MED-Midwest Medical Edition-July/August 2011

Vol. 2, Issue 5

2011 July August

Gearing Up

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

July 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 (Then & Now: Conversations with Blackie, Nov. 2010), gives voice to controversial ideas (“Examining Malpractice”, June 2011), celebrates physician talent (Music and Medicine, March 2011), lifts up volunteer efforts (Caring for a Needy World, April/May 2010), takes you inside new facilities (A New Home for Cancer Care, Nov 2010) and, as always, covers every major clinical advance (MRI Safe Pacemaker, April/May 2011).

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

From Us to You

Staying in Touch with MED

A letter from the VP and Editor

Publisher

Steffanie Liston-Holtrop

Alex Strauss

S

ummer is traditionally travel season for Midwesterners and, here at MED, we’re taking that to heart. There is nothing we love better than getting out and meeting so many of you, the movers and shakers who make this medical community ‘tick’. In July, we will be in Chamberlain for the South Dakota Association of Healthcare Marketing and Public Relations meeting. Then in August, we’ll be back for the SDMGMA meeting (with a basket of wine and other goodies to give away, complements of our friends at Good Spirits Fine Wine in Sioux Falls).

In September, we’ll head West River to the annual SDAHO conference. As always, we are looking for ideas that will help us keep MED timely, relevant, and interesting.

Don’t be shy!

Our hearts go out to those of you in the Pierre, Yankton and Dakota Dunes areas whose homes and practices have been impacted by flooding this spring. It has been inspiring to see the outpouring of support from friends and neighbors – especially those provider’s who have stepped in to cover so their colleagues could deal with their flooded homes.

Thanks to Rapid City Regional Hospital for giving us a ‘behind the scenes’ look at what it really takes to care for 500,000 ‘temporary’ residents. They appear to be proving the saying “Whatever doesn’t kill you makes you stronger.”

Here’s to a summer filled with sun and fun.

Until September, — Steff & Alex

Welcome

Two new additions to the MED Physician Advisory Board Bradley Randall, MD, is a Board Certified Clinical and Forensic Pathologist with Dakota Forensic Consulting in Sioux Falls. He served as the Minnehaha County Coroner from 1982 to 2010 and is Professor in the Pathology Department at the USD Sanford School of Medicine.

Dr. Randall is a Fellow of the American Academy of Forensic Scientists, the College of American Pathologists and the National Association of Medical Examiners. He is also past president of the SD Society of Pathologists.

James W. Young, DO, FAOCD, Board Certified Dermatologist, has been in practice at Yankton Medical Clinic, P.C. since June 1998 and currently serves as the clinic’s Board President. He is an Associate Clinical Professor of Dermatology at Sanford School of Medicine of the University of South Dakota, as well as a Fellow, Fellow of Distinction, and Past President, of the American Osteopathic College of Dermatology. Dr. Young provides dermatology outreach clinics in Vermillion and Freeman.

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MED Magazine, LLC Sioux Falls, South Dakota

VP Sales & Marketing Steffanie Liston-Holtrop Editor in Chief Alex Strauss Cover Design Darrel Fickbohm Design/Art Direction Corbo Design Web Design 5j Design Contributing Editor Darrel Fickbohm

Contributing Writers Lizabeth Brott

Heather Boysen Dave Hewett Contact Information Steffanie Liston-Holtrop, VP Sales & Marketing 605-366-1479 Steff@midwestmedicaledition.com Alex Strauss, Editor in Chief 605-759-3295 Alex@midwestmedicaledition.com Fax 605-271-5486 Mailing Address PO Box 90646 Sioux Falls, SD 57109 Website MidwestMedicalEdition.com

2011/12 Advertising / Editorial Deadlines Sept/Oct Issue August 5th November Issue October 5th December Issue November 5

2012 Jan/Feb Issue December 5 March Issue February 5

April/May Issue March 5 June Issue May 5 July /August Issue June 5

Reproduction or use of the contents of this magazine is prohibited.

©2011 Midwest Medical Edition, LLC Midwest Medical Edition (MED Magazine) is committed to bringing our readership of 3500 South Dakota area physicians and healthcare professionals the very latest in regional medical news and information to enhance their lives and practices. MED is published 8 times a year by MED Magazine, LLC and strives to publish only accurate information, however Midwest Medical Edition, LLC cannot be held responsible for consequences resulting from errors or omissions. All material in this magazine is the property of MED Magazine, LLC and cannot be reproduced without permission of the publisher. We welcome article proposals, story suggestions and unsolicited articles and will consider all submissions for publication. Please send your thoughts, ideas and submissions to alex@ midwestmedicaledition. com. Magazine feedback and advertising and marketing inquiries, subwe Don’t forget scription requests and r ea h to t wan address changes can be from you. sent to steff@midwestmedicaledition.com.

Writs!e to u

MED is produced eight times a year by MED Magazine, LLC which owns the rights to all content.

Midwest Medical Edition

Contents Midwest Medical Edition

July / August 2011

Cover Feature

Regular Features 2 |

From Us to You

13 | Medicine & the Arts Visual Artist Judith Peterson

21 |

25 |

Then and Now Changes in Cardiology

Grape Expectations Fishing for Fine Wine

By Heather Taylor Boysen

28 | News & Notes

News from around the region

29 |

L earning Opportunities Upcoming Symposiums, Conferences and CME Courses

In This Issue 4 |

The Long Term Consequences of Medicaid Cuts

By Dave Hewett

6 |

All aTwitter About Social Media

By Lizabeth Brott, JD

12 |

Clinical Trial: IORT for Breast Cancer

16 |

Feature: Program Teaches Empathy through Literature

By Darrel Fickbohm

22 |

New Cardiac Imaging Technology for Regional Health

27 |

Sanford Promise Hires Curriculum Coordinator

Gearing Up How Regional Health

Gets Ready to Rally

By Alex Strauss For 71 years, die-hard bikers and casual riders have been rolling into the Black Hills for the Sturgis Motorcycle Rally. What used to be a crowd of a few thousand young men has blossomed into a throng of a half million men and women of all ages and stages. Along with their chaps and leather and their tourist dollars, these party-goers also bring a wide range of health problems. In this month MED Cover Feature, we look at what it takes for the healthcare professionals of the Black Hills to be ready for them.

page

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The Long Term Consequences of the

Medicaid Cuts

By Dave Hewett, President/CEO, SDAHO

W

hen a South Dakota legislative session adjourns for the year, it’s typical for everyone involved to leave Pierre and decompress for a few months before returning to the preparatory rigors of the next session. That’s not the case for health care providers this year and a whole host of other interests associated with South Dakota’s Medicaid program.

For one thing, the Governor’s Office has convened a Medicaid Solutions

4

Workgroup to find new ways to cut the cost of the State’s Medicaid program.

SDAHO has also been devoting significant time and resources to develop new approaches in the areas of case management and reimbursement. Both efforts are the outgrowth of a 2011 Legislative Session that saw Medicaid provider rates cut for the first time in the history of the program.

To recap the Session, Governor Daugaard proposed a 10% reduction in Medicaid reimbursement for providers participating in the program in the

upcoming Fiscal Year 2012. (That includes all hospitals and most physicians in the state.) During the last week of session, some one-time money was found in the Medicaid program that allowed the Legislature to approve, on average, a 6.0% reduction in provider reimbursement for FY 2012. The Legislature took those cuts a step further and parceled them out so that some providers were assessed greater percentage cuts than others. For example, primary care physicians’ reimbursement was reduced 4.0% while specialists will see

Midwest Medical Edition

their reimbursement rates decline 5.1%.

