cites PACE (Program of AllInclusive Care of the Elderly), a federal program of all-inclusivecare for geriatric patients under both Medicare and Medicaid (itworks on a state-by-state basis, as locally approved), as anexcellent example.

“It’s an effective social-support medical model mergedtogether,” Jurivich said. “PACE programs thrive where there isgood community support.” Jurivich plans to teach. “I’m looking to establish a new geriatric course for medicalstudents,” he said. “One of the draws of the SMHS was its strongprimary care footprint; that is where geriatrics needs to be, andI want to encourage the building of geriatric skills andknowledge among primary care practitioners. This also willencourage interdisciplinary team dynamics among physiciansand other healthcare professionals.” Jurivich plans to travel the state, visiting UND familypractice centers and other healthcare facilities, to spread theword about UND’s new geriatric program.

Before joining UND, Jurivich held anendowed chair at the University of IllinoisCollege of Medicine at Chicago; he alsowas chief of geriatric medicine at a VAcenter in Chicago. He has conductedextensive research on aging and age-related diseases and their treatment formany years

“Because North Dakota has above-average life expectancy, we are fortunateto have proportionately more seniorcitizens and elders than comparablestates,” said Joshua Wynne, MD, MBA,MPH, UND vice president for healthaffairs and dean of the UND School ofMedicine and Health Sciences. “The

recruitment of a national leader like Dr. Jurivich to lead theSchool’s geriatric program will help ensure that the caredelivered in North Dakota will be the most advanced. He willplay a critical role in shaping the future of healthcare delivery tothe elderly in North Dakota.” While earning his bachelor’s degree in biology at HarvardUniversity, Jurivich was the founder of the school’s women’strack and field team at a time when opportunities were scarcefor women collegiate athletes. He has consistently supporteduniversity programs for mentoring women in their academicjourney to become senior faculty members. Jurivich earned hisosteopathic medicine doctorate from the MidwesternUniversity, Chicago College of Osteopathic Medicine. Hisresidency training was completed in internal medicine at RushMedical Center in Chicago and the Duke University MedicalCenter in Durham, N.C., where he also completed a fellowshipin geriatric medicine. Jurivich is a Diplomate in GeriatricMedicine, which he earned from the American Board of

DThe founding chairs of new departments at the SMHS will work to improveand extend care to all people and across all generations in North Dakota.

By Juan Pedraza

“

”

One of the draws of the SMHS wasits strong primary care footprint;

that is where geriatrics needs to be,and I want to encourage

the building of geriatric skills and knowledge among

primary care practitioners.


Donald Jurivich

Internal Medicine. The Eva L. Gilbertson, MD,Distinguished Chair in Geriatrics wasestablished through a generous investmentby the Dr. Eva L. Gilbertson Foundation tosupport education and research in the fieldof geriatrics. Eva Gilbertson earned herBachelor of Science in Medicine from theUND School of Medicine in 1939. Sheobtained her medical degree from TempleUniversity in 1941. Gilbertson grew up ona small farm near Maddock, N.Dak. Shewas the only woman in her medical class atUND, the first woman to complete theradiology residency program at MayoClinic, and upon her graduation, the firstfemale radiologist in the state ofWashington. She passed away in 2007.

Gary Schwartz, PhD, MPH, PhDHow are African Americans like Norwegians? That’s the kind of question that GarySchwartz, the newly appointed chair ofPopulation Health at the UND School ofMedicine and Health Sciences, aims to ask. “There are lots of answers floatingaround out there—what we don’t haveenough of are useful questions,” saidSchwartz, who started out his research careerwith a PhD in neuroscience studyingmonkeys. “Yes, I was a monkey psychologist.” But his driving curiosity about theright questions led him into the muchbroader field of inquiry, including a Masterof Public Health degree and anotherPhD—this one in epidemiology. To answer the first question, let’s seewhat Schwartz, also an expert in prostatecancer, observed about Norwegians andAfrican Americans. “The highest rate of prostate cancer isamong African Americans, then amongNorwegians,” said Schwartz, who likes toquote cultural figures such as British folksinger Sandy Denny and Spanish poetAntonio Machado. “As an epidemiologist, I understoodthat a lot of what I do is a kind of reverseengineering,” Schwartz said. “So what’s thequestion in this case? How are AfricanAmerican men similar to Norwegian men?They don’t look alike, they don’t have thesame genetics—but somehow they must bealike. The answer—both have very lowlevels of vitamin D.” Schwartz explains: African Americanshave low vitamin D because black skin sucksup ultraviolet light, and African Americanshave half the circulating vitamin D as whites.Norwegians have low levels of vitamin Dbecause of the latitude where they live. “You might say that African Americansare Norwegians all year long,” Schwartzsaid. “The world is full of answers—whatwe need are the right questions.” Population health is like that, Schwartzexplains. It’s not about the pathophysiologyof individual diseases, or, stated anotherway, how errors occur in an individual. “To use an analogy, it’s not about howstructural damage in a car leads to anaccident, it’s about why drivers fall asleep atthe wheel,” Schwartz said. “Epidemiology—population health—is about asking why


questions across populations instead ofhow questions about individuals.” The textbook definition ofepidemiology runs along these lines: it’s thestudy of the distribution and determinantsof disease frequency in populations. “Epidemiology often is seen as thebasic science of public health,” said Schwartz,who also has researched the occurrence ofovarian cancer. “It’s a huge universe ofspecialties, from analysts to people whoimplement effective health interventions inorder to improve disease outcomes.” Schwartz, who has patented a coupleof cancer screening tests, said he’ll also beworking with medical students. And when prompted for his visionabout his new job, he said, paraphrasing afamous Machado line, “Ask me in a coupleof years where we’ve been, and I’ll tell you

what my vision was.” Schwartz’s research interest involvesepidemiologic and translational studies(studies of screening and therapeutic trials)concerning the roles of vitamin D andrelated calcium-controlling hormones inthe natural history of prostate cancer. Hisother interests include the investigation ofcancers of unknown etiology (testicularand pancreatic cancer). Schwartz will work collaborativelywith faculty and institutional leaders tolaunch the Department of PopulationHealth and to develop and provideoversight of the department’s programs ineducation, research, training, and service.As chair, he will work with the SMHS’ssenior leadership team in helping to shapea population-based approach tohealthcare delivery to North Dakotans.

”

“Ask me in a couple of years

where we’ve been, and I’ll tell you what

my vision was.

Gary G. Schwartz


Parkinson’s Disease ResearchAn old technology may be the means to a new treatment to help alleviate one of the unseen effects of the disease.

A small medical device with a sci-fi name to match: transcranial direct current stimulation. But this relatively simple technology—a hundred years old at least—is the latestproposed therapy to treat the “cognitivefatigue” in patients with Parkinson’sdisease. It promises to improve the mentalfunctioning of Parkinson’s sufferers whooften must cope with significantimpairment of mental functions such aslearning and memory. “We’re ready to undertaketranslational research with thistechnology,” said Jau-Shin Lou, MD, PhD,MBA, the founding Dr. Roger GilbertsonEndowed Chair of Neurology at the UNDSchool of Medicine and Health Sciences,director of the School’s clinical neurologyprogram, and a neurologist with SanfordHealth in Fargo. If proved effective—and Lou, who hasbeen studying Parkinson’s for much of hiscombined clinical and research career, isconfident it will—this technique willsignificantly improve the quality of life ofpatients with Parkinson’s, aneurodegenerative disease that affectsabout 1 million people in this country,with 60,000 new cases diagnosed annually. “This is translational research becauseI’ve already laid the groundwork in earlierresearch in Oregon,” said Lou, who came toUND about a year ago. “This technologyapplies a very low current right into thebrain—it’s well-behaved electricity, notshock therapy, which can be very painful.” Another advantage of this proposedParkinson’s therapy is that it can be stackedon top of drug therapies used to treat theother major manifestation of the disease:motor control issues such as tremors. “The beauty of this treatment is thatit’s very portable, about the size of a smallcamera; patients will be able to take thistechnology home with them,” Lou said. Lou and his team are undertaking this

research because not much has been donebefore to address treatment for cognitiveimpairment in Parkinson’s. “The cognitive impairment inParkinson’s patients is at least as much of aproblem as motor impairment, so we reallyneed to address this issue,” Lou said. There’s no question about the safety ofthe transcranial direct current stimulation:it’s already been approved by the Food andDrug Administration to treat patients withdepression as an alternative to expensivedrug therapies that all too often carrymany unwanted side effects. “The reason it’s safe is the current isgenerated by a 12-volt system delivering 1milliamp of current; the patient feels a littlebuzz when it’s turned on, then nothing,” Lousaid. “It basically nudges the modulation ofthe brain’s own electrical pattern.” If it proves effective in the clinicalresearch that Lou is planning, then he’llmake sure that clinicians across the state gettraining to use the device. He wants to getthe community involved, too, by announcingthe clinical trial and recruiting volunteersto engage in the research process. It will be a randomized trial, with halfthe Parkinson’s patients getting the devicewith live current, and half getting thedevice with the current turned off. Lou notes that, as with any research,there are two fundamental but distinctlydifferent steps: framing the researchquestion appropriately—the aim is to get auseful outcome—and getting the money tocarry out the research. “And what we’re focusing on with thisproposed research project is cognitivefatigue in patients with Parkinson’s,” Lou said.“Mostly, we think about motion impairment,such as shaking, tremulous hands, walkingslowly—that’s what we can see. But whatwe can’t see is the cognitive impairment.Many Parkinson’s patients can’t focus.They have very short attention spans. Theydon’t sleep well. They can’t read a paper

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The beauty of this treatment is that it’s

very portable . . . .

