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Contents Midwest Medical Edition

June 2013

Regular Features 2 | From Us to You 4 |  Meet a MED Advisor Kelly Steffen, DO, Cardiologist 4 | Letters to MED From Our Readers 8 | News & Notes News from around the region 24 |  Off Hours: Allison Wierda-Suttle, MD, ObGyn & Yoga Instructor Doctor takes a practical approach to the mystical practice | By Darrel Fickbohm

26 |  The Nurse's Station Praising VA Nurses, Nurse a Cancer ‘Champion’

28 |  Grape Expectations: Local Physicians Create Wines Worth Slowing Down to Savor

| By Heather Taylor Boysen

29 | Learning Opportunities Upcoming Symposiums, Conferences, CME Courses

In This Issue 5 |  How to Pitch a Story to the Press

| By Alex Strauss Think you have medical news that would interest the media? Here’s why you’re probably right.

6 |  Get on Board the Patient Experience Train

| By Tana Phelps You know you deliver great care. But the future of your practice may depend on something much harder to quantify.

7 | New “Hall of Deans” Honors Medical School Leadership 18 | Clinical Spotlight Alternative Treatments for CTOs Now Available in Sioux Falls

18 |  Hope for Batten Disease 19 |  Becker’s Names Avera McKennan to the Top 100 List 20 | Regional Opens New Medical Staff Area 21 | Sioux Falls Doctor Honored with National Immunization Award 22 | Mercy Medical Center Opens Expanded Ambulatory Services Center 23 | Should You Go Back to School? MED talks with USF’s Business School Director on why a growing number of doctors are taking the educational plunge.

25 | Name Change for Iowa Health Systems 27 |  What Sequestration May Mean for Physicians

| By Dave Hewett

Going the


Physicians Travel to Serve No exam room, no modern equipment, no trained support staff…. Often, no lights, running water, or even walls. What motivates some area physicians to walk away from busy, well-equipped offices – often repeatedly – to teach or practice medicine in third world countries? Hint: It may be exactly what drew you to medicine in the first place. By Alex Strauss



From Us to You

Staying in Touch with MED


hile many of us think of international travel in terms of vacation destinations, a handful of area doctors and other medical professionals chose to take to the road (or sky or river) with a very different goal in mind. These are people who regularly choose to leave their modern offices to serve the healthcare needs of some of the world’s most impoverished people. In this month’s MED Cover Feature, we asked some of them what makes this challenging work so appealing. Also in this issue, we have advice on getting media attention for your medical news. Our expert contributors bring you insights into the impact of sequestration, why the patient care experience may define the future of your practice, and a review of wines developed by some local doctors. And, as always, we feature all the latest health community news, along with upcoming conferences and CME opportunities. In keeping with our mission to stay on top of news that may impact your practice, we were excited to once again be a part of the spring SDMGMA conference in April. Thanks to those of you who stopped by our booth. Please remember that we always welcome your comments and contributions. More than a ‘medical’ publication, MED is about community. Have an interesting hobby or artistic pursuit? Read any great books lately? Brought on a new partner? Have a notable case to discuss? There is a place for you in MED. Contact us via phone or email to learn more. Warmly, —Steff & Alex


MED Magazine, LLC Sioux Falls, South Dakota

VP Sales & Marketing Editor in Chief Design/Art Direction Cover Design/Photo Photographer Web Design Contributing Editor Copy Editor

Steffanie Liston-Holtrop Alex Strauss Corbo Design Darrel Fickbohm Kristi Shanks 5j Design Darrel Fickbohm Hannah Weise

Contributing Writers

Heather Boysen Dave Hewett Sarah McQuade Tana Phelps Liz Boyd Caroline Chenault John Knies

Steffanie Liston-Holtrop

Staff Writers

Alex Strauss

Contact Information Steffanie Liston-Holtrop, VP Sales & Marketing 605-366-1479 Alex Strauss, Editor in Chief 605-759-3295 Fax 605-271-5486 Mailing Address PO Box 90646 Sioux Falls, SD 57109 Website

2013 Advertising / Editorial Deadlines Jan/Feb Issue December 5

June Issue May 5

March Issue February 5

July/ August Issue June 5

April/May Issue March 5

August 5 November Issue October 5 December Issue November 5

Sep/Oct Issue

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

MED Quotes “Intuition will tell the thinking mind where to look next.” —Jonas Salk

e Woruits! t

t ccep We aader e r ns issio subm

©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 Magazine feedback and advertising and marketing inquiries, subscription requests and address changes can be sent to MED is produced eight times a year by MED Magazine, LLC which owns the rights to all content.


Midwest Medical Edition

One call accesses maternal & fetal specialists, for newborns requiring immediate intervention. The Fetal Care Center at Children’s Hospital & Medical Center In affiliation with

1.855.850.KIDS (5437)

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your 24-hour link to pediatric specialists for physician-to-physician consults, referrals, admissions and transport service.

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5/1/13 12:36 PM

A talk with MED Advisor

Letters to Med

Kelly Steffen,

From Our Readers

DO, Cardiologist

Q: You’re one of only 2 female cardiologists in the state and very few in the country. What led you to this specialty? A: After I got my Biology degree, I took a year off and worked at Sioux Valley as a telemetry monitoring tech. By the time I went to medical school, I felt like I had a bit of an edge because I had been looking at heart rhythms for years. Also, in my third year of medical school, I was diagnosed with dilated cardiomyopathy. In your third year, you know just enough to be dangerous. Everyone said, ‘Don’t read the Internet’. So, that experience further sparked my interest in cardiology and I just stuck with it. Q: Do you see more women in your practice because you’re a woman? A: I see men and women, but women’s heart health has been a big focus of mine. Women don’t present with heart issues the way men do, and I am interested in the differences. I tend to see a lot of the pregnant patients who have heart issues. Murmurs and fluttering are pretty common in pregnancy. Q: What upcoming cardiology development are you most excited about? A: One exciting thing on the horizon is a non-surgical device to reduce the risk of stroke in people with atrial fibrillation called the LARIAT Suture Delivery Device. This is a real innovation.[Note: Stroke is five times more common in people with A-fib.] Q: You’re a native of Aberdeen but you got your medical education in Kansas. What brought you home to SD? A: I really felt that there were people here at Sanford who could help me build my practice. Also, my children are little – 4, 2, and 10 months – so moving back to South Dakota was a priority. We knew we wanted to be in a larger community and Sioux Falls seemed like a good choice.


“I just finished reading your article 'How to Handle a Media Interview' (March 2013). Having given several interviews over the years (and not being very good at them), I thought your article was spot on. I am no “Dr. Oz” and many of us are not, but many of us have great information to deliver.  I wanted to thank you and your staff for making the docs in this region sound like 'Dr. Oz'.  What you do helps the patients of the region.”

—Pat Kelly, MD, Vascular Surgeon, Sanford

“These articles (‘Happy Staff, Happy Patients’, ‘Off Road with Off Hours’, November 2012) are awesome! We just received our issue in the mail. Cannot wait to engage the staff. We have already showcased to the surgeons. Great job, Alex and Steff. Go MED!”

—Brad Tieszen, Urology Specialists of Sioux Falls

“Wow – The photos and article (‘A Bright Future’, September/October, 2012) in the last issue of MED Magazine are amazing! … We are truly grateful for your wonderful story about our new facility as well as the ever-growing community of Aberdeen!”

—Julie Stevenson, MS, Ed, Sanford Aberdeen Medical Center

“Wondering if it is possible to get any extra copies of the MED Magazine featuring the Helmsley Trust and the Watertown survivor (‘Watertown Man’s Survival Story Featured at National Conference’, April/May, 2012)? The Trust LOVED it as well as the American Heart Association folks. Thanks!”

—Jodi Doering, RN, SD Mission: Lifeline Director

e Woruits! t

Have a comment about something you see in MED? We welcome your feedback any time. Write to us at

t ccep We aader r e s i o ns is subm

Midwest Medical Edition

Think you have information that might interest the media? You’re probably right.

How to Pitch a Story to the Press By Alex Strauss


ven if you have valuable health information to share, it is easy to get stuck wondering, ‘Would anyone really be interested in this?’ But here is the bottom line: All media outlets have time slots or space to fill. To stay afloat (i.e., sell advertising or subscriptions), they have to fill it with things people are interested in. Humans are ALWAYS interested in health and healthcare and now more than ever, which means the media is hungry for timely, relevant health news. There has literally never been a better time to pitch health news to the press.

How do I choose an idea to ‘pitch’? The keyword here is relevance. How will your news potentially impact the audience? One great way to spark interest is to offer a story that that you can link to a local or national news event. (i.e., PTSD in the wake of a disturbing event, such as a public bombing). Your information may be groundbreaking enough to win the Nobel Prize, but if you can’t clearly express why a viewer or reader should ultimately care about it, you’ll have a hard time convincing the press to cover it. (Unless, of course, you actually do win a Nobel Prize.) CAUTION: Don’t assume that it is a reporter’s job to find the relevance in your medical information or that it will be obvious. After all, how will you feel if they get it wrong, and miss the point entirely? Don’t take chances. Think this through ahead of time and be able to express it clearly in layman’s terms.

