med-midwest medical edition-july/august 2012

Eureka!

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

JulyA

ugust2012

Vol. 3 Issue 5

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Inspired By You.

Have you ever found yourself attempting to accomplish some task in your practice

and thinking, “There must be a better way to do this”? Have you

ever envisioned that ‘better way’ yourself,

but later forgot or dismissed the idea? Many doctors have.

But most medical tools and techniques

have come directly from doctors who were willing to do

whatever it took to turn their ideas into

reality. In this month’s cover

feature, find out exactly what it takes, and meet some local

doctors who have travelled the path to

medical innovation themselves.

The Path to Medical Innovation

ContentsJULY / AUGUST 2012

Midwest Medical Edition

RegulaR FeatuRes

2 | From Us to You

4 | News & Notes: News from around the region

New! We’re expanding our popular News & Notes section, covering late-breaking news from across our four-state coverage area. Let us know what is happening in your area and we will spread the word to your colleagues across the region.

7 | Meet a MED Advisor – James Young, DO

16 | The Nurses' Station

22 | Off Hours: Puttin' on the Stripes A local physician talks about his surprising pastime on the football field.

24 | Grape Expectations: Confessions of a Wine Glass Snob | By Heather Taylor Boysen

29 | Learning Opportunities: Upcoming Symposiums, Conferences, CME Courses

In thIs Issue 6 | Primary Care and Innovation | The SDAHO president explains

why this month’s dual MED topics of Primary Care and Medical Innovation share some important connections | By Dave Hewett

7 | Sanford Wins Largest Operational Grant in its History

12 | Avera Launches First-of-its-Kind Customized Website

14 | Communication to Female Patients: Not ‘One-Size-Fits-All’ | A marketing specialist offers some proven tips for better communication with your female patients | By Tana Tipton

15 | Local Joint Program Receives National Recognition

18 | The Fate of Primary Care – Part 2 | As South Dakota and the upper Midwest head toward a critical shortage of primary care doctors, can anything be done to stem the tide? In the second part of our two-part series, we get insight from primary care providers on why they chose their field and what might be done to encourage others to do the same

20 | Physician Compensation Study Reveals Ups and Downs

21 | Now is the Time to Estate Plan | By Alice Rokahr

25 | The Globally Harmonized System: What it Means for Your Office | By Terry Dell and John Gold

Cover Feature

page 8

eureka!

Midwest Medical Edition 2

CONTACT INfOrMATION

Steffanie Liston-Holtrop, VP Sales & Marketing

605-366-1479 [email protected]

Alex Strauss, Editor in Chief 605-759-3295 [email protected]

Fax 605-271-5486

MAILING ADDRESS PO Box 90646 Sioux falls, SD 57109

WEbSITE MidwestMedicalEdition.com

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2012 Advertising / Editorial Deadlines

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 informa-

tion, however Midwest Medical Edition, LLC cannot be held

responsible for consequences resulting from errors or omis-

sions. All material in this magazine is the property of MED

Magazine, LLC and cannot be reproduced without permis-

sion 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 [email protected].

Magazine feedback and advertising and marketing inquiries,

subscription requests and address changes can be sent to

[email protected].

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

PUBLISHEr MED Magazine, LLC Sioux Falls, South Dakota

VP SALES & MArkETING Steffanie Liston-Holtrop EDITOr IN CHIEf Alex Strauss DESIGN/ArT DIrECTION Corbo Design COVEr PHOTO & DESIGN Darrel Fickbohm PHOTOGrAPHEr Kristi Shanks WEB DESIGN 5j Design CONTrIBUTING EDITOr Darrel Fickbohm

CONTrIBUTING WrITErS Heather boysen Terry Dell John Gold Dave Hewett Alice Rokahr Tana Tipton

STAff WrITErS Liz boyd Caroline Chenault John Knies

from Us to YouStaying in Touch with MED

Write

to us!We accept

reader

submission

a letter from the editor

Alex Strauss

Steffanie Liston-Holtrop and son Jaxson

WHEN I WAS A KID, I remember spending whole

Saturdays in my room with tape, tools, plastic

wrap, small boxes and batteries, determined to

‘invent’ something. Needless to say, my efforts

didn’t pay off, despite my enthusiasm. The problem was that I

didn’t really NEED anything. And need, as we know, is the driving

spark behind true innovation.

