Stride September 2014

Diversifying

Health Care

Meet eight area doctors contributing to our growing health care system.

September 2014

team

meet the

meet the

EDITOR

TEAM

Every month, Spotlight Media brings you Stride, Fargo Monthly, Bison Illustrated and Design & Living Magazine. Here are the people who make these wonderful mags.

I

am ecstatic to be taking over as editor of Stride. While my last summer as a college student comes to a close, a new chapter begins for not only me, but for you, the readers, and this publication.

We hope to bring you a clearer, more defined mission for this magazine. Our community is bursting with health and lifestyle stories, so we want to bring them right to you. So when our publisher told me that September’s issue would be dedicated solely to doctors and the health care industry, I’ll admit I panicked. What do I, a journalism major, know about health care?

That’s right. Nothing.

But jumping into unknown waters is by far the most rewarding part of this job. Making connections and gaining knowledge you never thought you’d have makes me excited to come to work in the morning. (So does the free break room coffee!)

This month, I had the pleasure of meeting eight area doctors with incredibly unique stories.

For once, I was able to see the local health care systems not as a whole, but as a group of individuals trying to make a difference. By no means is this a complete representation of all the wonderful physicians in our area.

However, I hope that by putting some faces to the names of our local hospitals and clinics, you can see what we witnessed: regular people who love their jobs.

Special thanks to the marketing staffs and physicians of Essentia Health-Fargo, Sanford HealthFargo and Plains Medical Clinic.

They took time out of their unbelievably busy schedules to talk with us, and for that I am grateful.

If you have questions about the doctors or suggestions for future articles, feel free to email me at lisa@spotlightmediafargo.com. I would love to hear from you.

Lisa Marchand

2

Stride • September 2014

MIKE

JESSE

TRACY

TIFFANY

KRISTEN

MICHAEL

HEATHER

PAUL

GIGI

CRAIG

BOUGIE

ANDREW

SARAH

JOE

BRENT

CODEY

NICOLE

GEORGE

LISA

NICK

To learn more about the team at Spotlight Media and our four magazines, go to spotlightmediafargo.com

Stride is published 12 times a year and is free. Copies are available at over 1,000 Fargo-Moorhead locations and digitally at fmspotlight.com.

SEPTEMBER 2014 Publisher

Spotlight Media LLC. www.spotlightmediafargo.com President/Founder

Mike Dragosavich Editorial Director

Andrew Jason Editor

Lisa Marchand Graphic Design

Sarah Geiger, George Stack, Nicole Smart Research/Contributors

Lisa Marchand, Debra Walker Copy Editors

Andrew Jason, Gigi Wood

SPOTLIGHT MEDIA General Manager

Brent Tehven

Circulation Manager

Craig Holmquist Marketing/Sales

Tracy Nicholson, Paul Bougie, Kristen Killoran, Paul Hoefer Circulation Manager

Codey Bernier Administration

Heather Hemingway Web Developer

Nick Schommer Photography

J. Alan Paul Photography Delivery

Chris Larson, George Stack, Payton Berger, Hal Ecker

™

Spotlightmedia

CONTACT 502 1st Ave N Ste 100 Fargo,ND 58102 701-478-7768 info@spotlightmediafargo.com

Stride Magazine is published by Spotlight Media LLC. Copyright 2014 Stride Magazine & fmspotlight.com. All Rights Reserved. No parts of this periodical may be reproduced without written permission of Stride Magazine & fmspotlight.com. Stride Magazine & fmspotlight.com will not be held responsible for any errors or omissions found in the magazine or on fmspotlight.com. Spotlight Media LLC., accepts no liability for the accuracy of statements made by the advertisers.

CONTENTS

19

Meet Your Doctors From a female sports medicine doctor to a plastic surgeon giving back to his home country, meet eight area physicians who are contributing to North Dakota’s diversifying health care system.

10

Choosing a Family Doctor Family medicine physician Debra Walker of Sanford Health-Fargo provides five tips to keep in mind when choosing your family’s doctor.

12

Doctor Misconceptions Their paychecks are too big, plastic surgeons only perform facelifts and doctors know all the answers. Our physicians weigh in on the most common misconceptions the public has about them.

16

How North Dakota Compares See how the state of North Dakota stacks up next to Montana, Minnesota and California in health care and population wellness.

42

Sanford & Essentia Demographics Get a glimpse inside the numbers that make up FargoMoorhead’s main medical powerhouses.

Get Involved Email info@spotlightmediafargo.com with your story ideas.

Check out fargomonthly.com for additional stories.

Find us on Facebook by going to facebook.com/fmstride.

4

Stride • September 2014

35 4th Street N Fargo, ND 58102

“As a physician what is your most valuable asset?”

“We believe it’s your income.

Talk to us about your Income Replacement/Disability Insurance plan.”

Ryan Botner

Kara Kluvers

Office: 701-232-3888 Mobile: 701-840-1097 Fax: 701-540-0170

Office: (701) 232-3888 Mobile: (701) 306-4867 Fax: (701) 540-0170

begins by asking clients important questions and gaining a true understanding of their hopes, goals, dreams and aspirations. His clients receive not only financial solutions directed to help secure their future, but also the confidence that comes from working with a professional.

ryanbotner@financialguide.com

is passionate about helping others. As Vice President for Physicians National, Kara strives to leverage her values and experience in providing financial guidance to families, business owners and professionals.

karakluvers@financialguide.com

Ryan J. Botner is a registered representative of and offer securities through MML Investors Services, LLC, member SIPC (www.sipc.org) Supervisory Office: 901 Marquette Avenue, Suite 2600, Minneapolis, MN 55402 (612) 333-1413.