The key phrase in this last paragraph is “one-time money”. What is not well understood is that when Governor Daugaard proposes his budget next year (for FY 2013), he will be basing any change in reimbursement on an assumed overall 10% reduction in Medicaid reimbursement – not the 6% approved by the Legislature.

Governor Daugaard said last December that he was resetting the State Budget. That “reset” means physicians’ Medicaid payment rates in FY 2012 will be approximately 5% less than they were in FY 2011. It also means that if the Governor would, hypothetically, propose a 0.0% update for FY 2013, those rates would be less in FY 2013 than in FY 2012.

Make no mistake. The Medicaid cuts passed by the 2011 Legislature will have a lasting impact on physicians and other health care providers. We already know that Medicaid pays substantially less than the cost of providing care. I don’t know what it will take to get legislators and the Governor to understand the longterm consequences of their actions but clearly, significant dialogue between us and state legislators starting now would seem to be in order.

But talking just about the dollars isn’t productive. We must also engage in discussions that consider new pathways for delivering care to our poorest and neediest populations in the state.

Certainly the Governor’s Medicaid Solutions Workgroup provides that forum. Making sure the physician’s perspective on how best to construct those pathways begins with you. ■

July / August 2011

Reporting Now Mandatory

for Elder Abuse

Physicians and other healthcare professionals are now required by law to report suspected cases of abuse or neglect among elderly or disabled adults. The law, which took effect July 1, is similar to the mandatory reporting process that exists for child abuse. Mandatory reporters include any person who is an: ♦ MD, DO, dentist, chiropractor, optometrist, podiatrist, hospital intern or resident, nurse, paramedic, or any health care professional, hospital staff ♦ religious healing practitioner or social worker ♦ Psychologist, licensed mental health professional or counselor ♦ State, county or municipal criminal justice employee or law enforcement officer ♦ Nursing home, assisted living center, adult day care ♦ Long term care ombudsman If you have questions about mandatory reporting of abuse and neglect, contact Marilyn Kinsman in the Department of Social Services at Marilyn.kinsman@state.sd.us. ■

MidwestMedicalEdition.com

5

aTwitter

All about Social Media

By Lizabeth F. Brott, JD

S

ocial media and the Internet permeate today’s world.

In December 2010 TIME magazine named Facebook founder Mark Zuckerberg “Person of the Year,” citing Facebook’s 550 million members and noting that 700,000 new members join Facebook

on a daily basis. And, of course, these numbers don’t include membership on other social media websites, such as YouTube, Myspace, Twitter, Flickr, etc.

The opportunities and risks associated with the medical use of social media and the internet are numerous. For example, opportunities include, but are not limited to:

emails and entries on websites such as Facebook and Myspace);5 t Inappropriate employee use (e.g., employees posting information online about patients or the practice).6

t Patient care reminders, rural health

“ Cutting Rope With Which to Hang Myself”

care communication, updating family members during surgery, issuing allergy alerts, connecting patients with similar diseases, FDA drug safety alerts, epidemiological surveys, transmitting data to patients traveling abroad, post-discharge consultation and follow-up care, etc.;1 t Use as a crisis communication tool with media and the local community.

On the other hand, the risks may include: tT wo-way

communication between a physician and a user could be interpreted as medical advice (and create additional risk if the communication involves a user located in another state where the physician isn’t licensed);2 t Patient privacy issues (information on social media platforms is usually not encrypted);3 t The permanence of material posted online which could be used against physicians later in litigation4 (there are already court decisions requiring production of healthcare-related 6

Perhaps the most notorious example of a physician’s use of the Internet is the Boston pediatrician who blogged throughout his malpractice trial. His daily postings included reports of meetings with his defense attorneys and a trial expert who counseled him on proper courtroom behavior and jury psychology. He also posted his impressions of jury members. He was confronted about his blog on the witness stand by the female plaintiff’s attorney (whom he had referred to in vulgar terms in his postings); the case was settled the next day. The story— including the pediatrician’s name and photograph—made the front page of The Boston Globe. Within hours, parents called his office to have their children’s medical records transferred.

In a subsequent interview the pediatrician described the stress he experienced following the patient’s death and throughout the resulting lawsuit. He indicated he wanted to show ordinary people what physicians

experience during a medical malpractice lawsuit and thought the anonymity of a blog would shield him. He expressed regret about the child’s death and the effect the case and his blog had on the child’s mother and his own family.

When asked what advice he would give to medical bloggers, he responded “Every time you post, recite the following to yourself as though it were a mantra: ‘I am cutting rope with which to hang myself. I am cutting rope with which to hang myself.’”7

Risk Management To protect yourself, your practice, and your patients, consider the following: t Assume all Internet communications are public and never anonymous. t Use privacy settings to block information from public view; however, understand this may not completely prevent outside access.8 t Keep your personal and professional lives separate; do not “friend” patients. Block patients’ access to your personal social networking pages.9 t Ensure any information shared is generic or de-identified so patients cannot be identified.10 Midwest Medical Edition

t Use

disclaimers on websites or social media indicating you are not providing medical advice and that users should contact a physician or 911 in the event of an emergency.11 t Monitor your web presence regularly; if you enable two-way communication without proper monitoring, you run the risk of missing urgent information.12 t Develop a policy for social media usage by staff for work purposes; remind staff that communications are not private and may be discoverable.13 t Actively monitor for staff violations and discipline violators in a consistent manner.14 Labor attorneys indicate medical practices have the right to tell employees they cannot say things online that would harm the practice’s reputation; however, employees cannot be prohibited from posting information for the betterment of work conditions.15 Lastly, the American Medical Association (AMA) recently published a policy on “Professionalism in the Use of Social Media,” which reiterates and expands on several of the risk management suggestions herein. To access the AMA policy, go to http://www.ama-assn.org/ama/pub/meeting/professionalism-social-media_print.html. ■ Lizabeth F. Brott, JD is Regional Vice President, Risk Management. This article is not intended to provide legal advice, and no attempt is made to suggest more or less appropriate medical conduct. Copyright © 2011 ProAssurance Corporation.

References 1. Baumann, P., “140 Health Care Uses for Twitter.” January 16, 2009. http://philbaumanncom/2009/01/16/140-health-care-uses-for-twitter/ (accessed April 12, 2011).

2, 10, 11, 13, 14. Pate, M., and Ross, L., “Social Media Considerations for Health Care Providers.”(presentation, State Bar of Michigan’s Health Care Law Section’s teleconference, February 17, 2011).

3, 4. ECRI Institute, “Risk Management in the Age of Twitter.” Risk Management Reporter 5 (2009): 1-10.

5. Gallagher, M., “MySpace, Facebook Pages Called Key to Dispute Over Insurance Coverage for Eating Disorders.” February 1, 2008 http:// www.law.com/jsp/law/LawArticle Friendly jsp?id=900005559933 (accessed April 12, 2011).

6. Coffield, R., et al., “Risky Business: Treating Tweeting the Symptoms of Social Media.” AHLA Connections 3 (2010): 10-14.