June 2013

How do I communicate with news outlets? The Press Release remains the gold standard for communicating new information to both local and national news outlets that might want to cover it. There are no hard and fast rules for creating a press release, but a short, attention-getting release is most likely to be read. Remember to put the ‘what’s in it for your viewers/listeners/readers’ information front and center and make it clear that you are AVAILABLE FOR INTERVIEWS. This is critical. Like all time-pressed people, reporters will be most attracted to a great story that requires less effort. Make it easy on them – and yourself – by offering to hand them the information they need. There are a number of Internet sites with simple instructions for writing a press release, as well as inexpensive services that will do it for you. If in doubt as to where to send your news release, a quick call to your targeted news outlet can easily answer the question. Ask, by name, for the person who covers medical news and ask how best to send it. Most outlets now prefer email. For a fee, press release distribution services, such as PR Web, will even distribute your news release nationally.

the right person and b) ensure that the person understands the information. Don’t be surprised (or offended) if your precious press release got lost in the shuffle. News outlets may get hundreds of releases a week. Just reiterate why you believe that the information will be of great interest to their audience and offer to resend it. (Note: The follow-up phone call is primarily for local news organizations. It is not practical if you are distributing your release to a national audience.)

What do I do if someone wants to cover my story? Congratulations! You have managed to make your information stand out from the crowd and gain the attention of a news outlet. Once they show an interest, be as accommodating as possible in granting an interview or providing requested information. Most reporters are working on a deadline and if you can’t help them out within a reasonable time frame, they may be forced to fill that space/time slot with other news, costing you your opportunity. (For tips on ensuring that the interview will make both you AND the interviewer happy, see “How to Handle a Media Interview”, MED, March 2013)

What happens after the press release is sent? If you really want to increase your chances of getting coverage you (or someone from your office) must follow up. A follow-up phone call, within a few days of sending your release, is intended to a) ensure that it got to

If you have a communication issue you would like Alex to discuss in this column, send an email to


Get On Board

the Patient Experience Train By Tana Phelps


he patient experience train

healthcare organizations to assess patients’ perceptions of care and allowing has more than left the station. consumers to evaluate a provider’s patientIt’s zigzagged thousands of centeredness of care. miles across the country. Are The patient experience movement has you on board? If not, it’s time to call your nearest survey gained momentum with the Affordable vendor. Care Act and a push to tie payments Since 2002, CMS has mandated that hosincreasingly to value and quality of care. pitals measure and report inpatient survey Hospitals with less-than-stellar survey scores through the Hospital Consumer scores forfeit 1 percent of their Medicare payments, a number that doubles by 2017— Assessment of Healthcare Providers and to the tune of $1 billion. Systems, or HCAHPS. Such reporting is In addition to survey results being tied likely the future for clinics and doctors’ offices, too—starting as early as 2014. to reimbursement, surveys deliver informaThe system was designed to serve tion that physicians can use to reduce wait times, improve patient communication, patients and providers alike – allowing enhance the appearance of a practice and manage the courtesy We’ll take care of your business and friendliness of while you take care of your patients. staff. Survey results also provide an opportunity to decrease risk • Claims Billing of malpractice and • Accounts Receivable • Accounts Payable improve market share, • Taxes and Payroll patient loyalty and • Financial Statements referrals. • Full Service Accounting • EHR/EMR Systems • ICD-10 Training • Compliance Auditing

Jewel Kopfmann, RHIT, CCS, CPC VP DT-Trak - Technical Services, AHIMA Approved ICD-10 Trainer Chuck Nelson, CPA Partner, Nelson & Nelson Certified Public Accountants Natalie Bertsch, RHIT VP DT-Trak - Administrative and Business Operations

Sioux Falls, South Dakota (605) 336-1988 •

Sioux Falls, Huron & Miller, South Dakota (605) 853-2786 •

Please call us anytime at (605) 853-2786 to schedule a free consultation.


Consider these tips to impact the patient experience: Prioritize convenience. Patients generally prefer quick and efficient care. Improve the patient experience by offering extended hours, email communications with patients,

online medical consultations, online appointment scheduling, wellness brochures, and a website with hours, doctor biographies and contact information.

Be grateful. Thank the community for choosing you. Promote your achievements on banners and table tents throughout your facility, and on billboards, movie theater ads or radio spots to spread the word outside your doors. Don’t just toot your own horn, though. Messaging should focus on how quality, safety and the overall experience of patients and families are your chief concerns.

Vow to Improve. If your survey results aren’t as high as you’d like, communicate your improvement efforts to patients and staff, especially as you roll out new processes and programs. When you use your survey results to help drive targeted, operational performance improvement – you’ll be making good on your promise. And that improves patient safety and loyalty.

Ask for help. If you have a low survey response rate, train patient navigators, discharge nurses and other staff to educate patients about the importance of completing the surveys. Hang educational posters and have staff wear buttons to let your patients know that you’re listening. And don’t be afraid to push back on your survey vendor for additional resources. ■ Tana Phelps is a marketing specialist at Cassling, a Midwest healthcare company that provides local imaging equipment sales and service, and marketing and professional services.

Midwest Medical Edition

New “Hall of Deans” Honors Medical School Leadership

A display honoring the last five deans of the

The new sculpture busts depict the

USD Sanford School of Medicine is now open in

following former deans:

the Locken Lobby of Sanford USD Medical Center. The ‘Hall of Deans’ was officially unveiled in April and features bronze busts of the deans that

Karl H. Wegner, MD – 1972 to 1979 Charles E. Hollerman, MD – 1979 to 1982

have served the medical school since 1975, the year

Robert H. Quinn, MD – 1982 to 1986

it changed from a two-year to a four-year medical

Robert C. Talley, MD – 1986 to 2004

school. The change enabled medical students to complete their medical education in South Dakota, forever changing the state’s medical landscape.

Rodney R. Parry, MD – 2004 to 2012 In addition to honoring the work of these and past

Having a four-year medical school fostered

deans, the “Hall of Deans” also symbolizes the

numerous healthcare, education and research

medical school’s link with Sanford USD Medical

developments in South Dakota, which helped to

Center, as a teaching hospital and clinical setting

keep more physicians in the state, or attracted

for medical students and health professional

them back after their residency training. Today, a


high percentage of the region’s primary care physicians are graduates of the USD Sanford School of Medicine.


Happenings around the region

South Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

News & Notes Avera Avera McKennan and Avera Queen of Peace have been named top performers in the Premier healthcare alliance’s QUEST: High Performing Hospitals collaborative . Avera

McKennan was recognized in the areas of reducing mortality, reducing cost of care, improving the hospital experience and reducing preventable harm events. Avera Queen of Peace was recognized in the areas of reliably delivering evidencebased care in heart attack, heart failure, pneumonia and surgery, improving the hospital experience, reducing preventable harm events, and reducing readmissions. Brad Paulson, MD, with Avera Medical Group Radiology Sioux Falls has received an honorary fellowship award from the American College of Radiology. Honorary fellows

are elected by the Board of Chancellors on merit as well as individual involvement in internal political and historical achievements.

The South Dakota Counseling Association has recognized Avera Behavioral Health’s Friday Forums as a winner of its Special Contributions Award. Friday Forum events

host school counselors and other professionals, providing free education on pertinent behavioral health topics concerning children and adolescents. The Friday Forums are coordinated by Michael Jerke, Expressive Therapist at the Avera Behavioral Health Center. Avera Medical Group Behavioral Health Yankton is now open. A ribbon cutting

took place on April 23. Gale Walker, CEO/President Avera St. Benedict Health Center, has been chosen to serve on the Oversight Committee established by Governor Daugaard to monitor implementation of the Governor’s Primary Care Task Force recommendations.

Governor Daugaard appointed the Primary Care Task Force in 2012 to consider and make recommendations to ensure accessibility to primary care for all South Dakotans, with a particular emphasis on rural areas.

Avera Sacred Heart Hospital’s Cardiology Department has been granted a three-year term of accreditation in Echocardiography in the area of Adult Transthoracic and Adult Transesophageal by the Intersocietal Accreditation Commission (IAC). David Nagelhout, MD, FACC, a cardiologist with North Central Heart (NCH) in Sioux Falls has joined the Board of Governors of the American College of Cardiology (ACC) as the governor of the South Dakota Chapter. In his position,

Dr. Nagelhout will serve as the liaison to the ACC for health policy and grassroots-related initiatives, as well as implementation of quality improvement activities. He will also serve as the voice of the cardiology community in South Dakota, advising government and professional organizations on issues related to cardiovascular disease. Dr. Nagelhout is a graduate of the USD Sanford School of Medicine and completed residencies in Internal Medicine at the Medical College of Wisconsin in Milwaukee, and in Cardiology at St. Louis University Medical Center in Missouri. He has been with NCH since 1990.

Jason Wickersham, MD, has been elected by his peers to serve as President of the South Dakota Academy of Family Physicians, a group of over 315 Family Physicians from the state. He has served on the Board

of Directors for four years, three of those as Vice President. Dr. Wickersham is a graduate of the USD Sanford School of Medicine and completed residency at the Nebraska Medical Center/ Clarkson Family Practice Residency Program in Omaha. He currently practices in Parkston for Avera St. Benedict and does outreach in Tripp.