Family Medicine

how to

choose a family doctor Choosing The Right Physician For Your Family

DR. DEBRA

WALKER

Dr. Debra Walker is a family medicine physician at Sanford Health in Fargo. She has been in practice for almost 30 years.

Choosing your family doctor is an important decision and one that should be thoughtfully considered. It is vital to find the right person or team to serve your family’s health needs. Sanford Health’s Dr. Debra Walker shares some factors that families should consider when choosing their family physician.

RELATIONSHIP Choosing a family doctor you trust and feel comfortable with will help make the most of your doctor visits.

You should be able to openly discuss any health issues or concerns so your doctor can most effectively help you.

Family doctors will take the time to understand your family health history to provide the best care and best longterm health outcomes. A family doctor cares for families throughout the spectrum of life, so they can identify changes in your health and help you make informed health care decisions.

FAMILY FIT

CONVENIENCE

Every family is different and has unique health needs.

It is important to find a family doctor who can help with your specific needs or who can recommend specialists as needed.

The family physician is able to coordinate care amongst specialists and frequently functions as an advocate and interpreter.

The convenience of location, services and clinic hours is crucial when you lead a busy life. Choose a health care provider who is close to home or work and one who offers the services you need. When you’re sick, it is helpful to be close to the clinic, but it is also important to know if clinics offer sameday appointments and flexible online scheduling options. You might also consider which medical services you and your family may need. For example, if you are diabetic and know you’ll frequently need lab draws, you might want to seek out a provider whose clinic has an onsite lab.

INSURANCE COVERAGE DO YOUR RESEARCH Ensure the doctor you are considering will be covered by your insurance.

This will help avoid unnecessary outof-pocket expenses.

Both your insurance company and the clinic you are considering can help you understand your coverage.

For more information, visit sanfordhealth.org.

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Stride • September 2014

Seek out information on any doctors you are considering for your family. Do they have any specialties or background experience you think are important? What certifications do they hold? Schedule your next appointment with a doctor to see how you feel about their care. They might be the perfect doctor for your family, and if not, seek out a new provider. It takes time to build a physicianpatient relationship; it is important to see your doctor regularly to develop one to ensure your family’s health needs are understood and addressed before an emergency or illness occurs.

It’ s easier to see the glass half full when the bottle is half priced.

‘‘

On being a plastic surgeon:

misconceptions

Farooq Shahzad, MD

Plastic surgeons have a stereotype: Doctor 90210 or Nip/ Tuck. Although that may be true for an extremely small percentage of plastic surgeons who practice in Manhattan or Beverly Hills, for 99 percent of plastic surgeons out there, that’s not true. Most plastic surgeons don’t go in because they saw Doctor 90210 on TV; they go in because they want to do reconstructive surgery. They want to do pediatric surgery, microsurgery, hand surgery, burns, body contouring. All of that is not glamorous at all. I would say the biggest misconception of plastic surgeons is all they do is boob jobs and facelifts.”

Doctor Misconceptions Being a physician isn’t (always) like what you see on TV. McDreamy, McSteamy and House, MD, may be fun to watch on screen, but there’s a lot more to it. Hours are long, debts are steep and stakes are high. See what seven area doctors have to say about the public’s most common misconceptions on their specialities and doctors in general.

‘‘

‘‘

On being a sports medicine doctor: I think the biggest misconception about sports medicine is that it’s an easy or glamorous job, that you sit on the bench and watch the Twins play baseball and that’s what you do, because really honestly that’s super stressful. You spend all of your time thinking about what might potentially happen. Where are the defibrillators if somebody has cardiac arrest?

Where is the ambulance? Where’s the stretcher? Where’s the backboard? Where are the seizure drugs if your football coach is going to have a seizure on the field? … This is not just stand here and watch football five yards from the football game ... that’s real life or death medicine.”

On being a radiation oncologist: I think that the most common misconception is that it’s a depressing job, and that you’re probably a morose kind of person, and I’m not. I’m not. I want to lift my patients up. I will say, I’m very realistic with my patients; if it’s bad news, I tell them bad news.

If it’s not bad news, then I lift them up. Sometimes it’s appropriate to be quiet and to be serious, and sometimes it’s okay not to be.”

‘‘

On being a doctor:

Scott Engum, MD 12

Stride • September 2014

They kind of forget that there isn’t always a perfect answer. It’s still not a cookbook where you’re going to get the exact same result, because every patient’s different. Trying to tell them, ‘I don’t have an answer, but these are the choices we have that are the best, and we’ve drawn in all we can. Let’s make a good choice, the best choice, and see how things go.’ But there isn’t always an answer.”

Robyn Knutson Bueling, MD

Joni Buechler-Price, MD

‘‘

On being a doctor: I think perhaps the greatest misconception is that our advice is the last word, that what we do and say is such sound scientific basis that there is no room for modification of it or questioning of it.”

Joel Schock, MD

‘‘

Sam Kapphahn, DO

‘‘

Arveity Setty, MD

On being a doctor: I think one is that we are somehow in cahoots with insurance companies or the government ... so that I can go to Paris and live a life of luxury.