7. New York Personal Injury Law Blog, “My Interview with Robert (Dr. ‘Flea’) Lindeman.” http://www newyorkpersonalinjuryattorneyblog. com/2008/01/my_interview-with-robert-dr-flea-lindeman.html (accessed April 12, 2011).

8. Krupa, C., “AMA Meeting: Proceed with Caution on Social Media Tools.” American Medical News November 22, 2010, http://www.ama-assn. org/amednews/2010/11/22/prsc1122.htm (accessed April 12, 2011).

9, 12. Berkman, E., “Social Networking 101 for Physicians.” Virginia Medical Law Report 5 (2009): 3.

15. Dolan, P., “Rethink Social Media Policies in Light of NLRB Complaint, Lawyers Say.” American Medical News November 29, 2010, http://www.ama-assn.org/amednews/2010/11/29/bil21129.htm (accessed April 12, 2011).

July / August 2011

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Make-A-Wish Foundation® of South Dakota www.southdakota.wish.org 800-640-9198

7

Wes Brown

Rena Schild / Shutterstock.com

As many as 500,000 attend the Sturgis Motorcycle Rally each year, more than doubling the size of Rapid City Regional Health System’s usual service area of 400,000.

Gearing Up T

How Regional Health

Gets Ready to Rally

hey rumble in from across the country and around the world, some in leather and boots, others in jeans and sneakers. They are dentists, lawyers, mothers, retirees and blue collar workers of every stripe, bringing with them their tourist dollars, their party spirits and their personal health problems.

For them, the annual Sturgis Motorcycle Rally, now in its 71st year, is the ultimate bash.

By Ale x Str auss

8

Midwest Medical Edition

Ready to Roll

For 11 months out of the year, Regional Health serves a population of about 400,000 people. But in early August, during Rally time, another 500,000 people flow into this rural area, more than doubling the potential patient population. Add to this the additional 1.5 million non-biker tourists who also travel through the popular Black Hills each year, and it’s easy to understand why the health system starts planning for the next year’s onslaught almost as soon as the last bikes roll out of town.

“Starting in about March and continuing through July, we have Rally planning meetings multiple times a month at Rapid City Regional Hospital,” says Sughrue.

Closer to the event, meetings include representatives from Regional Health system facilities in Rapid City, Custer, Lead-Deadwood, Spearfish and Sturgis.

Those meetings also include representatives from the Hans P. Peterson Memorial Hospital in Philip and Weston County Health Services in Newcastle, Wyoming with which Regional has management agreements.

The team assesses budgetary and staffing allocation and discusses lessons learned and problems encountered during the last year’s Rally. As the number of July / August 2011

hospital visits begins to swell in the days prior to the Rally, the periodic meetings become daily meetings and telephone conference calls, which continue throughout the event. The group is constantly evaluating Emergency Department visits and inpatient numbers to ensure that resources, including staff and supplies, are effectively allocated.

Rapid City Regional Hospital takes part in a multidisciplinary task force that includes law enforcement, FEMA, the National Guard and EMS services.

Staff vacation time is restricted; hospital security is heightened; additional nurses, ER physicians and trauma surgeons are lined up for peak flow times; extra supplies of items like linens, gauze, food, and rubber gloves are ordered and at the ready. Air Methods, which provides ambulances, schedules additional

Regional H

ealth

But for the hospitals and healthcare workers charged with handling every conceivable medical emergency in a crowd of half a million people for almost two weeks, the annual festival is the equivalent of a disaster.

“Many hospitals have disaster plans in place,” says Tim Sughrue, CEO of Rapid City Regional Hospital and Regional Health Network, and COO of Regional Health. “The difference between ours and theirs is that ours is essentially a known and predictable ‘disaster’. It requires us to implement our emergency preparedness plan every year.”

Cour tesy

Timothy Sughrue, MPH, FACHE; Chief Executive Officer, Rapid City Regional Hospital; Chief Operating Officer, Regional Health; and Chief Executive Officer, Regional Health Network

helicopter coverage during the Rally.

They are the same actions any for wa r d thinking healthcare system might take in preparing for, say, a tsunami.

“The operational footing of the hospital definitely takes on the tenor of a major disaster response,” says trauma surgeon Justin Green, MD, Director of Trauma and Surgical Critical Care Services at Rapid City Regional Hospital.

“Daily command meetings, briefings from other agencies, increased staffing.

This is a phenomenon that requires a significantly different approach than

“We take the attitude that it is better to

sweat in practice than to bleed in war.”

lly, Rapid During the Ra and the al on gi Re ty Ci Health al on gi Re other ls typically ita sp System ho 800 see more than its and vis y nc ge er em 0 admit nearly 30 inpatients.

9

“It is pretty hard to get anybody one would have during a normal week.”

During the course of the Rally, the system usually logs about 800 Rallyrelated Emergency Department visits and on it’s busiest day has about 40 Rally- related inpatients, most of which occur at Rapid City Regional Hospital and Sturgis Regional Hospital. A sophisticated electronic patient tracking system helps doctors keep track of each patient’s care, which can be especially crucial for cases which may be brought into the closest facility by ambulance or air ambulance and then might be transferred to a larger facility. When patients do have to be admitted, the hospital often relies on volunteers from the Christian Motorcycle Association to help them meet some of the special needs of the bikers and their friends and family members.

Changing Demographics

But more has changed over the years than just the size of the crowd and the level of preparedness. The party that started with a few thousand leather-clad young men has blossomed into a monumental event made up of men and women of all ages, stages, socioeconomic levels and health conditions.

“In recent years, we have started to see a lot more folks in the middle to older ages. We see plenty of folks who are advanced in age and are still very active,” says Dr. Green, who says the social demographics of Rally participants has also changed, attracting more inexperienced bikers who may be less equipped for the physical demands of riding and, thus, more prone to accidents.

“One year, the majority of people that I treated for injuries sustained in accidents were either doctors, lawyers or police officers,” he says. “Even the occupations have changed a lot.”

Although accidents (and the

10

occasional assault) used to account for most of the Rally-related medical emergencies, these are now just pieces of a more complicated puzzle. The changing demographics and the sheer size of the crowd, have resulted in a gradual shift in the types of medical problems seen.

Chronic conditions like heart disease and diabetes are far more common than they used to be and physicians routinely see heart attacks, strokes, diabetic reactions, muscles pulls and orthopedic injuries, births and, sometimes, even deaths.

Charles Lewis, DO, a hospitalist at the 25-bed Sturgis Regional Hospital, has watched the transformation of the Rally’s crowd and the resulting shift in the types of medical emergencies for the last 27 years.

“We always see a few people with heart problems these days and back in the old days, you never saw that,” says Dr. Lewis, who says the town’s Massa Berry Regional Medical Clinic is closed during the Rally to devote more manpower to the emergency room. “For a town of 5500, dealing with these kinds of numbers is pretty staggering. Normally, we just have one physician managing the ER, but during the Rally, we work on a three-physician shift. For the most part, everyone looks at it as a challenge. It is definitely something different for us.”

Of course, the presence of a half million Rally attendees does nothing to stem the tide of medical emergencies and chronic medical problems among the region’s permanent residents. As the area’s tertiary care hospital, Rapid City Regional Hospital continues to manage the usual strokes, heart attacks, appendicitis cases, births and traumatic injuries, although some elective surgeries tend to be postponed until after the Rally.