Black Hills

BHHCS recognized its volunteers hosting several volunteer recognition luncheons in April during National Volunteer Week.

Collectively, BHHCS volunteers have contributed more than 40,000 hours toward caring for Veterans.

MED Quotes “I have no special talent. I am only passionately curious.” —Albert Einstein


Midwest Medical Edition

VA Black Hills Health Care System celebrated their nurses during National Nurses Week, May 6 to 12. The theme was,

“Nurses: Delivering Quality & Innovation in Patient Care.” A new look for many Spearfish residents has translated into a $3,000 donation for the Spearfish Regional Hospital Infusion Center, where local cancer patients receive chemotherapy. The second

annual Shaved Head Style event recently took place at Mark’s Old School Barber Shop in Spearfish. Eighty-four people came into the shop during the event and got their heads shaved to help raise funds for the Infusion Center. The barbers donated their time and talent, and some locals also made donations to show support for those who received the new look.

Spearfish Regional Hospital (SPRH) Infusion Department employees receive a check following the recent Shaved Heads Style benefit event. From left: Cathy Dill, Director of Patient Services; Ethan Burke, Shaved Head Style event organizer; Marc Casavan, Barber, Mark’s Old School Barber Shop; Lacey Joens, SPRH ED/Trauma Director; and Paulette Kub, RN, SPRH Infusion Therapy Department.

June 2013

Spearfish Regional Hospital (SPRH) was recently named an accredited diabetes education program by the American Association of Diabetes Educators. The accreditation is

valid for four years and will enhance access to critical diabetes education services for residents of the Northern Hills. The Spearfish Diabetes Education Program provides people with or at-risk for diabetes with the knowledge and skills to modify behavior and self-manage the disease and its related conditions. Diabetes patients can either attend monthly diabetes education classes or meet one-on-one with a diabetes educator. Rapid City Regional Hospital volunteers were honored during a Volunteer Appreciation and Awards Brunch on April 19 during National Volunteer Week.

The event theme was “Volunteers: Our Greatest Natural Resource.” In 2012, 400 volunteers contributed more than 38,000 hours to the RCRH. Volunteers were also presented awards commemorating accumulative hours served. The sixteenth annual Hospice Benefit Ball on March 2 raised $40,000 for Hospice of the Northern Hills (HNH) patients.

From left: Andrew Mahaffey, Abigail Mahaffey, Tina Marie Panzirer, Walter Panzirer, Julie Mahaffey, Robert Mahaffey, Charlie Mahaffey, Claire Mahaffey and Steven Benn, MD, RCRH Neonatologist. Photo credit Molly Morrow Photography.

Rapid City Regional Hospital’s Neonatal Intensive Care Unit (NICU) is now named “Claire’s Place.” Walter and Tina Marie

Panzirer recently made a generous donation to the hospital’s foundation in the name of Claire Mahaffey, the daughter of a family friend. The name “Claire’s Place” is in honor of her. Claire was born at 26 weeks gestation, weighing 2 pounds, 4 ounces and measuring 13 inches long. She spent the next 74 days in RCRH’s NICU. Now 5 years old, Claire is a preschooler and has no long-term complications. She and her parents, Robert and Julie Mahaffey of Mount Vernon, SD, attended a special naming ceremony in April, along with the Panzirers, and Steven Benn, MD, the physician who cared for Claire in 2008.

The ball is HNH’s largest fundraising event of the year. This year’s theme was “Enchanted Forest.”

Ephraim M. Gabriel, MD, MPH, has joined the Department of Veterans Affairs (VA) Black Hills Health Care System (BHHCS) as Associate Chief of Primary Care Services. In his leadership

role, Dr. Gabriel will ensure that the primary care team will provide the highest quality of patient care to the nearly 19,000 Veterans served by VA BHHCS. Dr. Gabriel came to the VA BHHCS from the Miami VA Health Care System where he most recently served as Physician Provider in Occupational Medicine and Urgent Care Medicine. He earned his MD from Addis Ababa University in Addis Ababa, Ethiopia and his Master of Public Health (MPH) from the University of Minnesota in Minneapolis. He completed the Occupational and Environmental Medicine Residency at Meharry Medical College in Nashville and served as a Clinical Fellow in Spinal Cord Injury/Diseases Medicine Fellowship at the University of Miami Leonard M. Miller School of Medicine.


South Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

News & Notes Randee Figuracion is the new Executive Secretary for VA Black Hills Care System. Prior to her

appointment as an Executive Secretary, she was the supervisor of Outpatient Medical Support Assistants for VA BHHCS. Figuracion attended Columbia College of Missouri at a satellite campus located at Whidbey Island Naval Air Station. Figuracion was an Aviation Electrician’s Mate 3rd Class in the US Navy. She served in the Aviation Intermediate Maintenance Department (AIMD), Avionics Division at Naval Air Station North Island, San Diego, California.

Sanford Christopher Stanton, MD, FHRS, electrophysiologist with Sanford Heart Hospital, has received acceptance in the Fellowship in the Heart Rhythm Society. This fellowship requires

American Board of Internal Medicine certification in cardiovascular diseases and clinical cardiac electrophysiology. Members must also be nominated by a current FHRS member who can vouch for the training, experience and delivery of care provided by the nominated physician. Their nomination is then reviewed by a committee to ensure the physician meets all necessary qualifications.


Mitzi Drey, RT (R)(CV), radiology administrative coordinator at Sanford USD Medical Center, has been elevated to the status of Fellow by the American Society of Radiologic Technologists (ASRT). The award recognizes

ASRT members who have made outstanding contributions to the profession and to the ASRT. Drey has held several leadership roles since she joined the ASRT in 1986. Sanford has added volleyball to its list of training programs for regional athletes. Launched in May, the Sanford POWER

Volleyball Academy includes a comprehensive skill-development program and a club-team component. Mark McCloskey, a club volleyball veteran who also spent time as a college assistant coach, leads the program. Thomas Cink, MD, of the Sanford Cancer Center is a recipient of the American Cancer Society’s “Champion in the Fight Against Cancer” Award. The award recognizes

outstanding efforts in the fight against cancer. Dr. Cink is a USD graduate who spent his radiology residency in Los Angeles, California. He pursued a fellowship in Colorado working on chest and breast imaging before bringing his specialty back to Sioux Falls and continuing in radiation/oncology at Sanford Breast Health Institute.


Siouxland Leah Glasgo has been appointed as the Vice President of Rural Development for UnityPoint Health–St. Luke’s in Sioux City and UnityPoint Health–Trinity in Fort Dodge. As

VP of Rural Development, Glasgo will be responsible for the development of new provider partnerships in communities surrounding Fort Dodge and Sioux City. In addition, she will lead efforts to advance relationships between rural and regional care settings, improving coordination and care to all patients in the region. Glasgo has over 19 years of management experience, currently serving as President and Chief Executive Officer of Stewart Memorial Community Hospital in Lake City, Iowa. Glasgo holds a BS in Nursing from University of Nebraska Medical Center and a Master of Healthcare Administration from Des Moines University. She is board certified in healthcare management as a Fellow with the American College of Healthcare Executives. The Siouxland Paramedics “Saving Lives” fundraiser on April 6 raised over $8,000.

Proceeds will benefit Siouxland Paramedics in purchasing new equipment and educational programs.

Siouxland Medical Education Foundation, Inc., Mercy Medical Center-Sioux City, and UnityPoint Health-St. Luke’s are sponsoring Medical Education– Community Orientation (MECO) students during May and June.

MECO was developed to provide sophomore medical students exposure to a local healthcare delivery system away from the university setting, and to assist them in making important career decisions. This year’s students are Joel Bricker, Deepti Sharma, Dana van der Heide, Jessy Dabit, and Paul Fenton. All of students this year attend the University of Iowa Carver College of Medicine. Vermillion Medical Clinic Family Medicine Physicians, William Dendinger, MD and Charles Yelverton, MD, were awarded the Sanford School of Medicine of The University of South Dakota Class of 1983 Clinical Faculty Award.

The Class of 1983 Clinical Faculty Award was established in 2008 as an award for a clinical faculty member with the Sanford School of Medicine. The award recognizes the critical role of clinical faculty members in preparing future physicians. Dr. Dendinger and Dr. Yelverton have been in practice at Vermillion Medical Clinic since 1989 and 1990, respectively. Both are Clinical Professors for the Sanford School of Medicine.

Midwest Medical Edition

Happenings around the region

Yankton Medical Clinic, P.C. announces the association of Denise Taggart, MPAS, PA-C. Taggart

specializes in the practice of Internal Medicine. She received her undergraduate degree from the University of South Dakota and graduated from the University of Nebraska Medical Center with a Master of Physician Assistant Studies. Taggart has certifications in Advanced Cardiac Life Support, Basic Life Support, and is certified by the National Commission on Certification of Physician Assistants. The physicians of Cardiovascular Associates (CVA) and St. Luke’s staff have been awarded a three-year term of accreditation for their echo department for services provided at both of their Sioux City clinic locations as well as outreach locations and their vascular departments located at their Sioux City clinics. Re-accreditation for the

echo department is awarded by ICAEL. The vascular department re-accreditation has been awarded from ICAVL. CVA is the area’s only cardiology group with triple accreditation in echocardiography, nuclear medicine and vascular diagnostic imaging.