By Juan Pedraza


Jau-Shin Lou

through. Their minds wander.” This happens really early on, and oftenby the time a patient is diagnosed withParkinson’s, their attention span already isaffected by the disease. “For example, I ask you to payattention to me, to repeat a five digitnumber to me, and you won’t have troubledoing that; however, a Parkinson’s patientwill have trouble with that because theyjust cannot concentrate,” Lou said. So a Parkinson’s patient can listen toyou, but after a while, they tune it outbecause they can no longer concentrate onwhat you’re saying. In effect, Lou notes, cognitive fatigueis a mental capacity decline. “This has not been adequatelyaddressed in the Parkinson’s literature,” hesaid. “The major challenge today:pharmacological interventions usingseveral commonly prescribed treatmentsto alleviate tremors have the unfortunateside effect of exacerbating mentalslowdown in some Parkinson’s patients.” However, he adds, “Patients persist inthe treatment because they want to controlthe tremors, which embarrass them.” It’s a catch-22 that Lou aims toeliminate with his transcranial directcurrent stimulation therapy.

$1 million boost“That’s why I and my team decided topursue this research—and we have beenvery fortunate to have an anonymousdonor who gave us a $1 millionendowment to pursue this line of researchat our Parkinson’s Center at Sanford—Fargo,” Lou said. “We were very happy to get that gift,”he said. “I started talking with the donor thefirst month that I got here to North Dakota.The gift was announced right beforeChristmas 2014. We are very excited becausenow we have the patient population andthe endowment, so we can proceed withthis research and collect the pilot data.” The goal then is to get federal researchfunding to do more extensive research. Lou earned his medical doctorate fromthe National Taiwan University MedicalSchool in Taipei, Taiwan. He completed hisresidency training in neurology at theBaylor College of Medicine in Houston,

and he completed a fellowship in motorcontrol at the National Institute ofNeurological Disorders and Stroke inBethesda, Md. His PhD in Neurophysiology is fromthe University of Minnesota. His researchand scholarly interests are fatigueassociated with Parkinson’s disease. He also holds a Master of BusinessAdministration in HealthcareManagement from the joint MBA programof Portland State University and OregonHealth Science University.


BUILDING PROGRESS

Ty Pritchard (left) and Craig Martinwith JLG Architects review construction progress on an iPad.

Nearing the Second YearConstruction progresses as planned as year two approaches.

As we near the second year of planning,design, and construction work on the newSchool of Medicine and Health Sciencesbuilding, I am pleased to report the following:

● The project isand will remainon budget.

● Work is twoweeks ahead ofschedule, andslated to openJuly 2016.

● Over 200,000sq. ft. ofconstructionhas beencompleted,which isroughly the sizeof 18 hockey

rinks (an appropriate comparison nowthat Grand Forks has been namedAmerica’s Best Hockey Town bySmartAsset.com).

● Over 100,000 worker hours ofconstruction time have been loggedwithout a lost-time incident.

● Over 200 North Dakotans have beenpassionately involved with the project.

Since I last wrote, the three maintowers have been poured, allowing interiorframing, mechanical, electrical, andplumbing work to occur. On the EastTower, exterior masonry on the first levelhas been completed and roofing has begun,and stairs are now erected for mobilitybetween floors. Over 70,000 sq. ft. ofexterior masonry is set—the equivalent ofthree-and-a-half football fields. The construction process has beenrunning very smoothly, in part thanks tothe utilization of some of the most advancedtechnology in data tracking. Using an iPad,any one of the trades is able to home in onthe smallest of details to ensure a system isbeing installed correctly and has met thearchitects’ design intent. Bar-coded doors

allow the construction manager andcontractors to study each room individuallyto streamline the punch-listing, which isthe process of checking off a list of contractitems in order to be deemed “complete.”An entire room has been dedicated on thejob site to house the hub for all of thisinformation, so that anyone in the field canattend a meeting and access all of the datafrom a single source. Lest you think construction timing isdue to luck or a surprisingly mild winter, theschedule has actually been closely maintainedby PCL, Community Contractors, JLG,and UND, and has included the addition ofsummer and Saturday work. The team willclosely monitor the schedule as workbegins on the West Tower. If you are interested in North Dakotapolitics, you will know that I proudly weartwo hats: one as the president of JLGArchitects, and another as a state senatorfor District 43 in Grand Forks. The 64thLegislative Assembly reconvened inJanuary, and we are in the process ofdrafting, debating, and voting on bills thatwill shape the future of North Dakota foryears—and often decades—to come. I have the same goal at JLG as I do inthe Legislature: to make every day better forNorth Dakota. All of us at JLG share theburning passion to elevate communitiesthrough thoughtful architecture, and there isno better opportunity to make us all healthier,happier, and set a new standard for highereducation in our entire region than at thenew University of North Dakota School ofMedicine and Health Sciences building. Healthcare delivery systems now relyon teamwork and the knowledge basesfrom many disciplines. The new buildingwill provide the academic and social areasto assist in developing the culture ofcollaborative and integrated healthcareeducation, which is exactly what studentswill find when they enter the real world. Ilook forward to seeing how the professors,students, and medical community at-large will thrive in their new home.

By Lonnie LaffenPresident and CEO, JLG Architects


WORKFORCE

“HOSA” Spells the Future of North Dakota’s Healthcare WorkforceMiddle school and high school students explore becoming healthcare professionals.By Stacy Kusler

For years, the State of North Dakota and the University of NorthDakota School of Medicine and Health Sciences have beenworking diligently to battle the state’s current healthcareworkforce shortage. Many of the efforts are focused on retainingour locally trained medical students by providing them withfinancial incentives during and after medical school. Forinstance, the RuralMed Scholar Program, implemented by theSchool in 2010, awards full tuition payment for four years ofmedical school to students interested in practicing familymedicine or general surgery in a rural North Dakota communityfor five years after the completion of residency training. The State of North Dakota has also focused on retainingmedical professionals by providing and participating in variousloan repayment options. Medical students enter the workforcewith well over $100,000 in student loans. The State’s loanrepayment options were recently reevaluated and a proposal wasmade to expand loan repayment options to include morehealthcare professions, as well as increase loan repayment

amounts in order to provide incentives for graduates of amedical profession to work in North Dakota. These efforts in retaining medical students andprofessionals have proved to be successful. But why stop there?A quickly growing program in North Dakota is targeting thefuture North Dakota healthcare workforce from a much earlier

point—as early as seventh grade. HOSA-Future HealthProfessionals (HOSA) is a national student-led organizationthat focuses on providing high school students from seventh totwelfth grade with leadership development, self-confidence,

A big part of HOSA’s focus is on developingprofessional and leadership skills.

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HOSA members at the 2014 State Leadership Conference.


