MED-Midwest Medical Edition-December 2011

South Dakota and the Upper Midwest’s Magazine for Physicians and Healthcare Professionals

Decem

ber2011

Vol. 2, Issue 8

4101 West 41st StreetSioux Falls, SD 57106

(41st St. at the Empire Mall)

605-361-0361siouxfallsford.com Please contact us for more information on the NEW MV-1 - Available only at Sioux Falls Ford Lincoln!

INSPIRED BY YOU.

Built like a truck,yet rides like a car.

RESERVETODAY!

The Vehicle Production Group (VPG)

is proud to announce the new 2011 MV-1.

Made in America, the MV-1 is the first

vehicle designed from the ground up

for wheelchair accessibility. It is also

the first purpose-built vehicle to fully meet

or exceed ADA vehicle guidelines.

The dynamic ramp system of the MV-1,

which deploys from within the vehicle floor,

gives you easy entry and exit while

maintaining a generous amount of

interior space and seating up to six.

Comfortable rear seat providesa perfect fit for everyone.

Ramp exceeds Americanswith Disabilites Act (ADA) guidelines

with 1,200 lb. capacity. Easy entry and exit for all passengerswith a floor-to-ceiling height ofnearly 5 feet and a low step-in.

Ford 4.6L 2VEFI V8 Engine.

36” by 56” doorway.

Anti-slip floor and ramp surfaces providegreat traction and a safer entry and exit.

THE 2011

ContentsDecember 2011

Midwest Medical Edition

RegulaR FeatuRes

2 | From Us to You

26 | Off HoursSports Medicine Doc Goes After the Big Game

31 | Grape Expectations In Praise of Tradition ByHeatherTaylorBoysen

32 | News & NotesNews from around the region

33 | Learning Opportunities UpcomingSymposiums,ConferencesandCMECourses

In thIs Issue 6 | MEDPACtoCongress:RepealSGRNow ByDaveHewett

8 | SmartphoneApps:TheNewTrendinMedicine ByJeniceM.Deming

9 | WinnersofAMA’sAppChallenge

18 | AveraDedicatesNewCentennialSculpture

19 | AveraCampustobe‘InthePink’byMay

20 | HealthcareintheHome ByDr.MichaelFleming

21 | IowaProclaimed“PurpleState”

22 | NewScholarshipHelpsAt-RiskStudents

24 | ICResearchatStanford

25 | AMATakesonDrugShortages

30 | BlackHillsCardiovascularResearchSeeksStudyParticipants

Cover Feature

Top Stories2011

Top Stories2011

Ithasbeenanotheryearofgrowthandprogressfortheregion’smedical

community.Inourannualwrap-up,wehighlightthearea’slargenewEyeBank,outstandingphysician

musicians,adynamicruralclinic’s65thanniversary,SanfordChildren’snew

pediatricspecialists,SturgisrallytimeatRegionalHealth,androbotic

technologyinactionlocally.Wehopeitinspiresyournominationfor2012

In RevIewTales of the Super Sib Squad

ByTinaMelanson,MD

page 28

page 11

MidwestMedical2

FromUstoYouStayinginTouchwithMED

CoNTACTINFoRMATIoN

Steffanie Liston-Holtrop,VP Sales & Marketing

[email protected]

Alex Strauss, Editor in [email protected]

Fax 605-271-5486

MAILING ADDrESS PoBox90646SiouxFalls,SD57109

WEBSITE MidwestMedicalEdition.com

Jan/Feb Issue December 5

March Issue February 5

April/May Issue March 5

June Issue May 5

July/August Issue June 5

Sep/Oct Issue August 5

November Issue October 5

December Issue November 5

2012 Advertising / Editorial Deadlines

Reproductionoruseofthecontentsofthismagazineisprohibited.

©2011MidwestMedicalEdition,LLC

Midwest Medical Edition(MEDMagazine)iscommitted

tobringingour readershipof3500SouthDakotaarea

physiciansandhealthcareprofessionals thevery latest in

regionalmedicalnewsand informationtoenhancetheir

livesandpractices.MEDispublished8timesayearbyMED

Magazine,LLCandstrivestopublishonlyaccurateinforma-

tion,howeverMidwestMedicalEdition,LLCcannotbeheld

responsibleforconsequencesresultingfromerrorsoromis-

sions.AllmaterialinthismagazineisthepropertyofMED

Magazine,LLCandcannotbereproducedwithoutpermis-

sionofthepublisher.Wewelcomearticleproposals,story

suggestionsandunsolicitedarticlesandwillconsiderall

submissions forpublication.Pleasesendyour thoughts,

[email protected].

Magazinefeedbackandadvertisingandmarketinginquiries,

subscriptionrequestsandaddresschangescanbesentto

[email protected].

MEDisproducedeighttimesayearbyMEDMagazine,LLCwhichownstherightstoallcontent.

Publisher MED Magazine, LLC Sioux Falls, South Dakota

VPSales&Marketing Steffanie Liston-Holtrop EditorinChief Alex Strauss Design/ArtDirection Corbo Design CoverDesign Darrel Fickbohm WebDesign 5j Design ContributingEditor Darrel Fickbohm

ContributingWriters Heather Boysen Jenice Deming Michael Fleming Dave Hewett

Weaccept

readersubmission

Write

to us!

A letter from the vP and editor

Alex Strauss

Steffanie Liston-Holtrop

ALTHoUGHWEALWAYSTAkETHEoPPoRTUNITY

tolookbackatthetopstoriesfromthepastyear,

Decemberisalsoatimeforlookingforward.This

isthetimeofyearwhenwebeginplanningour

editorialcalendarforthecomingyear,preparingtocasta

spotlightontheoutstandinglocaldoctors,technologiesand

institutionsthatarebuildingSouthDakotaandsurrounding

statesintoaworldclassmedicalmarket.Weinviteyouto

takeamomenttothinkofworthysubjectsyouwouldlike

toseeusfeaturein2012.Tomakeiteasy,youwillfinda

nominationforminthisissue.

Wehopeyouwillfindinspirationinsomeotherpartsof

thisissue,too.Wehavelocalexpertsweighinginontopics

ranging from healthcare apps for your smartphone to

Congressionalactionsthataffectyourbottomlineandtoasts

foryourNewYear’sbash.Weintroduceyoutoasports

medicinedoctorwhoseownsporthastakenhimtosomeoftheremotest

partsoftheglobe.Andwewillfindoutwhatinspiredakidneydoctortotry

herhandatkids’books.Plus,allthelocalmedicalnewsandeventsthatyou

havecometoexpectfromMED.Enjoy!

FromtheentirelocalMEDteam,blessingstoyouandyoursthisholiday

season.— Steff & Alex

TheMedMagazineAdvisoryBoard

JohnBerdahl,MD,ophthalmology

Vance Thompson Vision, Sioux Falls

DanHeinemann,MD,Family Practice/AdministrationSanford Health,

Sioux Falls

LuisA.Rojas,MD,Gynecologic OncologyAvera Women’s Center for Gynecologic Cancer, Sioux Falls

JamesW.Young,Do,FAoCD,DermatologyYankton Medical Clinic, PC, Yankton

BradleyRandall,MD.Forensic Pathology

Dakota Forensic Consulting, Sioux Falls

PattyPeters,MD,Family Practice

Avera McGreevy Clinic, Sioux Falls

TimothyMetz,MD,Anesthesiology

Anesthesiology and Pain Management,

Sioux Falls

DanielW.Todd,MD,Otolaryngology

Midwest Ear, Nose & Throat, P.C.,

Sioux Falls

200

-463

50-0

368

10/1

1

Dr. Michele Corsini’s compassion helps her recognize victories in the cancer journey. We’re proud to offer mastery, innovation and personalized care at every stage. For all the victories you seek, Sanford Cancer.

View my victory story at cancer.sanfordhealth.org.

My word is

compassion

MEDMagazine

2012 Call for nominations

Pleaseincludethefollowinginformation:

NameofNominee______________________________________________________________________________________________________

LocationofPractice_____________________________________________________________________________________________________

ReasonforNomination__________________________________________________________________________________________________

______________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________

YourName____________________________________________________________________________________________________________

YourContactInformation________________________________________________________________________________________________

MED noMInATIon FoRM

Mail / Fax or email thisformto:PoBox90646SiouxFalls,SD57109—Fax 605-271-5486—email [email protected]

MED Magazine is seeking Nominations for Cover and Feature Article topics for 2012. MED is committed to focusing on pioneering physicians, institutions, programs and technologies that are paving the way for the future of healthcare in our region. No one knows these pioneers better than MED readers.

If you know of a person or program that deserves a closer look, tell us about them. (Self-referrals are permitted!) Send us the following information via fax, mail or email.

In whose hands will you place her?

Physicians’ Priority Line 1.888.592.7955

Intensive Care for Newborns

www.ChildrensOmaha.org

When a newborn is critically ill, a single call gives you instant access to our neonatal intensive care specialists and a full range of pediatric and surgical subspecialists, all supported by state-of-the-art technology and equipment. It can also link you to our neonatal transport service team, who will arrange for transport to Children’s Hospital & Medical Center based on the child’s needs. Twenty-four hours a day, seven days a week, one call links you to physician-to-physician consults, referrals and admissions. There’s no problem too large, no child too small.

Med Mag.Sept., 2011indd 1 8/2/11 2:22 PM

MidwestMedicalEdition6

MEDPACtoCongress Repeal SGR nowBy Dave Hewett , President/CEO, SDAHO

THE MEDICArEPAYMENTAdvisoryCommission (MEDPAC) has sent aspecial report to Congress recom-mending the repeal of Medicare’s

Sustainable Growth Rate (SGR) system – thatprogram’s methodology for paying physiciansand other health care professionals. Describingthe system as “fundamentally flawed” and as“creatinginstabilityintheMedicareprogramforprovidersandbeneficiaries”,MEDPAChascon-cluded that the risks of retaining the SGRnowoutweighthebenefitsandthecostofeliminationwillonlyincreaseinthefuture.

So,eliminateandreplacewithwhat?MEDPACisproposingatenyearfreezeofpaymentratesforprimarycarephysicians.Medicarefeesfornon-primarycareserviceswouldbereducedby5.9%eachyearforthreeyearsandthenfrozenfortheremainingseven.MEDPACjustifiesthisdif-ferentiation by noting that based on surveysprimarycareprovidersaremorelikelytolimitthenumberofMedicarepatientstheyseecomparedtospecialistsandotherMedicareproviders.

Butthereareotherrecommendationsthatwillalsoimpactpaymentrates.Thefirstishowdataarecollected toestablishRelativeValueUnits(RVU’s).MEDPACbelievesseveralofthecurrentdatasourcesarebiasedandisrecommendingthattheDepartmentofHealthandHumanServices(HHS)collectdataonacohortofpractitioneroffices–officesthatrepresentabroadrangeofspecialtiesandpracticeswithfeaturesthatmakethemefficient.Inotherwords,RVU’swouldnotbebasedon“theaverage”butratherthosedeemedtobemorecosteffective–therebyfurtherpenal-izingthosedeemedtobelessefficient.

Inarelatedrecommendation,MEDPACasksHHStoidentifyoverpricedfee-scheduleservicesandreducetheirRVU’saccordingly.Thisrequire-ment is tobebudget-neutralbutclearlywouldreconfigure reimbursement levels amongandbetweenthedifferentproviders.

Finally,MEDPACattempts to inject“valuebased”ratherthan“volumebased”incentivesintoitsrevisedpaymentsystembyrewardingphysi-ciansandhealthprofessionalswhojoinorleadAccountableCareOrganizations(ACO’s)–espe-ciallythoseACO’sthatwouldassumebothfinancialriskandreward.The“reward”wouldbetoexemptallparticipatingphysiciansfromthethreeyearfeereductionsdescribedabove.

Keepinmindthatthesearejustrecommenda-tionstoCongress.MEDPAChasnoactualauthoritytoimplementtherecommendationsitproduces.Andforawholehostofreasons,I’massumingthatCongresswon’tbegettingaroundtopassingthiskindofprogramanytimesoon.