These days, doctors often find themselves in need of a tool

or technique that could help them work more effectively, safer,

faster or more economically. few have the time, the means or

the know-how to turn that need into an actual product, but

those who do are changing the face of medicine and, some-

times, their own financial futures in the process. We hope

you’ll be inspired by the advice and encouragement we gath-

ered from local people who have either been through that

process themselves or guided others through it. To our surprise,

we discovered that South Dakota is actually a prime spot for

medical innovation.

Also in this issue, we want to bring your attention to our

expanding section exclusively for late-breaking healthcare and

practice news from around the region. MED is committed to

being your most timely, local and relevant medical news source.

News & Notes is the place to see who is building or moving, who

has been awarded or promoted, who has new equipment or is

offering a new technique…. Or to let your colleagues know of

similar news in your own practice life. If our large and diverse

medical community was a single building, News & Notes would

be the employee bulletin board. We invite you to use it that way.

finally, in the spirit of innovation, MED VP of Sales Steffanie

Liston Holtrop has an invention of her own to announce. She

and her husband Nate welcomed Jaxson Jon Holtrop, newest

member of the MED family, on June 13th. The designers and

their totally original creation are doing well.

May this summer be a time of inspiration in your own life and

work. Thanks for your continued support and readership of MED.

—Alex

“I look forward to meeting many of you in Chamberlain at the SDMGMA fall conference. In the meantime, please contact me if you want to be a part of MED’s September/October conference issue. Thanks to all of you who have wished us well with our new addition.” – Steff

PUBLISHEr MED Magazine, LLC Sioux Falls, South Dakota

VP SALES & MArkETING Steffanie Liston-Holtrop EDITOr IN CHIEf Alex Strauss DESIGN/ArT DIrECTION Corbo Design COVEr PHOTO & DESIGN Darrel Fickbohm PHOTOGrAPHEr Kristi Shanks WEB DESIGN 5j Design CONTrIBUTING EDITOr Darrel Fickbohm

CONTrIBUTING WrITErS Heather boysen Terry Dell John Gold Dave Hewett Alice Rokahr Tana Tipton

STAff WrITErS Liz boyd Caroline Chenault John Knies

One number accesses our pediatric surgical specialists, any problem, anytime.

Physicians’ Priority Line 1.888.592.7955

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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.

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Happenings around the region

AverAAvera Sacred Heart Hospital in

Yanktonbroke ground on its new Northern Lights expansion

project in June.Thethree-story,$17million+additionwillincludeanewkitchen,cafeteria,pharmacy,laboratory,physicianamenities,sleeplab,environmentalservicesspaceandmeetingareas.Locatedonthenorthwestcorneroftheexistinghospital,theprojectwasnamedforthemanywindowsthatwillletinnaturallight.

Avera Flandreau Hospital and Avera Medical Group Flandreau have broken ground on a $7.6 million construction and

remodeling project.Phase1includesanewclinic,anoutreachphysicianclinicandanewlaboratory.Nextwinter,Phase2constructionwillbeginonnewhospitaloutpatientareasandanewEmergencyDepartment.

Avera Medical Group Worthington has begun construction on a three-story, 60,000-square-foot facility to house family practice and

internal medicine, aswellasspecialtiesincludingsurgery,pediatrics,obstetricsandbehavioralhealth.Withthisnewbuildingwillcomenewserviceadditions,includinganoutpatientsurgerycenter,physicaltherapyandhomemedicalequipment.

Avera Medical Group has opened new primary care

locations in Sioux Falls, includingAveraMedicalGroupMcGreevyWestBensonRoad,AveraMedicalGroupMcGreevyPediatricsSouthat69thandMinnesota,andAveraMedicalGroupMcGreevyDawleyFarminfrontoftheEastsideTargetat1035S.HighlinePlace.