I sit around and wear my jeans and T-shirts everywhere I go; I’m not dressing flashy or wearing expensive jewelry. I like to go have a dinner and movie with my friends when I see them as much as anybody else. I just have littler amounts of time to do it.”

On being a doctor: They don’t understand how rewarding it is. Some people I have seen, some children who will come to me, like adolescents (ages) 17, 18, and we ask them, ‘What do you want to be in the future?’ … Most of them, they choose apart from being a physician. They say, ‘It takes a long time for me to be there and start earning, and I don’t know what the health care is going to be with this current system.’ That is the only thing I have heard. It takes a long time, and that’s correct, but still, it’s more rewarding than any other jobs, I believe. Obviously I don’t do anything else apart from being a physician, but I still think it’s more rewarding.”

#

statistics

Hospitals & Doctors Hospitals

Health Care Employment PERCENTAGE

Active Physicians

Med School Grads

Male:

41

9.5

1,649

37

Female:

18

Male:

48

9.2

2,072

N/a Female:

N/a

For more statistics and resources, visit kff.org

Male:

16

132

9.8

15,412

156

Female:

130

Male:

345

7.8

95,041

535 Female:

520

Stride • September 2014

H

ow do North Dakota’s health care system and the health of its citizens line up next to other states? We compared our growing state to our neighbors, Montana and Minnesota, as well as the country’s most populous state, California. Some statistics may surprise you. While we appear to successfully treat mental health needs and 90 percent of our population is insured, we have some of the highest teen death rates in the country and a rising obese population. || Research by Lisa Marchand, Statistics by Henry J. Kaiser Family Foundation

medical care & coverage

Health status

(Percentages of total population)

Mental Health Seeing no Care Needs doctor due to Met cost

Medicaid Enrollment

Medicare Beneficiaries

Uninsured

PERCENTAGE Overweight/ Obese Children

83.14

8.1

12

16

10

25.5

14.6

13

18

18

29

61.38

10.7

18

15

9

43.92

17.1

31

13

19

Teen Birth Rate

rate of teen deaths

(per 1,000)

(per 100,000)

35.8 28.8

PERCENTAGE of adult smokers

# of deaths by firearms (per 100,000)

78

21.2

9.5

35

85

19.7

15.4

27.2

22.5

48

18.8

6.8

30.4

31.5

40

12.6

7.7

17

Diversifying

Health Care

As North Dakota’s population grows, so too does our health care system. Between two large health care entities and a handful of private practices, the diversity of Fargo-Moorhead’s doctors is overwhelmingly abundant. From the state’s first pediatric surgeon to a radiation oncologist who lives for North Dakota’s winters, meet eight physicians with stories that prove they are more than just a white lab coat and a stethoscope.

By Lisa Marchand Photos by J. Alan Paul Photography

19

Doctors

“500 itself is just a number. I do a lot more of other operations when it comes to numbers.

But the fact that I do a lot more of many other surgeries, and in addition to that we have been able to do this many transplants, is pretty good, I think, for our community.�

Bhargav Mistry, MD 14 Years, 500 Transplants

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Stride • September 2014

T

o Dr. Bhargav Mistry, 500 is just another number. However, it’s also a personal milestone. Mistry is quickly approaching his 500th transplant surgery since joining Sanford Health-Fargo in 2000, and it happens to align perfectly with Sanford’s 25th Year of Transplants.

“500 itself is just a number,” he said. “I do a lot more of other operations when it comes to numbers. But the fact that I do a lot more of many other surgeries and in addition to that we have been able to do this many transplants is pretty good, I think, for our community.”

“There is some degree of what we call is ‘healing’ to the family,” the surgeon said.

“Many times the donor families meet the

As remarkable as the number may seem to others, Mistry remains humble.

“It’s kind of a personal milestone, or it’s a number that is kind of impressive,” he said.

“One thing that my presence has ensured here is consistency, and I hope to continue that consistency for some more time.”

Consistency, indeed. Since Sanford began offering transplant services two and half decades ago, there have been a total of 683 surgeries. Mistry has performed 497 of them.

Most of Mistry’s operations involved kidneys, while 66 of them were pancreas transplants.

“When we do transplants, we improve both the quality and the quantity of life, and it’s really amazing,” he said. “It not only affects the patient himself, but it affects the whole family … You do a transplant, they start feeling better mentally and physically, they go back to work, they have a productive life, and the entire family is happy.”

Organ donations come through one of two ways: a living donor or a deceased donor, someone who had either opted to be a donor prior to their death or whose family has decided to donate on their behalf.

Depending on what organs a donor or their family is willing to donate, up to 50 other patients can benefit. For many families, Mistry said, they can feel good in the face of tragedy. They have the potential to save another’s life.

From India Medical School Mahadevappa Rampure Medical College (Gulbarga, India) Residency General Surgery, St. Louis University Hospital (St. Louis, Mo.) Fellowship Transplant Surgery, St. Louis University Hospital (St. Louis, Mo.) Trauma Surgery, St. Louis University Hospital (St. Louis, Mo.) Internship Mahadevappa Rampure Medical College (Gulbarga, India) Years of Schooling 22 Certifications American Board of Surgery, American Board of Surgery: Critical Care, Royal College of Surgeons of England (London, United Kingdom)

recipients, for example, who received a heart or liver or lung, whose life has been saved. It’s a very important, emotional bond.