Thatsaid,itisinstructivetonotethegrowingdiscontentwithSGR–liketherewasn’tenoughalready.Moreimportantly,theserecommendationsoffer aglimpseas tohowMedicarepaymentstophysiciansmaybealteredtoreplaceinpart“volume-based”orfee-for-servicepaymentincen-tiveswiththosethatrewardvalueandefficienciesofcare.

Tworelatedobservationsarenecessary.First,thedollarreductionsinthisproposalaremassive($219billion)buttheyarelessthanifthe1996programwereallowedtoproceedwithoutadjust-ments($300billion).IfthereisevenaglimmerofasilverlininginthisforSouthDakota,itisthatprovidersinthisstatewilllikelybeharmedlessthanthose inotherpartsof thecountrywheregreaterconcentrationsofspecialistsandlessercommitmentstointegratedcareexist.

It’sunlikelythatthesespecificrecommenda-tionswillevercometofruition.ButasthepublicpolicydebateonMedicarephysicianreimburse-mentmovesfrompatchingupthecurrentSGRsystemtooneofreform,itisimportanttoknowjusthownewpracticeincentivesmightbewovenintothatsystemandhowthatimpactsproviders’planningforthefuture.■

Hypertension is oneof the most serious healthproblems in the country.

Fortunately, itʼs also one ofthe easiest to diagnose

and treat.You know the classificationsand risks. Donʼt assume your

patients do. Talk to themabout their BP and do it often.Breaking the silence is one

of the best ways to fightthis silent killer.

December2011 7MidwestMedicalEdition.comMidwestMedicalEdition.com

Bankers Trust Companyof South Dakota

5032 S. Bur Oak PlaceSuite 131Sioux Falls, SD 57108

(605) 338-5033

ProvidingExperienced & Personalized

Trust Services

• Asset Protection• Product Knowledge• Comprehensive Solutions• Personal Service

“THE rELEASE OF THE MEDICArE physician fee schedule

ruleservesasaremindertoCongressthatthereisalooming

crisis in the Medicare program only they can stop, and the

clockisticking.WithoutswiftactionbyCongress,onJanuary

1physicianswhocareforMedicarepatientswillbehitwitha

27.4 percent cut caused by the broken Medicare physician

paymentformula.

“Many physicians are already struggling with inadequate

Medicarepaymentratesandtheongoingthreatoffuturecutsfrom

thisbrokenphysicianpaymentformula.PaymentsforMedicare

physicianserviceshavefallensofarbelowincreasesinmedical

practicecoststhatthereisa20percentgapbetweenMedicare

paymentupdatesandthecostofcaringforseniors.TheJoint

SelectCommitteeonDeficitReductionmust includerepealof

theformulaintheirrecommendationtoCongresstoprotectaccess

tocareforseniorsandstabilizetheMedicareprogram.”■

FromAMAPresidentPeterW.Carmel,MD


A SMArTPHONE isn’t justa phone. It’s a miniaturecomputer. We surf theweb, email, play games,

and—thanks to the rapidly expandingworld of smartphone applications(“apps”)–use our smartphones andotherwirelessdevices as tools for theworkplace. The field of medicine ischanging rapidly with the growth ofavailable medical apps. Today, physi-cians can monitor a patient’s vitalsigns, download their patient sched-ules, access current patient medicalrecords, dictate office notes, and con-sult with other physicians withoutenteringaclinicalsetting.

Oneofthefirstmedicalappsinuseand arguably the most widely usedmedicalapptoday—isEpocrates,1whichprovidesclinicalinformationonthou-sandsofprescriptionandover-the-counterdrugs.2Anotherusefultool,Mediqua-tions,isamedicalcalculatorthatincludes229medicalformulasandscoringtools.3ExamplesofappsavailabletospecialtyfieldsincludetheACCPocketGuide-lines for cardiology, Anesthesiology

i-pocketcards, and CORE—ClinicalOrthopedicExamfororthopedicsur-geons.Suchappsprovideamultitudeofup-to-date references immediatelyaccessibleatthetimeofcare.

Unlikereferenceapps,AirStripOBisasemi-interactiveappthatistakingtheobstetricalworldbystorm.AirStripOBallowsphysicianstomonitorfetalhearttracingsandmaternalcontractionsinreal timeontheirmobiledevices.4AirStripTechnologieshascreatedaddi-tional apps to includemore areas ofinpatientandhomecaremanagement.While patients may be comfortedknowingtheirphysiciancanremotelymonitorwhatisoccurring,suchappsshouldnottaketheplaceofface-to-faceinteraction.

Anotherrecenttrendincludesmobiledictation,whichallowsphysicians todictateinformationthatcanbetransmit-ted and/or directly transferred to anelectronichealthrecord.Insomecases,theseappsalsoallowphysicianstoviewpatientlists,searchpatientIDs,anddis-playcurrentpatientinformationontheirmobiledevice.5

REFERENCES

1,2,3.Neal,H.“TheBestMedicaliPhoneAppsforDoctorsandMedStudents.”SoftwareAdviceBlog,December9,2010,www.softwareadvice.com/articles/medical/the-best-medical-iphone-apps-for-doctors-and-med-students-1100709/#ixzz1B34Cg6c4(accessedJanuary11,2011).

4,9.Farrel,J.“MarketingDealtoExtendAirStripoBReach.”TheMobilityBlog,August31,2010,www.mobilehealthwatch.com/blog/marketing-deal-extend-airstrip-ob-reach(accessedDecember17,2010).

5. Dolan, B. “3M Launches Smartphone Physician Dictation App.” December 16, 2009,wwwmobilehealthnewscom/5793/3m-launches-smartphone-physician-dictation-service/(accessedJanuary12,2011).

6.Wysopal,C.“SmartphoneAppSecurityIssuesBeingoverlookedbyCompanies.”July21,2010,http://www.infosecurity-us.com/view/11133/smartphone-app-security-issues-being-overlooked-by-companies(accessedDecember17,2010).

7,8.GuidanceSpecifyingtheTechnologiesandMethodologiesThatRenderProtectedHealthInformationUnusable,Unreadable,orIndecipherabletoUnauthorizedIndividualsforPurposesoftheBreachNotificationRequirementsUnderSection13402ofTitleXIIIoftheAmericanRecoveryandReinvestmentActof2009;RequestforInformation,74Fed.Reg.19,006(2009).

Copyright©2011ProAssuranceCorporation.

Thisarticleisnotintendedtoprovidelegaladvice,andnoattemptismadetosuggestmoreorlessappropriatemedicalconduct.

SMARTPHoNEAPPSTheNewTrendinMedicine

New Technology—New RisksAswith any newmedical device,

therearerisks.Unsecuredsmartphonescanbe“plunderedbycybercriminalsfordata,”andsmartphoneappsare“oftenoverlookedwhenitcomestotestingthesecurityofsmartphones.”6TheHealthInformationTechnologyforEconomicand Clinical Health (HITECH) Actrequiresnotificationwheneverabreachofunsecuredprotectedhealthinforma-tion (PHI) occurs.7 Additionally, theDepartment of Health and HumanServices requires securityofPHIonstoragedevices(harddrives),transmis-sionmedia(cyberspace),andportableelectronicmedia(e.g.,smartphones).8

By Jenice M. Deming, JD, risk Management Consultant, ProAssurance

Pho

to c

ou

rte

sy o

f A

irSt

rip

Te

chn

olo

gie

s In

c A

irSt

rip

OB

™ is

a t

rad

emar

k o

f A

irSt

rip

Te

chn

olo

gie

s In

c.

AirStrip OB™

December2011 9MidwestMedicalEdition.com

Exclusively promoted and recommended by the South Dakota State Medical Association.

You’re always there for them.

We’re always here for you.

We have defended and supported the individual needs of health professionals for more than 30 years. And nobody is more personally

committed to protecting you from the risks you face every day.

To learn more, call 888-397-3034 or visit MMICGroup.com

CHICAGO – THE AMErICAN Med-ical Association has announced thatCynthia L. Beamer, M.D., of Texasand Michael Ray Bykhovsky ofGeorgia, have won the 2011 AMAApp Challenge with their ideas forthenextgreatmedicalapp.

“Out of the hundreds of ideassubmitted,twowereselectedbyAMAmembersasthenextgreatmedicalappideas,”saysAMAChair-ElectStevenJ.Stack,M.D.“Appsareamongthemanywaysphysicianslearn,stayconnectedandjugglebusyschedules.”

Dr. Beamer’s idea, the Rounderapp,wonthephysiciancategory,andMr.Bykhovsky’sidea,theJAMAClini-calChallengeapp,wontheresident/fellow/medicalstudentcategory.

TheRounderappwouldprovidea

datacapturepointforinformationonhospitalpatients,allowingphysicianstoeasilykeep trackof theirpatients’progress.TheJAMAClinicalChallengeappwouldpresentclinicalvignettesandimagesalongwithmedicalcaseinforma-tion,servingasalearningtool.

Earlier this year,U.S.physicians,residents andmedical studentswereinvitedtosubmittheiruniqueappideasforachancetohavetheAMAbringittolife.Outofthehundredsofsubmittedideas,10wereselectedasfinalists,andAMAmembersvotedfortheirfavoriteappideas.Thewinnerseachreceived$2,500incashandprizes,plusa tripfortwotoNewOrleansfortheunveilingof theirwinning ideasat theAMA’ssemi-annualpolicy-makingmeetinginNovember.■

AMA Announces 2011APPChallengeWinners

Consider the typesof informationstoredonyourmobiledevice.ReferenceguidessuchasEpocratesshouldnotbea HIPAA risk. However, PHI saveddirectlytothedevicebydictationappsshould be secure. Beyond storageissues,physiciansshouldconsiderthesecurityofPHItransmittedviamobiledevices.AppssuchasAirstripOBthattransmitPHIcouldbe interceptedbyhackersand/orcorruptedbyavirus.This risk can bemitigated by usingencryptionsoftwarethatmakesthedataunusablebyanypartywhomayinter-ceptitduringtransmission.Someappcreators, likeAirStripTechnologies,advertise their products as HIPAAcompliant.9

Regardlessofwhetheraphysician’smobiledeviceisusedtoaccess,trans-mit,orstorePHI,considerallHIPAAandHITECH requirements. HIPAArequires data security and properdestruction,and/orfileretentionofPHIwhenappropriate.Beforediscardingdeviceswithapps,physiciansshouldhavePHIremovedtoensureHIPAAcompliance.

What Can You Do?s Reviewpotentialwirelessappsto

ensuresecurityofPHIatalllevels;

s Limitthetypeofappsthatcanbeusedbasedupon the individualapp’slevelofsecurity;

s Developasecuritypolicyaddress-ingmobiledevicesandappsthatcan be used, along with theappropriateuseanddestructionofPHIdata;

s Develop an eDiscovery policyrequiringassistancefromdefensecounseloryourlocalProAssur-anceriskmanagementofficeinretaining PHI in the event oflitigation;and

s WorkcloselywithITpersonneltoaddressallsecurityissues.■


December 2011

Dear MED Reader,For more than 20 years, the creators of MED (Midwest Medical Edition) Magazine

have had their finger on the pulse of medicine in the South Dakota region.Before the first laparoscopic surgery was performed in our area or the first MRI suite

installed . . . Before the first freestanding Heart Hospital, acute care Children’s Hospital, Cancer Center or Surgical Hospital opened . . . Before HIPAA, Medicare cuts, or Electronic Medical Records . . . Even before the words ‘Sanford’ and ‘Avera’ were household terms . . . we were committed to producing compelling and relevant local medical news.

Through years of getting to know so many of you, we have come to understand that the healthcare professionals who read this news are more than a set of technical skills. You are also parents, volunteers, teachers, artists, entrepreneurs, athletes and more. So our vision for a local medical magazine expanded to encompass the rich artistic, educational, business and cultural interests that make you not only better physicians, but also better people.

And MED was born.With MED, you will never see a ‘cookie cutter’ approach to publishing. Instead, every

issue is a truly local, truly customized publication created with you in mind. Only MED invites you to reminisce, gives voice to controversial ideas, celebrates physician talent, lifts up volunteer efforts, takes you inside new facilities and, as always, covers every major clinical advance.