Justin L Green, MD, Medical Director of Trauma and Surgical Critical Care at Rapid City Regional Hospital

And the work does not stop when the Rally ends. Patients may need follow-up care or rehabilitation after their hospital stay, which must be coordinated with their primary care doctors back home. Regional Health billing specialists face their own challenges, as they process hundreds of extra invoices and submit claims to a myriad of insurance companies from around the country.

The Long View

Although one might imagine that the extra strain on the system’s resources brought about by the Rally might make it harder to provide top quality care to patients year-round, Sughrue and Green say the affect is just the opposite.

“The key lesson we have learned from this experience is that preparedness and forward thinking benefit everyone,” says Dr. Green. “The challenges of doing this for many years have allowed us to perfect the operation plan that we have in place. We are more prepared to respond efficiently to potential natural disasters or large-sale medical emergencies. It is pretty hard to get anybody rattled around here anymore.”

With more than 50,000 visits a year,

Midwest Medical Edition

rattled around here.”

Courtesy Regional Health

Rapid City Regional Hospital’s Emergency Department is already the busiest in South Dakota. Sughrue says preparing for the Rally has only made them better. Multi-patient accidents and emergencies that might overwhelm a larger trauma department have been handled at RCRH without a hitch. The facility was even prepared to accommodate an overflow of injured patients from Hurricane Katrina, should it have become necessary.

“We take the attitude that it is better to sweat in practice than to bleed in war,” says Sughrue, borrowing a quote from his military training. “We are a better organization because of this.

Every year, we get a little smarter because we have put ourselves through the paces. Every year, we know that we need to be prepared to run a marathon, so we are ready. That builds peoples’ confidence.”

In fact, Sughrue says confidence in Regional Health’s ability to handle the Rally, or just about any other disaster, has translated into an upbeat, almost festive atmosphere among the staff during Rally time. Few people complain about the extra work and many departments even design ‘team t-shirts’ to bolster morale and show off their readiness.

“I think everyone has a real sense of doing good, of doing what they have been trained to do,” says Sughrue. “Although it is stressful, challenging and exhausting, it is also immensely satisfying to know you are making a real difference. It gives us a real sense of what we are truly capable of even under the most challenging circumstances.” ■

July / August 2011

Rapid City Regional Hospital’s emergency department is the busiest in South Dakota, logging more than 50,000 visits annually.

During the Rally, Tim Sughrue says “the Emergency Rooms are pretty much cooking 24-hours a day.”

Barbara Downen, Regional Health

MidwestMedicalEdition.com

11

Clinical Spotlight

IOeRT Technology May Mean More Options for Rural Breast Cancer Patients Groundbreaking research on the newly installed IntraOperative Electron Radiation Therapy (IOeRT) equipment at the Avera Cancer Institute may have special implications for patients in remote areas. ACI is the first institution in the U.S. – and the fourth in the world – to enroll patients

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in a new international research trial of the technology specifically for breast cancer.

“This is exciting technology which we hope will ultimately give select breast cancer patients another treatment option,” says principal investigator and Avera radiation oncologist, Kirsten

Erickson, MD. “We’re able to deliver the entire scope of treatment in a shorter time frame, and we hope we’ll see the same high outcomes that we’re already experiencing with other treatment regimens.”

IOeRT delivers a single targeted dose of radiation directly to a tumor site during surgery. While still in the research stages for breast cancer, the technology has already become standard treatment for certain types of cancer, such as advanced pelvic and abdominal tumors, sarcoma and colorectal cancers.

Through the research project, the Mobetron IOeRT machine from IntraOp Medical Corporation will be used to treat women with early stage breast cancer. The treatment involves a lumpectomy, with IOeRT at the same time as surgery. Patients will then undergo three weeks of external beam radiation therapy. “For selected women with early stage breast cancer, IOeRT may be an alternative to mastectomy, or lumpectomy with six to seven weeks radiation,” says Dr. Erickson.

In the rural Midwest, IOeRT could save significant drive time, stress and expense to cancer patients, said Dr. Wade Dosch, surgeon and sub-investigator for the IOeRT study. “It is heartbreaking to watch a woman choose to have a mastectomy because she cannot tolerate the time commitment required of radiation therapy after breast conservation. It is hoped that more women – especially women in rural areas – would be able to fit the IOeRT treatment protocol into their schedule, and take advantage of breast-conserving surgery rather than undergoing mastectomy,” Dr. Dosch said.

IOeRT is being offered at Avera thanks to a $2.5 million grant from the Leona M. and Harry B. Helmsley Charitable Trust. Study results will eventually be combined with results from other research sites, and internationally published to guide future breast cancer care. ■ Midwest Medical Edition

Medicine

Dr. Petersen’s photo to accompany an essay on shellfish allergies

Photo: Dr. Judith Peterson

Life is short but art endures — Hippocrates

Dr. Judith Peterson,

&Arts

Physical Medicine and Rehabilitation Specialist

V isual Artist

For years, Judith Petersen, MD, of SoDak Rehab in Sioux Falls has been the official photographer for South Dakota Public Broadcasting’s ‘On Call’ program website. Each week, Dr. Peterson creates a photographic image to complement the week’s public health essay on the website.

Although she also has other photography interests including women’s professional sports and botanical subjects, when MED asked about her art, it was her work on issues of health and illness on which she wanted to focus.

These are core issues. The same is true of the photography I have done for special issue magazines put out by the South Dakota State Medical Association. This year I did the photography for a special issue they produced on obesity.

I try to really meditate and think about what I’m trying to get out of the photograph and what I’m trying to convey to people. At times that’s humor, at other times it’s just my perspective on things. For an essay on the spread of respiratory illness, I photographed water droplets at close range. For another essay on Parkinson’s disease, where there is an issue with rapidity of response, I chose to use the image of a metronome swinging at high speed. I am always trying to learn more about medicine and about art.

Dr. Peterson’s photographs and Dr. Richard Holm’s essays have been compiled into a book called The Picture of Health: A View from the Prairie which was chosen for presentation at the South Dakota Festival of the Book by the South Dakota Arts Council in 2009. Her work has also been recently displayed at the Washington Pavilion, the Dacotah Prairie Museum in Aberdeen, the Avera Cancer Institute and Omaha’s JCC Gallery. ■

I

believe that a physician is really a teacher and I have always been interested in new ways to format information. Also, I’ve always had an interest in the arts and I’ve been doing photography for a very long time. I try to think about information in a variety of different ways, so my photography is a natural extension of me as a physician. It can be very helpful to patients to have a new way to visually approach issues that, at times, can be overwhelming. That is what I try to do with my public health work.

The nice thing about working with the ‘On Call’ program at Public Broadcasting all these years is that I’m always photographing for topics that affect us as a community in South Dakota, but also issues that speak to our humanity: Illness, health, loss of a loved one, how we handle chronic conditions.

July / August 2011

MidwestMedicalEdition.com

13

Hip Fractures

a Focus for New Program

14

After surgery, a key goal of the program is to determine why the fracture occurred and to implement steps to prevent re-injury or future fractures.

“So many times, fixing the fracture is the main concern rather than fixing the reason why it occurred,” said Nancy Klinkhammer, community educator for Avera McKennan’s Physical Medicine and Rehabilitation department.