They can see their son’s or daughter’s heart beating in somebody else and feel good about it.”

According to the U.S. Department of Health & Human Services, someone is added to an organ donation waiting list every 10 minutes.

Over 100 million people in the United States have signed up to be an organ donor, but Mistry encourages more to get involved.

“In our country, most of the people understand that when the organs have been removed, doctors have tried everything possible to save their life,” he said. “I would again request everyone to sign their driver’s license and be a donor.”

Transplant surgery is a complex and unpredictable process. Mistry said sometimes they won’t perform transplants for months, or they could perform up to four in a 24-hour period.

When he gets the chance to leave the office, he has a rock solid staff beside him to handle any complications that may arise.

“It is definitely difficult and (I’m) always a little worried if a patient has a major complication when I’m physically not present,” he said. “I’m glad to say that my surgical partners have been able to handle that, which has been rare, but on a couple of occasions that my patients have needed help in my absence, my colleagues have taken care of (it).”

For more information on becoming an organ donor, visit organdonor.gov.

21

Doctors

“The real beneficial thing, or the real challenge, is to go to underprivileged countries and then transfer your skills over there, so when you leave they have something they can continue.”

Farooq Shahzad, MD Giving Back to Pakistan

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Stride • September 2014

D

espite what “Doctor 90210” may tell you, plastic surgery isn’t glamorous. In fact, there is a lot more to it, and Dr. Farooq Shahzad is a testament to that.

He always knew he was interested in surgery, but finally settled on this path because it steered clear of monotony. Every case, every patient differs, and that excited him.

“As opposed to all the other forms of surgery, it requires a lot more planning and the surgeries are frequently staged,” Shahzad said. “It’s like an artist: you’re looking at the final product … and then you’re looking at individual components and you make the picture come together.”

With that artistry comes higher expectations, which he said adds a bit more pressure to his work.

“When patients come to a plastic surgeon, that’s the final stop,” he said. “Frequently they’ve been other places, and then they come here and they expect everything to be absolutely perfect. Whatever you do is

immediately visible, so yes, that adds extra pressure, but it also makes you better.”

The Essentia Health-Fargo plastic surgeon tries to take time each year to return home to Pakistan. There, he volunteers his time and expertise to those in need of services, particularly children. He often deals with

patients with cleft palates, congenital facial and hand anomalies, burns or fused hands and feet.

“Pakistan is very different from the United States,” Shahzad said. “If you’re not in a big city, if you’re in the rural areas, you don’t have any physicians.”

With Houston-based organization House of Charity, Shahzad and a team of physicians travel to Pakistan for a period two weeks.

From Pakistan Medical School Aga Khan University (Karachi, Pakistan) Residency General Surgery, West Virginia University School of Medicine (Morgantown, W.V.) Plastic Surgery, Oregon Health and Science University (Portland, Ore.) Fellowship Craniofacial and Pediatric Plastic Surgery, Washington University (St. Louis, Mo.) Years of Schooling 13 Certifications American Board of Surgery

His impact stretches farther than just the patients he operates on. In addition to performing surgeries, he gives lectures to local medical and nursing students, patients and residents.

“Now I’m in a position where I can go back and not only operate, but the bigger thing is to take the skills back home,” he said. “… The real beneficial thing, or the real challenge, is to go to underprivileged countries and then transfer your skills over there, so when you leave they have something they can continue.”

Although he grew up in Pakistan, Shahzad said he still must adapt to the situation and the state of health care when he returns. In the United States, physicians have unlimited resources at their disposal. Patients, for the most part, are economically sound. There, it’s a different story.

“Patients come from far away, they are malnourished, they have no money,” he said. “They don’t even have money for the train ride, so you have to give them money to go back home. That’s the situation, so you’re working in a situation that you’re not used to and you have to improvise all the time. That is the most challenging part to kind of come down from being spoiled over here to the real world where you’re constantly trying to improvise.”

23

Doctors

“Some residents have a hard time deciding where to go ... For me, it was easy: I wanted to go to one of the big square states up by Canada. I’ve lived on the East Coast, I have no desire to live on the West Coast, nothing down low. So I wanted to go (to a) big square state; give me one of those.”

Joni Buechler-Price, MD North Dakota: Home Sweet Home

24

Stride • September 2014

Doctors

F

or many North Dakota residents, winters are the bane of their existence. For Dr. Joni Buechler-Price, they’re the best part of her year. Call her crazy, and the Golden Valley, N.D., native may agree, but that’s all right with her.

After completing her residency at the University of Iowa, this radiation oncologist had to decide what was next. Some residents have a difficult time choosing where to settle, but for her, the decision was a piece of cake.

“For me, it was easy: I wanted to go to one of the big square states up by Canada,” BuechlerPrice said with a laugh. “I’ve lived on the East Coast, I have no desire to live on the West Coast, nothing down low. So I wanted to go (to a) big square state; give me one of those.”

So when a job opened up in Billings, Mont., she and her husband made the move.

However, something was missing. To sum it up: bone-chilling winters. Even though snowcovered mountains were a 45-minute drive away, that wasn’t quite close enough for her.

“It’s hot and dry, and I hate hot and dry,” she said. “I was annoyed because they didn’t have a good winter, and I love winter … I love when your nose hairs freeze (when) you walk outside, when you walk outside and your shoes go, ‘Scrunch, scrunch, scrunch’ on the snow. I love that.”