Mercy Medical Center in Sioux City has earned recertification as a Primary Stroke Center by The Joint Commission on the Accreditation of Healthcare Organizations. Orthopedic Surgeon, Brent Adams, MD has joined the Yankton Medical Clinic, PC staff.

Originally from Yankton, Dr. Adams completed his undergraduate degree at South Dakota State University and is a graduate of the USD Sanford School of Medicine. Dr. Adams completed his orthopedic surgery residency at the University of Kansas, Wichita and a fellowship in spine surgery at the Twin Cities Spine Center in Minneapolis. He is board certified in orthopedic surgery and has also been a faculty member for the University of Kansas, Wichita orthopedic surgery residency program. Dr. Adams is a member of the American Academy of Orthopedic Surgeons, North American Spine Society, and Scoliosis Research Society.

Mercy Child Advocacy Center joined hundreds of groups and organizations across the nation in recognizing Child Abuse Prevention Month with Blue Out Day on April 19. Community

members were encouraged to wear blue that day to remember children who have suffered from abuse and in support of efforts to prevent abuse. Throughout the year, Mercy Child Advocacy Center works to support families by providing parent education classes and prevention programs through the Light a Child’s Life program. Prevention classes are also offered to adults working with children through the Darkness to Light program.

Mercy Medical Center celebrated Doctor’s Day with a ceremony on March 29. Sioux

City Mayor Bob Scott made a special presentation to Jerome Pierson, MD, Mercy’s Chief Medical Officer. The Mercy Foundation also highlighted a new program to honor a doctor who has made a difference in patients’ lives.

Other The local chapter of the Crohn’s and Colitis Foundation of America (CCFA) will have a Take Steps for Crohn’s & Colitis walk-a-thon on Saturday, June 8. The event will take place at

Falls Park in Sioux Falls. Take Steps for Crohn’s & Colitis is the CCFA’s largest fundraising event. Participants raise funds and awareness throughout the year and come together to celebrate the steps that have been taken towards a cure. Dr. Laura A. Aeschlimann recently opened ABC Pediatric Dentistry in Sioux Falls. Dr.

Aeschlimann is a Board Certified Pediatric Dentist providing positive dental care experiences for children and children with special needs.

MED Quotes “Do not wait for the conditions to be perfect to begin. Beginning makes the conditions perfect.” —Alan Cohen

June 2013



Going the Distance Physicians Travel to Serve


Every year,

teams of American doctors, dentists and other healthcare professionals clear their schedules and pack their bags for some of the world’s poorest and most remote places. Their mission: to improve the lives and futures of underserved and vulnerable people around the globe by providing medical, dental, and surgical care, medicines, equipment, instruction and support. While their ranks are not large, their service-driven hearts invariably are. For this month’s Cover Story, we spoke with three area physicians who have embraced the joys and considerable challenges of medical mission work.

Craig Hedges, MD,


t is not always

easy to craft an article focused on physicians who travel extensively. ENT Craig Hedges, MD, is a case in point. When we first reached his office to request an interview, he was in the midst of his fourth trip to Honduras, where he was teaching otolaryngology techniques at a medical school. Honduras, which Dr. Hedges first visited in 2011, was a relatively late addition to his list of medical mission locations. Although he has served in Russia, Africa, Mexico and Cuba since 1994, teaching and training and bringing equipment, his first love is Vietnam, where he has served on 18 separate mission trips in 19 years. “The people of Vietnam

Ear Nose & Throat

were so open and welcoming and clearly glad we were there,” recalls Dr. Hedges of his first trip to the country. “The response was just so drastically different from what we had seen in Moscow earlier the same year (1994), that I asked one of the doctors what he thought the difference was. He said, ‘Moscow has been humbled and is bitter, but we are happy because we are free. In Vietnam, we are poor, but we are happy.’” While he did some patient examinations and performed some procedures on that first trip, Dr. Hedges especially enjoyed sharing his knowledge and experience with his gracious Vietnamese colleagues. “The doctors there were so grateful and eager to learn that I thought, ‘Man, this is great!’,”

Dr. Craig Hedges and a Vietnamese colleague.

Dr. Hedges and his Vietnamese hospital team.

By Alex Strauss

June 2013


says Dr. Hedges. “I am not a high-powered academician, but, as it happened, the things that we do and see on a day-to-day basis in Sioux Falls – cancers and nasal polyps and perforated ear drums and chronic infections – were the exact things they wanted to learn.” When he returned a second time to Vietnam 18 months later, Hedges and his team brought 25 boxes of donated ENT equipment, including otoscopes, cameras, and microsurgical equipment – tools of the trade that were rare or unheard of in Vietnam. “When I first went, they were taking safety razors and breaking them into two pieces and holding the broken piece with a hemostat in order to make an incision,” says Hedges. “They were reusing rubber gloves. They were performing procedures with pliers and other things they could get in a hardware store.” Most of Hedges’ trips have been orchestrated by Resource Exchange International, a humanitarian organization aimed at developing human resources through training and education in multiple areas, including medicine. Dr. Hedges now sits on the REI board of directors. The work has rewarded Dr. Hedges with lasting relationships. He and his family have hosted several of his Vietnamese colleagues in their Sioux Falls home. Now, when he returns for his annual two- to four-week mission trips in places like Hanoi, Hoi An, Saigon, and Ho Chi Minh City, he is greeted by friends instead of strangers. Beginning next year, he hopes to make two annual trips to Vietnam and may make his first trek to Nepal. “I have to admit that it is a little addictive,” says Dr. Hedges, the 2006 recipient of the American Academy of Otolaryngology’s Humanitarian Award. “It has made me much more grateful for what we have and compassionate for the suffering and needs of people around the world. God has made me a doctor and I find great satisfaction and pleasure in being able to impart what I have learned to improve other people’s lives.”


Dr. Paul Amundson in 2011 with his Nicaraguan host family.

Paul Amundson, MD,


r. Paul Amundson’s

adventure with medical missions began 12 years ago with simple curiosity about Nicaragua, a country served by the regional Evangelical Lutheran Church in America through a partnership with the Lutheran Church in Nicaragua. “I knew some people who went and came back with interesting stories,” recalls Amundson, an active member of his Sioux Falls Lutheran church. “I thought it sounded like an opportunity to get involved in some short term medical work in an area that was readily accessible geographically and that really had a need.” After that first trip, providing primary care services to clinics and rural villages in the second poorest country in the Western Hemisphere (Haiti is first), Amundson never looked back. Working through the South Dakota Synod of the ELCA, he has travelled 10 of the last 12 years on teams that also included nurses, PAs, NPs, students, and non-medical support personnel. Amundson’s ophthalmologist wife and his teenaged son

Family Medicine

have even served with him on a few of the annual trips, which typically take place in February and March – the dry season – when rural roads are still passable . “We drive through dried out creek beds to get to villages of 10 to 15 families where we set up a clinic in whatever structure is available,” says Amundson. “These are mountainous areas with very limited access to healthcare. Even if the nearest clinic is 25 miles away, if your means of transportation is a donkey, it’s a long way. For some, we are the first physicians they have ever seen.” As in many developing countries, parasites are a common problem in Nicaraguan villages. Issues related to malnutrition are next on the list. The increasing availability of cheap packaged foods and soft drinks are wreaking havoc on the health of a Hispanic population already prone to diabetes and obesity. “They know their wells are contaminated, so they drink pop,” says Amundson. “They are hungry, so they eat potato chips. We have really been seeing more diabetes, high blood pressure, and obesity – things you wouldn’t normally see in underdeveloped countries. So we are doing more public education, as well.” Asthma and allergies exacerbated by Nicaragua’s dusty, smoke-filled air are another problem. “We are so blessed in this country with clean air and clean water,” says Dr. Amundson, who often stays in villagers’ homes

Midwest Medical Edition

A modest single-room home near Gracias, Honduras.

Dr. Greg Schultz with PA MaryAnn Sherman and Sulmy from Honduras. Sherman and her family have fostered Sulmy during her time in Sioux Falls.

when on the road in Nicaragua. “You become very emotionally close to the people you are trying to help when you see firsthand how much they suffer just to survive.” As if the work itself was not challenging enough, the Nicaraguan government has further complicated the cause of medical mission work in the country by limiting the medications that can be brought in and requiring more detailed credentialing and activity information from volunteers. Still, Amundson says he will continue to provide what he admits may be “Band-Aid medicine” in Nicaragua, in the hope that it will have an impact he may never even know. “Have we made a big improvement in the health of the Nicaraguan people?”, he asks, philosophically. “Probably not. But hopefully we have built cross-cultural relationships that will last for generations. The biggest impact may not even be in a person we have treated, but as people there see that there are people who care about them, maybe it will instill some hope. And perhaps we will instill the passion in someone else, who will go on to do something even greater.”