WORKFORCE

social skills, teamwork, and technical healthcare skills. HOSA formerly stood for Health Occupation Students ofAmerica, but was changed to HOSA-Future HealthProfessionals in 2011 to expand the program outside of theUnited States, thus making the acronym obsolete but still usedto identify the program. HOSA currently exists in 49 states plusthe District of Columbia and Puerto Rico. North Dakota’sprogram was established in 2011 as a result of the “grow ourown” initiative of the North Dakota Area Health EducationCenter (ND AHEC). The implementation of HOSA is filling alarge gap in healthcare career education. Currently, there are168 public schools in North Dakota, and just 31 of those schoolsoffer some kind of health career occupation course. ThroughHOSA, ND AHEC is expanding the reach of healthcareoccupation education and training to produce the nextgeneration of healthcare workers. ND AHEC supports andadministers the program across the state and has beeninstrumental in the rapid growth ofchapters and members, going from justthree chapters and 33 members in 2013to nine chapters and 206 members in 2015. Members of a HOSA chapter aremainly students who are interested in afuture career in healthcare, although it isnot a requirement. Each chapter operatesa little differently depending on whatworks for their school and community.The Grand Forks chapters at both RedRiver and Central High Schoolsincorporate their HOSA activities intothe Medical Careers classes held at bothschools. Dani Rowenkamp, RN, of RedRiver High School, and Kim Adams, RN, of Central HighSchool, are the chapter leaders in Grand Forks. “We treat HOSAas a cocurricular activity so we hold meetings during classtime,” Adams said. “A big part of HOSA’s focus is on developingprofessional and leadership skills. We consider most of what wedo in class as part of HOSA.” The opportunity for learning about healthcare careersthrough HOSA happens on two levels: training for HOSA-sponsored competency-based competition events, and exposureto healthcare careers through clinical experiences. HOSAcompetitions take place at state and national levels. There are 56competency-based competition events in six differentcategories, including health sciences, health professions,emergency preparedness, leadership, teamwork, andrecognition. Through the chapters’ regular meetings, membersare able to learn about each of these categories and then focuson training for their preferred competition area. Twice annually,all of the state’s chapters gather for the spring and fall leadershipconferences. The spring leadership conference is when thestudents have the opportunity to compete in their categories.Top performers from this state competition will have a chanceto compete nationally, which may provide students with

additional opportunities for scholarships and internships.Grafton’s North Valley Career and Technology Center hosts aHOSA chapter and prepared 13 students for the statecompetition at the spring leadership conference at theUniversity of Jamestown. Valerie Heuchert, BSN, is the healthsciences instructor and North Valley’s HOSA chapter leader. Shesaid her members are motivated by the opportunity to compete.“Some students actually study and try very hard to place firstbecause they want to make it to nationals,” Heuchert said. The other level of HOSA training is through clinicalexperiences, which are offered slightly differently depending onthe chapter. These experiences give students a chance toconnect what they learn from competition training in theclassroom to the actual job setting. Both Grand Forks chaptersoffer a nine-week clinical experience for their advancedstudents in a variety of healthcare job settings. Adams said thesupport from the Grand Forks healthcare community is key to

being able to let students “try the careeron” and experience the reality of it withtrained professionals at their side.

No matter how each chapter choosesto function, the overall goal of fuelingstudents’ interest in a healthcare careerremains the same. “[Through HOSA,]the students gain a sense of what itmeans to be a professional and worktogether as members of a healthcareteam. Students also get a chance to honethose valuable leadership skills such aspublic speaking, problem solving, anddeveloping organizational and criticalthinking skills,” Adams said.

Future ImpactHOSA student members enjoy benefits such as résumé building,opportunities for scholarships, collaboration with healthprofessionals and future employers, and leadershipopportunities at the local, regional, state, and national levels.And just as the student members benefit, Adams agrees that thefuture of North Dakota’s healthcare workforce will benefit fromHOSA as well. “Any exposure to the different careeropportunities in the healthcare field will only encouragestudents to follow that career path,” Adams said. “As HOSAcontinues to grow at the secondary and postsecondary level, wehope to see continued opportunities for students includingscholarships, internships, and creating more awareness ofHOSA within the healthcare community [about] how thisstudent organization can benefit them in the long run.” Because North Dakota’s program is so new, it’s hard to placea number on how it has affected the workforce so far. Heuchertbelieves that the impact of HOSA on the state’s workforce willlikely be realized farther down the road. “I do believe HOSA isa great organization because it offers so many educationalopportunities. Even though [some] students may not befocusing on that aspect right now, most will look back and

The more exposure students have to medical professionals,

medical careers, and medical experiences,

the more likely they are to choose a healthcare career.

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remember what they learned to make their future careerdecision. I have found that most of my [HOSA] students willchoose to work in the healthcare field,” Heuchert said. The work of HOSA in North Dakota is important in keepingthe pipeline of future medical professionals filled. Christi Millerof ND AHEC is the state adviser for North Dakota. Sheencourages current medical professionals to take an interest inthe up-and-coming healthcare workforce by engaging in HOSA-related activities. “Support can be offered on many differentlevels,” Miller said. “If you are willing to donate time, funds, orcontribute resources for competitions and meetings, any supportfrom the medical community will go a long way in training NorthDakota’s future healthcare workforce. The more exposure studentshave to medical professionals, medical careers, and medicalexperiences, the more likely they are to choose a healthcarecareer.” To find out more about how you can contribute toHOSA events or activities, or to learn more about starting aHOSA chapter in your community, visit www.ndhosa.org.


At the state Capitol, Representative Richard G. Holman, Mayville, meets withHOSA State Secretary Abby Kaseman (left) and HOSA State President JessicaStair. They are both from Bismarck.


The Center for Rural Health makes recommendations based on a study of ways to improve North Dakotans’ oral health.

A trip to the dentist is a childhood rite ofpassage. Children go in for a routine cleaningand hopefully become members of the “NoCavity Club.” For adults, it’s a commonexperience that we like to commiserate about.No one really enjoys it, yet we all know it’snecessary. But for many populations,especially those in rural areas, routine visitsto the dentist can be few and far between. In order to assess oral health in NorthDakota, the state’s Legislative Health ServicesInterim Committee was charged withconducting a study. The Pew CharitableTrusts approached and subsequentlyfunded the Center for Rural Health (CRH)to conduct a neutral study and to providerecommendations based on the findings.Pew is an organization working to improveoral health access across the United States.They chose to fund North Dakota’s studybecause the state had been discussingaccess and workforce around oral healthfor some time. The Trust works to movethe discussion along and assist a state inmaking recommendations, whatever theymay be, to the legislature. “Everyone involved worked to ensurerecommendations to the Legislature comefrom within the state and those that havefirsthand knowledge of the needs,” saidShawnda Schroeder, PhD, researchspecialist at the CRH. “We chose ourresearch methods and stakeholders basedon what we know about North Dakota.” Beginning in May of 2014, Schroederbegan assembling two groups ofindividuals to provide input and to helpassess oral health data for North Dakota.The Stakeholder Working Group was madeup of people that worked with populationswith oral health needs, such as teachers,nonprofit health centers, long-term careorganizations, and emergency roompersonnel. This group met frequentlythroughout the summer of 2014 to identifyoral health needs in North Dakota and to

hear state and national presenters addresspossible models to improve the oral healthstatus of North Dakotans. “Oral health status means the level atwhich North Dakotans are getting the oralhealth they need,” said Schroeder. “Arepeople getting the care they need whenthey need it? The assessment process wasdeveloped around answering that question.” In addition to the Stakeholder WorkingGroup, a separate Input Group also workedon the assessment. The Input Groupcomprised organizations that have experienceengaging in oral health work, such asprovider organizations. This group was askedto share their knowledge regarding oralhealth access, workforce, and models, as wellas review and provide recommendationsfor the full assessment report. These two groups worked together toassess the existing oral health workforceand service capacity, evaluate the unmetneed for oral healthcare, perform analyseson oral health workforce data, and developa report of outcomes, findings, andrecommendations. Among those findingswere the following:

● American Indian third-gradersreported higher rates of tooth decay,untreated decay, rampant decay, andneed for treatment than their whiteand other minority peers.

● More third-graders presented withhistory of decay, untreated, treated,and rampant decay among schoolswhere 50 percent or more of studentsqualified for free or reduced lunch.

● Medicaid reimbursement ratesincreased in 2011, 2012, and 2013;

yet the percentage of Medicaid-enrolled children who had had adental visit in the last year declinedover that same period.

● In 2014, 12 counties had no dentist, ninehad one, nine counties had two dentists,and five counties had not reported.

Brushing Up on Dental By Nikki Massmann

Are people getting the care they need

when they need it?

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Care in North Dakota● In 2013, 67 percent of all the licensed

North Dakota dentists worked in thefour largest counties: Burleigh, Cass,Grand Forks, and Ward

The top needs that were identified inthe state were related to prevention, carefor the under- or uninsured and Medicaidpopulations, and workforce and accessissues for special populations. Oral healthdisparities were prevalent among children,American Indians, those with low-incomes, those with disabilities, homeless,aging, rural residents, and those coveredby Medicaid. “Oral health is an important part ofprimary care,” said Schroeder. “It has takenawhile to come to the forefront, and haslong been seen as such a separate piece ofhealthcare. But it really is a part of overallhealth. If patients aren’t getting in to see adentist for preventive care, these patientsmay end up in the emergency departmentwith oral health problems. Left untreated,they can lead to other health issues, andinfection can spread to other parts of thebody. Improved access to dental care couldlead to better outcomes in the oral healthstatus of these populations.” As a result of the assessment process,work will continue to improve access tooral healthcare in North Dakota.Partnerships have been created amongentities in the state that are working onoral health. They now have a platform withwhich to work together and be aware ofeach other’s successes. The goal ofeveryone involved in oral health is to get itto be viewed as just as important as anyother part of healthcare. “We now have a single location and afull list of all the organizations in the stateworking to improve oral health status inthis assessment report,” said Schroeder.“Work will continue to develop solutionsto these health disparities and improveaccess across all populations in NorthDakota. The common goal of everyoneinvolved is that all those needing oral

healthcare will receive it when they need it.A trip to the dentist for routine care shouldbe a common experience that’s accessibleto everyone.” The full oral health assessment reportcan be accessed by visiting the Center forRural Health’s website athttp://ruralhealth.und.edu/projects/nd-oral-health-assessment.