Again, call her crazy, and she’ll probably agree with a contagious smile.

Then last winter, something wonderful happened: Buechler-Price saw there was an opening at Essentia Health-Fargo. She interviewed and said she wasn’t all that confident that it would happen. But sure enough, it did, and she was elated to return home.

“When I crossed that Montana-North Dakota border,” she said, “I was screaming, I was yelling, I was like, ‘Yay, I’m home!’ I was so happy to be moving back to North Dakota.”

The day after she arrived, winter played its favorite hand and sent a blizzard her way.

She said she was tucked into her house

26

Stride • September 2014

while the storm raged, and she couldn’t have been happier.

“I went outside and I was shoveling the driveway and my neighbor, he comes out (and says), ‘You moved from Billings? How come you moved from Billings?’ I was shoveling and I said, ‘I didn’t like the winters.’”

But her journey back home wasn’t an easy one; it wasn’t short and it wasn’t cheap. Out of college, she began as an X-ray technician.

Then, she went back to become a radiation therapist. After that, she attended nursing school at Johns Hopkins University.

She was content as a nurse. But according to Buechler-Price, God had bigger plans.

She felt she needed to head to medical school and become a doctor, making for a whopping 18 years of schooling. She thought she was “too old” and it was going to cost too much money, but she couldn’t shake the feeling.

From Golden Valley, N.D. Medical School University of North Dakota (Grand Forks, N.D.) Residency Radiation Oncology, University of Iowa (Iowa City, Iowa) Years of Schooling 18 Certifications American Board of Radiology in Radiation Oncology

“One night I said, ‘Fine, fine. I’ll try one time to get in and then You leave me alone about this,’” she said. “I tried one time to get in and I got a scholarship, and so that just kind of solidified that I was on the right path.”

At the age of 40, Buechler-Price graduated medical school with a degree in radiation oncology.

Her grand plan may have been, and continues to be, a time-consuming one, but for her, that’s the way it’s meant to be. Lucky for her, that grand plan dropped her back in the icy tundra of her favorite state.

“God made doctors, and God made smart people who can make linear accelerators, and God made smart people who can give chemotherapy, and God made dumb people who can be doctors who are just willing to work real hard,” she said with a hearty laugh.

“But things do happen for a reason, and I do think there’s a grand plan, but that doesn’t mean that the grand plan can’t be, ‘You’ve got cancer; let’s treat it.’”

Doctors

“For a physician, actually, I think it’s more important that you communicate very well with the patients, and speaking in their own language is definitely an edge ... If you can’t understand what they’re telling you, you can’t get your diagnosis. If you can’t get your diagnosis, you can’t treat anything.”

Arveity Setty, MD

Connecting Through Language 28

Stride • September 2014

D

r. Arveity Setty doesn’t speak one language, he speaks four: English, Telugu, Kannada and Malayalam. If you count “kid,” that makes five.

Setty is a pediatric sleep medicine physician from Shimoga, India, who joined the Sanford Health-Fargo team about five months ago. He is the only doctor of his kind in both North and South Dakota, as well as western Minnesota.

America, where many of his classmates were practicing. Here, he’s found the support of two much larger teams: the pediatric unit and the sleep medicine unit.

Although he may not utilize his Indian dialects as often as he used to, being multilingual allows him to communicate with a variety of patients.

“For a physician, actually,” Setty said, “I think it’s more important that you communicate very well with the patients, and speaking in their own language is definitely an edge ... If you can’t understand what they’re telling you, you can’t get your diagnosis. If you can’t get your diagnosis, you can’t treat anything.”

Setty practiced across three states in India for several years before applying for residency in the United States. While practicing in his home state, he worked at a clinic where he was the only pediatrician on call 24/7.

Although the metropolitan areas of India are virtually Westernized, the rural areas are anything but. Services are scarce and physicians are few and far between.

“People are very poor, (services) are not very affordable,” he said. “Very rarely you get to see a physician there, and (patients) have to travel for a long distance … and because of the population there and availability of physicians, I would see nearly 100 to 120 patients, easily, in the eight- to nine-hour period.”

With little rest and even less time with his family, he decided to make the move to

From India Medical School JJM Medical College (Davangere, Karnataka India) Residency Pediatrics, Hurley Medical Center (Flint, Mich.)

Pediatrics, Sri Devraj Urs Medical College (Kolar, India) Fellowship Sleep Medicine, Cincinnati Children’s Hospital Medical Center (Cincinnati, Ohio)

“Sanford has been very helpful and they have nearly 20 pediatricians now,” Setty said. “It’s a very huge group, which I like about it, and that’s the reason I came here.

Talking to both the groups here, in the sleep medicine as well as the pediatric group, I just love them … They’re very cooperative and very knowledge-sharing.”

Although Setty ended up loving the thought of becoming a doctor towards the end of medical school, medicine hadn’t always been his plan; he wanted to study computer science.

But when a family tragedy struck, he opted to take a different path. At the age of 15, he lost his father to a fatal misdiagnosis.

The doctors thought the abdominal pain his father was experiencing was caused by malaria, a common ailment in India. However, it was much more severe than that.

“That motivated me, actually,” Setty said. “I said, ‘Misdiagnosis is terrible.’ If they had diagnosed him sooner, then definitely he would have been alive. So that motivated me for being a doctor and that’s how I got into medicine.”