June 2013

Greg Schultz, MD, Vascular Surgery


ascular surgeon Greg

Schultz, MD, was connected to his first medical mission experience through his friend Greg Kuiper, MD, a former Luverne, MN family doctor who serves as Director of Ministry Development in the Sioux Fallsbased Luke Society. “I told Greg, ‘If there is ever an opportunity where you need a surgeon to provide volunteerism in a Spanish-speaking country, let me know,” says Schultz, who says he speaks “marginal Spanish”. Two years ago, he got his chance in Gracias, Honduras, one of more than 50 sites around the world where the Luke Society provides support to indigenous mission-minded physicians. “It was an incredible week,” recalls Dr. Schultz. Although the Luke Society typically sends doctors to support, rather than practice, Dr. Schultz’ skill was needed in clinic where no surgeons were available. “On our first day, we probably saw 50 to 60 cases and they

all came in with obvious medical problems… gallbladders, hernias, cancer. These people travel for 6 to 10 hours on bumpy roads, have major operations, and get up and leave the next day. And they are so gracious and so happy about it.” An experience on that first Honduran trip ensured Dr. Schultz’s connection to the country long-term. On the last day, the team encountered a six-year-old girl with a perforated anus and a draining colostomy. Working with Sanford USD Medical Center, Schultz was instrumental in bringing the child, Sulmy, to Sioux Falls last June for more extensive treatment. After multiple operations, the child is now “socially confident” and is looking forward to eventually being reunited with her family in Honduras. “One of the tragedies in these developing countries is that healthcare is not a priority,” says Dr. Schultz, who will travel to Honduras with the Luke Society for the third time


Are you a physician with an interest in short-term medical mission work? There are many ways and places to serve. Here is a sampling of organizations that offer opportunities to physicians:

Dr. Schultz and his fellow brigade members enter a Honduran clinic at the start of their workday.

this year. “Medical treatment is really only for those who are critically ill. If you want to have a growing tumor or a painful hernia treated, it’s very hard to get help. And there are so few surgeons available that cases are often very advanced by the time they are seen.” Like so many other Americans who volunteer in undereveloped countries, Schultz was shocked and humbled by the poverty around him. “These are people who sleep in huts with dirt floors. Heat is provided by a fire inside the house. There is no running water and the water that is available is almost always contaminated with parasites. The roads are dirt and are bumpy. Eight people might live in a single room house.” Schultz and his surgical brigade of 14 to 15 people brought with them 60 to 80 thousand dollars of surgical equipment and other donated supplies. He has even collected clean, used Ace bandages to be used on future trips. Although he admits that it is challenging to take ten days away from his busy Sioux Falls practice, Dr. Schultz calls mission work “the joy of my life”, a chance to return to the reason most physicians got into medicine in the first place. “This is what medicine should really be about – taking care of people,” says Dr. Schultz. “Everything is not about money. It’s about helping people. That is the core of what we do. I think that, if you talk to anyone who does this kind of work, they will tell you that they get so much out of the feeling that they are really helping mankind. It is very fulfilling and satisfying.” ■


Global Health Outreach Bristol, TN 423-944-1000

CURE International Lemoyne, PA 866-730-2873

GO International Wilmore, KY 859-8858-3171

Emmanuel Hospital Association Arlington Heights, IL 888-893-2654

CERT International Crossville, TN 931-707-9328 Christian Community Health Fellowship Chicago, IL 773-277-2243

Health Teams International (has a dental focus) Broken Arrow, OK 810-229-9247 Hope Haven International Ministries Rock Valley, IA 712-476-3180

Medical Teams International Tigard, OR 800-959-4325 Resource Exchange International Colorado Springs, CO 719-598-0559 www.resourceexchange Volunteers in Medical Missions Seneca, SC 800-615-8695 World Servants, Inc. Richfield, MN 800-881-2170

Other Short Term Mission information:

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Midwest Medical Edition

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June 2013


Clinical Clinical Spotlight Spotlight

Alternative Treatment for


Now Available in Sioux Falls

Area patients with chronically occluded arteries, known as chronic total occlusion (CTO), who may not be candidates for coronary artery bypass surgery now have another option. Heart specialists at both Sioux Falls Heart Hospitals have recently begun offering a minimally invasive alternative procedure to treat the condition. The BridgePoint CTO System, developed by Minneapolis-based BridgePoint Medical and acquired by Boston Scientific late last year, is designed to allow navigation around occluded coronary arteries to restore blood flow. The new technology is especially valuable for patients considered too risky for bypass surgery or whose surgically-repaired arteries have reclosed. In addition to reducing surgery-related complications, BridgePoint can dramatically improve recovery times, reducing hospital stays from weeks to 24 hours or less. It is the only crossing and reentry system cleared by the FDA for the treatment of coronary CTOs. Interventional cardiologists Drs. Sean Halligan and Raymond Allen of North Central Heart first performed the outpatient procedure at Avera Heart Hospital in April. During the procedure, a catheter is threaded around the blockage by passing into the wall of the artery. “We are able to insert a catheter into the wall of the artery, go around a part of the artery that was completely blocked, and then reenter the artery using a new balloon,” says Dr. Allen, who adds that the first procedures in the region went well. “In the coming years, I believe this will become the standard of care,” says Dr. Tom Stys, medical director and interventional cardiologist at Sanford Heart Hospital. The BridgePoint procedure is compatible with the Corindus CorPath200 robotic heart catheter system, which gives the cardiologist the added benefit of surgical assistance to work through an artery in the wrist or groin. An occlusion may be labeled a CTO if it lasts for 3 months or longer, preventing circulation to critical areas of the heart. Many patients suffering from CTOs experience regular angina. The improved blood flow offered by the CTO procedure can often improve quality of life. ■


Dr. Sean Halligan

Dr. Raymond Allen

Dr. Tom Stys

Hope for

Batten Disease? Sanford researchers publish new study in Human Molecular Genetics A team from Sanford Research has discovered a potentially promising therapy for reducing the degenerative effects of Batten disease, according to a recent study published by Human Molecular Genetics. Sanford Research’s Jake Miller, ChunHung Chan, PhD, and David Pearce, PhD, authored the study, “The role of nonsensemediated decay in neuronal ceroid lipofuscinosis.” All three researchers are members of the Pearce Lab for Genetically Inherited Diseases of Children, which primarily explores Batten disease. Batten disease, most commonly found in children, is a group of neurodegenerative diseases that result in seizures, blindness, motor and cognitive decline and premature death. It is caused by mutations in at least 14 different genes that result in a lack of the normal gene product, or protein. The mutations often pre-dispose the gene product to premature decay, known as nonsensemediated decay (NMD). Miller, Chan and Pearce found that by chemically blocking NMD in cells, the gene product and thus protein levels are increased, suggesting that the cellular consequences of the mutation can be corrected. Further studies will address whether this approach can be harnessed to slow the degenerative symptoms of Batten disease. “By addressing nonsense-mediated decay, we were able to identify a promising therapeutic target to lessen the impact of Batten disease,” said Miller. “Because the effects of this disease are often debilitating—and eventually fatal— for children, it is paramount that we consider avenues to improve the quality of life for those living with the disease.” Led by Pearce, who also serves as chief operating officer and vice president of Sanford Research, the Pearce Lab for Genetically Inherited Diseases of Children is globally known for its research of Batten disease. Pearce has studied the genetic disorder for more than a decade. ■

Midwest Medical Edition

The Avera McKennan campus in Sioux Falls

Becker’s Names Avera McKennan to the Top 100 List Avera McKennan Hospital has been named to Becker’s Hospital Review’s 2013 list of “100 Great Hospitals in America”. According to Becker’s, hospitals on the list “continually improve upon themselves and are innovators for medical treatments, research, technology and care delivery. These hospitals are home to medical breakthroughs and act as anchors of health within their respective communities.” To develop the list, The Becker’s Hospital Review editorial team accepted nominations, and analyzed data from reputable sources including U.S. News & World Report, Truven Health Analytics’ 100 Top Hospitals, HealthGrades, Magnet Recognition by the American Nurses Credentialing Center, the Studer Group and the Baldrige Performance Excellence Program. Hospitals do not pay to be a part of the Becker’s list. The following area hospitals are included in the 2013 edition of “100 Great Hospitals in America”

v Abbott Northwestern Hospital (Minneapolis). v Avera McKennan Hospital & University Health Center (Sioux Falls). v Mayo Clinic (Rochester, Minn.). v Mercy Medical Center (Cedar Rapids, Iowa). v St. Luke’s Hospital (Cedar Rapids, Iowa). v University of Iowa Hospitals and Clinics (Iowa City). Avera McKennan was recently named to 100 Top Hospitals by Truven Health Analytics and was ranked as the top hospital in South Dakota by U.S. News & World Report. To see the full list of included hospitals and a short write-up on each of the hospitals, visit■

June 2013


Comfort, Space and Efficiency Top Priorities in Regional’s New Medical Staff Area Rapid City Regional