Avera Heart Hospital in Sioux Falls and Avera Sacred Heart Hospital in Yankton have received the 2012 HealthGrades

OutstandingPatientExperienceAward™.Thisdistinctionranksthesetwohospitalsamongthetop5%ofhospitalsnationwidebasedonananalysisofpatientsatisfactiondatafor3,837U.S.hospitalsbyHealthGrades.AccordingtoHealthGrades,80%ofpatientstreatedatthenation’sbest-performinghospitalswoulddefinitelyrecommendthehospitalcomparedtoonly53%ofpatientswhoreceivedcarefromthepoorest-performinghospitals.

regionAlRegional Health Clinical Research is participating in a clinical research study, Type

I Diabetes TrialNet,andwasrecentlyawardedaCertificateofAppreciationbyTrialNetandUniversityofMinnesota.LedandfundedbytheNationalInstitutesofHealth(NIH),TrialNetisaninternationalnetworkofresearchersexploringwaystopreventanddelaytheprogressionoftype1diabetes.Thestudyaimstohelpresearchersbetterpredictwhowilldevelopdiabetesandwhenitwillrequiretreatment.

Custer Regional Hospital (CRH) has closed its Edgemont Clinic

after 20 years in operation. TwoofthethreemedicalproviderswilljoinLisaBrown,M.D.,andBruceEaton,M.D.,atthenearbyHotSpringsRegionalMedicalClinic.PatientscanalsoobtaintheirhealthcareservicesattheHillCityClinicorCusterClinic.

Regional Health Laboratories has opened a new outpatient location in the Western Hills Professional building on

Fifth Street in Rapid City.Thenewlocationoffersoutpatientblooddraws,freeparkingandcompetitivepricing.Noappointmentisnecessaryandallinsurancetypesarewelcome.

SAnfordSanford USD Medical Center President Charles O’brien has been listed among the 100

Physician Leaders of hospitals

and Health SystemsbyBecker’sHospitalReview.Physicianleaderswereselectedforinclusiononthislistbasedontheirhealthcareexperience,awardsthey’vereceivedandtheircommitmenttoqualitycare.

SiouxlAndMercy Medical Center has been resurveyed by the Iowa Medical Society (IMS) Accreditation Council for Continuing Medical Education (ACCME) and awarded the

CME status for four years.Mercy’smedicalstaffhasoneofthelongestaccreditedprogramsinIowaandistheonlyaccreditedproviderofCMEactivitiesforphysiciansinNorthwestIowa.Theprogramhasbeenaccreditedcontinuouslysince1981.

The President and CEO or Trinity Health, parent company of Mercy Medical Center has been installed

as Chairperson of the Catholic Health Association (CHA) board of trustees for fiscal year

2012-13.Joseph R. SwedishwasfirstelectedtotheCHAboardoftrusteesin2006andwaselectedtohiscurrentrolelastyear,servingasVice-Chair/Chair-ElectduringCHA’sfiscalyear2011-12.

News&NotesSouth Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

Brian Lassiter, President of the Performance Excellence Network, presents the Network’s Advancement Award to Avera Sacred Heart President Pamela J. rezac and Doug Ekeren, VP of Planning and Development.

July / August 2012 5MidwestMedicalEdition.com

Sue Froid, a 26-year veteran of Mercy Medical Center, has been promoted to Director of

Emergency/Mercy Air Care/

Ambulatory Services.FroidholdsadualMastersdegreeinNursingandHealthCareAdministrationandhasbeeninstrumentalinfacilitatingmanyspecialprojectsacrosstheorganization.

Siouxland patients have a new tool in the fight against

breast cancer. TwonewdigitalmammographymachineshavebeeninstalledinSt.Luke’sImagingandBreastScreeningCenterlocatedinPhysicianCenterTwoontheSt.Luke’scampus.PurchasedthroughagrantfromTheLeonaM.andHarryB.HelmsleyCharitableTrust,St.Luke’snewequipmentisupgradeabletoadvancedimagingapplications,vitalforthepreventionandearlydetectionofbreastcancer.

St. Luke’s Hospital has broken ground on its new Sunnybrook Medical Plaza for patients in the

Morningside area.Inanticipationof30%growthinoutpatientservicesoverthenexttenyears,the86,000squarefoot,two-storybuildingwilloffervariousoutpatientservicesincludinganewprimarycareclinicwithobstetrics,urgentcareclinic,cardiology,digestivehealth,lab,imaging,infusion,maternal-fetalmedicineandpulmonarycare.Someofthefacility’sspacewillbereservedforfuturedevelopment.St.Luke’splanstoopenthenewfacilityinthesummerof2013.