The National Center for Injury Prevention and Control reports that the number of U.S. residents age 65 and older is projected to more than double from 35 million in 2000 to more than 77 million in 2040. Three times as many people will suffer a hip fracture in 2050 than in 1990. ■

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Hip fractures will be a primary focus of a new Geriatric Fracture Program at Avera McKennan Hospital & University Health Center.

Hip fractures are often the most serious and life-changing type of fracture in the elderly, leading to an estimated 350,000 hospitalizations every year.

Mortality for a geriatric patient who breaks a hip is at least 25 percent. Of those who survive, only 20 percent are able to return home at their prior level of functionality.

“We are on the verge of an epidemic of osteoporotic fractures in the aging population,” says Erik Peterson, MD, orthopedic specialist and surgeon with CORE Orthopedics Avera Medical Group. “It is imperative that we utilize evidence-based medicine when treating these fractures to optimize outcomes.”

The program takes an interdisciplinary team approach to fracture care, including orthopedic surgeons and primary care physicians; anesthesiologists; nurses, many of whom have specialized training in orthopedics; physical therapists and occupational therapists; social workers; and case managers.

To expedite care, providers refer hip fracture cases to the Emergency Department with a goal of getting patients to surgery with 24 hours of a fracture.

Patients who have surgery sooner face fewer complications such as skin

breakdown or pneumonia resulting from hospitalization and immobility.

The most common surgical approaches to repair a hip fracture include a total joint replacement, hemi-arthroplasty or open reduction and internal fixation.

“The Geriatric Fracture Program is a compilation of best practices, from diagnosis of fracture, to pre-operative decisions, to medications given before and after surgery, to recovery and rehabilitation,” says Mary Wilson, director of Hospital Medicine and Clinical Orthopedics at Avera McKennan.

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July / August 2011

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15

The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul, although the two cannot be separated. ~Plato

Literature and Medicine:

Program Teaches Empathy through the Written Word

M

By Darrel Fickbohm

ost people have used a book to unwind from daily stress, or to gain perspective on their own lives. Sometimes a title is chosen at random and at other times the person gravitates to what is needed – an article or books that deals with the issues they are moving through at the time. That tendency to find solace and perspective in the written word was the impetus behind Literature & Medicine, an award-winning national program made possible in our region by the South Dakota Humanities Council.

Last year, Sioux Falls’ Royal C. Johnson Veterans Memorial Medical Center was selected as one of 15 hospitals nationally to participate in the program, a reading and discussion group specifically for healthcare professionals. Under the auspices of the SDHC’s Center for the Book, Literature & Medicine aims to enhance providers’ understanding of their patients’ experiences by using literature and film.

The experience of battle is legendary for its raw emotion and physically and mentally crippling situations. Most lay people will never have anything but a remote idea of this, but the Maine Humanities Council, creators of the Literature & Medicine program, asked the question ‘What if someone is given the task of helping a soldier regain health in the face of that experience?’ Their conclusion: It would seem to behoove the healer to understand something of the wounds.

“With so many different disciplines contributing perspectives, I found it very valuable because it expanded my knowledge base,” says psychologist Vanessa Ferguson, PhD, who attended Literature & Medicine groups at the VA both years.

“Last year’s focus was on Vietnam; this year we concentrated on Iraq. There were some ‘ah-ha’ moments during both of them. It definitely gives me more insight in my practice.”

The program brings together a range of healthcare providers, including physicians, PA’s, nurses, social workers, administrators, psychologists, chaplains, IT staff, and lab personnel. About 20 people currently participate at the Sioux Falls VA. Although the South Dakota program is still too new to gauge its success, data

16

Midwest Medical Edition

At the end of Earnest Hemingway’s For Whom the Bell Tolls the reader sees a strange mix of peaceful everyday sights and sounds along with the terrible, certain death that is now approaching the main character. It is not something most people can know first hand, but after reading this, one may better understand the essence of a soldier’s anguish:

Robert Jordan saw them there on the slope, close to him now, and below he saw the road and the bridge and the long lines of vehicles below it. He was completely integrated now and he took a good long look at everything. Then he looked up at the sky. There were big white clouds in it. He touched the palm of his hand against the pine needles where he lay and he touched the bark of the pine trunk that he lay behind.

Then he rested as easily as he could with his two elbows in the pine needles and the muzzle of the submachine gun resting against the trunk of the pine tree.

from Maine’s Literature & Medicine between 2005 and 2008 point to a positive impact. More than half of participants there say the program has helped them improve their communication skills; 64% say their interpersonal skills have improved; 62% report greater job satisfaction; 67% say they have gained more cultural awareness; and a full 79% say Literature & Medicine has given them greater empathy for patients.

The VA says the program has been so well received in Sioux Falls that the VA Black Hills Health Care System has launched a Literature & Medicine group of its own. Steve Binkley, of the Humanities Council’s Center for the Book, who has sat in on some of the classes, says that the concrete

July / August 2011

evidence of the success of this class is that the staff doesn’t want to see the program end, although the grant funding is up soon.

“The curriculum is made by the current instructor and they use film clips and other media to augment the sessions,” Binkley says of the monthly meetings. “It is comfortable and informal and the group discussions are in a book club type format that seems to work for all the participants.”

In 2010, SDSU professor and Vietnam Veteran Dr. Charles (Chuck) Woodard was the class facilitator, possibly the only facilitator who is also a veteran. This year, the job belongs to Dr. Jason McEntee, Associate Professor of English and the Acting Head of the Department of English at SDSU.

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McEntee, who regularly teaches classes on the Vietnam War, as well as the Gulf and Afghanistan wars, both in literature and film, is quick to support the program.

“This program is one of the most valuable things I’ve ever done or taught,” says McEntee. “And remember, these doctors are results oriented people, so what the group especially enjoyed was that there was a real-life application to be made with their patients.

“What became clear was that although war may change in some ways over the years, the effect on the soldier is the same. Even in the Homeric epics, there were parallels to be drawn,”

observes McEntee, who says violence and suicide among today’s veterans may be even higher than among Vietnam Veterans. “It impressed us most, when we were reading Sebastian Junger’s War, how universal the experiences were compared with all the previous wars.

“Although people will tell you that PTSD is something we can identify, it’s just too complicated. The jury is still out on this particular problem. There are psychiatrists to help and anti-depressants that are good, but there are lots of other ways to help, also.

When it comes to working with vets who are damaged, we have to be open to using every style of approach.” ■

Literature & Medicine facilitator Dr. Jason McEntee, Associate Professor of English, Acting Head of the English Department, SDSU

17

Fixed Wing Aircraft Enhances Children’s Transport Capabilities Specialized care for critically ill newborns, children and teenagers is becoming even more accessible. Children’s Hospital & Medical Center in Omaha, Neb. has added fixed wing aircraft to its Critical Care Transport Service.

Arriving in July 2011, Children’s will have a dedicated Cessna 414 available 24/7.

“The primary benefit of fixed wing aircraft is the extended reach it provides,” said Megan Connelly, MSN, APRN-NP, CPNP-AC, CCRN, CNML, manager of Emergency Services and Transport at Children’s. “It allows us to ensure physicians and hospitals across the region can access our specialists when their young patients have an urgent need and time is of the essence.”

Fixed wing aircraft allows Children’s Neonatal and Pediatric Transport Teams to be in the air even when weather prohibits a helicopter flight. The team can also travel longer distances than a helicopter would allow. Connelly says they expect to use fixed wing when the location is more than 100-150 miles outside of Omaha.