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Oral health is an important part of primary care. . . . It really is a part of overall health.

Shawnda Schroeder


STUDENT PROFILE

Granrud and his Grade 10 students at graduation.

Marc Granrud Experience in service and research prepared first-year student for medical school.

Everyone may have a different idea of whatconstitutes a good doctor, but most peoplewould probably agree that the ingredientsinclude intelligence, compassion, anddrive. It is safe to say that first-yearmedical student and Minneapolis, Minn.,

native Marc Granrud possesses all threequalities. He is an incredibly drivenindividual, obviously very intelligent, beinga medical student and having worked witha biotechnology company, and he is also acompassionate person, having spent time

By Claire Lenard


in the Peace Corps. He was introduced to the idea ofpursuing medicine because it has alwaysbeen a part of his life; both of his parentswork in the medical field. Though the ideaof pursuing medicine has always been anoption, it has not always been the definitechoice. After graduating from GonzagaUniversity in Spokane, Wash., even thoughhe had completed the premedicalrequirements, he did not have any set plansto apply to medical school yet. “I ended upjoining the Peace Corps because I thoughtit would be interesting and a different kindof experience,” Granrud said. And that itmost definitely was. He was placed inNamibia, and he went into this really notknowing what to expect. “The thought thatfirst came to mind when thinking oftraveling to Africa was something similarto The Lion King set, but what I foundthere was completely different. Myexperience profoundly changed my view ofwhat life is, especially in that part of theworld.” He spent two years in Namibiateaching biology, chemistry, and physics tothe ninth- and tenth-graders at a local highschool. With his free time, he was able tobecome involved in helping thecommunity. This experience was thedeciding factor in his decision to pursuemedicine when he returned. “Workingwith the kids, and seeing how hard thepeople worked really inspired me.” By his second year working there, thespecific high school he was working withhad been voted the most improved becauseof such a high increase in the passing rate.This was his most memorable moment ofthe Peace Corps; it was when he was reallyable to see the effect his time and workwere making. “I firmly believe that withoutthis experience, I would not have gone tomedical school. This was truly one of mymost amazing experiences, and I would doit again if only Africa were a little bit closer.” After returning from Africa, Granrudworked for St. Jude Medical, abiotechnology company in St. Paul, Minn.,testing pacemakers and ablations for heartarrhythmias. “The pacemakers were testedusing intraoperative testing, whichinvolves testing during the operation.” Theablations for cardiac arrhythmias weretested using EP mapping. EP mapping is

the term for mappingthe electrical activityof the heart in anelectrophysiology(EP) lab, and it is usedto diagnose heartdisease and otherheart issues. St. JudeMedical has madeimportantdevelopments in thecardiology field, andGranrud had theopportunity to be apart of these advances. Granrud has hada lot of incredibleexperiences, and hehopes to continuemaking an impact. Heis known as a personwho goes out of hisway to help, dedicatedto the importantthings in his life, loyal,and really just fun tobe around. As for therest of his medicalcareer, “I am not sureof what area I want tospecialize in, thoughemergency medicinecould potentially be inthe cards.” Whateverhe decides, he has thedrive to be successful.Everything has led him toward doingsomething in the medical field, and whenhe sets his mind to something, he does notstop until he succeeds. His determinationwill have a lasting effect, whether inhelping to develop an innovativetechnology or in making a patient’s day. Heis an inspiration to future medicalstudents, fellow classmates, and anyonewho has a goal to strive for.

Marc Granrud receives his stethoscope from Dean JoshuaWynne and Dr. James Moller (right) at the Adopt-a-Med-Student program in October 2014. Dr. Moller donatedGranrud’s stethoscope.

Granrud and his host parents Johanna Nangombe andVeiyo Nangombe.


ALUMNI PROFILE

The Quack with a DuckGlenn Thoreson—Physician, Flight Surgeon, Fighter Pilot

In Mayville, N.Dak., you can see a car withthe custom license plate designated“F4FANTM.” In the driver’s seat of this caris a man who not only provided medicalcare for the people of Mayville but alsoserved our country during the Vietnam War. Glenn Thoreson grew up in Mayville,where his dad was a veterinarian. Whenasked what got him into medicine, Thoresonsaid, “My heritage is medicine; I didn’thave a ‘gee-whiz’ or a ‘wow’ moment.” Thoreson attended Luther College inDecorah, Iowa, for his first year of school.His older brother went there, so it was only

natural he said that he followed in hisfootsteps. But he missed his girlfriendwhom he grew up with, Rose. This led himto transfer after the first year to ConcordiaCollege in Moorhead, Minn., to be closerto her. At Concordia, he finished hispremedical training in three years instead offour. “I applied to both medical school andveterinary school, when I was getting readyto be done with Concordia. I got letters backfrom both schools that said, ‘You completeyour studies and you will be enrolled.’ ” When Glenn was deciding if he shouldgo into human or animal medicine, his

By Morgan Goulding and Denis MacLeod

Captain Glenn Thoreson and the Rosie Dee.


father asked him, “Do you want to deliver acalf in a barn at 10 degrees below zero, witha farmer helping you, maybe? Or do you wantto do human medicine in an air-conditionedor heated delivery or emergency room?” Glenn started at the University ofNorth Dakota Medical School in 1962. Atthat time, the medical school was only atwo-year school. Glenn married Rose, andthey moved into UND housing—the “tinhuts” on campus. Rent was only $36 amonth, and they lived among other medicalstudents and their spouses. After finishing uphis two years at UND, Glenn then attendedthe University of Kansas for his final twoyears of medical school; he graduated onJune 6, 1966 (6/6/66). Rose and Glennknew they wanted to get back to NorthDakota, so he applied for an internship inFargo at St. Luke’s Hospital. There hecompleted a rotating internship in all thedifferent specialties of the hospital,working six days (80 hours) a week. He was among a generation of youngphysicians that all knew they were boundto be called for duty in the Vietnam War.Glenn applied to be in the Air Force. Hewanted to be a flight surgeon because hewanted to fly and his best friend in highschool was a jet pilot. In the spring of 1967, he applied to theAir Force. He was accepted for flightsurgeon training at Brooks Air Force Basein San Antonio, Texas, starting on July 1,1967. “I was interested in flying. I did getexposed to flying. They understood that Ienjoyed being in airplanes and on theflight line taking care of pilots and thehealth of their ground crews.” As a flightsurgeon, part of my duty was training in T-37 and T-38 jet planes. “During the Christmas of 1967, I got aChristmas card from President Johnson,with orders to report for duty in Vietnam,June 1, 1968,” Glenn said, “I was to reportto McChord Air Force Base, which was inSeattle, luckily assigned as a flight surgeonin a jet fighter squadron.” At 10 p.m. onJune 1, 1968, Glenn was on a flight toVietnam. “You could hear a pin drop,” hesaid. “You could hear sniffles and crying—and dead silence. How many of these 300young men are coming back?” After crossing the international dateline, they arrived in Cam Ranh Bay, South