YAnktonDr. Karen E. Dickes of Willcockson Eye Associates, P.C.in Yankton was recently recognized as a

finalist for the Patrick G. Murray,Doctor of Osteopathy (DO) Award At the 2012 American Osteopathic Association (AOA)

meeting. ShewasawardedsecondplaceforthesecondyearinarowforherscoreontheOphthalmicKnowledgeAssessmentProgram(OKAP)exam.Dr.DickesjoinedtheWillcocksonEyeAssociates,P.C.practiceinAugust2011andseespatientsinboththeYankton,SDandNorfolk,NEofficelocations.

Yankton Medical Clinic, PC, has received the South Dakota State Medical Association Media Award for its direct-mail publication, The Healthcare

Examiner. TheawardwaspresentedtoYanktonMedicalClinic’sDirectorofMarketing,JoannaL.Mueller,andDr.JamesW.Young,atthe2012SouthDakotaStateMedicalAssociationBanquetinJune.ThequarterlyExaminerfeatureshealth-relatedarticlesfrombyphysiciansoftheYanktonMedicalClinic,P.C.andVermillionMedicalClinicandincludesacomprehensivephotodirectoryofalloftheprimaryandspecialtycareprovidersatbothclinics.

otherMelinda Heegel, MS, CCC-A, Kristen Kaufman, Au.D., CCC-A and Lindsey Koch, Au.D., CCC-A have opened a news clinic, Audiology Specialty Clinic located at 5124 S. Western

Avenue in Sioux Falls.Thegroupoffershearingservicesincludinghearingevaluations,hearingaidsales,cochlearimplantmappingandcustomearmolds.Allarecertifiedaudiologistsspecializinginhearinghealthcarefromchildrentoadults.Appointmentscanbescheduledbycalling605-275-5545.

Children’s Care Hospital and School in Sioux Falls recently received a $100,000 donation from the Children’s Care Auxiliary. Theauxiliaryraisedthefundsthroughthreefundraisingeventsinthepastninemonthsandwillusethefundstoprovideitemsfromawishlistcreatedbystaff.Thisyear’swishlistitemsincludeIpadsforclassrooms,anupgradetothesensoryroomforchildrenwithautismandothersensorychallenges,scholarshipsforhorsetherapyandaquatics,ablanketwarmerforchildrenunabletomaintainbodytemperature,therapybikes,andcommunityoutings.

A new television ad campaign made possible by a grant from the Leona M. and Harry b Helmsley Charitable Trust in partnership with the American Heart Association is encouraging people not to ignore the signs of

a heart attack.TheTellyaward-winningadsweredesignedbyEpicMultimediainSiouxFallsandfeatureEMT’sfromacrossSouthDakotarecountingexcusestheyhaveheardfornotcalling911attheonsetofheartattacksymptoms.

Surgical Institute of South

Dakota recently moved itspracticefromthe8thfloortothe7thfloorofthePhysicianOfficeBuildingontheAveraMcKennancampus.Thenewclinicspaceisaccommodatingthegrowthofthepracticebyproviding40%moresquarefootageforadditionalexamandprocedurerooms,nursingandreceptionareas,andadministrativeareas.

Cardiovascular surgeon Dr. Lewis Oftein is retiring from North Central Heart Institute

after32years.Dr.OfsteinreceivedhismedicaleducationattheUniversityofIowaanddidhissurgicaltrainingatIndianaUniversity.HeandsixfellowphysiciansfoundedNorthCentralHeartInstitutein1981.HewasinstrumentalinfoundingtheAveraHeartHospitalwhichopenedin2001andservedasChiefofSurgerythere.

Mary Dekker Nettleman,

MD, MS, MACP,beganhertermasDeanoftheSanfordSchoolof

MedicineandUSD’sVPforHealthAffairsinApril.Dr.Nettleman,agraduateofVanderbiltMedicalSchool,completedaresidencyininternalmedicineandafellowshipininfectiousdiseasesatIndianaUniversity.SheearnedherMAinpreventivemedicine/epidemiologyfromtheUniversityofIowa.Dr.Nettlemanbecomesthe14thdeanofthemedicalschool,succeedingDr.RodneyR.Parry.