Launched in 2006, Children’s Transport Service has experienced significant growth. The hospital introduced a customized Children’s ambulance in the fall of 2009.

Designed for pediatric patients, it features pediatric-specific medications and medical equipment. It also sports a childfriendly interior with coloring books and a DVD player to act as a distraction and help ease anxiety.

Children’s added helicopter travel in the summer of 2010.

The combination of ground and air accessibility made for a record year at Children’s with more than 600 transports

18

Midwest Medical Edition

Treatment for Torticollis Physical therapy is extremely effective in young infants Children’s Care offers skilled physical therapy for infants with muscle tightness in the neck.

For best results, refer infants at 2-3 months of age.

For consultation or free screening appointment, call (605) 782-2400.

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completed. Already this year, the team has completed nearly 450 transports in a five-month period from January 1 to May 31.

“The steady increase in numbers clearly illustrates the need. More and more physicians are seeing the advantage of having a dedicated pediatric team to transport their sickest children to Children’s for care,” said Rob Chaplin, M.D., Medical Director of Children’s Transport Service. “The intervention our team provides even before a patient reaches our door can dramatically improve the outcome.”

Team members are certified in procedures necessary for neonatal and pediatric transport including intubation, umbilical line insertions, intraosseous needle insertions, and chest thoracentesis. They communicate directly with the medical control team including a neonatologist or pediatric intensivist to develop a plan of care for each patient. ■

July / August 2011

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19

Intensive Care for Newborns

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Physicians’ Priority Line

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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.

www.ChildrensOmaha.org

Then & Now Our Changing Medical Landscape

Changes in Cardiology Standardized Care, Better Stents, and a Fellowship Program mark a new age in cardiac care in Sioux Falls and around the world

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A graduate of Warsaw University Medical School with a fellowship from the State University of New York, Interventional Cardiologist Adam Stys, MD, is in a unique position to have watched the development of cardiac care in Sioux Falls and around the world since the 1990’s. He practices cardiology, nuclear medicine and vascular medicine at Sanford.

We asked him to comment on changes he’s seen in heart care during the course of his career.

rom an organizational standpoint, cardiology is leading the progress in medicine.

Heart disease remains the number one killer in the country, so it is an important clinical field. This is why there is a great deal of well-organized research that has resulted in some highly developed technology.

In our region, the ability to communicate with referring doctors – especially those in rural care centers – has been invaluable. Not only are we able to transport information more quickly and efficiently thanks to improved digital communication, but standardized protocols and supporting programs like the Chest Pain Network have also make it easier to transfer and transport patients, when necessary.

We now know that, in heart attack cases especially, the faster you can mechanically open the heart, the better the chance for a good outcome. So facilities can start treating heart attack patients with standardized protocols and we can be ready to bring those patients right into the cardiac cath lab. As a result, there is

June 2011

less mortality from heart attacks and less morbidity later from injured hearts.

MED: You have said that cardiology is becoming more globalized. What do you mean by that?

As more cardiac programs shift their focus toward evidence-based medicine, there is a push to come up with a standard set of care guidelines for cardiovascular disease. We are working with European and Asian societies to develop these globalized guidelines, so that we are all utilizing best practices. This is a major change in cardiology in the last 20 years.

MED: What are some of the most notable advances in technology?

Among the most valuable for patients are improved revascularization techniques. Twenty years ago, our equipment was primitive. Stents were big and bulky and very difficult to put in the heart, so the number of cases we could do with these devices was limited. Many more patients had to have open heart surgeries back then. Now we have 7th generation stents that are better, more effective and

MidwestMedicalEdition.com

much smaller. Now, most blockages can be handled with stents. There has been a quantum leap when it comes to the device market in the U.S. MED: What can we expect for the future of cardiovascular care in the Upper Midwest?

Sanford is awaiting certification for its first Cardiovascular Disease Fellowship program, which will start in July 2012. This is very exciting because such a program will attract motivated young doctors who are progressive and interested in applying evidence-based medicine. It also means that those of us who are already here can be exposed to the fast changing landscape of cardiovascular care around the world. We will have to not only know but also teach the newest guidelines and techniques.

Having ambitious, motivated students will keep us on our toes, so it benefits everyone. ■

Write to us!

Do you have a memory or observation on the practice of medicine in our region?

How have things changed?

What’s improved?

What do you miss?

Contact us at:

Alex@MidwestMedicalEdition.com or call 605-366-1479

21

New Cardiac Imaging for Black Hills Patients

Rapid City Regional Hospital’s (RCRH) Medical Imaging Department recently installed two new nuclear medicine scanners for cardiac care that will produce better images in less time and with less radiation.

A first for South Dakota, the D-SPECT Cardiac Imaging System is a two-step imaging process. The first step involves taking one resting image and a second image with the heart under stress. The two images are then compared for changes. Larger radiation collection angles and a unique scan pattern provide 10x more eff icient photo collection resulting in images with twice the

resolution of previous technology.

The final images offer twice the resolution of previous technology, for more accurate diagnosis. The D-SPECT allows for the use of lowdose and new radiopharmaceutical formulations resulting in a 30-percent decrease in radiation exposure to the patient.

The new imaging system is also faster and more comfortable for patients.

In the past, patients receiving the test had to lie with their arms over their heads as a camera moved around the body at 365°. There was also a weight limit of 400 pounds. This new technology allows patients to receive the test

while sitting in a reclined position and can accommodate patients up to 530 pounds. Testing now takes just four to six minutes versus the 20 minutes needed for previous tests.

One of the new scanners will be housed at RCRH, the other at Regional Heart Doctors. ■

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Midwest Medical Edition

Television Helps Create

Healing Environment

for Hospital Patients Rapid City Regional Hospital (RCRH) has added a new channel to its hospital line-up. The Continuous Ambient Relaxation Environment (C.A.R.E.) Channel is now available on televisions in all patient rooms at RCRH and the RCRH Hospice House.

Funding for the C.A.R.E. Channel is being provided by the RCRH Auxiliary.

Combining images of nature and soothing instrumental music, the programming serves as an environmental tool to enhance and promote healing.

The images transition slowly to avoid agitating or confusing those on high levels of medication. The C.A.R.E. Channel was designed to support the circadian rhythms and includes a special nighttime star-field for overnight broadcast to promote restfulness and sleep.

The perception of a caring environment can be a powerful and effective tool, both in tending to patients and supporting treatment protocols. While the environment is experienced on all sensory levels, soothing sounds have been shown to have particular impact patient satisfaction and morale.

Research and patient satisfaction data have shown that sound and other

environmental factors, such as the C.A.R.E. Channel, can also significantly impact clinical results.

Hospitals using this system have reported reductions in the use of pain medication and restraints, and improved quality of rest for patients. They have

also noticed a decrease in the level of noise on the units and an increase in patient and staff satisfaction due to lower stress levels. First developed in 1992, the C.A.R.E. Channel is now provided in hospitals throughout 48 states. ■

MORE EQUIPMENT UPTIME, MORE SERVICE COVERAGE Keeping our customer’s equipment up and running is an important part of what we do every day. That’s why we’re proud that Cassling customers experienced an equipment uptime of 99.88 percent last year.

Cassling’s service coverage is unmatched in the industry. Our highly trained service engineers are ready to address your immediate issues and our call center is available for assistance 24 hours a day, seven days a week.