Vietnam, on June 3, to start the in-processing for his squadron of F4C Phantomfighter jets—the 559th Tactical FighterSquadron (known as the Billy Goats) of the12th Tactical Fighter Wing. When Glennarrived, Zach, the flight surgeon he wasreplacing, took him to meet some of thepilots. When Glenn walked in, one of thepilots said, “Oh, the new quack is here.” “I said, ‘Hold it!’ ” Zach said, “Quack is good. If they like you, you’re the squadron quack. Quack is OK.” “It was a nickname of affection,” Glennsaid. “I got along with them very well.” Rose stayed home in Mayville withtheir two children; she got a job as a nurseat the local clinic. She worried about herhusband, the father of Mark and MaryAnn. She would listen to the casualtiesreported on radio and TV every week.Glenn and Rose were able to send eachother letters every week and voicerecordings on reel-to-reel-cassette tapes. “Iwould put them in the mail,” Rose said.“And they would always go to GrandForks, to the base, and he sometimes gotthem the next day, or two days later. It wasour version of modern day Skype.” In Vietnam, Glenn’s duties consisted ofoverseeing the health of the squadron’s pilotsand crew members. “You’re not only lookingafter their health and well-being; you’re alsoallowed to train in the F-4 fighter as a copilot.On the ground I was a doctor, in the air I wasa fighter pilot, with full stick-and-rudderflying control. ” He also went 15 milesoutside the base, where he volunteered tohelp the Montagnard villagers. “They wereour allies; they liked us.” Glenn and his pilot were selectedto name an F-4 in honor of their wives. Tobe stenciled on the nose of their Phantom, Glenn chose “Rosie” to be painted in white. Glenn’s closest brush with death cameon the evening of January 28, 1969. Duringtakeoff the canopy of a Phantom foggedover from the high humidity of the night air,and the pilot lost control and veered off therunway and struck a cement barrier. Thepilot was killed instantly, and the copilot diedwhen he ejected from the plane at groundlevel. Glenn, in an ambulance, arrived at thescene and waited with the fire crew for thefuel to burn off. “All of a sudden, one of the


rockets that had come off the airplanehappened to be facing the airplane andlaunched into it and exploded,” Glenn said.“The explosion blew off the right arm ofthe fireman standing next to me. I didn’tget hurt. I just got thrown in the air andknocked into the sand; I got up and went towhere the fireman was crying and moaning.I got in there and pulled him out and gothim away from the fire. The ambulancewas there. We clamped the bleeder and gothim in the ambulance, then got him to thehospital. He was then flown directly toClark AFB in the Philippines. He lost hisarm, but he survived.” For his exemplary courage and heroismon that evening, the U.S. Air Force awardedGlenn the Airman’s Medal. The citation reads,“Captain Glenn M. Thoreson distinguishedhimself by heroism involving voluntary riskof life on the Flight Line, Cam Ranh Bay AirBase, Republic of Vietnam on 28 January1969. On that date, Captain Thoreson rushedto the area where an aircraft crashed upontakeoff. With complete disregard for hisown safety, Captain Thoreson, despite thehazard of exploding fuel cells and highexplosives, unhesitatingly entered the areanear the flaming aircraft and persevered inhis humanitarian efforts until he succeededin removing the injured fireman to a placeof safety. The exemplary courage andheroism displayed by Captain Thoresonreflect credit upon himself and the UnitedStates Air Force.” Glenn flew his 30th and last combat

mission with Hoople, N.Dak., native JimMcMullen. Glenn had met McMullenupon arrival at Cam Ranh Bay. They had aconnection; Jim’s brother Harvey wasGlenn’s high school coach. Traditiondictates a champagne celebration uponlanding after the last combat mission. Thefire crews would spray them with water,and Glenn and Jim would drink acelebratory glass of champagne. Glenn hada surprise for everyone. White ducks werepresent everywhere, so Glenn asked thesergeant of their maintenance crew to get aduck and meet the plane as they taxied inand deliver the duck to Glenn. Glenn andJim taxied back to the squadron and shutdown the engines. Glenn had the duck inthe backseat cockpit. He tossed the duckinto the air and thus became known as“The Quack with a Duck.” In 1969, Glenn returned home afterhis one year of duty. It took him only twohours to be discharged. He returned toMayville, where he went into familymedicine with three other partners at theMayville Clinic. He practiced there for 36years. He delivered about 700 babies. SonMatthew Lynn joined the Thoreson familyin July of 1971. He is named after Glenn’sVietnam roommate Lynn Adams.

Glenn retired on a Friday in 2006 afterpracticing 36 years in Mayville. After twoweeks of retirement, he missed practicingmedicine so much that he decided to workpart-time in Valley City for three years. Healso worked part-time for a year at the VAin Fargo. After retiring for good the secondtime in 2009, Dr. Thoreson’s retirementmeant more time with kids and grandkids.Rose and Glenn’s lake house has become agathering place for family and friends. TheNorth Dakota Medical Association presentedDr. Thoreson with the CommunityPhysician of the Year award in 2006.

Rose and Glenn with Glenn holdingthe display of his Airman’s Medal,certificate, and citation letter.

“

”

Quack is good. If they like you, you’re the squadron quack.

Quack is OK.


ALUMNI NOTES

Eric Mjelde, MPAS ’14, has joined the internal medicinedepartment at Essentia Health–Park Rapids Clinic in ParkRapids, Minn.

Toni Rheault, MPAS ’14, has joined the Essentia Health Heartand Vascular Center in Fargo, N.Dak. Rheault previouslyworked for Essentia Health as a respiratory therapist.

Melinda Picard, MD ’11, is now atTrinity Health in Minot, N.Dak.,specializing in hospital medicine.Picard, a native of Williston, N.Dak., isboard-certified in internal medicine.

Jill Klemin, MD ’07, a family medicinephysician at Sanford North Clinic inBismarck, N.Dak., has recently beenappointed to the Burleigh CountyBoard of Health. She will serve a five-year term with four other boardmembers. The board is responsible forenforcing all laws, rules, and regulationsrelating to the preservation of the lifeand health of the people of the county

outside the corporate limits of cities.

Jessica Skjolden, MD ’07, is a recipient of the National HealthService Corps scholarship award. Skjolden, a Bottineau, N.Dak.,native, is a family medicine physician with St. Andrew’s HealthCenter in Bottineau.

Michael LeBeau, MD ’02, was electedto Sanford Health’s Board of Trustees.He is an internal medicine physician andnephrologist at the Sanford BismarckClinic. LeBeau is certified by theAmerican Board of Internal Medicine.In addition to his work in Bismarck,LeBeau practices at outreach locationsin New Town and Fort Yates, N.Dak.

Chad Vandrovec, MD ’02, has joined the surgical and specialtycare service line at the Fargo VA Health Care System. Vandroveccompleted his residency in anesthesiology at the Medical Collegeof Wisconsin and his fellowship in pediatric anesthesiology atthe Children’s Hospital of Wisconsin in Milwaukee.

Paul Olson, FM Res ’90, was recentlynamed the 2014 Physician of the Yearby Trinity Health in Minot, N.Dak. Alongtime physician in Trinity’sEmergency/Trauma Center, Olson wascited for his kindness, intelligence, andbeing the ultimate team player.

James Volk, MD ’84, has received the Golden StethoscopeAward from Sanford Health, which recognizes outstandingphysicians who demonstrate excellence in patient care,customer service, communication, and teamwork. Volk is thechief medical officer for Sanford Health in Fargo, N.Dak.

Thomas Jacobsen, BS MD ’63, was recently honored with thePioneer Award given by the South Dakota PerinatalAssociation. Jacobsen received the award at the 39th annualmeeting in Deadwood, S.Dak. Jacobsen recently retired frombeing a physician in Hettinger, N.Dak..

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IN MEMORIAM

William Edward Anderson, BS Med ’47, passed away onOctober 23, 2014. He was born July 29, 1921, and raised inMissoula, Mont. He attended the University of Montana for twoyears, majored in forestry, and fought forest fires as a smokejumper in the summers. He was raised by a single mother duringthe Depression and was a self-made man. He enlisted in the U.S.Navy in 1942, serving in the South Pacific on the battleship NewMexico in World War II. He received his undergraduate medicaltraining through the Navy, at the University of Notre Dame, andthe University of North Dakota. He completed his postgraduatemedical training at Temple University School of Medicine inPhiladelphia, where he received his Doctorate in Medicine inFamily Medicine in 1949. It was there that he met his future wifeDoris Eloise Treiber, who graduated in 1949 from TempleUniversity’s School of Nursing. They married in 1950 andrecently celebrated 64 years of marriage. After serving a one-yearinternship at the U.S. Naval Hospital in Bethesda, Md., he andDoris moved to Spokane, Wash., where he did his residency atSacred Heart Medical Center followed by a three-year practiceat the Rockwood Clinic. He was called back to serve in the U.S.Navy during the Korean War and was stationed at WhidbeyIsland, Wash. Upon discharge, he returned to Spokane andopened a solo family practice clinic in the Spokane Valley in1954 and worked there until he retired in 1983.