Internship JJM Medical College (Davangere, Karnataka India)

Now, he’s in medicine for the long haul.

Lucky for him, he found two specialties he loves that allow him to give back to other families.

Years of Schooling 12

“Just yesterday I had a patient who was telling (me), ‘You got my life back,’” he said with a smile. “… I feel very happy. I was almost able to cry because he told me that.

That’s why we become doctors; that’s what we want to do.”

Certifications American Board of Pediatrics, American Board of Sleep Medicine

29

Doctors

“I have a different personality than the next person, and I think there are some women who would approach being the only female differently than I do. I feel pretty strongly that we all are just a bunch of people who are well-trained to be science nerds and sports nerds, and we like the interplay between those two things.”

Robyn Knutson Bueling, MD

Sports, Science and High Heels 30

Stride • September 2014

B

eing a sports medicine physician isn’t about getting a front row seat to the action on the field or in the rink, although it’s definitely a perk.

A little sweat and blood doesn’t keep Dr. Robyn Knutson Bueling of Sanford Health-Fargo from thinking she has the best job in the world.

Knutson Bueling always knew she liked medicine, and she actually like the idea of going to school for a long time. She played five sports in high school and had plenty of injuries herself, so sports medicine seems to be a perfect fit. But the match wasn’t as obvious to her when she started out.

“Sports medicine chose me,” she said matterof-factly.

Initially she toyed with the idea of pediatrics, orthopedic surgery, cardiology and then family medicine. Finally, in her residency, someone on the sports medicine faculty stated the obvious.

“He said, ‘There are lots of people who can do (family medicine,) and you can’t. You will not ever be happy if you don’t do this. This is what you have to do,’ and he was absolutely right …” Knutson Bueling said. “I don’t think I really knew that this is what I was going to do, even though it probably all along, since forever, was what I was going to do.”

On an easy day as a high school athlete, she had at least five hours of practice, and she loved every minute of it. Lucky for her, she never sprained anything or pulled a muscle.

But she did experience a stress fracture in her back and an avulsion fracture in her pelvis, among other injuries.

Maybe that’s what makes her so good at her job. She doesn’t just know what her patients’ injuries are, but she knows what it feels like to have them.

“I can, almost every day, say, ‘Well I had one of these and remember what it’s like,’ she said. “… I think I also have an appreciation for understanding different sports. I think it’s exciting to learn what it is you do when you

play lacrosse or rugby or something else that I’ve never done.”

Sports and medicine aren’t the only things she’s good at, though. Chalk it up to her competitive nature or just being a stellar multi tasker, but she and her husband had their first child while she was in medical school and

From Wahpeton, N.D. Medical School University of North Dakota (Grand Forks, N.D.) Residency Family Medicine, Methodist Hospital (St. Louis Park, Minn.)

Fellowship Sports Medicine, University of Minnesota (Minneapolis, Minn.)

Years of Schooling 15 Certifications American Board of Family Medicine: Sports Medicine

their second towards the beginning of her residency. To her, it doesn’t really matter how she did it; she just did.

“I know there are a lot of people in my situation who would feel like they needed to concentrate on one thing before moving on to the next,” she said. “It was really important to me, personally, that I was the kind of mom that I wanted to be, and I wanted to be that at a certain age and energy level. So it wasn’t something that I was willing to put off another eight years, and I like to win … If you’re going to do one thing well, what if you can do two things?”

Overall, sports medicine in general has been primarily male-dominated. At Sanford, she is the only female doctor in the department and the only board-certified female sports medicine physician in the entire state.

“I have a different personality than the next person,” she said, “and I think there are some women who would approach being the only female differently than I do. I feel pretty strongly that we all are just a bunch of people who are well-trained to be science nerds and sports nerds, and we like the interplay between those two things.”

Being surrounded by men on a daily basis doesn’t faze her. She loves sports, she loves medicine, she’s good at her job and she likes to wear heels. So what?

“We always joke about females in sports medicine,” Knutson Bueling said with a laugh.

“Either you’re a high heel female or you’re a tennis shoe female. I’m a high heel female, which means I have absolutely walked onto a football field in my high heels. I don’t think it means that I can’t get down on the ground and do a knee exam.”

31

Doctors

“Here, everybody’s talking about growth … It’s a rare moment that Fargo and this area gets to relish in. I hope everybody takes advantage to see that and enjoy that because not everybody gets that right now.”

Scott Engum, MD Painting a Bigger, Better Picture for N.D. Pediatrics

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Stride • September 2014

Doctors

D

r. Scott Engum left North Dakota 25 years ago to complete his medical degree in pediatric surgery. Now, the Minot native is back as the sole pediatric surgeon in the state.

Engum’s career path wasn’t always clear. He knew he liked working with children, but said the pediatric clinic wasn’t a perfect fit.

With the help of one monumental mentor, it became clear that pediatric surgery was his calling. That mentor was Dr. Mark Blaufuss, still a practicing pediatric gastroenterologist at Sanford Health in Fargo.

but they can now remain closer to home and receive top-notch care.

As Engum settles in at Sanford Health-Fargo, and he and his team continue to grow, he said they may not be able to accept every case that comes through their doors. But six months from now, he seems confident it will

“I was kind of a builder,” Engum said. “I just had to do stuff with my hands, so gravitating to surgery made sense. But (Blaufuss) was the one, believe it or not, way back then in 1988 that said, ‘You know, you ought to think about putting the two together.’”