Written, designed and printed right here in our area, with the support of local advertisers, MED is also a proud part of our region’s economy. With the direction of a local physician advisory board, the dedication of a Sioux Falls-based design and sales team, and the contributions of professionals who live here, we are excited to keep growing and changing right along with this vibrant medical community.

Sincerely,

The MED team

Top Stories2011

Top Stories2011B

y A

lex

Stra

uss

ASeasonInReview

is proud to feature a wide variety of cover article subjects each year, from the largest health systems, to the most progressive independent practices and exceptional individual providers. We not only look at extraordinary people, programs and institutions, but we examine issues and trends that impact the evolving practice of medicine in our region.

As has long been our tradition, we wrap up our publication year with another look at this year’s MED Top Stories. Following are excerpts from this year’s MED Magazine.

MED Magazine

Ifyouknowofaperson,institution,orprogramthatyouwouldliketoseefeaturedinMED,pleaseshareyourideaswithus.LookfortheNominationForminthisissue.

20112011January

February

12

Hope is in SightTheSouthDakotaLionsEyeBankExpandsitsServices

NEWS FlASH RodneyR.Parry,M.D.,retiredinJune2011asDeanoftheSanfordSchoolofMedicineofTheUniversityofSouthDakotaaswellasUSD’sVicePresidentofHealthAffairs.In2004,ParrywasnamedInterimDeanandbecameDeanin2005.Hehadbeenamedicalschoolfacultymemberfor35years.

FOr 20 YEArS, the SouthDakota Lions Eye Bank hasbeenquietlyhelpingtorestoresight to thousands of people

inSouthDakotaandsurroundingstates.“In2010,wehaveprovidedcorneal

transplantstonearly500people,”saysEye Bank Executive Director JensSaakvitne.

Withtheneedfortransplantablecor-neasandtissuescontinuingtorise,theEyeBankrecentlyopenedthedoorsofanew,expandedfacility.Inadditiontoaddedspacefortissueprocessingandstorage,the14,000squarefootbuildingfeatures surgical suiteswith hospitalgradeHEPAfiltrationforon-siterecov-eryandmorespaceforeyeandtissueresearchprojects,stafftraining,andeven

training space for emergency firstrespondersworkers.

Thisyear, theEyeBankaddedtheword ‘Tissue’ to its title to reflect theexpansionof itsprocurementservicesoverthepastdecade.EyeBankprofes-sionalsnowregularlycollectavarietyoftissues other than corneas, includingbone,connectivetissuesliketendonsandligaments,heartvalvesandveins.TissuesprocuredbytheEyeBankareshippedtooneofseveralnationalprocessingcenterstobepreppedfornationaldistribution.

Eventhoughimprovedfacilities,newequipmentandadvancedtechnologyareenablingtheEyeBanktotouchmorelives,Saakvitnesaysitisstillthedonorsand their familieswhomust get thegreatestcredit.

“Itstartswithafamily.Itifweren’tforpeoplebeingwillingtosignupasdonorsandfamiliesbeingwillingtosay,inthemidstofunspeakablegrief,‘Yes,webelieveinthis’,noneofthesemiraclescouldhappen.Itistheirincrediblekind-nessthatmakesallofthispossible.”•

Alan Berdahl, Tissue Distribution Specialist, examines a cornea to determine its integrity.

20112011March


TheRe IS AN IMMeNSe

ARTISTIC CuRReNT

MOvINg ThROugh The

MeDICAl COMMuNITY,inspiringapassionforcreatingandperformingmatchedonlybythedesiretoexcelinmedicalpractice.WechosethreemusicianstolaunchMED’songoingcoverageofphysiciansintheartsandencouragedthemtotellustheirstoriesintheirownwords.

ChRIS CARlISle, MD Emergency Physician and Cellist

Iactuallymajoredinmusicmyfirstyear…andwasn’tasgoodasIthoughtIwas.SoIswitchedtoengineering.ButIkeptplaying;wehadanexcellentorches-trainthecommunity.

ItcamebacktomeafterIhadkidsandtheystartedtakingpianolessons.IwasgraduallyinspiredtotryoutfortheSouthDakotaSymphonyOrchestra.Acouplethingshappenedthatgotmeseriouslyinspired:ThePavilionwasbuilt,anditwassuchabeautifulfacility,andthenYoYoMa, thegreatcellist,wasgoingtocomeplayhere.AllofasuddenIhadnoexcuses,andIhadtoatleasttry.

Someofmymostadmiredscientificmindswerealsomusical,andIthinktheremustbesomecrossoverinthebrainthatcausesthetwotohavemanymoresimi-laritiesthanI’mabletoputtogether.AlbertEinstein,aviolinist,comestomind.

DonAlD BAuM, PhD Psychologist and Drummer

Ithinkthere’sdefinitelyacorrelationbetweenthescientificandtheartistic.Especiallywith drumming, there’s acorrelationbetweenpatterns.It’smath-ematicsandrhythm.Justasmusicianshipandpsychologyworktogether;theybothhave sort of a creative perspective.

Different, yes, but bothgive a lot ofleewayforcreativeintelligence.

Itdoesn’tsurprisemeatallthatmanyphysicianstendtomusic.Ithinkpartofthatishowthemedicalculturealwaysseemstopushtheachievement/perfectionthingtothelimit.Nothingisevergoodenough,andIthinkthatcarriesonintothemusic,too.

It’s a balancing act, between themedicalandmusicalworlds.Youdon’twanttoputallyoureggsinonebasket,whichworkstheotherwayaround,too.The therapy and Psychology makesdrumming thatmuchmore fun—it’ssucharelease.Theybothbenefitfromeachother, though.Thedrummingiscreative,but it’salsoveryphysical,soit’salsolikeaworkoutforme.

MARIAn PeTRASko, MD, PhDCardiologist and Pianist

ItwasattheendofhighschoolwhenIstartedthinkingaboutchoosingbetweena“realjob”ormusic—Idecidedtokeepit[music]asahobby.Buttherearealwayschancestoplay.

AfterImovedhere,Ifoundoutthattheyhave thiswonderfulDoctors inRecitalprogram.SoImadeacalltotheChildren’sCareHospitalandSchooltoseeifIcouldauditionandbeapartofit.It’stotallydif-ferent to play something for someonebesidesyourselforyourfamily.It’smoredifficult.Youpracticetoperfection.

Musictomeissomethingbetweenthe rational and the emotional. As aphysicianyoustarttoseethevulnerabil-ityasaraceandhowlittlethedifferenceis between life and death, or ill andhealthy. Perhaps you are looking forsomethingtorechargeyouafterlookingatsuchissues.Afteradifficultday, itsortofjustwashesoutthebrain.•

Music and Medicine South Dakota Symphony Cellist and Er Physician, Chris Carlisle, MD.

Ph

oto

s b

y r

eist

roff

er

De

sig

ns,

Co

urt

esy

Ch

ild

ren

’s C

are

Ho

spit

al a

nd

Sch

oo

l

Dr. Petrasko performing with Julie Melik-Stepanov in the annual CCHS fundraiser, Doctors in Concert.

Dr.Young


FOrMED BY THE MErGErOF TWO SEPArATE CLINICS, theMedical Clinic and the Yankton Clinic, both of which wereestablishedin1946,theYanktonMedicalClinic,P.C.openedinitsnewincarnationin1982andhaslookedforwardeversince.

“Yanktonhasalongtraditionofhavingveryprogressivehealthcare,”saysboard-certifieddermatologistJamesYoung,DO,FAOCDwhojoined theYanktonMedicalClinic13yearsago.Notonlydidtheclinicbringhisandotherspecialtiestotown,butitalsoopenedthefirstAmbulatorySurgicalCenterthereinthelate1980’s.

Whatbeganwithjustahandfulofprimarycarephysicianshasgrownintoaregionalpracticeof39primarycaredoctorsandspecialistsand5physicianassistants.Theseprovidersrepresentmorethan16areasofexpertise,includingprimarycare–familymedicine,internalmedicine,ob/gynandpediatrics–andmedicalandsurgicalspecialties.Comprehensivediagnosticimaging,includingMRIandotherancillaryservicessuchasanonsitepharmacyownedandoper-atedbytheclinichavehelpedtomaketheYanktonMedicalClinica‘onestopshop’forhealthcare.

Thenewly-constructedAmbulatorySurgeryCenterfeaturesfully-equippedoperatingroomsinwhichsurgeonsperformoutpatientproceduressuchaseartubesandtonsillectomies,colonoscopyandflexiblesigmoidoscopy,herniarepair,breast,prostateandskinbiopsies,laparoscopiccholecystectomy,appen-dectomy,vasectomyandanumberofob/gynprocedures.

“Foratownof13,000,thisisquiteunique,”saysDanielMegard,MD,aboard-certifiedInternalMedicinephysicianwhojoinedtheclinic19yearsago.

Update:YanktonMedicalClinichasrecentlyaddedanephrologistandwillwelcomearheumatologistandlaunchahospitalistprogramin2012.•

Hometown Healthcare65YearsofProgressiveCareinYankton

NEWS FlASH kurtStone,M.D.,MedicalDirectoratRapidCityRegionalHospital(RCRH)FamilyMedicineResidencyClinicwasnamedtheSouthDakotaAcademyofFamilyPhysicians(SDAFP)2011FamilyDoctoroftheYear.StonehasbeenpracticingintheRapidCityareasince1993.

Photos courtesy YMC

The Medical Clinic merged with the Yankton Clinic 65 years ago to form Yankton Medical Clinic, PC.

April/May

Dr.Megard

December2011 15MidwestMedicalEdition.com 15

Turning TwoSanfordChildren’sHospital...HeretoStay

Gearing UpHowRegionalHealthGetsReadytoRally

FOr 11 MONTHS OUT OF THE YEAr,RegionalHealth serves a population of about 400,000people. But in early August, during the SturgisMotorcycle Rally, another 500,000 people flow

into this ruralarea.RegionalHealthapproaches the influxlikeaplannednaturaldisaster.Inadditiontoregularplan-ning meetings with all Regional Hospitals beginning inMarch,RapidCityRegionalHospitaltakespartinamulti-disciplinary task force that includes law enforcement,FEMA,theNationalGuardandEMSservices.

“Theoperationalfootingofthehospitaldefinitelytakesonthetenorofamajordisasterresponse,”saystraumasurgeonJustinGreen,MD,DirectorofTraumaandSurgicalCriticalCareServicesatRapidCityRegionalHospital.

DuringthecourseoftheRally,thesystemusuallylogsabout800Rally-relatedEmergencyDepartmentvisitsandonitsbusiestdayhasabout40Rally-relatedinpatients.AlthoughaccidentsandassaultsusedtoaccountformostoftheRally-relatedemergencies,thechangingdemographicsandthesheersizeofthecrowdhaveresultedinagradualshiftinthetypesofmedicalproblemsseen.Chronicconditionslikeheartdis-easeanddiabetesarefarmorecommonthantheyusedtobeandphysiciansroutinelyseeheartattacks,strokes,diabeticreactions,musclespullsandorthopedicinjuries,birthsand,sometimes,deaths.

“Wetaketheattitudethatitisbettertosweatinpracticethantobleedinwar,”saysRegionalHealthCOOTimSughrue.“Weareabetterorganizationbecauseofthis.”•

IN THE LAST TWO YEArS, SANFOrD CHILDrEN’SHospitalhasmaturedintoaregionalcenterfortertiarycare,notonlyinSouthDakotabutinWesternMinne-sota and the adjoining states,” says Sanford’s Chief

PediatricMedical Officer, Dr. Gene Hoyme, Chair of theDepartmentofPediatricsattheSanfordSchoolofMedicine.“Oneofthemostimportantthingsthathavingthehospitalhasallowedustodoisrecruitasignificantnumberofhighqualitypediatricspecialists.”

SanfordChildren’sincludesanumberofpediatricspecial-ties,suchaspediatricurology,nephrology,infectiousdisease,hospitalists, and soon, pediatric ENT that are availablenowhereelseintheregion.Inthepasttwoyears,Sanfordhasadded9pediatricspecialistsincludingagastroenterologist,nephrologist,urologist,hematologist/oncologist,optometrist,infectiousdiseasespecialist,andthreeadditionalhospitalists.Thepediatrichospitalistprogramisoneofthefastergrowingsubspecialtyareasforthehospital.