Hospital (RCRH) has opened a renovated and expanded Medical Staff area, designed to accommodate the needs of a rapidly-growing staff. The new space, located on the back side of the hospital and to the east of the Emergency Department entrance, had an official grand opening in May. RCRH says the Medical Staff renovation and expansion project was necessary as the growing staff had outgrown its former space. It was also deemed more efficient to locate physician support services, which had

been scattered throughout the The new RCRH medical staff dining area hospital previously, closer to the physicians who use them. stations will also make it The new, larger area easier for physicians to have includes the RCRH Medical a space to dictate and comStaff dining area, physician plete patient follow-up work. sleep rooms, computer staThe RCRH medical staff tions, Medical Staff offices, now numbers more than 300 space for the Allied Health physicians and mid-level Professionals and medical providers. It is hoped the residents, and Clinical Infornew visually pleasing and matics offices. The new area technologically advanced will now house these medical dedicated staff area will not professionals in one space only serve the needs of existing staff, but will also be an with the aim of providing enhanced support for the phyattractive perk in recruiting sicians who practice at RCRH. new physicians to the Black Twenty-two new computer Hills area. ■

New outdoor dining area

Type 1 Diabetes Network Expands Reach with Online Sign-Up, Nationwide Testing Regional Health System in Rapid City is looking for volunteers to help dis-

cover ways to delay or prevent Type 1 diabetes, and it’s making it more convenient than ever for them to participate. The screening, consisting of a questionnaire and blood test, is for Type 1 Diabetes TrialNet, a National Institutes of Healthfunded long-term international collaboration, of which Regional Health is a part. The collaboration is aimed at discovering ways to delay or prevent Type 1 diabetes in people at increased risk. In adults, Type 1 diabetes accounts for about 5 percent of the approximately 19 million people diagnosed with diabetes. TrialNet must screen more than 20,000 relatives of people with Type 1 diabetes each year to perform studies to reach its research goals. Previously, relatives were needed to visit a study site or attend a screening event. But


now, thanks to a new website, people with a family history of Type 1 diabetes can now participate in free and confidential screening, even if they live far from a study site. After answering a few questions online at www., eligible volunteers will receive a kit and be directed to a local lab for a free screening. Of every 100 people tested, typically only three or four will have antibodies showing an increased risk for Type 1 diabetes. People who test positive are contacted by a TrialNet center to review the results. They might be invited to have more blood tests at a study center, and might be invited to join a study aimed at preventing or delaying the disease. Children under 18 who do not have the antibodies can be retested annually to see if their risk has changed. “Patient safety is very important when doing testing for this trial,” said Rachel

Edelen, MD, Principal Investigator and Pediatric Endocrinologist at Regional Medical Clinic – Aspen Centre. “We hope to find more ways to prevent Type 1 diabetes and this study helps the process.” TrialNet studies have already helped. People at risk for Type 1 diabetes who participated in TrialNet’s earlier Pathway to Prevention Study were more likely to be diagnosed early. Launched in 2001, TrialNet has also demonstrated that two drugs, Rituximab and Abatacept, slow the loss of insulin production in people with new-onset Type 1 diabetes. This finding could improve diabetes control and delay complications. TrialNet has also contributed to research showing that antiCD3, an immunosuppressive drug, can slow loss of insulin production. These prevention studies are ongoing. TrialNet is a network of 18 clinical centers working in cooperation with more than 200 sites throughout the United States, Canada, Finland, Britain, Italy, Germany, Australia and New Zealand. ■

Midwest Medical Edition

Sioux Falls Doctor Honored with National Immunization Award Sioux Falls Infectious

Disease specialist Wendell Hoffman, MD, has been honored by the Centers for Disease Control and Prevention (CDC) with its 2013 Childhood Immunization Champion award. The annual award recognizes one individual from each state for making significant contributions to childhood immunizations. The award was announced in conjunction with National Infant Immunization Week, April 21-28. “Over his 27-year medical career in South Dakota, Dr. Hoffman has become the leading authority on immunization in the state and is well-known here and throughout the region,” said Doneen Hollingsworth, Secretary of Health. “He is the South Dakota State Medical Association’s spokesman on childhood immunizations and is a vocal advocate on the issue, testifying before the State Legislature on the importance of maintaining the state’s long-standing immunization laws.” Hollingsworth noted that Hoffman was the driving force and managing editor behind the recent special edition of the South Dakota medical journal, The Story of Immunization, which covered a wide range of immunization topics and has been recognized as a primary resource for healthcare and public health workers. “Immunization plays a key role in protecting the health of America’s children,” said Dr. Melinda Wharton, Acting Director of CDC’s National Center for Immunization and Respiratory Diseases. “Ensuring that all children are immunized requires a cadre of dedicated health professionals and community leaders nationwide. The Champion awards give us the opportunity to salute these individuals for their service.” Dr. Hoffman is the Patient Safety Officer for Sanford Health. ■

June 2013


Mercy Medical Center Opens

Expanded Ambulatory Services Center Patients who receive infusion

therapy at Mercy Medical Center now have the convenience of receiving treatments in a newly-designed Ambulatory Services Center near Mercy’s Jones Street Entrance. The Ambulatory Services Center has been designed so each infusion patient will have a comfortable, private room in which they can relax and even have family members wait with them during their treatment. “The new Ambulatory Services Center is located in a much larger space with new, state-of-the-art equipment, which allows us to accommodate more patients and offer additional services that were previously not available on an outpatient basis,” says Sue

A nurse cares for an infusion patient in Mercy Medical Center’s newly-expanded Ambulatory Services Center.

Froid, Director of ER, Ambulatory and ICU at Mercy Medical Center. The new Ambulatory Services Center is staffed by nurse clinicians with special expertise in providing outpatient treatment services and monitoring patients during their treatment. In addition to facilitating the outpatient treatments, they teach patients how to care for themselves during therapy so they can be active participants in their healthcare. The Ambulatory Services Center is conveniently located next to Patient Access Services at the Jones Street entrance near the helipad. Complimentary valet parking is available at this entrance for Mercy patients. ■

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Midwest Medical Edition

Should You Go Back to School? In the rapidly changing world of healthcare, an increasing number of


physicians and other healthcare professionals are heading back to school for business

That is a real concern for adult learners. We

insights and practical tools they don’t teach in medical school. As writer Bob Keaveney

try to help address this by mapping out the

once observed for Physician’s Practice, “While there’s no doubt you are a trained expert

schedule, in its entirety, so that they can see

in the exam room, how well do you understand what you’re doing in the back room,

the end at the beginning. Everyone starts with

where payer contracts are negotiated, new physicians are recruited, staff is trained, and

a one-credit Overview course where we talk

decisions are made about opening new offices and adding new services? How confident

about time management and self-direction so

are you in those areas?”

that they can begin to calculate whether this

The University of Sioux Falls has offered an MBA in Healthcare

is achievable for them. If you are sitting on 3

Management since 2005. Rebecca Murdock, Chair of USF’s Vucurevich

different boards as well as practicing medicine

School of Business and the program’s first director, explains why so

and volunteering, some of that may have to

many health professionals are willing to stretch themselves to sharpen

change for a while. It is not easy, but it’s not a

their business acumen.

life sentence either. You’re done in 2 years.

MED: What do you

MED: For whom is this program

think draws physi-


cians to pursue a business degree? 17. USF Healthcare MBA Program.jpg

RM: Most health professionals don’t start out thinking about embarking on a business career. But the changing nature of healthcare is changing their thinking. They are practicing in a highly-regulated, highly-competitive environment and now the public has a stake in making sure that they are doing it in the most efficient way possible. So, many health professionals have found themselves sitting at a table talking about business decisions and many don’t feel they have the foundation to really be confident in this area.

MED: What surprises new healthcare MBA students most?

RM: I think many find, while they are broadening their knowledge base, that they actually have an aptitude for business and that can come as a surprise. Organizational strategy, management, financial decision making….Many healthcare professionals may have an innate understanding of these things. With the deeper understanding that they get in an MBA program and the technical knowledge they already have, they become much better, more efficient leaders in their practices and in their organizations.