Rodney Clark, BS Med ’46, 90, Grand Forks, died peacefully athis home, Wednesday, December 3, 2014. Rodney George Clarkwas born to Basil and Louise (Johnson) Clark on July 1, 1924, atGrey Eagle, Minn. Rodney grew up and attended school atRedwood Falls, Minn., and graduated from Redwood Falls HighSchool. In 1942, Rodney began his college education at CarletonCollege for one year, where he joined the U.S. Navy Reserve. Hewent into the Navy college program and continued hiseducation at St. Mary’s College, Winona, Minn., where hesigned up for premed. Rodney then attended the two-yearUniversity of North Dakota Medical School. It was in GrandForks that Rodney met the true love of his life, Carol Kopperudof Grafton, N.Dak. Rodney went on to complete his medicaldegree at the University of Illinois College of Medicine inChicago, Ill. Rodney and Carol were united in marriage on June30, 1947, at Berwyn, Ill. Rodney served an internship in Denver,Colo., and his OB-GYN residency at Louisville GeneralHospital. Upon completing his medical education, Rodney anda fellow graduate established a private practice in obstetrics andgynecology in Nampa and Caldwell, Idaho. Rodney and Carolreturned to Grand Forks in 1957, and Dr. Clark practicedmedicine at the Grand Forks Clinic until his retirement in 1987.

Dr. Manuchair “Mike” Ebadi, retired Chester FritzDistinguished Professor, associate vice president for healthaffairs at UND, associate dean for research and programdevelopment, and director of the Center for Excellence inNeurosciences at the UND School of Medicine and HealthSciences, passed away Jan. 19, 2015, at his residence in LagunaNiguel, Calif., at age 79. He was born September 6, 1935, in

Iran. Dr. Ebadi joined the University of North Dakota School ofMedicine and Health Sciences in 1999; he retired June 30, 2007.Under his leadership, the research enterprise at the UNDmedical school increased sixfold in large measure related to hisrecruitment and support of talented researchers. He and hiscolleagues investigated the nature and underlying causes ofParkinson’s and other neurodegenerative diseases as well asdrug addiction. Dr. Ebadi pursued and won support for thePositron Imaging Research Facility, one of only 12 such centersin the country at the time, which houses the microPET(positron emission tomography) scanner—a first for NorthDakota. He was instrumental in obtaining funds for theNeuroscience Research Facility. He was an award-winningteacher, having received 11 Golden Apple Awards, and aninternationally recognized researcher in the area of Parkinson’sdisease. He wrote several books on topics concerningpharmacology and Parkinson’s disease; two of these texts havebeen translated into Chinese and Japanese. In December 2004,the University of North Dakota awarded him its highest honorfor faculty, the Chester Fritz Distinguished Professorship.

Robert E. Hankins, BS Med ’48, MD, 87, Minot, N.Dak., passedaway Sunday, December 28, 2014, in his home. Robert E. “Doc”Hankins was born in Parshall, N.Dak., to Fredrick Hugh andEmma (Eckes) Hankins on January 22, 1927. He attended schoolin Lidgerwood, N.Dak., until his sophomore year, and thengraduated from Parshall High School in 1944 as co-valedictorian.Following his high school graduation, he was accepted into theV-12 Navy program and completed his premed program in twoyears in Milwaukee, Wisc. He then attended the University ofNorth Dakota Medical School in Grand Forks, receiving aBachelor of Science in Medicine in 1948. He completed hismedical degree at Loyola Stritch School of Medicine in Chicago,Ill., in 1950, followed by an internship at Milwaukee CountyHospital in 1950–51. He was a Navy recruit medical examphysician for a short time in Chicago. While attending Loyola,he met the love of his life, Florita Thielen, who was a nurse at St.Elizabeth’s Hospital Emergency Room. They were married onSeptember 16, 1950. He, Florita, and eldest daughter, Kathy,moved to Mott, N.Dak., in 1953, where he set up his firstindependent medical practice. He was the primary physician inMott until the family moved to Minot in 1975, where he was thefirst director of the UND Family Practice Center (currentlyMinot Center for Family Medicine). He opened a privatepractice in Minot in 1980. He retired from his practice in 1996,but continued as the medical director for St. Joseph’s Hospitalchemical dependency unit, Trinity Nursing Home, and theDakota Boys and Girls Ranch in Minot until 1999.

Ryan B. Harrington, BS Med ’58, died in the palliative careunit of Sanford hospital on December 16, 2014. He had been illfor more than 13 years with myeloproliferative disease. OnNovember 26, he sustained a hip fracture and was not able torecover from the additional health problems associated with theinjury. He was born in Hancock, Mich., on the shores of


beautiful Lake Superior, on October 2, 1932, to Ryan C. andConstance (Freidrichs) Harrington. He attended North DakotaAgricultural College (now NDSU). When the Korean conflictbroke out, he was activated by his Naval Reserve unit. He servedfor two years as a Navy corpsman, assigned to a Marine unit.Upon discharge, he enrolled at the NDAC as a premed student.He was accepted by the UND Medical School, where he receiveda BS in Medicine. In 1958, he transferred to the University ofKansas. He received his Doctor of Medicine there in 1960. Aftergraduation, he interned and completed a residency in internalmedicine at St. Luke’s in Kansas City. He was then accepted for afellowship at the Mayo Clinic in neurology and neurodiagnosticmedicine. In 1966, he began practice with the NeurologicAssociates at the Neuropsychiatric Institute in Fargo and servedas clinical professor for the University of North Dakota Schoolof Medicine and Health Sciences.

Aivars Imants Kalnins, BS Med ’57, 80 of Kettering, Ohio,passed away October 21, 2014. He was born March 20, 1934, inAllaži, Latvia, to the late Dr. Arnold and Milda Kalnins. Anemigrant from Latvia in 1950, he and his family settled in NorthDakota, where his father Arnold established a general medicinepractice in Washburn. Aivars attended Bismarck High School,the University of North Dakota, and finally earned his medicaldoctorate from Tufts University School of Medicine in 1959. Aftercompleting his training in Minneapolis, he settled in Dayton,Ohio, where he practiced general surgery for over 30 years.

Dr. Don Martindale, BS Med ’82, FM Res ’85, 58, of Fargo,N.Dak., died Saturday, December 20, 2014, at Sanford Health inFargo. Donald Jay Martindale was born May 31, 1956, in GrandForks to Thomas and Loraine (Gierke) Martindale. He attendedFargo Public Schools, graduating from North High School in1974, where he was recently inducted into the Hall of Fame. Hisundergraduate studies were completed at North Dakota StateUniversity, after which he attended the University of NorthDakota School of Medicine and Health Sciences. He thencompleted his family practice residency in Fargo. He met hiswife, Lori (Nolting), at St. Luke’s Hospital in Fargo, where shewas a nurse and he was a resident. They married on June 5,1982. He began his career in family practice at the SouthMoorhead MeritCare Clinic, where he worked until earlyDecember 2014. In addition to his practice, he served as teamphysician for the Moorhead State Dragons football team as wellas a team physician for the North Dakota State Bison.

Robert C. Nordlie, MS ’57, PhD ’60, was born June 11, 1930, inWillmar, Minn., to Peter and Myrtle (Spindler) Nordlie, andgrew up in New London, Minn. He earned a BS in Educationfrom St. Cloud (Minn.) Teachers College in 1952, served twoyears in the U.S. Army Combat Engineers, and then earned hisMS and PhD in Biochemistry from the University of NorthDakota in 1957 and 1960. There he met his future wife SallyAnn Christianson. They were married in Pembina, N.Dak., onAugust 23, 1959, and have three children: Margaret, Melissa,

and John. After his graduate work, Dr. Nordlie studied for twoyears as a postdoctoral fellow at the University of Wisconsin’sInstitute for Enzyme Research. He returned to UND in 1962 asthe Medical School’s first James J. Hill Research Professor. His38-year career in the Department of Biochemistry andMolecular Biology included serving as its chair from 1983 to2000. Dr. Nordlie’s internationally renowned research onglucose-6-phosphatase and its role in blood glucosehomeostasis resulted in 135 research papers and reviews, andnumerous invitations to speak in the United States and abroad.He mentored 12 MS, 20 PhD, and 15 postdoctoral students. Dr.Nordlie was a highly respected teacher, and received numerousawards for teaching and research throughout his career, themost recent of which was the Sioux Award from UND in 2011.

Jean Colville Oberpriller, PhD, 72, Jean Colville Oberpriller,retired professor of anatomy at the School of Medicine andHealth Sciences, passed away Dec. 23, 2014 in Eagan, Minn.,with her family at her side. She was born in Pittsburgh, Penn.,and was the first in her family to attend college. She received herundergraduate degree from Mount Mercy College and earnedher graduate degree at Tulane University, where she met herfuture husband John, who also taught at UND. “Dr. Jean” was anintegral part of the UND Medical School for 30 years as aprofessor of anatomy.

John Oscar Oberpriller, PhD, 79, retired professor of anatomy,died January 4, 2015, in Eagan, Minn., with his family by hisside. He was born in St. Croix Falls, Wisc., and raised inNewport, Minn. He received his BA in Biology from St. John’sUniversity, his master’s degree in zoology from the University ofIllinois, and earned his PhD degree at Tulane University, wherehe met his future wife Jean. John was genuinely interested ineveryone and everything around him, a natural inquisitor. Hebrought people together with masterful social skills. “Dr. John”was an integral part of the UND Medical School for 30 years asa professor of anatomy.