OneofthebiggestchangesatSanfordChildren’ssincethehospitalopenedistheadditionoftheregion’sfirstpediatricresidencyprogram.AccreditedlastMaybytheAccreditationCouncilforGraduateMedicalEducation,thenew3-yearpro-gramaccepteditsfirstclassofsixresidentsthissummer.

Asuccessfulfirstresidencyprogramalsoopensthedoortoothertypesofresidencyprogramsinthefuture.Itmayevenpavethewayforafellowshipprogramatatimewhenthenumberofpediatricsubspecialists,andtheprogramstotrainthem,isinadequatetomeetthedemand.•

Sanford Children’s atrium

Photo courtesy regional Health As many as 500,000 attend the Sturgis Motorcycle rally each year.

July AugustJune

Septemberoctober

16

oNCE THE STUFF OF SCIENCE FICTION, robotsarenowascien-tificfact.Rollingrobotsarestreamliningmedicationmanagementinlocalhospitals;humanoidrobotsserveaslife-liketrainingtoolsformedicalstudentsandEMSworkers;andtelemedicine-equipped

robotsarebringingspecialistsintounderservedpartsoftheregion.Butperhapsthemostprofoundandfar-reachingapplicationforroboticsinmedicineisinsidetheoperatingroom.

SanfordacquireditsfirstdaVinciroboticsurgicalsystemin2004andAverain2007.Bothhospitalslateraddedsecondsystems.“Anytimeyoucanimproveexposureandvisualization,youaregoingtohaveabetteroutcome,”saysSanfordgynecologiconcologistMariaBell,MD,whohasperformedmorethan700roboticassistedoperations.

“HereatAvera,wenowdoaboutthreequartersofourminimallyinvasivesurgerieswiththerobot,”saysgynecologiconcologistLuisRojas,MD.

InSouthDakota,gynecologicproceduresarethemostcommonroboticproceduresfollowedbyurologicsurgeriesincludingprostatectomy.Generalsurgeonsintheregionhavealsousedtherobotforadrenalectomy,Nissenfundoplication,colonandesophagealprocedures.SanfordheadandneckcancersurgeonJohnLee,MD,recentlybeganofferingtransoralroboticsurgeryforincision-freeexcisionoftumorsinthetonsilorbaseofthetonguewhichmayreduceradiationexposureandhelpsomepatientsavoidchemotherapy.

AtAveraMcKennan,rollingAethontubrobotsdistributemedicationsthatcan’tbedeliveredviathepneumatictubesystembecauseofcomposition,size,weightorotherfactors.

“Thelongevityofsurgeonscoulddefinitelybelengthenedwithrobotics,”saysDr.Bell.•

NEWS FlASH SanfordHealthassumedoperationofaprimarycareclinicinCapeCoast,GhanaandannouncednewclinicsinBaja,MexicoandCarmiel,Israel.ThethreenewclinicsarepartofagroupofsevenclinicsannouncedbySanfordaspartoftheinitiativesoutlinedin2007.

NEWS FlASH TheCareflightAirTransportprogramatAveraMckennanHospital&UniversityHealthCenteriscelebratingits25thyearinservice.Careflightaverages1,200flightsayear.

Aethon ‘tug’ robots deliver

medications that can’t be sent through the

hospital’s pneu-matic tube system.

The Electric DoctorsHow robots are Transforming Medicine

Septemberoctober

november

17MidwestMedicalEdition.com

NEWS FlASH ThenumberofPhysicianAssistantsinSouthDakota–andtheamountofmoneytheyareearning–isontheincrease,reflectinganationaltrendthathasmorePAsinpracticethaneverbefore.Approximately450PA’snowpracticeinthestate.

Telling the StoryAvera’sFirstHundredYears

AVErA MCKENNAN HOSPITAL & UNIVErSITY HEALTH CENTEriscelebratingahundredyearsofprovidinghealthcare toSiouxFallsandthesurroundingcommunities.

OpeninDecember1911,AveraMcKennanisnowa545-bedtertiaryhospitalandhealthnetworkthatalsoincludes14regionalhospitals,over70primaryandspecialtycareclinics,longtermcarefacilitiesandmore.Annualinpatientadmis-sionsarenowapproaching22,000withover260,000outpatientvisitsandamillionclinicvisitsayear.IthasbeenrunbythePresentationSistersofAberdeensinceitopened.

“WhenwejoinedwiththeBenedictineSisterstoformAvera,itwasarealshiftforus,togiveupsoleownershipofsomethingthatwehadreallyputourblood,sweatandtearsinto,”saysSisterMaryThomas,SeniorVicePresidentofMission.“Butweknewthatitwastherightthingtodoasthehospitalgrew.”

“Eventhoughourabilitytoservepatientsisfarmoresophisticatedandbroad-based,somehowthePresentationandBenedictineSistershavemanagedtopreserveaphilosophyofhealthcarebeingaministrythatisrootedinthegospel,”saysretiredgeneralsurgeonPatMcGreevy,MD,whopracticedatAverafor36years.

“Ifyourmissionisjusttomeetneeds,itguaranteesthatyouaregoingtoremainrelevanttoyourcommunity,”saysAveraHealthCOOandlongtimeMcKennanCEOFredSlunecka.“ThatiswhyIhavenodoubtthatinanother100yearsoursuccessorswillbecelebratingthe200thanniversary.”•

Both Sanford and Avera utilize the da Vinci robotic System for many types of surgical procedures.

Song of Creation


PArT OF AVErA MCKENNAN’S celebration of its centennial includedtheunveilingofa31-foothighstainlesssteelsculptureentitledSong of Creation.

The commissioned sculpture wasdesignedandcreatedbySouthDakotasculptorDaleLamphereofSturgis.Ithas been installed on the lawn justnorthofthePrairieCenter.Thecostofthe work was covered by the AveraMcKennanFoundation.

“AveraMcKennanhaslongrecog-nizedtheimportantroletheartsplayinhealingthewholeperson–body,mindandspirit.And,celebratingacentennialisaonce-in-a-lifetimeopportunity.Wethoughtitwasonlyfittingtocommissionaspecialsculpturethatcommemoratesourcentennial,andservesasaniconofallthatAveraMcKennanhasbeen,is,andwillbeinthefuture,”saidDr.DavidKapaska,regionalpresidentandCEOofAveraMcKennan.“Wethankourmanydonorswhojoininthiscommitment,makingitpossibletosharethisandotherexpressions of the arts with ourcommunity.”

The sculpture’s design includeselementsofspirituality,animportantcomponentofAveraMcKennan’sCatho-licheritage,aswellas theadvancingscienceofmedicineandtechnology.

LampheresaidthesculptureincludestheBenedictine cross, and sixmajorelements that honor the Presentationheritage.“Wovenintoitisadoublehelixform,whichspeaksofscienceandDNA.Throughitsspiritualelements,thepiecepointstowardtheultimatesourceoflife.Amelodic,lyricallineflowsthroughthepiece,asitdoesourlives.”■

AveraMckennanDedicates

CentennIal sCulptuRe


A NEW CrOP OF PINK TULIPS atthePrairieCenteronthe campus of Avera McKennan Hospital & UniversityHealthCenternextspringwillserveasavisualreminderofbreasthealthawareness.

The Avera Cancer Institute and the Prairie Centerpurchased1,000pinktulipbulbsfromtheAmericanCancerSocietyCancerActionNetwork(CAN)’s“PlantitPink”program.BulbsplantedinthefallwillbloominMay.

“WeplantedthebulbsinthemonthofOctober,whichisNationalBreastCancerAwarenessMonth.WhentheybloominMay,itwillbejustintimefortheannualAveraRaceAgainstBreastCancer,”saidDr.AmyKrie,oncologistwithAveraMedical Group Oncology and Hematology, andmedicaldirectoroftheAveraBreastCenter.

Proceedsfromthesaleof“Plant itPink”tulipbulbsbenefitACSCAN,thenation’sleadingcanceradvocacyorganization.■

Tulip bulbs will bring awareness in time for breast cancer race

Avera Campus to be ‘In the Pink’ by May

PROTECTING RESOURCES, SERVING PEOPLE

www.rascompanies.com1.800.732.1486

Workers’ Compensation.our Focus. Your opportunity.sm

n STAy AT WORk/ReTuRn TO WORk PROGRAM DeVeLOPMenTn LOSS PReVenTiOn AnD TRAininGn SAfe PATienT HAnDLinG PROGRAMS/eRGOnOMic ASSeSSMenTSn injuRy ASSiSTAnce cenTeRn LOcAL cLAiMS MAnAGeMenT AnD cASe MAnAGeMenT

That's the bottom line in workers’ compensation. At RAS,we deliver a complete product array encompassing allaspects of workers' compensation. Our comprehensiveapproach is aimed at restoring the injured worker to optimum health and productivity, while eliminating thecost of inefficient health care delivery and unnecessarytime away from the workplace.

Quarter Page Horizontal 3.875 x 5.275 DEC 2011 ISSUE - FINAL 2011-10-26_Layout 1 10/26/2011 10:01 AM Page 1


HEALTH CArE IN THEhome benefits doctors byoffering a skilled team ofnurses, therapists and

aidestoworkcloselywithprimarycarephysiciansandspecialiststocoordinateallaspectsofpatientcareforthetreat-mentofchronicdiseasessuchasCOPD,CHF and diabetes. Advanced home-based health care methods are alsoavailable for stroke recovery, woundtreatment and behavioral health man-agement. Along with providing thecare, home health clinicianswill giveregularupdatesonpatient progress todoctors in the format best tailored to

meet thephysician’sneed,fromdirectphoneconversationstocommunicationviafaxmachine.

Healthcareinthehomehasanaddedbenefittoruralpatients,whogenerallylive inmedically underserved areaswithouteasyaccesstohospitalfacili-ties.Therecessionhasledtoacutbackinthemedicalfacilitiesinmanyruralcounties.Aqualifiednurseortherapistcaregiver can provide patients withthe skilled service in their home.Awholerangeofservicesareavailablewithoutrequiringpatients toundergotheexpenseandtroubleofarrangingtransportationtoahospitalormedical

clinicthatmaybehoursaway.The benefits of health care in the

home are obvious: coordinated highqualitypatientcareinacomfortableset-tingwithlowermedicalcosts.Andtheservice iseasilyaccessible toelderlypatientson afixedbudgetor to low-incomehouseholds.HomehealthcareservicesarecoveredbyMedicareandmanyprivateinsurers.ManystateMed-icaid programs offer full or partialcoverageforhomehealth.

Oftenforphysicians,theissueisn’tthebenefitsofhomehealth care, butwhentoreferpatientsfortheservice.

Healthcareinthehomeisn’tjustforpatientswhoareprimarilyconfinedtobed.Thesoonerpatientsenterthehomehealth system, themore effective thetreatmentcanbe.Apatientwithanormalinabilitytoleavethehouse,unlesstheyputupconsiderableeffortoruseassistivedevices,whoneedsskillednursingcareonanintermittentbasisorregulartherapysession, is typically eligible for homehealth.Anypatientwithanewlydiag-nosedconditionandnewmedicationwhoneeds education and monitoring; orpatientswhohabituallycallondoctorswithquestionsaboutmedicationorsymp-toms;orpatientswhoneedfollowupcareandhavedifficultygettingtoadoctor’sofficecouldbeagoodcandidateforhomehealth. Hospitalization may even beavoidedifapatiententershomehealth

HEALTHCAREINTHEHoMEoffersbenefitsforpatientsanddoctors

By Dr. Michael Fleming, Chief Medical Director of Home Health, Amedisys Home Health of Sioux Falls

WheN IT COMeS TO helPINg OlDeR,

ChRONICAllY Ill PATIeNTS geT

heAlThIeR WhIle ReDuCINg MeDICAl COSTS, TheRe’S NO PlACe lIke hOMe.