MED MAGAzINE'S Mid-west’s dual themes thismonth of physicians asinnovatorsandthefateof

primary care are notmutually exclusive.Farfromit.Infactwiththecloserconsid-erationofaccountablecareorganizations,medicalhomes,healthhomes,valuebasedpurchasingandotherconceptsinthiseraof “reform” innovation and the future ofprimarycareareinexorablylinked.

Thelinkisforgedbythegeneralconceptsthatourhealthcaredeliverysystemshouldbefocusedonkeepingpeoplewellinsteadofjusttreatingthemwhentheyareillandproviding service based on value, notvolume.Thetouchstoneforturningthosetheoriesintorealityisprimarycare.Butaswearelearningthroughtheexperiencesofpilotprojectsandprovidergroupsthathave

launchedheadlongintothesemodels,theycanfailaseasilyastheycansucceedifthemanyaspectsofthenewdeliverymodelsarenotalignedandmanaged.

So what are the components of these new models of care that need to be in sync? Here are a few examples:

✔ Primary care must be centered on the

patient and the family.

✔ Systems of care should be closely

partnered with public health and other

organizations focused on wellness.

✔ Physicians and other health care providers

must retool their understanding of

team-based health care.

✔ Comprehensive clinical data systems that

allow the primary care provider team to

closely monitor the status of their

patients on a real time basis.

✔ reimbursement systems that truly reward

the provider community based on value

and for keeping patients well.

✔ A greater focus on behavioral health needs

of clients and patients as well as enhanced

wellness coaching, screening and

preventive services.

✔ Methods and programs to have the

patient and the patient’s family take it

upon themselves to be committed and

compliant to a wellness plan in a world

where temptations to eat the wrong

things, multitask from the couch, text

from the car, tan indoors, etc., abound.

Allof thesearemajorchallengesforwhichinnovationsinprimarycarehavenotprovidedall theanswersyet.Bywayofexample, think about reimbursementsystems.Byandlarge,theycontinuetobebasedonfee-forservicemodelsthatrewardvolumeinsteadofvalue.Theyrewardpro-vidersfordoingmorewhenpeoplearesick.Ofcoursetherearepermutationsthatseektolimitutilization,butingeneraluntilpro-viderscanshareintherewardsforkeepingpeoplewellacrossthepayerspectrum,thesemedical home models will be just that–models.

Primarycareisripeforinnovation.Inno-vationwillbecentraltotransformingthecurrentlyunsustainablehealthcaredeliverysystem.Physicianshavealwaystakenthelead in transformingclinicalcare in thiscountry–thattransformationcontinuesitwillbethephysiciancommunitythatulti-matelydetermineswhetherthisforayintokeepingpeoplewellsucceedsorfails.■Dave Hewett is President/CEO of the

South Dakota Association of Healthcare

Organizations.

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Primary Care &

InnovatIon by Dave Hewett


A talk with MED Advisor

James Young, DO

Q: As a dermatologist, you are a passionate proponent of sunscreen. Why is it so important?

A: Everyone who is alive has a 1 in 55 chance of getting melanoma. It is increasing at a faster rate than any other cancer and unprotected sun exposure is a big part of the reason. One of the strongest risk factors for melanoma is a blistering sunburn before age 20. But sunburn at any age raises your risk.

Q: Picking a sunscreen used to be easy, but there are so many options now. How do you decide what to use or recommend?

A: The old adage goes ‘The best sunscreen is the one you’ll use’. And no sunscreen is going to do any good if you don’t use enough of it. Most people use way too little. You need about a shot glass full to ade-quately protect your face, hands, arms and neck. Also, people should avoid rubbing their hands together before applying because so much of it will stay on your hands. People come in all the time with sunburn and tell me they were wearing sunscreen.

Q: Are there certain ingredients we need to be looking for when selecting a sunscreen?

A: You want to get a ‘broad spectrum’ product, one that protects against both UVA and UVB rays. If a patient is on a medication that makes skin more sensitive to sunlight, it’s the UVA rays they need to be worried about. Same with lupus, for which sun exposure is one of the diagnostic criteria.