Richard John (Dick) Schindler, BS Med ’66, 72, of Austin,Minn., died Saturday, October 18, 2014, from injuries receivedin a bicycle accident. Dick was born on February 23, 1942, inFargo, N.Dak., to Edward and Angeline (Havel) Schindler. Hismother took the train from Barnesville, Minn., in a snowstorm,and he was born in the hallway at the hospital. He marriedBelita Softing in Fargo in July 1964. The family recently had awonderful celebration of their 50 years of marriage. Dickcompleted his first two years of medical school at the Universityof North Dakota and graduated from the University of IowaMedical School. He did his internship in Biloxi, Miss., andcompleted his medical studies in the United States Air ForceAcademy Hospital in Colorado. He joined the AustinMedical Clinic in 1972 and recently retired.


Rural Surgery Support Program This novel SMHS program serves as a national model in providing surgical care to rural patients.

A recent North Dakota job posting tells acompelling story about what “rural” means:

The University of North Dakota invitesapplications and nominations for theposition of Director of Rural SurgeryProgram. . . . We seek an outstandingeducator to fill this position . . . acandidate with a background in clinicalresearch and rural general surgerypractice. Candidate will be expected tomaintain a clinical practice in generalsurgery or a surgical subspecialty.

The posting was signed by ProfessorRobert Sticca, MD, chair and programdirector of the UND School of Medicineand Health Sciences Department ofSurgery and head of surgery at Sanford-Fargo. This was the first step in launchingthe University of North Dakota School ofMedicine and Health Sciences Rural SurgerySupport Program—the first, and so far theonly, such program in the country. “When I got here in 2003 from theEast Coast, I started working with peoplearound the state, and it became clear to methat the surgeons who practice in ruralhospitals have a different type of practice,and different issues related to that kind ofpractice,” said Sticca. It’s all about who’s available to do what. “First, rural surgeons do a widerspectrum of procedures compared withsurgeons in urban and metropolitanlocations, where general surgeons have amore limited practice because there areplenty of surgeons who can focus onspecialties,” Sticca said. Rural surgeons perform a lot of differentthings across specialties, such as obstetricalsurgeries, delivering babies, urologyprocedures, and ear-nose-throat operations.They don’t do the really complicated stuff inthe subspecialty areas of surgery, Sticcanoted, but they often handle the basic careand procedures in these surgical disciplines,

including cesarian sections, hysterectomies,nose bleeds, and setting broken bones. In 2006, Sticca and his colleaguesbegan taking a closer look at surgerypractice in rural North Dakota and SouthDakota, personally interviewing the 58surgeons in the two states who wereactively practicing at that time. “It’s interesting that as we began to dothat, there was also an interest developingacross the country in the unique challengesfor surgeons in smaller communities,which in many cases were having troublerecruiting and retaining surgeons,” Sticcasaid. “That was a change because when I firststarted talking about this at national meetingslike the American College of Surgeons, itwasn’t received very well. I was told ‘allsurgeons are the same.’ Then things started tochange—many prominent national surgicalsocieties began to acknowledge the uniquepractice and role of the rural surgeon. Forexample, in 2012, the American College ofSurgeons, of which I’m a member, organizedthe Advisory Council for Rural Surgery,which was created to address the difficultiesof practice in a rural community.” “One of the biggest issues we found wasthat if a small-town surgeon left, it was a bigproblem; conversely, surgeons who practicedin small hospitals found it tough to get away,”Sticca said. And hiring a locum tenens—asurgeon from out-of-town who would visitthe community for a certain time period—was often a very unsatisfactory option. “So your small-town surgeon has troubletaking vacation, taking time off forcontinuing medical education, and becausethey’re working in a smaller facility, they havea hard time keeping up to date, so they getburned out,” Sticca said. “Thus communitieshave ongoing troubles recruiting andretaining competent surgeons.” After completing the 2006 study ofrural surgery practice, Sticca mulled bothproblems and solutions. “I started to think about the many

By Juan Pedraza

Mary Aaland

”

“She’s the mainstayof our program, a real godsend.


problems faced by rural surgeons, many ofwhich had been discussed in nationalforums, but no one had any answers,” hesaid. “I then thought about different wayswe could try to fix some of the problems,and decided based on our study thatcoverage for surgeons while they wereaway was the biggest challenge.” Sticca considered the best solutionwould be to provide support to the ruralhospital surgery practice. “I thought that providing themsomeone to come from the medical school,already licensed and credentialed in thestate, to provide coverage would be a majoradvance,” Sticca said. “And we could do it alot cheaper than a locum agency. The smallrural hospitals appreciate having anaffiliation with the state’s only medicalschool. I thought it sounded like a win-winfor everybody.” Enter UND’s Rural Surgery SupportProgram, officially launched last July. Mary Aaland, MD, a native ofNorthwood, N.Dak., and a 1982 grad ofthe UND School of Medicine and HealthSciences, has been on the job since then.She had already been recruited back to thestate after many years away and got the callfrom Dr. Sticca. “She’s the mainstay of our program, areal godsend,” said Sticca. “It’s wonderful tohave someone local do this too. Every timeI mention someone to her, she seems toknow them or someone who knows them.” The program, over the skeptical asidesfrom some, has taken off. For example, Aaland was able to stepin to help the hospital in Hettinger, whoselongtime surgeon retired a couple of years ago. Moreover, she met the surgeon whomHettinger was trying to recruit. Of course,as he mulled the job offer, he wonderedhow he would get time off. That doubt wasallayed by Aaland, who noted that the RuralSurgery Support Program would providecoverage on the weeks he was off—so hesigned up. Aaland has committed to severalweeks of coverage at Hettinger each year. Aaland covers for surgeons in ruralpractice around the state as a generalsurgeon, but she also is board-certified intrauma and critical care. There’s an important economic

component to this program besides costingless than a locum tenens service: ruralhospitals depend on a general surgeon’srevenue. In-patient stays of surgicalpatients can account for up to 50 percentof revenues in many rural hospitals. “When they lose a surgeon, they can gounder because they can’t make up that lostrevenue,” Sticca said. “Our program helpsto alleviate that concern. After six months,we’re seeing a lot of interest, and not just fromrural hospitals. I told my colleagues on theAmerican College of Surgeons Rural SurgeryAdvisory Council about this, and they said itwas unbelievable. This is the first time thishas been done, and they’re asking me tosubmit an article in the College’s bulletin. Thisis, in fact, a model for the rest of the country.” Aaland said she traveled the state,knocking on doors to talk about the new program. “No e-mails—I did it the old-fashioned way, meeting people at ruralhospitals directly,” said Aaland, whosegreat grandmother Eli Thingelstad startedthe first hospital in Northwood beforeWorld War I. Now, she tailors the coverage to meetthe individual needs of each locality thatshe can serve. “Just like we tailor a plan for each patient,I do it to meet the needs for each ruralcommunity,” said Aaland, who recentlycompleted a surgical mission trip to Ecuador.“And another benefit: unlike a locum, orwhat I call a ‘doc-in-a-box,’ if I operate andthere’s a problem, they know how to get ahold of me, so there’s continuity of care.” Aaland said one of her goals is to take surgery residents along on hertemporary assignments. She performs many of the procedureson an out-patient basis—operations suchas gall bladder removal, hernia repair,colonoscopies, thyroidectomies, and breastbiopsies can be done that way. Being a female surgeon out theredoing this is no problem for Aaland. “The first appendectomy in theDakota Territory was performed by awoman, a physician from the state ofMichigan, on a kitchen table,” Aaland said.“Basically, I feel pretty good about beingable to give back to my state thatprovided me with a foundation.”

Robert Sticca

”

“I feel pretty good about being able

to give back to my state that provided me

with a foundation.


Contact UsFor additional information on how to best structure your bequestgift to benefit the University of North Dakota, please contact:Dave Miedema, ’76, CGPASenior Director of DevelopmentUND Foundationdavem@undfoundation.org701.777.4933und.giftlegacy.com800.543.8764

Since she was seven years old, KarenRobinson had aspirations of serving inthe medical field—a goal backed by herparents, Pembina County farmers Clarineand Howard Robinson, who understoodthe importance of quality healthcareaccess, especially in rural communities.