TheNationalCenteronShakenBabySyndrome(NCSBS)hasproclaimedIowaa“PurpleState”foritsstatewideeffortstopreventShakenBabySyndrome.Approximately80percentofIowabirthsareinhospitalsthatprovideevidence-basededucationandresourcestopreventShakenBabySyndromethroughthePeriodofPURPLECryingprogram.

PreventChildAbuseIowa,theIowaDepartmentofPublicHealth,EarlyChildhoodIowa,BlankChildren’sHospitalandotherpartnerswerehonored.Locally,St.Luke’scon-tributedtothestate’ssuccess.InSiouxCity,St.Luke’sistheonlybirthinghos-pitalthatisusingthePeriodofPURPLECryingprogram.

“Iowaisonlythefifthstateinthecountrythathasreceivedthisdesigna-tion,” says Steve Scott, ExecutiveDirectorofPreventChildAbuseIowa.“Thesuccessweachievedafterorganiza-tionscollaboratedtopreventShakenBabySyndromeisanexampleofwhatcanbedone,andneedstobedone,topreventall child abuse in the stateof Iowa.Child abuse really ispreventable.”

ShakenBabySyndrome(SBS)isatermusedtodescribeacollectionofsignsandsymptomsresultingfromtheviolentshaking or slamming of an infant or young child. SBS isbyfartheleadingcauseofyoungchildhomicides.LongcryingepisodesarecitedasthenumberonetriggerincasesofSBS.TheacronymPURPLEisusedtodescribespecificcharacteristicsofaninfant’scryingandtoletparentsandcaregiversknowthat

whattheyareexperiencingissimplyaphaseintheirchild’sdevelopmentthatwillpass.P–Peak of crying:Your

babymaycrymoreeachweek;themostat2months,thenless

at4to5months.u–Unexpected:Crying

cancomeandgoandyoudon’tknowwhy.

R–Resists soothing:Yourbabymaynotstopcryingnomatterwhatyoudo.

P–Pain-like face:Acryingbabymaylooklikethey’reinpain,eventhoughthey’renot.

l–Long lasting:Cryingcanlastasmuchasfivehoursadayormore.

e–Evening:Yourbabymaycrymoreinthelateafternoonandevening.Thecurriculumisdesignedtoteachparentsthatcrying

isnormalandprovidethemwithactionstepstheycanfollowtomanagetheirownfrustrationwhilecalmingacryinginfant.Aspartoftheevidence-basedprogram,nursesprovideeduca-tiontoparentspriortodischargefromthehospital.ParentsaresenthomewithaDVDandbooklettohelpthemunder-standtheseriousnatureofSBS,aswellas techniques toprevent it,andareencouragedtoshare thematerialswithanyonewhocaresfortheirbaby.■

“SBS is by far the

leading cause of

young child

homicides”

early enough so they can startreceivingthecaretheyneed.

Newrequirements from theCenterforMedicareandMedic-aidServicesmeanthatdoctorsmust document a face-to-faceevaluationofapatient inorderto start homehealth care.Theevaluationmust take place 90days before the start of careor30daysaftercarebegins.Theevaluation can even be per-formedbyanursepractitioner

or clinical nurse specialist orphysician’s assistant, under adoctor’ssupervision.Whiletherearea lotofconcernsabout thenew requirements for face-to-faceevaluations,it’sataskthatcanbeeasilymet right inyournotes.Seeanoverviewofhowtobecompliantwithface-to-faceat www.amedisys.com/FacetoFace and a simple check-list used to quickly assess apatient’shomeboundstatuscan

befoundatwww.amedisys.com/HomeboundChecklist.

Themedicalfieldischanging– with more of an emphasison collaborative care and costcontrols. Health care in thehome offers all of that, withbenefits for both patients andphysicians.Doctorsgetthehelpofa strongsafetynet thatwillmonitorpatients,whilepatientscan receive care in a familiarenvironment.■

Iowa proclaimed “PuRPle STATe”National organization honors statewide shaken baby syndrome prevention collaboration


PhysicianUrgent Care

42 physician independently owned multi-specialty clinic seekingBE/BC Family Medicine physician to staff our urgent care Clinic.Current schedule is Sun, T-F with Saturday and Monday off butcould be subject to change with the right person; Urgent care clinicis open 5-9 M-F and 12-5 Sat and Sun. Competitive salary andoutstanding benefits; No State Income Tax; work closely with 3rdyear medical students from USD Sanford School of Medicine;teaching opportunities.

Seeking

So Much Care, So Close to Home.®

1104 West 8th Street • Yankton, SD 57078605-665-7841 • www.yanktonmedicalclinic.com

A NEW COLLEGE SCHOLArSHIP program targeted toward at-risk stu-dents has been developed at Univer-sity Center by Avera McKennanHospital&UniversityHealthCenter.

TheAveraMcKennanSisterSheilaSchnellScholarshipEndowmenthasbeendevelopedspecificallytoprovideopportunities to area students whograduate from high school aftercompleting the USucceed program.USucceed,anewinitiativeofSiouxEmpire United Way and LutheranSocialServices,willbe launched inareahighschoolsinJanuary.Throughtheprogram,volunteermentorswillcommittoworkwithat-riskhighschoolstudentsthroughthedurationofhighschool.ThegoalofUSucceedistopro-videsupportandencouragement foryoungstudentstocompletehighschool.

“Helpingat-riskstudentspursueacollegeeducation isanoutreachthathelps fulfill our mission at AveraMcKennan, and the mission of theSisters.Supportinghighereducationalsohelpsusdevelopastrongworkforceforthefuture.Thisscholarshipprogramaddressesbothgoals,”saidDr.DavidKapaska,regionalpresidentandCEOforAveraMcKennan. “SisterSheilahighlyvalueseducationandatthesametime is dedicated to helping peoplewhoareunderprivileged.Namingthisscholarshipafterherhonorshercom-mitmentandexample.”

In addition to the scholarshipopportunity, plans are underway tocreate a higher education resourcenetworkcalledUSucceedUniversity.Beginningintheirfirstyearofthepro-gram,USucceedstudentsandmentorswillhaveaccess to informationandeducationalworkshopsonnavigatingtheworldofpost-secondaryeducation.

All post-sec-ondaryschools intheSiouxEmpirehavebeen invitedtoparticipate.TheUS Department’sNational CenterforEducationSta-tistics shows thatyoungadultswithabachelor’sdegreeearned114percentmore than thosewithout a highschooldiploma,50percentmore thanyoung adult highschoolcompleters,and 25 percentmore than youngadults with anassociate’sdegreein2009.

“ U S u c c e e dwas designed toprovide studentswhomight lack a

strongsupportsystemwithsomeonetoguidethemallthewaythroughhighschool,”saidScottLawrence,SiouxEmpireUnitedWayBoardChair.“Thisscholarshipfundhastakenthatconceptevenfurtherbyshowingourfirstclassofparticipantsthatourcommunityisreadytoseethemthroughhighschool,college,andbeyond.”■

new Avera ScholarshipHelpsAt-RiskStudents

What do yoU have

to say?

We want to hear from

yoU!

At MED Magazine, we believe the knowledge and experience of readers like

you are the medical community’s most valuable resource. We invite you to share

your thoughts, memories, and insights with your peers through regular reader columns.

Then&Now is an opportunity to share your memories. How has time

changed the way you practice medicine?

InReview shines a light on what you’re reading, watching and writing. Don’t

keep it to yourself – share your recommenda-tions – or critiques – with fellow readers.

Medicine&theArts gives recognition to the vast undercurrent of artistic

talent in our local medical community. Tell us about the art you love.

offHours follows the passionate pursuits – from mountain climbing

and hang gliding to gourmet cooking and wine making – that fill your

time outside the office

Look

for this

typewriter

for a chance

to have your

say!

November 2010

29

MidwestMedicalEdition.com

What You’re Reading, Watching, Hearing

In Review

a utism’s false Prophets by Paul a. offit, MD, is a thorough treatment of the history, background, scientific evidence, and hysteria sur-rounding the controversy regarding vaccines and the cause(s) and treatment of autism.The word “controversy” is used advisedly since there is no medical con-troversy at all. as the author observes, all of the credible medical institutions involved in the study of vaccines have stated, unequivocally, that vaccines do not in any way contribute to the develop-ment of autism. The only controversy is outside of the medical community.as a Professor of vaccinology and Pediatrics at the university of Pennsyl-vania and Chief of infectious Diseases at the Children’s Hospital of Philadelphia (CHoP), one of the most prestigious children’s hospitals in the nation. Dr. offit is well equipped to discuss and explore the autism issue. He initially delves into the history of vaccines and points out that vaccination is arguably the most significant medical advance of the 20th century. in terms of lives saved and misery spared, vaccination against the diseases that ravaged children as recently as 30 or 40 years ago certainly fulfills that criterion.

Dr. offit then goes on to explore the bad and probably fraudulent science that started the mis-information about autism and vaccines. incredibly, one article by 13 authors (11 of whom recanted) began this odyssey which, to this day, still exists in spite of legal, medical, and

scientific evidence that the “controversy” is nonsense.The legal, political, and highly pub-licized celebrity involvement is also discussed. This involvement is what primarily characterized the subsequent 12 years of continued anecdotal stories and machinations which kept the con-troversy alive. as Dr. offit points out, the celebrity and Tv involvement was and is, unfortunately, a continued force that counteracts logic with emotion. He notes that it is hard to mention “science” and “studies” when Jenny McCarthy says, “My science is Evan, and he’s at home. That’s my science.” McCarthy is clearly a loving, highly concerned and involved mother who just “knows” what contributed to her child’s autism. Celeb-rity bias has been rampant on television. oprah, at the time autism’s False Proph-ets was published, had never had an articulate defender of the scientific facts of this issue on her show. The closest she came, says offit, was to present a face-less statement from the CDC. at the time that this review is written, that continues to be the case.

a fair amount of the books is devoted to the political aspects of vaccination and autism. Some of this is fascinating reading as one learns about politicians with little or no scientific knowledge or background speaking and pontificating vehemently on the subject. at the end, before the index, the book is heavily annotated with Dr. offit’s sources, giving acolytes or skeptics the opportu-nity to do further research, if desiredon the whole, autism’s False

Prophets was an enjoyable read – well written, informative and very hard to put down. Medical folks as well as the laity will thoroughly enjoy Dr. offit’s exami-nation of the facts and fantasies surrounding vaccination and autism in the united States. ■

Have you read a book, seen a movie, heard a concert, etc. that moved you? Whether it made you mad or make you laugh, MED wants to help you share it with your colleagues. Send your reviews to [email protected]

reviewed by dr. Albert J. Strauss, Jr.

Autism’s False Prophets Bad Science, risky Medicine, and the Search for a Cure

author Paul a. offit, M.D

“ . . . celebrity and TV involvement was and is, unfortunately, a continued force that counteracts logic with emotion.”

June 2011

17


Then & NowOur Changing Medical Landscape

DR. BRAD RANDALL and

I were having lunch the

other day, looking out

over the 18th street view.

I asked him about changes in the

healthcare profession and eventually

we got to his wish list of some things

that he thought should be different:

some of the consultation work i do

is on malpractice, on both sides. the

doctors dropped the ball on malpractice

a long time ago.

the profession should have set up

some way of adjudicating bad results.

there should have been an internal

system that said, “oh, gee Mrs. smith,

we see that you’ve had a bad result.” it

should never have gotten to a legal

system. We didn’t police ourselves so the

courts ended up having to do it for us.

for a successful lawsuit, an attor-

ney has to prove negligence, but the

definition of negligence has gotten

too broad. take pathology practice:

there’s absolutely no doubt that of the

thousands of pap smears that i’ve exam-

ined that i’ve missed something. i just

didn’t see or somehow misinterpreted

that one important cell out of the thou-

sands on a pap smear. that unavoidable

human error would have to be called, in

this legalistic system, “negligent.” so the

term has gotten so stretched out of

proportion that some poor doc who’s

made a human error is labeled this way.

they’re labeled because it has become

the patient’s only redress.