June 2013

RM: The Healthcare MBA program is really a melting pot of lots of different people… physicians, nurses, clinic administrators,

The USF Healthcare Management MBA includes such courses as Managerial Communications, Financial Planning and Control, Marketing Management and Legal and Regulatory Issues in Healthcare. More information can be found on the website a

people in technical rolls. These are people that might not interact on a regular basis, but I think

A st u d e

nt’s st “I don’t or y have tim older. T e ; I work to students in being hese are to o m all excu u ch ; m back to aybe w ses tha s ch o o l able to connect with hen my t I gave for my child is as to w M BA . I worke hy I wa other aspects of their d as a jo s not re urnalist marketi ady to for six y ng in a go industry in this way. ears be hospita all gone fo l s re e tt e in n te g o . n for ad ring the The peo They tend to learn a vanced field of ple I ad was usu schoolin mired a ally my g t the ho . s ‘I ta ’v great deal from ndard re e been head of spital h thinking sponse. ad the bus of goin It wasn iness sc each other and could d g ’t h back,’ u ool at th ntil I me o it. t Rebec e Unive rsity of ca Murd there is a great I have b Sioux F ock, een in alls, tha the USF busines t I knew support network program s with a I healthc workin online g on m are em that forms within classes p y hasis fo master’ and I k r o ve r a s in classro new th o m s et each student year. I h at I pre ting, in fe ad tried rr e d and te ra F a few c o ting wit r me, th would cohort. learn m h other e b es t p people o s a re tu rt d in a o ents. f the pro of man y profe gram is experie s s th io n e al back people nce. W MED: How ground . Our cla e have marketi s and d physicia ss has ng profe ifferent n s , p h can someone y degree s s ic s io a n l and a p a a n ls s d , of a re pharma spirator erson w cist, ad y thera ith a law as timeany con m p is in ts b is a , tr ckgrou versatio ators, la nd. This n topic b profe pressed they are v . s a T s ri h io e e nals, ty s e p e op my frie helps to le now nds. Th add de I will ac as a not only at is a p p th tually m to art of th are my iss spen classma e progra profess ding tim physician tes, m I did ionals w e e n v ’t expe er y wee hen I g ct to ga raduate k with I’m con possibly in. . these w vinced onderfu that an The cla l yo n e c a find time sses giv n e g o bac you the and bu k for an benefit siness is to do a d va n c of think sues th ed deg ing care at w e a ree. fully th ll strug this? rough e gle wit h in he thical althcare .” Lindsey Meyers at Avera , Direc to r of Co McKen mmunic na n H o spital a ations n d M BA Candid ate there is a real advantage

Off Hours

Passionate Pursuits Outside the Office

Allison Wierda Suttle,

MD, Ob/Gyn

Yoga Instructor

By Darrel Fickbohm


u tsid e rs may assume

that life moves with a softer rhythm here in the heartland. But events can still crash in on any of us with an all-too-familiar pattern. When the pressures of modern life threaten to overwhelm, the followers of yoga are adamant that their practice is the key to keeping mind, body and spirit from collapsing under the strain. Allison Wierda Suttle, MD, is one of those followers. In addition to being a busy Sioux Falls Ob/Gyn with Sanford Health, Dr. Wierda Suttle also regularly teaches power Vinyasa Yoga at Santosha Hot Yoga in Sioux Falls. Her practical approach to a subject that may seem mystical to some sheds light on what yoga really is. “I learned about the spiritual and philosophical parts of yoga, too, and all that is interesting,” says Dr. Wierda Suttle. “But, for me, it is very much a physical thing and a tool for stress reduction that impacts your overall health. That’s what I went into it for, and it’s how I’ve stayed. Of course, it’s almost an extension of my medical practice, now. I never set out to teach it, but what I found was that since I was already teaching my patients, it was a natural extension of that.” But does a yoga practitioner need to embrace the vast philosophies of yoga in


order to benefit from it fully? In the book, Yoga as Medicine: The Yogic Prescription for Health and Healing, author Timothy McCall, MD, agrees with many other yoga practitioners that, even if a student does not fully understand the depth of it all, he or she can still enjoy the full benefits of the art, simply by doing it. “Stepping out of the crazy, fast-paced world to pay close attention to what’s happening right then and there puts me in touch with a calm place deep inside me—deep inside all of us,” writes Dr. McCall in his forward to the book. “It’s like the stillness on the ocean floor that remains undisturbed, no matter how frantically waves crash on the surface.” In other words, results precede the understanding, to give practitioners the possibility of attaining true calm. According to Dr. Wierda Suttle, when people who have attained that calm get together, they often form strong bonds. “There’s an immediate bond when you meet with people that do yoga,” says Dr. Wierda Suttle. “You want to talk about the experience. When you spend so much of your life under stress, always looking to the future or looking back to the past, it is a relief that, when you’re on your yoga mat, you just have to be present and relax. We don’t do that enough and when you get the chance to do that with someone else, it can be quite meaningful.” How does an on-call physician manage to find the time to do this? Dr. Wierda Suttle

says it would not be possible without a great deal of support. “I think I’m able to teach because I have great support from my husband and also my partners. They are always willing to trade calls,” says Dr. Wierda Suttle. “You do need a lot of support for this, but you make time for what’s important to you and yoga gives you energy; it doesn’t take it. In fact, some of my best yoga classes have been post-call. Instead of taking a nap, I’ll go to yoga for 45 minutes and I’m completely revitalized. It definitely gives energy.” Yoga instructors come from all walks of life, from part-time fitness instructors to college students and business people. As a physician-instructor, Dr. Wierda Suttle says the opportunity to subtly incorporate her medical knowledge into her teaching has made the experience that much more enjoyable and meaningful for both her and her students. “I think the most exiting thing is to take a little bit of my medical background, in the way of anatomy and physiology, into the classes,” she explains. “When that happens, there are some real ‘ah-ha’ moments for some students. I’ve had people from my classes come up and say, ‘Wow, that was really great when you talked about the thyroid function and how that particular yoga pose can impact it.’ When my medical degree applies to the yoga mat like that, it’s very satisfying.” ■

Midwest Medical Edition

Name Change for Iowa Health System and brand speaks to our commitment to care centered on helping our patients get healthy and stay healthy. It better reflects the integrated care our patients receive.” The change to UnityPoint Health follows two years of discussions between the organization’s regional affiliate hospitals, local community board members, physicians, staff and leadership regarding healthcare changes and how to best position the organization for the future. The name change to UnityPoint Health will not impact St. Luke’s ability to make decisions

at the local level, and there will be no leadership changes due to the name change. UnityPoint Health – St. Luke’s provides care to communities in the tri-state area that includes Iowa, Nebraska and South Dakota and treats more than 77,000 patients annually. Also a part of UnityPoint Health – Sioux City is St. Luke’s Health Foundation, now UnityPoint Health – St. Luke’s Foundation, and St. Luke’s College – UnityPoint Health that remains on the campus of St. Luke’s to shape healthcare professionals for the future. ■

Peter Thoreen, President and CEO

Previous Name New Name Iowa Health System (IHS), the nation’s fifth largest non-denominational health system, is now UnityPoint Health, a new name that it says reflects the way its hospitals, physicians and home care entities are transforming health care delivery through patient-centered coordinated care. With the name change, St. Luke’s Regional Medical Center in Sioux City will be known as UnityPoint Health – St. Luke’s. St. Luke’s Clinic Network is now UnityPoint Clinic and St. Luke’s Home Care is UnityPoint at Home. Together, they are UnityPoint Health – Sioux City. Iowa Health System began in 1993 when Iowa Methodist and Iowa Lutheran merged, creating the state’s largest provider of hospital and related health services at that time. St. Luke’s joined Iowa Health System in 1996. Since then, UnityPoint Health has grown to encompass eight major geographic regions in Iowa and Illinois and includes relationships with more than 900 physicians and providers in UnityPoint Clinic, 29 hospitals in metropolitan and rural communities and regional home care services. The new name and brand logo were unveiled to system leaders and employees in mid-April. “Health care delivery has fundamentally changed over the years,” says Peter Thoreen, President and CEO of UnityPoint Health – Sioux City. “For the patient, coordinated care is more than a physician making a diagnosis and prescribing treatment. The new name

June 2013

St. Luke’s Regional Medical Center

UnityPoint Health – St. Luke’s

St. Luke’s Clinic Network

UnityPoint Clinic

St. Luke’s Home Care

UnityPoint at Home

All Together, they are UnityPoint Health – Sioux City

The more we get together, the happier and healthier we’ll be.

At MMIC, we believe patients get the best care when doctors, staff and administrators are humming the same tune. So we put our energy into creating risk solutions that help everyone feel confident and supported. Solutions such as medical liability insurance, physician well-being, health IT support and patient safety consulting. It’s our own quiet way of revolutionizing health care. To join the Peace of Mind Movement, give us a call at 1.800.328.5532 or visit


The Nurses’ Station

Brittani Neely, RN

Nursing News from Around the Region

Neely, Baily Latest




In Praise of VA Nurses National Nurses Week took place May 6 to 12. Many area institutions celebrated their nurses with special events and acknowledgment. The following is an excerpt from a letter to the editor, written by VA Black Hills Health Care System’s, Jo-Ann Ginsberg, Associate Director for Patient Care Services:

“I am delighted to acknowledge this group of individuals who have mastered the art and science of caring for our nation’s heroes with compassion – a celebration of VA’s Nursing workforce . . . I know of no other group of nurses more dedicated to providing cost-effective, safe and quality health care services as an ever more important component of the health care system, and a critical component of transforming VA BHHCS into a 21st century organization. Everyone enrolled in our health care system – nearly 19,000 Veterans – is touched by a nurse.”