“My mom passed away in 2013, andshe had the same physician since the mid-1980s,” said Karen, who pursued herchildhood dream, working as a VeteransAffairs nurse for more than 30 years. “I

know from talking to other people that they’re not always sofortunate to keep the same primary care provider for so long.” The Robinsons’ primary physicians were graduates of theUND SMHS: David Glatt, BS Med ’73; John Wahl, BS Med ’66;and Peggy Sheldon, MD ’79. Karen says her family alwaysrealized how fortunate they were to have a medical school soclose by. So her parents showed their appreciation for the goodhealthcare they received throughout their lives by including theUND SMHS in their estate plans. Karen, honoring her parents’ wishes, recently establishedthe Howard, Clarine, and Karen Robinson ScholarshipEndowment in support of scholarships for North Dakota’sfuture healthcare providers. “Early on, my parents recognized the importance of themedical school, so it was their idea that we establish anendowment,” Karen said. “They felt it was very important tosupport endowed scholarships. They understood student debt,and carried out their intentions in their will.” Karen made a pledge toward the endowment that will allow thefund to begin awarding scholarships immediately; additionally, sheestablished a living trust that will eventually award a percentage

of her inherited assets tofund a bequest to the UNDFoundation, growing herfamily’s endowment andfurthering their gift toSMHS students. “My parents realizedthat, no matter youreducational background,you can give back,” she said. Through the years,Karen not only has workedto fulfill her parents’wishes of giving to UNDbut also has given backherself. Though she’s not aUND graduate (she has adiploma from St. Luke’s School of Nursing in Fargo, abaccalaureate from the University of Kentucky, a Master ofNursing from Texas Woman’s University, and a PhD in Nursingfrom the University of Texas in Austin), she served as the VArepresentative for the SMHS Advisory Council from the mid-1990s to 2010. The School will continue to feel the effect of herfamily’s gifts of time and treasure for years to come.

Bequests to benefit UNDOver the years, SMHS students have benefited immenselythanks to thoughtful estate planning done by alumni andfriends of UND like Howard and Clarine Robinson. Please contact us for additional general bequest information,for other recommended bequest language, or to discuss howyou would want your gift to specifically benefit the SMHS.

By Alyssa Konickson

Pembina County farmers invest in future of rural medicine

PHILANTHROPY

North Dakota woman fulfills parents’ intentions ofinvesting in SMHS scholarships.

Clarine and Howard Robinson

Karen Robinson

On Feb. 10, Mark Hall and Claire Herland of Alerus Financial visited the UND Schoolof Medicine and Health Sciences to present three generous gifts from the estate ofLinda Redmann that will benefit public health, rural health and cancer research.Left to right: Dave Miedema, UND Foundation; Herland; Hall; SMHS Dean JoshuaWynne; DeAnna Carlson Zink, UND Foundation.

NORTH DAKOTA MEDICINE Spring 2015 33NORTH DAKOTA MEDICINE Spring 2015 33

Janell and MarkAnderson of Bismarck,N.Dak., have establishedthe James RuddMemorial ScholarshipEndowment, which willprovide scholarships forathletic training (AT)students and the firstscholarship in the AT program’s 25-yearhistory. Janell earned her Kinesiology andPublic Health Education degree from UNDin 1991 with a minor in Athletic Training.She is a radiologic technologist at MercyHospital in Valley City, N.Dak. James Ruddwas the inaugural chair of the AthleticTraining Program 1990–2003. He was anassistant professor when he passed awayin 2014. This fund includes gifts given byothers in his memory after he passed away.

Rev. Gerald Bass ofGrand Forks, N.Dak.,has established the GailShimer Bass OTScholarship in honor ofhis wife Gail Bass,PhD ’04. The fund willprovide scholarshipsfor occupationaltherapy (OT) students with preferencegiven to students interested in pediatricOT. Gail retired as an assistant professorof the UND OT Department inDecember 2014.

Dr. Cecil, BS Med ’63, and PennyChally of St. Paul, Minn., continue tosupport the Dr. Cecil and Penny ChallyMedical Scholarship Endowment, whichprovides scholarships to medical studentswith preference given to students fromWalsh County, North Dakota. Dr. Challyis a gastroenterologist at GastrointestinalDiagnostics Center in St. Paul, Minn.

The Dr. Eva Gilbertson Foundation inSeattle, Wash., continues to support theEva L. Gilbertson, MD DistinguishedChair of Geriatrics, which providessupport to the new Department ofGeriatrics and its Chair Dr. DonaldJurivich. Dr. Eva Gilbertson, BS Med ’39,was a radiologist at Pacific MedicalCenter in Seattle. She passed away in 2007.

M. Brian Hartz, MD ’99, of St. Paul, Minn.,has established the M. Brian Hartz, MDScholarship Endowment, which willprovide medical student scholarships. Dr. Hartz is a pulmonologist at the St.Paul Lung Clinic.

Betty (Wold) Johnson of Hopewell, N.J.,continues to support the Karl ChristianWold MD Medical Library Endowment,which provides funding for the Harley E.French Library of the Health Sciences;and the Katherine Maryann RasmussenMemorial Scholarship Endowment,which provides scholarships forphysician assistant students.

Dr. Donald, BS Med ’61, and BlanchePerson of San Antonio, Texas, haveestablished the Dr. Donald and BlanchePerson Scholarship Endowment, whichwill provide medical studentscholarships. Dr. Person, a native ofFargo, N.Dak., also supports the School’sAdopt-a-Med-Student Program annually.

to our thoughtful donorswho recently gave gifts or made pledges

to support the UND School of Medicine and Health Sciences.

James Rudd

Gail Bass


Gunshot wound to the femoral artery.Emergency childbirth. Resuscitation of a child who fell through thin ice and drowned.

These are a few scenarios theSMHS first- and second-year medicalstudents bravely took on in theSimlympics competitions on January 29and 30. Simlympics is a tournament-style simulation competition madepossible by cooperation between theSMHS Emergency Medicine InterestGroup (EMIG) and the North DakotaSimulation, Teaching, and Research(STAR) simulation training facility inGrand Forks.

Simlympics teams are presentedwith a case that could realisticallypresent to any local emergencydepartment. The teams must collectinformation about the patient’s historyand condition, and use leadership,teamwork, communication, and clinicalreasoning to establish appropriatedifferential diagnoses and to administereffective treatments. The simulationsprovide a high-pressure, low-stakesenvironment in which medical studentscan apply their classroom knowledgeand learn from their successes andmistakes in a forgiving atmosphere.

In the final round of the competition,first-year medical student finalists treateda patient who sustained a gunshotwound to the right femoral artery whileon a hunting trip. The winning teamwas composed of first-year studentsSyed (Nabeel) Hyder, Kathryn Johnson,Cameron MacInnis, DhilhanMarasinghe, and Vanessa Stumpf.

On Friday, January 30, three teamsof second-year medical students andone team of first-year medical studentsfaced challenging scenarios, includingpediatric cold-water drowning,pediatric Tylenol overdose, andemergency childbirth. The winningteam was composed of second-yearstudents David Collins, Wes Halseth,Steven McKnight, and Megan Meyer.

Simlympics 2015

First-year student winners: Syed (Nabeel) Hyder, Dhilhan Marasinghe, Vanessa Stumpf,Kathryn Johnson, and Cameron MacInnis.

Second-year student winners: Steven McKnight, Megan Meyer, Wes Halseth, and David Collins.

PARTING SHOTS


PARTING SHOTS

In December 2014, Dean Joshua Wynne thanked the School’s volunteer faculty as well as School faculty and staff at holidayreceptions held in Bismarck, Fargo, Grand Forks, and Minot.

The Physician Assistant Class of 2016 is shown on the steps of the Vennes Atrium of the School after the White Coat Ceremonyon January 16. For more information and a list of students and their hometowns, please visit http://tinyurl.com/n9b7tnw.

University of North Dakota School of Medicine and Health SciencesA National Leader in Rural Health - Serving North Dakota since 1905501 North Columbia Road Stop 9037 ● Grand Forks ND ● 58202-9037 701-777-4305 www.med.und.edu

ADDRESS SERVICE REQUESTED

Periodical POSTAGE PAID

Athletic TrainingJune 24, 2015 — St. Louis

www.med.UND.edu/events/at-2015.cfm

Upcoming Alumni ReceptionsHeld in conjunction with national conferences

Upcoming Alumni ReceptionsHeld in conjunction with national conferences

Occupational TherapyApril 17, 2015 — Nashville

www.med.UND.edu/events/ot-2015.cfmPhysician Assistants

May 23, 2015 — San Franciscowww.med.UND.edu/events/pa-2015.cfm

Bridging the Healthcare Generation Gapmed.und.edu/nd-medicine/_files/docs/spring-2015.pdf ·...

Documents

Transcript of Bridging the Healthcare Generation Gapmed.und.edu/nd-medicine/_files/docs/spring-2015.pdf ·...