So he did. He completed both his residency and fellowship at Indiana University and remained in the state until recently. For the last five years, he directed a state-of-the-art simulation center in Indianapolis that he himself helped develop.

With an established career and a solid team surrounding him, why return to North Dakota?

To Engum, this was an opportunity to truly impact health care.

“There are so few times now in medicine that you can make a difference,” he said. “They’ve been stripped away. In the old days, you were given a big paintbrush and you could paint a beautiful picture. You could paint something and someone could tell what’s going on. You could make big changes, and leaders had the opportunity to really implement big changes.”

Engum’s presence in the state will yield big changes. Patients and their families will no longer need to travel to health care centers in far away cities like Minneapolis. He said that many will still travel a long way to Fargo,

34

Stride • September 2014

be a different story. The surgeon wants to provide the best care for their patients, and he won’t stop until the system gets there.

“That’s the right thing. Do no harm,” Engum said. “We have to get the same results as Sioux Falls gets, we’ve got to get the same results that Minneapolis gets, we’ve got to get the same results that U of M gets, got to get the same results Mayo gets. There isn’t second fiddle … We have to be equivalent.”

As families flock to the state, North Dakota’s health care industry is rapidly expanding and improving. From new building projects to a rising physician population, Fargo is along for the ride.

From Minot, N.D. Medical School University of North Dakota (Grand Forks, N.D.) Residency General Surgery, Indiana University (Indianapolis, Ind.) Fellowship Pediatric Surgery, Indiana University, Riley Hospital (Indianapolis, Ind.) Years of Schooling 15 Certifications American Board of Surgery, Pediatric American Board of Surgery

“The health care (industry) is excited to grow,” Engum said, “where in some environments, they’re freaking out to contract to be able to keep the services they have and save money.

Here, everybody’s talking about growth … It’s a rare moment that Fargo and this area gets to relish in. I hope everybody takes advantage to see that and enjoy that because not everybody gets that right now.”

His dedication and motivation are evident, but what’s palpable is his passion; his passion for his patients and his passion for their futures. The gratification of fixing or easing a problem is a great component of his job, but it’s not the best.

“At the end of the day, it’s when you get this invitation to a wedding and you’ve known them for 18 years … “ he said. “Or when Mom puts (up) a Facebook post because it’s a birthday and their kid wasn’t going to live, but you were part of the team that made it happen, and they’re acknowledging it. Not that it’s kudos to you, but just they’ve welcomed you into their community. That’s probably the best part. That travels with you.”

Doctors

“When you go into a field, people want to know, ‘Well how experienced are you? ... ’ it’s very hard, I think, for people to realize that your doctor trained on people at some point along the lines ... I’ve completed my residency, I’ve completed my fellowship, but there will always be new technology; there will always be new techniques. Even the expert in the field had to do their first one at some point.”

Sam Kapphahn, DO One Year Down, Many to Go

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Stride • September 2014

T

he only time Dr. Sam Kapphahn thinks about how long she went to school is when someone asks her, but it still doesn’t seem to bother her much. She knew what she signed up for.

“I knew I was going to be a doctor from a very early age,” Kapphahn said, “and with that came this awareness that the next step was going to be the next step. That was not something that was going to be over in a year or two.”

After spending 12 of those years on both of the coasts, the Essentia Health-Fargo interventional cardiologist has returned to the Midwest, and just wrapped up her first official year as an attending physician.

She hadn’t planned on coming back, but she saw an opportunity she couldn’t pass up as a first-year doctor.

“Fargo is a great community. It’s growing leaps and bounds,” Kapphahn said. “Our surrounding areas are filled with great people who work hard (and) have spent a life doing that. It’s rewarding to come back and give something back to those areas of people, especially considering that I know they haven’t had the same access that people in New York would have had, for a variety of reasons.”

She has her whole career ahead of her, but that doesn’t mean she doesn’t have a long list of experience in her repertoire. However, Kapphahn recognizes that some people aren’t quite sure about being some of the first official patients of such a young doctor.

“When you go into a field, people want to know, ‘Well how experienced are you?

You’re going to be doing this.’ It’s very hard, I think, for people to realize that your doctor trained on people at some point along the lines,” she said.

“I’ve completed my residency, I’ve completed my fellowship, but there will always be new technology, there will always be new tech-

niques. Even the expert in the field had to do their first one at some point.”

Kapphahn is embarking on her second year

From Elbow Lake, Minn.

Medical School Western University of Health Sciences and the College of Osteopathic Medicine of the Pacific (Pomona, Calif.)

Residency Internal Medicine, North Shore University Hospital (Manhasset, N.Y.) Fellowship Cardiovascular Disease and Interventional Cardiology, North Shore University Hospital-Long Island Jewish Health System (Manhasset & New Hyde Park, N.Y.) Years of Schooling 16 Certifications American Board of Medical Specialties in Internal Medicine, Cardiovascular Diseases and Interventional Cardiology

as an attending physician. Not only is she young for her field, she said she’s also a rare entity in interventional cardiology: a woman.

“I had somebody yesterday who was an older person. He was asking the staff, ‘How old is that doctor?’ I get that a lot. I got it when I was a fellow, I got it when I was a resident. I look young; I’d rather do that than the alternative,” she said with a grin.

If you had told this Minnesota native 10 years ago that she was going to become an interventional cardiologist, she wouldn’t have believed you. But she said she’s the kind of person who needs to see results, and most of the time, this field gives her just that.