Q: You say you try to lead by example. What sunscreen do you use?

A: I have oily skin, so I am glad to have found Coppertone Sport 50 for faces, which is much less greasy than some other products. fortunately, there is a sunscreen to work with just about every skin type now. If you’ll use it regularly, then it’s the right one for you.

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Contact your independent agent or broker or check out

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Be protected, stay cool.

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THE FEDERAL GOvERNMENT HAS AWARDED SANFORD HEALTH A $12 MILLION Health Care Innovation grant – the largest operational grant in the organiza-

tion’s history. The grant was awarded as part of a nationwide program that stemmed

from the Health Care reform Act. These Centers for Medicare/Medicaid grants are given

to applicants who show the ability to quickly implement the most compelling new ideas

to deliver better health, improved care and lower costs to Medicare and Medicaid patients

and those with the greatest healthcare needs. Sanford will use the grant to expand its

Medical Home program in South Dakota, North Dakota, and Minnesota. This grant will:

● Expand the Medical Home program

● full integrating behavioral health services into primary care

● Increase the number of nurse health coaches available for patients

● Maximize IT, a major support system within our organization

● Standardize quality reports

According to Sanford, the grant will allow the system to “develop a more holistic

approach to primary care”. The hope is that, through better management of patients with

chronic conditions, the number of emergency room visits can also be decreased, improving

care and reducing costs. The $12 million CMS grant is one of the largest that CMS awarded

under the new program.■

GRANT WILL bOOST

Local Primary Care

by Alex Strauss

Have you ever had an idea you were sure could improve how you practice medicine if only you had the time, money, patience and know-how to take it to the next level? Although it can seem like a daunting task, many of the most

innovative medical tools and procedures began as the brainchildren of physicians with unmet needs and ‘outside the box’ attitudes.

Sioux falls vascular surgeon Pat kelly, MD, is a prime example. for Dr. kelly, medicine is a second career. “I was a structural engineer for four years before deciding to go to medical school. I have always been a person who likes to solve problems,” he says.

As a vascular surgeon, one of the biggest problems he noticed was the highly invasive nature of abdominal debranching for treatment of thora-coabdominal aneurysms. Although thoracoabdominal aneurysms occur most often in the elderly, many of these patients have comorbidities that make them poor candidates for major surgery. Dr. kelly’s practice performs only about seven of these procedures annually but he believed those numbers could be higher if the procedure could be made more tolerable for fragile patients.

eureka!. . . . . . . . . . . . . . . The Path to Medical innovation


“Abdominaldebranchingisthebiggestoperation we do,” says Kelly. “It ofteninvolvessignificantbloodloss,significantORtime.Manypatientswhocouldbenefitfromtheprocedureneverevengetreferredbecausetheycouldnothandleit.Ithoughtforalongtimethattherehastobeabetterfixforthis.”

Oneoptionisfenestratedstentgrafting,whichrequiresacustom-madegrafttofiteach patient’s anatomy. Fewpatients arecandidatesandfewcentersofferthechal-lenging procedure. But when Dr. Kellymentionedtheneedforabetterfenestratedstentgrafttosomedevicemanufacturerreps,theywerelessthanencouraging.Drawingonhisengineeringbackground,hedecidedtofindhisownsolution.IntheSanfordlab,Dr.Kellymodified and reconstrained anexistingfenestratedstent,makingituseableinafarwiderrangeofpatients.

“Thisnewstentgraftallowsustogetthesamejobdonewithalmostinfiniteanatomy,”explainsDr.Kelly.“Patientscanhaveonekidneyhigherthantheotherorjustaboutanyscenario.Thisstentcanbetakenofftheshelfandusedbyjustaboutanypatient.Andwecandothewholeprocedurewithjustthreesmallincisions.”

Theresultsinpatientsinwhomthestenthasbeentested,withtheirinformedconsent,have been dramatic. Thoracoabdominalaneurysmpatientswhomighthavebeenhos-pitalizedformonthsgohomewithindaysinstead.Dr.Kellyishopingthatthestentmodificationwillbesignificantenoughtomakethenewdevicepatentableandisbegin-ningtheprocessofshoppingitaroundtomedicaldevicemanufacturers.