What should have happened is we

should have said, “Yes, Mrs. smith,

something went wrong. it’s a rare

but unavoidable part of the process

sometimes. We will compensate

you something—it doesn’t mean some-

one did something wrong—it just

happens.” there have been talks of emulating

the federal Aviation Administration’s

manner of fi ling reports. if you screw

up, you fi le a report, which prevents

you from being fi ned, and they use that

information to fi nd out how to improve

the system—everyone benefi ts.

of course the malpractice apparatus—

those who profi t from the process—are

completely against this, and a structure

for compensation would have to be

established, and people would have to

admit their mistakes; so it’s a tough sell.

But it would generate a lot of information

of what’s wrong with the system.

in this environment, if you lose a

malpractice case, the message is, “Don’t

get caught next time.”

the hospitals are trying to monitor

these things and do a better job than

they used to. they have staff that looks

at errors and mistakes, but most of

this information is internal and not

available to people outside the hospital.

We come back around to the fact that

hospitals should have the freedom to

right these problems internally while

assuring that the patients are properly

compensated. ■

Write to us!

Do you have a

media review?

A book, fi lm, or article?

How about an opinion

on a current event?

write to us at:

[email protected]

Examining Malpractice

By Darrel fickbohm

November 2011

21

November 2011

21


20

Off HoursPassionate Pursuits Outside the Office

Dr. Patrick CollisonOtolaryngologist and

Student of Archaeology

By Darrel Fickbohm

It took very little coaxing

to convince Dr. Patrick Collison,

an Ear, Nose and Throat specialist

with Yankton Medical Clinic, to

talk about his long-standing interest in

archaeology. But he was also quick to

differentiate between a “hobby” and an

“avocation.” As with many other physi-

cians, Dr. Collison’s passion for his

extracurricular occupation turned out to

be much more than merely dabbling.

“My interest in archaeology first

came to me while I was doing research

for an article on mastoiditis in chil-

dren” says Dr. Collison. “I came across

some articles by Dr. John Gregg, an

ENT in Sioux Falls, who had developed

a second career in archeology. He had

published articles about fascinating

things like evidence of ear diseases in

500- or 600-year-old Native American

skulls. It just caught my interest.”

Dr. Collison, who was in his 50’s at

the time, began to feed his growing

interest with Internet classes through

USD and the University of Iowa, even-

tually completing an undergraduate

degree in archaeology. After that, he

took a seminar class per semester that

met once a week – the only schedule he

could manage with his ENT practice.

Eventually, over a number of years he

“cobbled together” a course of study

that earned him a Masters Degree in

Interdisciplinary Studies, primarily

Archaeology and Anthropology.

“It was like getting a second life

without actually being illegal or

immoral,” jokes Dr. Collison who calls

his archaeology studies a “mood

elevator”. “On the other hand, it wasn’t easy.

You must interact with professors with-

out being a know-it-all, obviously. And

I will never have the traditional stu-

dent’s quick memory or computer skills.

But it stretches you. I took way more

classes than I needed to—I didn’t want

it to end. The study was the end, so I

dragged it out.”Among other things, Collison says

his academic studies helped revive his

writing skills and his ability to express

himself without using jargon or

“medicaliese”. More than that, he says archaeol-

ogy has broadened his world view.

“Archaeology is a social science as opposed to

a biological science like medicine,” he explains.

“Medicine emphasizes scientific positivism to a

strict degree, so it’s very different in its world

outlook. Looking at things from an anthropological

standpoint gives me a more inclusive worldview.

Archeology dovetails with medicine by its very

contrast, if you will. It helps me in my practice,

indirectly. It gives me an overview of different

perspectives.”Over time, Dr. Collison’s passion also began to

pay off in practical ways and the devoted student

also became a teacher.“Suddenly, they were giving me research to do

and I loved it! I enjoyed the challenge of figuring

out ‘Who made this? Where did it come from?’ And

then I was coming up with a report to describe it

all. (And I got paid for some of it, too.) Meanwhile,

if I needed to, I could drop everything that day and

suddenly go work in the ER.”

Dr. Collison began teaching classes at USD on

the study of artifacts and methods of studying his-

torically important diseases through the analysis of

skeletal remains. He has analyzed the records of the

7th Cavalry for Ear, Nose and Throat diseases,

which will soon be part of a new book.

“All of this gives me a widening future,” says

Dr. Collison. “I’m hoping to stretch this to a nice

part-time retirement job after I’m out of the practice.

My family supports this, although my kids roll their

eyes when I’m ranging into some obscure details

out loud. My wife actually goes

along on some of the fieldwork.

“When you think of archeol-

ogy, you think of Indiana Jones

going after the Arc of the Cove-

nant. That’s the wrong attitude.

What we’re trying to acquire is

understanding, not stuff. That’s

what motivates me.” ■

Patrick Collison, MD

Tell us about your

own ‘passionate

pursuits’ outside

the office.

Write to us!


14

MED: tellusalittleaboutyourhistorywiththeviolinDr. Kunkel:istartedviolinwheni was eleven, and i continueduntil iwasasophomore inhighschool.iplayedinalittlecollegeorchestrawheniwasinpremed,aswellasthePurduesymphonyorchestra.While i was in practice, iplayedveryminimally—onceayearwiththeAugustanaorcom-munity orchestra just to keepmyhandin.i’dplayonceortwiceayearonpiano.thenwheniwasa resident inrochester ididn’tplayatall. itwas just toobusyasadoctor.And that’showlifewasforme.

it was an eighty-hour workweek and i had kids. now, i’mhigh-energy, but i had to sleepsometime.ijustalwaysthoughtthattherewouldbeatimeinmylifewheni’dgetbacktoit.We’vealwayshadapianointhehouse,buti’vealwayslikedtheviolinbetter.Whenihadin-housecall(24hours),i’dactuallytaketheviolinintotheclinicwithme,sometimes,andplay.iwouldn’tdothatathomebecauseihadthekidsathomesotherewasjustnoquiettime.

MED: Whenyourestarted theviolin,how longdid it take togetyourchopsup.Dr. Kunkel:Firstithought,“i’mwaytoooldforthis.”iwasawreck.iwasreallynervousforthesymphonyaudition.itallcamebackmuchslowerthanithoughtitwould,buttwenty-fiveyearsisalongtimeforatalenttorest.luckily,iwasretiredbythattimesoifinallyhadsometimetopractice.ithinkmyfieldofObgynisalsoafieldofart,moresothanscience.there’salotofhumancontactandmorethanonewaytoskinacat—morethanonewaytosolveaproblem.it’screative.now,wheni’minsurgery,i’mnotexactlyweavingdesigns,butotherwise there’sa lotofcreationgoingon.ithinktheyareboththesamekindofdiscipline.tobeabletoexcelinmusicorinmedicineyouhavetobededicatedandwillingtoputinthetime.theygotogether.■

Medicine&Arts dr. shirley Kunkel, retired oBGyn tHebiggrAPereserve, a pre-mier wine and food tasting event tobenefit pediatric patients and theirfamilies,willtakeplace6:30-9:30p.m.thursday,April 14 at themuseum ofvisualmaterialsinsiouxFalls.

thiseventisdesignedasanelitewineandfoodtastingexperience,whichalsoraisesawarenessandfundsinsupportofpediatricpatients’needs.livemusicandasilentauctionarealsopartoftheevent.Proceeds and donations benefitchildrenandtheirfamiliesatAveraChil-dren’s Hospital & Clinics throughequipmentacquisition,staffeducation,training, and charitable health care.Amongprogramssupportedthroughbiggrapefundsarepediatricsocialworkers,Child life specialists, the AveraChildren’sChampionprogram.AveraChildren’sisa“hospitalwithinahospital”comprisedof114bedsdevotedtothecareofinfants,childrenandado-lescentsinAveraChildren’sleveliiineonatalintensiveCareUnit(niCU),newbornnursery,PediatricUnit, andPediatricintensiveCareUnit(PiCU),aswellasthechildandadolescentunitsattheAverabehavioralHealthCenter.Alongwith theAveramcKennanFoundation,presentingsponsorsoftheeventareJJ’sWine,spirits&Cigars;CadillacofsiouxFalls;andrepublicnationalDistributingCompany.

Formoreinformationcall(605)322-8900orvisitwww.thebiggrape.org.■

life is short but art endures — Hippocrates ‘BiG GRApe’WInE tAStInG

Benefi t set for April 14& dr. shirley Kunkel,& dr. shirley Kunkel,

& Violinist

“Interview and photo by Darrel fickbohm

Send your submissions and ideas to Editor Alex Strauss at [email protected] or 605-759-3295.


KEVIN BENSON, MD, MS,recentlypresentedresultsofaone-year study of patients with interstitial cystitis (IC), anoftenmisdiagnosedconditionhallmarkedbypelvicpainandurinaryurgencyandfrequency,attheannualmeetingoftheInternationalIncontinenceSocietyinScotland.TheSanfordspecialistinUrogynecologyandReconstructiveSurgerywasone of a select group of physicians chosen by his peers topresentresearchfindingsattheevent.

Theobjectiveofthestudywastoexplorewhetherdiffer-ential gene expression was seen in IC and to develop anon-invasivenewtestingmethodforICthatcouldbeusedtobothdiagnosetheconditionandtoletpatientsknowiftheyarepredisposedtothedisease.Preliminaryresultsofthestudyinvolving28womenshowedthatpatientswithIChadauniquegeneexpression,withdifferentgenesexpressedincellsintheirurinethanpatientswithoutthedisease.

Currently, most patients are not diagnosed with the

conditionuntilaftertheyhavesufferedsymptomsforyears.Thediagnosisisoftennotuniformandisdifficulttomakewithoutbiopsiesandinvasivetesting.Manypatientsaremis-diagnosedashavingurinarytractinfections,orotherconditions,andmissouton thechanceforearly treatment thatcouldimprovetheirhealthandlifestyle.

Priortotheconference,theprojectwasoneofaselectgroupofscientificabstractschosenbysocietymembersforpresenta-tion to other specialists in urogynecology. There wereapproximately2800physiciansattheconference.

Dr.Bensonisnowconductingasecondstudywithalargernumberofparticipants.Thisfollow-upresearchwillhelpdeter-mineifgenetictestingofurinecanbeconsistentlyusedasagooddiagnostictoolforIC.

Dr.Benson,agraduateoftheSanfordSchoolofMedicineattheUniversityofSouthDakota,practicesatSanfordClinicUrogynecologyandFemalePelvicmedicineinSiouxFalls.■

ASanforddoctor’sresearchmayleadtoalessinvasivewaytomoreaccuratelydiagnoseabladderproblemthataffectsqualityoflifeformanypatients.

ICResearchatSanford

BUSINESSMAN DENNY SANFOrD,long-time supporter of health pro-grams, children’s services and othercharitablecausesinSouthDakotaandacross the US, has been selected toreceivethe2012AwardforOutstandingPhilanthropist, given by the Associa-tion of Fundraising Professionals’(AFP)astheorganization’stopphilan-thropyhonor.

Sanfordhasgivenmorethan$600millionoverthepastfouryears,includ-ingthelargestdonationtoahealthcareorganizationinhistory.In2007,Sanfordcommitted$400milliontotheSiouxValleyHealth System, now renamedSanfordHealth.ThedonationledtotheestablishmentofSanfordWorldClinicsinOklahoma,Oregon,California,Israel,Ghana,MexicoandIrelandwithseveralmoreunderconsideration.Thegiftalso

supportsseveralSanfordResearchCen-ters including theSanfordChildren’sHealthResearchCenter—whichfocusesonthehealthneedsofchildren.

Sanfordhasgivenmillionsofdollarstovarietyoforganizations, includinghisfirstsignificantcontributionof$16million for the Sanford Children’sChallengein2004,acampaigntobuildtheonlyfree-standingstate-of-the-artchildren’shospitalinSouthDakota.In2008,heprovided$30millionto theSanDiegoConsortiumforRegenerativeMedicine(nowtheSanfordConsortiumforRegenerativeMedicine) and $20million to the Burnham Institute ofMedicalResearch inLaJolla,Calif.Later,heissueda$50millionmatchinggiftschallengetobenefittheorganiza-tionnowknownastheSanford-BurnhamInstitute.