“I need to see something get better, and with my field I get the best of both worlds,” she said. “I get some very sick people where things don’t always go the way you want them to, but you get enough sick people where you can really be a game-changer … they get a second chance, and their choice is what they do with it.”

As an interventional cardiologist, she performs intervention and diagnostic procedures on the heart, its valves, its arteries and sometimes arteries in the legs. In Kapphahn’s words, she plays in a high stakes game.

“You realize you’re saving somebody or helping someone be there for their family,” she said. “These are families with young kids, they’re families with babies, infants and they need to be around. Their spouses need them around, their families need them around …

You’re not just impacting a family, you’re affecting a generation of people and the ones who come after them.”

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Doctors

“Most people, from a patient’s point of view, perhaps don’t realize that we are basically just as connected, or more so, to the referral sources, so that when they need a specialty referral, it’s basically as seamless here as it would be in the large institution and that the quality of care we’re required to adhere to is as stringent.”

Joel Schock, MD

Exploring Medicine Through Private Practice 38

Stride • September 2014

E

leven years ago, Dr. Joel Schock embarked on a new adventure: he opened a private practice. The family medicine practitioner saw an opportunity for more flexibility and independence in his work, and he seized it.

Together with his partner Dr. Hoadley H. Harris, they opened Plains Medical Center in south Fargo. They focus on acute and chronic illness, from pediatrics to geriatric care and most everything in between. This spectrum of care is exactly what Schock loves.

“I couldn’t find any one specialty that I enjoyed so much that I would want to do just that. Sometimes not to decide is to decide,” he said. “It seemed like that kept more doors open as far as being able to practice in a large or small town, any region, and not limit myself to any one field of study.”

The relationship between Schock’s practice and the larger entities remains strong. He said while Plains Medical Center is great for day-to-day issues, the larger entities are often

From Ashley, N.D.

Now that Schock and Harris operate Plains Medical Center, they also have the leeway to explore other areas of medicine. Several years ago they started their pharmaceutical research company and age management clinic, Eternity Medicine. The company conducts research surrounding diabetes, asthma, cardiovascular health and immunizations.

Medical School University of North Dakota (Grand Forks, N.D.)

Prior to exploring the research facet, Schock and Harris had practiced family medicine together at a larger institution for 17 years.

Years of Schooling 11

“Although it was rewarding … it does restrict somewhat your ability to go off into some of these areas that I had an interest in,” Schock said.

Certifications American Board of Family Medicine

“I felt that the practice of medicine, because of pressures from the federal government and insurance companies, is becoming much more technical and based more on outcomes of large groups, and so we’re almost pressured more and more to follow a very cookbook style of medicine where things are repeated the same for everybody.”

Residency University of North Dakota Family Practice Center (Fargo, N.D.)

better suited for more critical care.

“The FM area is very fortunate to have two premiere large groups,” he said, “and for sure when you get beyond wellness and routine chronic illness and acute illness care into the more critical injury critical care, you need big institutions, and they do a stellar job.”

Private practices may be smaller, but they have just as many hoops to jump through as larger institutions, and they are just as plugged in to specialty referrals and insurance companies. They also offer full laboratory and X-ray services. Often times, Schock said, unfamiliar patients have a very narrow view of what the practice can offer.

“It’s basically as seamless here as it would be in the large institution in that the quality of care we’re required to adhere to is as stringent,” he said.

With the help of the Heartland Healthcare Network, Schock and his partner found the resources they needed to open a private practice. Heartland is a system of independent physicians and practices in the Fargo-Moorhead and Grand Forks area.

The physician also discovered that starting up a business wasn’t as daunting as it seemed.

“I was pleased to find that there were many companies, and there’s a good deal of people, managers, accountants, attorneys (and) payroll professionals who can take care of so much of that for you that it really didn’t prove to be the burden I thought it would be,” Schock said. “I like the idea of getting out from underneath the many layers of management that are piled on to a larger institution.”

39

HOSPITAL

demographics

BEDS at Sanford Medical Center Fargo

times as a

2,500

Top 100 tal spi Heart Ho

BIRTHS per year

1 out of 27 people

in FargoMoorhead work for Sanford Health

500

board-certified

PHYSICIANS

400,000+ outpatient visits per year

for Sanford Health-Fargo*

1908

Year Sanford (first called St. Luke’s) opened in Fargo

42

Stride • September 2014

*For the full list of accreditations, visit sanfordhealth.org/MedicalServices/ProgramsOfDistinction Resources: sanfordhealth.org/Content/PDFs/About/CHNA/SanfordFargoMedicalCenter.pdf

Demographics

4

STATES in which Essentia operates

Essentia HealthFargo clinics

700+patients served

per day at the South University Clinic

Essentia Health-Fargo employees in 1926

3

Joint Commission

BEDS at Essentia Health-

ACCREDITATIONS

Fargo hospital

for Essentia Health-Fargo*

2008

Year Innovis Health & Dakota Clinic began integration of Essentia Health System

*For the full list of accreditations, visit essentiahealth.org/Fargo/Find-a-Clinic/Essentia-HealthFargo-87.aspx Resources: essentiahealth.org/Uploads/Public/Documents/ESSH2842_Annual_ReportFINALREV20140116.pdf essentiahealth.org/main/QualitySeeAll.aspx

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