In addition to unbeatable local service, Cassling offers Siemens imaging equipment and end-to-end efficiency solutions that help increase efficiency, reduce costs and improve quality.

Find customer case studies, white papers and upcoming educational events at www.cassling.com.

Contact Shane Slaughter, Cassling Account Executive 605-321-6909 | sslaughter@cassling.com

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July / August 2011

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23

Health Professionals Invited to Attend

National Colon Cancer Expert to conduct live webinar in Sioux Falls on July 12

National colorectal cancer expert Durado Brooks, MD, MPH, with the American Cancer Society, will address physicians and health plan executives on colon cancer during a live webinar broadcast nationwide from Sioux Falls on July 12. Dr. Brooks will present updated tools and new strategies to increase screening rates and reduce deaths from colon cancer.

South Dakota has a 66.2% screening rate for people age 50 and older, which still means that a full third of people are not being screened. This year in South Dakota, 160 colon cancer deaths

are expected. People at a higher risk for colon cancer, such as those with a family history of the disease, should be screened before age 50.

Dr. Brooks will discuss updated colon cancer screening tools and resources from the American Cancer Society to support doctors and clinic staff in talking to their patients about colon cancer and improve their screening rates. The webinar is the result of a collaborative effort by a number of SD healthcare organizations.

“The South Dakota Council on Colorectal Cancer, a collaboration of Avera Health Plan, DakotaCare, the

Sanford Health Plan, Wellmark, the SD Foundation for Medical Care, the SD State Medical Association, the SD Department of Health, and the American Cancer Society, joined together in 2008 to implement strategies to increase colorectal cancer screening rates in South Dakota,” says Denise Kolba of the American Cancer Society.

Kolba says ACS data indicates that the effort has helped increase screening rates by 10% in the past 3 years.

The 1-hour webinar will take place at noon at the Schroeder Auditorium on the Sanford Hospital camper in Sioux Falls. Lunch will be provided. ■

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5/18/2011 2:02:24 PM

Midwest Medical Edition

Grape Expectations

Fishing for Vacation Wine

By Heather Taylor Boysen

T

oday was a great day.

I’m sitting in a comfy camp chair with a glass of wine in the middle of a Canadian wilderness paradise. There are no computers, phones, radio or TV and no electronic communications. We are at our family’s fishing camp after a 20 hour drive from Sioux Falls and a one hour flight from Buffalo Narrows, Saskatchewan in an Otter float plane.

Members of our family have been making this trek to Cree Lake in Northern Saskatchewan since the 1940s, beginning with my Grandfather, Jess Taylor. Although the cabin location has changed and the equipment had become more advanced, including a satellite phone for emergency situations, the exhilarating feeling is the same. While we still don’t have plumbing, we do have many accoutrements not found since my first trip to the lake including a nice wine selection carefully chosen to pair with very fresh Walleye, Northern Pike and Lake Trout. Since we have to bring in everything we need, preparation is key.

Just because we are in the middle of nowhere doesn’t mean we can’t enjoy certain pleasures. This year marks the first year we have had refrigeration other than coolers and dry ice, so we brought white win! My brother Tom brought in an apartment sized refrigerator for the cabin, so life just couldn’t get any better!

Everything at this cabin is run off of gas powered generators so this was a big deal for us. In the days before generators, fish that needed to be preserved to come home were buried in the Canadian permafrost until we left camp. As I got older and the trips to Cree revolved around July / August 2011

friends, we brought beer, never wine.

We’d put the beer cans in old nets and dangle them from the boat as we fished, hoping they might get a chill from the Canadian waters.

Tonight, it is Walleye in a simple beer batter. Our sides are basic (potatoes, rice, veggies) so all of the emphasis is on the fish. Our fishing companions both caught 8-pound Walleyes today – big, beautiful fish caught with jig heads and destined for our table. I chose a California Sauvignon Blanc to go with our Walleye. With just as hint of citrus and lemongrass, it is a great companion for the fresh fish. There is truly nothing better than fish cleaned, cooked and eaten all within 12 hours of catching them. The wine needs to be as fresh, crisp and clean as to not overwhelm the delicacy of the fish.

Our choices for the trip included a Trinchero Mary’s Vineyard Sauvignon Blanc and a Michel Picard Vouvray (Chenin Blanc). Both whites exhibit a fresh and vibrant flavor that are good on their own and pair well with fish. I must say that the beer batter we used to fry the Walleye went very well with the Sauvignon Blanc. We also poached Northern Pike in a foil packet on the Coleman grill using the Vouvray that was outstanding.

We did not eat fish every day. A girl has to bring home some treats for the family, after being gone for 10 days!

As I left for Canada my 8 year old daughter declared, “You can go on your trip, Mommy, if you bring me back some fish!” So we also had steak, chili and other non-fish entrees. For these, we chose a Shiraz, Cabernet Sauvignon MidwestMedicalEdition.com

and red blend of Grenache and Mouvedre.

Let’s put it this way, it all tasted good.

Honestly, most of the reds we consumed were not meal centric. Rather, they were glasses we consumed while playing cards, snarfing down hamburgers and eating overdone sirloin steaks. I will admit that I overcooked the steaks on the Coleman, so the lovely Cabernet we had saved for the meal really was the best part of the meal.

I am already planning for Cree Lake 2012. It is something that I can’t get out of my system, much like the wine I consume, love and sell to my clients.

The love of Cree Lake comes from my childhood and the love of wine comes from my adulthood. The sheer pleasure of combining the two comes from luck, grace and family. Cheers to all! ■ 25

The Impact of Wishes Paul Krueger, President & CEO Based on a year-long study by our national Make-A-Wish organization, parents and volunteers believe that wish children receive much more than hope, strength and joy from their wishes. After a wish is granted: s W ish s

s

s

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parents say a wish makes kids feel stronger and more energetic.

W ish parents describe the wish experience as a turning point in their child’s fight against his/her illness.

W ish kids are less isolated from friends and feel like normal kids again.

W ish families – often strained by stresses of the illness – are repaired and strengthened.

W ish parents report that feelings of hope and optimism replace fear and stress.

Our goal is to reach every eligible child between the ages of 2½ and 18 with a life-threatening medical condition in South Dakota. ■

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Midwest Medical Edition

Flandreau Science Teacher to Lead Sanford PROMISE Curriculum Elizabeth McMillan

has been hired to serve as the Education Curriculum Coordinator of Sanford Research and will oversee programming and activities for the new Sanford PROMISE program. The Sanford PROMISE is an innovative outreach program connecting students, educators and communities with science and research with the ultimate goal of preparing and inspiring the next generation of scientists.

The Sanford PROMISE is designed to include a variety of hands-on opportunities that engage middle and high school students, undergrad and graduate students as well as current scientists, science teachers and lifelong learners in the Sioux Falls and Fargo regional communities.

As a middle school science educator in Flandreau, SD, McMillan understands the impact these learning opportunities will have on students.

“In the classroom I find that kids can always do more than we expect, we just need to develop relevant, engaging material,” said McMillan.

“We hope that the use of hands-on

Inspiring Young Scientists

learning activities designed by scientists to mirror authentic research investigations will complement educator’s curriculums and enhance student learning, performance and interests in science careers,” says Sanford researcher and PROMISE co-director Peter Vitiello, PhD. McMillan says that type of learning

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July / August 2011

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experience inspired her to pursue a career in science education. “As an undergraduate studying biochemistry and molecular biology at Denver University, I was amazed at the inquiry science going on all around me and thought that someday I’d like to do something similar,” says McMillan.