SomeofSanford’sothercontributionsinclude$70milliontotheSouthDakotaSciencesandTechnologyAuthoritythatisturningtheformerHomestakeMineinto an underground laboratory; $20milliontoexpandeducationalprogram-mingattheUniversityofSouthDakotaSchoolofMedicine;$15milliontotheMayoClinic; and $15million to theChildren’sHomeSociety,ahomeforabusedchildren.

TheAssociationofFundraisingPro-fessionals (AFP) represents 30,000membersin227chaptersthroughouttheworld,workingtoadvancephilanthropythroughadvocacy,research,educationandcertificationprograms.Theassocia-tionfostersdevelopmentandgrowthoffundraisingprofessionalsandpromoteshighethicalstandardsinthefundraisingprofession.■

DENNYSANFoRDnamed International outstanding Philanthropist


Marketing SolutionS from a TrusTed source

800-228-5462 ext. 1117 | [email protected]

13808 f st. | omaha, Ne | 800-228-5462 | www.cassling.com

need to develop a brochure but don’t have a design program?Want to send a patient newsletter but don’t have the time to write? Cassling understands the marketing challenges that are unique to health-care organizations. Backed by 25 years of industry experience, Cassling has the knowledge and resources to help you develop targeted marketing materials for your key audiences.

From print ads to comprehensive rebrands, we develop customized materials on your timeline, so you can focus on your job and your patients.

Download our marketing case studies at www.cassling.com

THE AMErICAN MEDICAL ASSOCI-ation has adopted a policy to combatnational drug shortages during itsrecent semi-annual policy-makingmeeting.

Inthepastfewyears,shortagesofmedicallynecessarydrugshavewors-enedappreciably.In2010,almost180shortagesofmedicallynecessarydrugswereidentifiedbytheFDA,triplethenumberfrom2005.

New AMA policy supports drugshortage legislation, such as H.R.2245 and S. 296, thatwould requiremanufacturers to notify the FDA ofany discontinuance, interruption, oradjustmentinthemanufactureofadrugthatmayresultinashortage.ThenewpolicyalsocallsontheAMAtoadvocatethattheFDAand/orCongressrequiredrugmanufacturerstoestablishaplanfor continuity of supply of vital andlife-sustainingmedicationsandvaccinestoavoidproductionshortageswheneverpossible.

Adrugshortagemaycompromiseanddelaytreatment,leadingtoprogres-sion of disease, adverse outcome, ortherapeuticfailure.Whenphysiciansareforcedtouselessfamiliaralternativedrugs,errorsandpreventableadversedrugeventsaremorelikely.Healthcare

AMATakesonDrug Shortages

costsareincreasedduetoclinicalhoursthat are diverted to managing drugshortagesandtheadditionalacquisitioncostsofalternatives.

TheAMA’snewpolicyalsosupportsthe recommendations of the 2010DrugShortageSummitconvenedbytheAmerican Society of Health System

Pharmacists, American Society ofAnesthesiologists,AmericanSocietyofClinicalOncologistsandtheInstitutefor Safe Medication Practices andcallsontheAMAtoworkinacollab-orative fashionwith these andotherstakeholders to urgently implementtheserecommendations.■

In the past few years, shortages of medically necessary drugs have worsened appreciably


offHoursPassionate Pursuits Outside the Office

BRAD ReeveS, MDOrthopedic & Sports Medicine Specialist,

Big game hunter

SANFOrD’S DIrECTOr OF Sports Medicine, orthopedistBradReeves,MD,discoveredthe thrill of the hunt early in

life, as a young man growing up inArkansas.

“Iamabowhunterandhavealwayshunteddeerandturkey,etc.andhavetaughtmykidstodoit, too,”saysDr.Reeves.NowinhisthirdseasonwithSanford,andalongwayfromhisArkan-sas roots, Dr. Reeves has taken hispassionforbiggamehuntinginrecentyearstosomeofthewildestandmost

challengingplacesonearth,includingSaskatchewanandhisfavorite,Africa.

“Africaisreallythedreamplacetohunt,” saysReeveswho this summermarkedhissixthtriptothecontinentwherehehaspursuedkudu,eland,water-buck,zebras,impalas,bushpig,waterbuffalo, leopard and Cape buffalo,amongothers.“ItistheplacethatRoos-eveltandCapstickandRobertRuarkwroteabout.Itisthefantasyplaceforahunter togoand requiresallofyourskills.Youarereallyoutinthemiddleofnowhereandtherearenorules.”

“ThefirsttimeIwenttoAfrica,wesatatawaterholeandwaitedforthegametocome,”Reevesrecalls.“Now,IgetdroppedoffwitharadioandIgooffbymyself.Inthatkindofsetting,youspendalotoftimethinkingaboutthingslikewhatkindofdadyouare,whatkindofhusbandyouare.InAfrica,it isallaboutyouandyourbootsonthegroundandyouhavetorelyonwhatyoucansenseandwhatyoucanread.Soitisarealchallenge.”

Alwaysonthehuntforabiggerchal-lenge, Reeves travelled to Calgary,

Dr. Reeves and his son in Africa

After the Big Game

Dr. Brad Reeves orthopedic&SportsMedicineSpecialist,BigGameHunter


0000239966

Finding Balance

low sex drive7 out of 10 women complaining of

low sex drive have a hormone imbalance

hot flashes8 out of 10 women complaining of

hot flashes have ahormone imbalance

depressed2 out of 3 women complaining

of depression have a hormone imbalance

Pharmacy Specialties will help you find balance again.

Call today to schedule an appointment!

2333 W. 57th Street - Suite 107 Sioux Falls, Sd | 605-334-1672

The big prize: a cape buffalo.

Africa 2006

Alberta,Canadain2005insearchofblackbear.“Thiswasaone-on-onehuntandIendeduptakinga7-footblackbearat5yards.Butitwassupposedtobemyreallybighunt,andinasenseitcamealittletooeasy.SoIstartedtothinkwhatwouldbethehardesthuntofall.”

HesettledonAfrica’sCapebuffalo,widelyconsideredtobethemostdangerousandmostchallenginggameofall.Inadditiontorigorousphysicaltraining,Dr.ReevesspentayearreadinguponCapebuffalo,watchingvideos,andkeepinginclosecontactwiththeprofessionalhunterwhowouldserveashisguideandbackuponthetripbeforeembarkingontheadventurethispastMay.

“Itwasjustasurrealthing,”saysDr.Reeves.“Myarrowhitintherightspotbutdeflectedofftheribsandintotheabdomen,sothenhewaswoundedandwehadtotrackhim.Everytimewewouldgetinthejeep,hewouldchargethejeep.FinallywedecidedthatIshouldgetoutofthejeepandwewouldlurehimwiththejeep.Thesecondshotwentrightthroughhisheart.”

ThissummermarkedoneofReeves’mostmemorabletripstoAfrica,huntingwarthogsandwildebeestinthecompanyofhiscollege-ageson,Matthew.Althoughhedoesnotdelib-eratelygoafterrecord-breakinganimals,Dr.Reevesholdstherecordforthe19thlargestelandevershotandawaterbuckthatisranked79th.In2013,heplanstoflytoaremoteriverintheYukontohuntmoose…atripthathepredictswillbehislastbeforeheexpectstoneedakneereplacement.

Withsomuchhuntingexperiencetheworldover,itmaycome as a surprise to know thatDr.Reevesfoundoneofhisbiggesthuntingchallenges right here in the fields ofSouthDakota.

“LastyearwasthefirsttimeIhadeverbeenpheasanthuntingandIlosttwoofmybestarrows.Afteracoupleofhoursandacoupleofwaywardarrowsinto the sky, I finally gave up andswitchedtoashotgun!”■

Dr. Brad Reeves

nEPHrOLOGIST Tina Melan-son,MD,hasrecentlymovedfrom Sioux Falls to thePrairieLakesHealthSystem

inWatertown after nine years atAvera.Sheremarkslaughinglyatthetransitionsshehasmade.

“Myhusbandis fromthebigcity,fromBoston,andIwasafraidhewouldhavesomekindofreactiontothemove,”shesays.“We’vedownsizedthreetimes:BostontoSiouxFalls,andthentoWater-town. But when we visit Boston,nowadays,it’snotverylongbeforewestartwantingtogohome.Weallloveithere,andwe’vedonewell.”

AndthatisnottheonlytransitionDr.Melansonhasmadeinrecentyears.Sheisalsotheauthorofthreebooks,whoisquicktotalkwithpassionaboutherinter-estinwriting.

“I never envisioned myself as awriter,”Dr.Melansonadmits.“Growingup,Ineverwasabigfanofthelanguagearts.Imajoredinphysiologyandwentrightintomedschool.Myfirstbookisrelatedtomywork.‘HeelingtheBoys’Club’isaself-publishedworkoffictionaboutbeingawomanintheever-chang-ingfieldofmedicine.”

Afterherfirstbook,Dr.Melansonturnedherattentiontochildren’slitera-ture,attherequestofherchildren.

“Someofthecontentinmyfirstbookwasnotappropriatefortheirages.Theychallengedmetowritesomethingthat‘theycouldread’andthatsomeoneelsewouldpublish.”

Theresultingseries,“Talesof the

SuperSibSquad”aboutatrioofsuper-herosiblings,becamesomethingofafamilyproject.

“Thekidscameupwithalotofthecharacterdetailsandsomeplotlines,”saysDr.Melanson, whose twomostrecent bookswerepublishedbyTatePublishing.“Suddenly, thereweresomanyideasthatitledtothree,goingonfour, books.They’re funny stories—oftensarcastic,thewayItalk.”

Whenaskedhowabusyprofessionalandmotherfindstimetowrite,Melansongivespartialcredittohermedicalcareerandinsomnia.

“It startedwhen IwasatAvera. Iwasoncallandyouknowthatpagerisalwaysthere—Ijustcouldn’tsleep,evenwhennothingwasgoingon.So,Iwouldjustsitwithmylaptop.OnedayI startedwritingand it just tookoff.NowIwritewheneverIcan.

“Ithinkthatdoctorsareinterestedinmysteriesbecausethat’swhatmedicineis.Youdevelopaplotandyougoalongandtrytofindoutwhat’shappeningwithaparticularcase.Writingfictionisoftenthe same. I get my best ideas whileI’m driving or showering,” she says,laughing.

Whenaskedwhyphysiciansoftentend to achieve so much with theirhobbies, Dr. Melanson thinks aboutthe question for a moment beforeanswering.

“Ithinkasphysicianswetendtobeoverachieverswhoareusedtolackofsleep and are in need of distractionof some sort. I think it’s greatwhen

there’s something besides medicinethatwecanspendsometimeon.Alifededicated tomedicine is special, butthere’ssomuchmorethanthat.

“Itmakesmecoolwithmykids.Andthat’sahugestepthesedays.”

Dr.Melanson’sbooksareavailableon line through Amazon or Barnes& Noble or directly from TatePublishing. Copies are available inMore ThanWords at theWatertownMallandinCovertoCoverBookstoreindowntownBrookings.■

InReviewWhat You’re reading, Watching, Hearing


Tales of the Super Sib SquadInterview by Darrel Fickbohm

Author Tina Melanson, MD

Write to us!

Doyouhavea

mediareview?

Abook,film,orarticle?

Sendusanote

Alex@



Inpatient Medically Complex Program

The 18-bed specialty hospital at Children’s Care offers cost-effective care for children through age 21 who need 24-hour medical monitoring. Services include:

• IV Medication Delivery • Suctioning, Oxygen Administration

• Tracheostomy Care • Ventilator Use & Weaning

• Skilled Nursing Observation following casting or surgeries

• Nutritional therapy via gastrostomy, jeujostomy, NG or NJ

Call our Director of Nursing with questions or for further details: (605) 782-8475

Our specialty hospital provides excellent 24-hour nursing care for your pediatric patients!

CHILDREN’S CARE HOSPITAL & SCHOOL2501 W. 26th St., Sioux Falls, SD 57105-2498 (605) 782-2300

www.cchs.org

James Wallace, MD Medical Director of Respiratory Care Services

Julie Johnson, MD Medical Director of Rehabilitation Services

BlackHillsCardiovascularResearch

Seeking Participants for Cholesterol StudyBLACK HILLS CArDIOVASCULAr rESEArCHisseekingparticipants for a clinical research studyon the tolerabilityand efficacy of AMG 145 co-administered with statins inpatientswithhypercholesterolemia.