—Jo-Ann Ginsberg, RN, MSN

Associate Director for Patient Care Services

VA Black Hills Health Care System

Jean Bailey, RN, received the April DAISY Award for Extraordinary Nurses at Rapid City Regional Hospital (RCRH) and Brittani Neely, RN, received it for March Bailey has worked in the NICU for 16 years and was nominated by a new mother who wrote, “I have no words to describe the feeling of getting to hold my son for the very first time and Jean is the angel that made it happen,” the mother said. “That moment was something I will always cherish… I cannot thank Jean enough, and I have no doubt that my son is in the very best care possible.” Neely has worked in the Progressive Care Unit for four years. Her nominator had high praise for her willingness to be accommodating. “I had the best night’s sleep because she was so considerate of my needing rest and making me comfortable,” the patient said. “You could tell just by the way Brittani presented herself that she truly cares about her patients and it is not just a job to her… Every patient should have a nurse like her. "■

Jean Bailey, RN

Gaster Named a ‘Champion’ by ACS The American Cancer Society has named Kris Gaster a 2013 winner of the “Champion in the Fight Against Cancer” Award. Gaster is the Assistant VP of Outpatient Cancer Clinics at the Avera Cancer Institute. She holds bachelor’s and master’s degrees in nursing, and is a clinical nurse specialist and certified nurse practitioner. Gaster has been involved in oncology care from early in her career as an oncology nurse, and progressed into leadership positions. In 1994, she was named program manager for the region’s first and only bone marrow transplant program at Avera McKennan, and continued in that role until being named to her current position in 2004. In this role, she is in charge of all outpatient cancer care. She has been on the ground floor of the planning and development of many aspects of the Avera Cancer Institute, including the new facility as well as tumor-specific programs, navigation, survivorship care, integrative medicine, and more. ■


Midwest Medical Edition

What Sequestration May Mean for Physicians By Dave Hewett, SDAHO


he Federal spending pro-

gram that was never supposed see the light of day is the law of the land. Sequestration, passed by Congress in November 2011, is now the operative policy for implementing approximately $1.3 trillion in federal spending cuts over the next nine years. And those cuts are having a real impact on physicians and other healthcare providers. First, there is the 2% across-the-board cut on Medicare reimbursement for all providers. That took effect on April 1. And for physicians involved with federally funded research projects, you know that current projects are all under review and new projects are virtually nonexistent. By most accounts, the worst part of Sequestration is the indiscriminate means by which it achieves the $1.3 trillion in cuts. And that is precisely why Republicans and Democrats alike never thought this law would be implemented. But the political reality of Washington has made the development of an alternative, heretofore referred to as The Grand Bargain, even less thinkable. Now there are some in Congress who believe a Grand Bargain is still achievable as the United States Federal government faces yet another deadline – expanding the federal debt ceiling. Others are hopeful that something can be done. But the overriding message that keeps resonating is that the Grand Bargain just isn’t going to happen anytime soon – certainly not this year. In its absence, we will see a series of patchwork small deals that address the most egregious shortcomings of Sequestration. We’ve already experienced the patchwork approach when air traffic controllers

were furloughed and thousands of f l ig ht s, including some that car r ied members of Congress, were delayed or cancelled. (That lasted about 2 days until both houses allowed the FAA to redirect those cuts to other areas.) community will likely be playing defense So what’s the next patchwork solution? Certainly there will be many groups that as we attempt to ensure the resources are promote their respective causes. One there to sustain the delivery of healthcare thing I’m reasonably sure of is that there in our communities. ■ will be relatively little success for healthcare providers in promoting theirs. I say that because the impact of those cuts are slow to develop and, in the case of research, tough for the public to visualize. The greater threat for healthcare providers in this environment is becoming the funding source for other priorities. So, until the political winds can align under the guise of a Dynamic Technical Building Systems Inc Grand Bargain, 106 N Indiana Ave • PO Box 787 • Sioux Falls, SD 57103 t he prov ide r p 605.335.4397 • f 605.335.4397

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June 2013


Grape Expectations

Local Physicians Create Wines Worth Slowing Down to Savor By Heather Taylor Boysen


e live in an era where speed is prized in most areas of our lives; get to work, finish that report, return calls, etc. Like most people, I probably check my email a dozen times a day to ensure I’m responding expediently. But, do we get so used to speed that we forget to embrace life’s simple pleasures? This question was posed to a small group of us attending a wine tasting for Handwritten Wines. Founded by local physicians, Dan Blue and Vance Thompson and their wives Becky Blue and Jana Thompson, Handwritten is the sister winery to Jessup Cellars, both based in Napa Valley. These are wines that represent, for their founders, personal connections, special moments, and human interaction... the kind suggested by the lost art of the handwritten letter. While the Handwritten Chardonnay was being poured, I tried to remember the last time I had written or received a letter that wasn’t typed or emailed. Perhaps a little sniff and swirl of the Chardonnay would refresh my memory. What struck me first was the wine’s beautiful golden color. Perhaps winemaker Rob Lloyd took some of his past experience with Rombauer and crafted this


bold and lively Chardonnay in the same style? Citrus notes and a bright acidity definitely balance the blatant richness of this wine. When I tasted the Handwritten Pinot Noir, I immediately wondered whether there was a Syrah blended in, a trick some winemakers use to darken color and intensify flavor. I was assured that this was 100% Pinot Noir, despite the gorgeous color and deep flavor. As with a great Pinot, there are beautiful leather and tobacco notes, but the richness of the wine goes beyond the cool austerity of an Old World French Pinot Noir and stops wonderfully short of overblown New World fruit. One might call it the best of both worlds. As we were enjoying the fresh flush of our first two wines, Three Words Red, a blend of Cabernet Sauvignon, Malbec and Cabernet Franc, was introduced. This wine spent 22 months in French Oak. Carefully–Tenderly – Crafted. Dr. Blue challenged us to use three words to tell the story of a moment in time. In the case of Three Words Red, my words are ‘Decant – Decant – Decant’. This wine was wonderful but I knew if I had the opportunity to let it decant for several hours, the flavors would open up and blossom. The two Napa Valley Cabernets were next. The Napa Cab from the Yountville Vineyard contains a 2.5 % Cabernet Franc, which serves to ‘season’ it the way a little salt can bring out the flavor in a great steak. With flavors of rich black fruit and hints of toast, the subtle acidity and firm structure gives a picture of what this wine might taste like in 4 to 5 years. The Stag’s Leap Cabernet is all about terroir. As Rob Lloyd

describes it, “It is the minerality that gives this wine its character and sense of place. Our winemaking philosophy shows a commitment to the unique terroir of California.” This 100% Cabernet is from the Stag’s Leap District, one of the most prestigious wine growing areas in all of California. It is elegant, complex and worthy of it lineage. Handwritten wines suggest that it may indeed be possible to slow time. Mr. Lloyd has created techniques that allow the fruit to be handled gently, slowly coaxing out the truest flavors. Perhaps lingering over an evening meal for just a little longer, unhurriedly tasting wine with friends, or pausing in the middle of the day to pen a handwritten letter can help us all to slowly coax more and truer flavors out of our own lives. ■

Midwest Medical Edition

June June 8 3:30 pm

Learning Opportunities

‘Take Steps for Crohn’s & Colitis’ Walk

Location: Falls Park, Sioux Falls Information: 651-917-2424,

June 11 – 12 9:00 am – 5:15 pm 9:00 am – 3:00 pm

Collaborative Research Center for American Indian Health: Annual Summit Location: Sanford Center, Dakota Room Information: 312-6232, Registration:

June 11 8:00 am – 4:00 pm

Transplant Education Day

June 12 12:00 pm – 4:45 pm

Critical Care Symposium

June 13 9:00 am – 4:00 pm

Avera Gerontological Conference

June 14 9:00 am – 3:00 pm

2013 Avera Pulmonary Symposium

Location: Sanford USD Medical Center, Schroeder Auditorium Information: 328-9290 Registration:

Location: Prairie Center, Sr. Colman Room Information: Registration: 322-8950,

Location: Holiday Inn City Centre Information: Registration: 322-4645,

Location: Prairie Center, Avera McKennan campus, lower level classroom Information: Registration: 322-8950,

June 28 – June 29 7:00 am – 5:00 pm 7:00 am – 12:30 pm

35th Annual Sanford Black Hills Pediatric Symposium Location: The Lodge at Deadwood Information: Registration:, keyword: BH pediatric Symposium

September 9 – 12 8:00 am – 4:00 pm

Sanford Perinatal Nurse Fellowship 2013

September 13 8:00 am – 4:00 pm

Diabetes Care Conference

Location: Sanford USD Medical Center Information:, 328-7140

Location: Sanford Center, Sioux Falls Information: Registration:

September 27 – 28 8:00 am – 4:30 pm 8:00 am – 12:30 pm

Avera Cancer Institute 14th Annual Oncology Symposium Location: Prairie Center Information: Registration: 322-8950,

Note: Many of these Learning Opportunities offer CME credits to providers. Check with the individual conference coordinators to determine if credits are offered.

MED reaches more than 5000 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

Wilson Asfora, MD

Bryan Wellman, MD

Troy Gust, MD

They’re no ordinary team. They’re your trusted partner. Surgeons at Sanford Neurosurgery and Spine Clinic are ready to partner with you and provide your patients with minimally invasive neurosurgery and spine care. Our highly skilled team of physicians is the largest in the area, dedicated to offering quick access to comprehensive services, including spine, brain and trauma care. We’re ready to support you and your patients. For referrals, call (605) 328-8660. Sanford Neurosurgery and Spine Clinic 1210 W. 18th St., Suite 104 Sioux Falls, SD, 57104

Choose expert care. Choose Sanford.

500-55235-0095 3/13

Charles Miller, MD

MED-Midwest Medical Edition-June 2013  
MED-Midwest Medical Edition-June 2013