According to Sanford Health executive vice president Dave Link, promoting STEM (Science, Technology, Engineering, and Math) education will play an important role for developing a strong science workforce in the Midwest. “The 21st century workplace and workforce is vastly different than a generation ago which is why STEM educational opportunities are a growing focus and priority for all of our communities,” says Link.

The Sanford PROMISE is unveiling a series of educational platforms, which will be introduced over the course of the summer, including community lectures, shadowing opportunities, sideby-side learning with researchers and internships. ■

27

News & Notes

Happenings around the region

Avera Avera McKennan Hospital & University Health Center has received the American Heart Association/American Stroke Association’s ‘Get With the Guidelines’ Stroke Gold Plus Performance Achievement Award. To receive the award, Avera McKennan achieved 85% or higher adherence to all ‘Get With the Guidelines’ indicators for two or more consecutive 12-month intervals. The “Plus” means that Avera McKennan achieved 75% or higher compliance with six of 10 ‘Get With The Guidelines’ Stroke Quality Measures including aggressive use of medications, such as tPA, antithrombotics, anticoagulation therapy, DVT prophylaxis, cholesterol reducing drugs and smoking cessation. Avera McKennan has been using GTWGStroke since 2004.

Avera Medical Group Pierre is now open for routine appointments as well as urgent-care walkins. Clinic hours are 8am-5pm, Monday-Friday, and 9am-Noon Saturday. Routine Same-Day Surgeries will also run as scheduled.

A juried art show, “The Art of Healing”, is on display through Aug. 12 at the Prairie Center on the Avera McKennan campus. The show is displayed on the unique Community Digital Art Gallery and features digital images of 77 works by 36 artists from South Dakota, Minnesota and New York. A variety of mediums are represented, including oil and acrylic paintings, oil pastel, monoprints, drawings, mixed media collage, sculpture, pottery, painted woven canvas and photography. Hours are 7:30 a.m.-5 p.m. Monday through Friday.

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The Prairie Center has received the 2011 Mayoral Beautification Award in the Business and/or Public Space category, as nominated by Sioux Falls Beautiful, a non-profit citizen group with a mission to beautify and improve the city’s outdoor environment. The Prairie Center is home to the Avera Cancer Institute and Avera Surgery Center and was designed to reflect the heritage of South Dakota’s Northern Plains.

This photograph by artist Cherie Ramsdell is of her sister, mother and aunt, all three of whom have faced a cancer diagnosis.

Regional

HenkinSchultz Communication Arts and Avera were honored with eight awards – including four gold – at the 2011 Aster Awards, a program that focuses on the best health care marketing in the nation.

Three gold awards were given for HenkinSchultz’s work for the Avera Cancer Institute, including invitations for the Building Hope Gala, a donor wall display and a newspaper insert. HenkinSchultz and Avera also won a gold award for foundation/fundraising for Avera Queen of Peace Foundation’s Avera Brady Case Statement.

More than 3,000 entries were judged on creativity, layout/design, typography, production, quality and overall effectiveness.

Sanford The Pioneer Memorial Hospital & Health Center in Viborg will receive a $180,000 federal grant from the Department of Health and Human Services to utilize telehealth services in emergency rooms across the region. U.S. Senator Tim Johnson (D-SD), a member of the bipartisan Senate Rural Health Caucus, made the official announcement in May.

Regional Heart Doctors (RHD) Nuclear Laboratory has successfully fulfilled the requirements for renewal of their accreditation from the Intersocietal Commission for the Accreditation of Nuclear Medicine Laboratories (ICANL). ICANL has recognized the RHD Nuclear Laboratory for its commitment to high-quality patient care and its provision of quality diagnostic testing. Participation in the accreditation process is voluntary.

Six Regional Medical Clinic (RMC) providers recently received concussion management certification that will enhance their injury treatment services. Providers who have received the ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) training include: Jay Bogard, M.D., and Jason Knudson, M.D., of Queen City Regional Medical Clinic; Christi Childers, D.O., of Spearfish Regional Medical Clinic; Mark Heine, PA-C, of Regional Orthopedics; Crystal Page, PA-C, of Buffalo Regional Medical Clinic; Douglas Everson, MD, FACP, of Buffalo and Belle Fourche Regional Medical Clinics; and Karen Tjaden, M.D., AAFP, of Lead-Deadwood Regional Medical Clinic.

OTHER Rachel Edelen, M.D., a Pediatric Endocrinologist with Regional Medical Clinic has received a 2011 Champion for Children Award from the South Dakota Voices for Children. The mission of South Dakota Voices for Children is to improve the lives of children through policy and program advocacy. Dr. Edelen leads numerous community projects to promote awareness of childhood diabetes, including the annual Black Hills diabetes camp that brings together pediatric Type 1 diabetics and their parents from a four-state region.

The Children’s Care Hospital & School Rehabilitation Center, Rehabilitation Medical Supply, and the office of rehabilitation physician Julie A. Johnson, MD, opened June 20 at a new location at the corner of 18th and Grange in Sioux Falls. The operation had outgrown the 41st street facility it opened in 1999. The new space provides an additional 2000 square feet for outpatient services.

Midwest Medical Edition

Learning Opportunities Happenings around the region

July / August 2011 July 11 7:45 am– 3 pm

PALS Renewal (Pediatric Advanced Life Support Renewal) Location: Avera Education Center, Classroom 2 Information: 322-8950 Website: www.AveraMcKennan.org click on Events Calendar

July 15 – 16

Sanford Black Hills Pediatric Symposium

Location: The Lodge at Deadwood Information: 605-328-6353 Contact Email nikki.terveer@sanfordhealth.org Credits Offered: CME = 11.5 AMA PRA Category 1 credits

July 20 – 22

July 27 – 28

National Rural Health Association Quality and Clinical Conference Location: Rushmore Plaza Holiday Inn Information: 816-756-3140 Website: www.RuralHealthWeb.org/quality Fundamental Critical Care Support (FCCS) Location: Avera Education Center, Classroom 1 Information: 322-8950 Website: www.AveraMcKennan.org; click on Events Calendar

August 3 – 4

SDAHO – Defining the Minimum Data Set 8:00 am – 4:00 pm In-depth training on MDS 3.0 and RUGSs IV

Location: AmericInn, Chamberlain, SD

Contact Email and Phone: Wendy.Mead@sdaho.org, 605-361-2281

September 8 – 9

SD Perinatal Association, 36th Annual Conference Location: Highland Conference Center, Mitchell, SD Contact: Kris Mark, Executive Director Contact Email: sdperinatal@gmail.com Website: http://highlandconferencecenter.com

September 16

Community Response to Child Abuse Conference

8:00 am – 4:00 pm

Location: Best Western Ramkota Conference Center, Sioux Falls

Contact: nikki.terveer@sanfordhealth.org

MED reaches more than 3500 doctors and other healthcare professionals across our region 8 times a year. If you know of an upcoming class, seminar, webinar, or other educational event in the region in which these clinicians may want to participate, help us share it in MED. Send your submissions for the Learning Opportunities calendar to the editor at Alex@MidwestMedicalEdition.com.

Midwest Medical Edition

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