ThestudyentitledLAPLACE-TIMI57willcomparetheeffectsoftwo-weekandfour-weekdosingscheduleswithpla-ceboforpercentchangeinLDL.Thestudyaimstoinclude600randomizedpatientswithintheUnitedStates,Canada,andEuropeduringaneight-monthrecruitmentperiod.

Toparticipate in the study, apatientmustbebetween18and80yearsofageandonanapprovedstatin(i.e.Zocor,Lipitor,Crestor,etc.),withorwithoutezetimibe,onastabledose(s)foratleastfourweeks.

“Weareexcitedtobepartofthisstudyandforthepotentialbenefititmightprovideforpatientswhoaren’tabletogettheirLDLdownwiththeuseofastatin,”saysDrewA.Purdy,M.D.,CardiologistwithRegionalHeartDoctors.“Thispivotalstudywillpotentiallygiveusanothertooltoaidinourfightagainstheartdisease,theleadingcauseofdeathintheU.S.”

Otherongoingstudiesincludeastudyofcanakinumabinpreventionofrecurrentcardiovasculareventsinpost-myocar-dialinfarctionpatientswithelevatedhs-CRP,astudycomparingEdoxabantoWarfarinforpatientswithatrialfibrillation,andastudyontheeffectsofdronedaroneonatrialfibrillationburdeninsubjectswithpermanentpacemakers.

Formoreinformationandparticipantcriteria,contactLynnKimball,ClinicalResearchCoordinator,at(605)718-6295orvisitthewebsiteatwww.regionalhealth.com/bhcr.■

Providing an Exceptional Experience

The Avera Surgery Center combines

medical expertise and the latest technology

with 5-Star service and amenities, providing the

optimal patient experience in same-day surgery.

We deliver comprehensive care of the

highest standards, concentrating on

delivering care for the whole person,

with the compassion Avera is known for.

The Avera Surgery Center LOOK NO FURTHER THAN AVERA

For an exceptional patient

experience featuring top medical

expertise, technological

sophistication and 5-Star service.

To schedule a procedure, referring

physicians may call (605) 322-2700.

To learn more, please visit our website

at www.AveraSurgeryCenter.org.

YOU HAVE A CHOiCE!CHOOSE THE AVERA SURgERY CENTER FOR YOUR SAmE-dAY

SURgERY pROCEdURES.

EXCEpTiONAL EXpERiENCE.

Look no further.


GrapeExpectations

Tradition!By Heather Taylor Boysen

December2011

FOr THOSE OF YOU WHOlovemusicals, thewordmayprobably brings to mind thefatherTevyefromFiddler on

the Roof who constantly laments theloss of family traditions. For somereason,theresonanceofthisworkplaysinmymindoverandoveraswegointotheChristmasseason,perhapsbecauseIparticipated in the musical in highschoolandthesongsjustseemtostayinmyheadwheneverIthinkofthem.Yawdadadadadadadadadada………

ButIamremindedconstantlyasIgetolder that traditions change. Some,becausetheynolongerfitwiththefamilydynamic,butothersbecausetheyfadein our memory or for some reasonbecomegenerational.Iwasaskedtheotherdayatawinetastingeventtopres-ent a toast andwas concerned that Ididn’thaveonetooffer.“Mudinyoureye”justdidn’tseemappropriateandmanytoaststhatIhavewitnessedhavebeenlessthaneloquent.Ibelieveourgeneration(I’m44bytheway)haslosttheancientartofthetoast.

Inourfamilywehavebegunatradi-tion of clinking our glasses together

frequently,butnotintheformofatoast.Webringourglassestogetherasasignalthatallaroundthetablemustpayatten-tionandthenourchildrentelluswhattheywerethankfulforthatparticularday.Itisn’tatoast,butitisaconversationbegunwiththesymbolicraisingoftheglasseveniftwooftheglassesarefilledwithmilkandcoveredwithvarioussuperheroesandflowers.

Likecursivewritingintoday’sworldoftouchscreensandtexting,manyofusarenottaughttheproperwaytoacknowl-edgeourguests,companionsorlovedonesinapublicwaywherewecanall“clink”glassesinashowofsolidarityforthatmoment.Doyourememberthelasttimeyousawatoastpresentedotherthan at a wedding celebration or abusinessfunction?

Withgreatfearofbeingembarrassedinpublicbyalessthanstellarperfor-mance,Ididwhatanyonemightdoinsuchasituation…Iboughtabookoftoasts.Littledid Iknow that I hadapurchasedabookthatnotonlygavemethehistoryofthetoast,butalsogavememuchfoddertouseasappropriatelyor inappropriately as the situationwarranted.

Inthebusinessofsellingwineandspirits,weareoftenaskedaboutprod-ucts,howtomixthem,whentoservethem and howmuch to serve. To behonest,Icananswerthosequestionswithmyeyesclosed.Butwhattoastisappro-priateforwhatsetting?Thatisanotherstory.SoIboughtthebook,didtheresearch,andwouldlovetoleadthecrusadetobringbackthetoast!

“ Here’s to holly and ivy hanging up, and to something wet in every cup.” —Ogden Nash

“May all your troubles last as long as your New Year’s resolutions.” ―JoeyAdams

“ Here’s to holly and ivy hanging up, and to something wet in every cup.” ―OgdenNash

“ As you slide down the banister of life may the splinters never face the wrong way.” –Irish

“May love and laughter light your days and warm your heart and home. May good and faithful friends be yours, wherever you may roam. May peace and plenty bless your world with joy that long endures. May all life’s passing seasons bring the best to you and yours!” –Irishblessing

So during this Christmas season,raiseaglassandletthetoastsflow.Toastincelebration,friendshipandgoodfood.

“So prepare your feasts, purchase your libations, and have a safe and happy holiday season!” –HeatherTaylorBoysen


News&NotesHappenings around the region

AverAAvera McKennan Hospital & University Health Center has recently welcomed Amy

Lindaman, MD,familypractitionerwithAveraMedicalGroupMcGreevy7thAvenue.Dr.LindamanhasamedicaldegreefromtheUniversityofIowaCollegeofMedicineatIowaCity.ShecompletedresidencyattheUniversityofIowaHospitalsandClinicsatIowaCity,andiscertifiedbytheAmericanBoardofFamilyMedicine.

regionAlregional Cancer Care Institute radiation Oncologist Daniel Petereit, M.D.,

wasrecentlyinductedasaFellow,alongwith20otherphysicians,atanAmericanSocietyforRadiationOncology(ASTRO)specialceremonyinMiami.MembersofASTROareeligibletobecomeaFellowiftheyhavebeenamemberforatleast15years,servedinaleadershiprolefortheorganizationandhavemadeasignificantcontributiontothefieldofradiationoncology.TheprimarypathwaystobecomingaFellowareresearch,patientcare,educationandleadership/service.ThenominationswerereviewedbyaninememberFellowsSelectionCommitteewhomaderecommendationstotheASTROBoardofDirectorstomakethefinaldecision.

regional Health’s Infection Control departmentshaveannouncedtheorganization’s2011 Infection Prevention and Patient Safety Ambassadors.SixRegionalHealthemployeeshavebeenselectedforthehonor

basedontheircommitmenttokeepinghospitalpatients,employees,andvisitorsfreefrominfection.Recipientsinclude:MaureenBauer,RN,RapidCityRegionalHospital,PeggyErb,RN,SpearfishSurgeryCenter,BeckyJetson,EnvironmentalServicesAide,RCRH,RoannaPope,LPN,SturgisRegionalHospital,JudyShannon,EnvironmentalServicesDirector,Lead-DeadwoodRegionalHospital,andGeriSmith,RN,SameDaySurgeryCenter.

Crystal Gruetzmacher,RegionalHeartDoctors,CertifiedClinicalResearchCoordinator,recently

earnedadditionalcertificationinHealthcareResearchCompliance(CHRC)bytheHealthCareComplianceAssociation.ToobtainCHRCstatus,onemusthaveoneyearoffull-timecomplianceexperienceoratleast1,500hours/twoyearsofcompliance-relatedexperience.Candidatesmustalsoobtain20ContinuingEducationUnits(CEUs)inthe12monthspriortotakinganexam.

SAnfordThe South Dakota Safety Council has awarded a Governor’s Safety Award to Sanford USD Medical Centerforexcellenceinworkplacesafetyandhealth.SanfordUSDMedicalCenterisoneof41employersrecognized.Since1993,theannualGovernor’sSafetyAwardshavespotlightedSouthDakotaemployerswithaboveaveragesafetyrecords.Participantssubmitinjuryinformationwhichiscomparedwithstateandnationaldata,aswellastheentrant’spastperformance.Ongoingsafetyprogramsandactivitiesarealsoconsidered.SanfordUSDMedicalCenterhasbeenrecognizedthelastfouryearsandhasreceivedtheAwardofHonor,thehighestaward,thelasttwo.

The Coordination of rare Diseases at Sanford (CorDS) registry welcomes Lauren BeaumonttotheCoRDSteam.LaurenbeganasaresearchassociateinSeptember.TheCoRDSregistryisanationalregistryforallrarediseases.Thiscentralregistrywillhelpresearchersidentifyparticipantswhomaybeeligibleforclinicalresearchstudiesrelatedtorarediseases.

otherJason r. MerkleyhasbeenappointedthenewCEOofBrookingsHealthSystem.Merkleyhas

beenVPofProfessionalServicesatAveraQueenofPeaceHospital.Merkleyholdsabachelor’sdegreeinBusinessandHealthServicesAdministrationfromAugustana

andamaster’sdegreeinHealthServicesAdministrationfromtheUniversityofKansas.MerkelyassumedhisnewresponsibilitiesDecember5th.BrookingsHealthSystemincludesa49-bedhospital,a79-bednursinghomeandtheBrookhavenEstatesapartments.

Yankton Medical Clinic otolaryngologist Patrick Collison, MD,isnowofferingBahaimplantstopatients.TheBahaisasurgicallyimplantablesystemfortreatmentofhearinglossthatworksthroughdirectboneconduction.Bahaisusedtohelppeoplewithchronicearinfections,congenitalexternalauditorycanalatresiaandsinglesideddeafnesswhocannotbenefitfromconventionalhearingaids.

You Take Care of your patients, we’ll take care of the rest.

We pride ourselves in our ability to proficiently handle the needs of physician practices large and small. We understand the complexities of your business and work as a team to facilitate sound decision making, reduce practice costs and maximize profits.

WE CAN HELP YOU WITH:

✢ EMR Solutions: PrognoCIS & Intergy

✢ Contracting and Credentialing Services

✢ Compliance

✢ Meaningful Use Assistance

✢ Billing and Accounts Receivable Management

✢ Full Accounting Services, Including Payroll and & Accounts Payable

✢ Practice Administration

Contact Carla Campbell or Kay DeWitt for an initial assessment 800-658-3901

EmpoweringIntegrated Care

LearningopportunitiesHappenings around the region

December 2011

MEDreachesmorethan5000doctorsandotherhealthcareprofessionalsacross

ourregion8timesayear.Ifyouknowofanupcomingclass,seminar,webinar,

orothereducationaleventintheregioninwhichthesecliniciansmaywantto

participate,helpusshareitinMED.SendyoursubmissionsfortheLearning

[email protected].

December, Perinatal Nurse Fellowshipmultiple dates Information on dates and locations:[email protected],

8 am – 5:00 pm 605-328-6353

January 25, 2012 38th Annual Perinatal Conference8 am – 4:15 pm location: St.Luke’sRegionalMedicalCenter,SiouxCity,IA

Information: 712-279-3235

Website: www.stlukes.org/professional-education

February 24, 2012 Tri-State Pulmonary Care Conference8 am – 4:15 pm location: St.Luke’sRegionalMedicalCenter,SiouxCity,IA

Information: 712-279-3235

Website: www.stlukes.org/professional-education

MED-Midwest Medical Edition-December 2011

Documents

Transcript of MED-Midwest Medical Edition-December 2011