Patents and Intellectual Property“Beforeyougotoofardownthepath,itisimportant to know what your rights areregardingintellectualproperty,”saysMikeJerstad,JD,MBA,ofPrairieGoldVentureCapital in Sioux Falls. “If you work in ahospitalsystemoreveninaprivateclinic,chances are there is something in youragreementthatdiscussesintellectualprop-erty.Wouldtheinventorgetroyaltiesontheinvention or own it outright? Does theagreementspecifywhoownsthepatent?Orisitsilentontheissue?”

Manysystemsencouragephysicianstoinventbysupportingtheireffortswiththeappropriateinfrastructureandofferingthemashareoftheprofitsfromanewproduct.Oncetherelationshipisunderstood,thenextstepisdeterminingpatentability.

“You can’t invent something that hasalreadybeeninventedorisobvious,”saysJerstad.“Apatentlawyerwilldoathoroughsearchtoseewhatisoutthereandcanadvisewhetherornottheideaispatentable.Ifitis,theycanstarttheprocessofwritingapatent.”Atthispoint,Jerstadadvises,themoredetail,intheformofdrawings,schematics,photos,models, etc. that can be provided to thelawyer,thelesstime-consumingandexpen-sive the patent-writing process will be.Duringtheprocess,itisbestnottopublishorevenmentiontheidea,notonlyforfearofimitators,butbecauseanideathatbecomes“publicdomain”isindangerofbecomingunpatentable.

vascular surgeon Pat Kelly’s modified

stent graft allows for repair of thoracoab-

dominal aneurysm through just three

small incisions, making the operation

feasible for even fragile patients.

“if you work in a hospital system or even in a private clinic, chances are there is something in your

agreement that discusses intellectual property.”

sioux Falls neurosurgeon wilson asfora

invented the asfora Bullet cage spinal

fusion device, the dakota Knife for carpal

tunnel release, holds 18 patents, and

owns his own medical device company.

“once you realize that you really need

something, chances are others need it,

too, and you should pursue it,” he says.


Toprotectanideaduringtheinitialdevelopment phase, a patent

lawyermay file a provi-sional patent, whicheffectively places a“hold” on the con-cept for a year.Eventually,adesignpatent may beissuedforaproductthat represents amodification to an

existingproduct,whilethemorevaluableutility

patent is more common foruniquenewinventions.

Butthepatentprocessisnotforthefaintofheart.Thosewhohavebeenthroughitcautionthatitcantakeyears,duringwhichlegalfeescancontinuetorackupeachtimethepatentlawyermustrespondtothePTO’srejection (calledan“OfficeAction”)ofaclaim.Forthisreason,itpaystoconsideranidea’smarketabilityearlyintheprocess.

Business ConsiderationsOnce the intellectualpropertyrights toanideahavebeenestablishedanditisproperlyprotected–or,insomecases,evenbefore–an inventor should consider the businessaspectsofthepotentialproduct.

“Doestheinventionaddressarealpointofpaininthesystem,and,ifso,whosepain?”suggestsJerstad.“Is it thedoctors’pain?Patients’?Hospitals’?Payors’?Thegovern-ment?Isyourdeviceagame-changer,oristhechangeitmakesincremental?Thesemayseemlikeobviousquestionsbuttheywillguideyouinknowingwhetherthisisthekindofthingonewouldlicensetoanothercom-pany,orbuildacompanyaround.”

SiouxFallsNeurosurgeonWilsonAsfora,MD,tookthelatterrouteafterinventingtheAsforaBulletCage,alumbarspinalfusionsystemthatreceivedFDAapprovalin2009.Buoyedbythesuccessofthebulletcage,Dr.Asforawentontodevelopacarpaltunnel

releasesystemknownastheDakotaKnife,aswellasanothervertebralfusiondevice.Inall,Dr.Asforaholds18medicaldevicepat-ents,manyofwhicharemarketedthroughhis company,Medical Designs, LLC, inSiouxFalls.

“Needisthemotherofinvention,”saysAsfora.“Whenyouareasurgeon,youneedcertain things.Onceyourealize thatyoureallyneedsomething,chancesareothersneedit,too,andyoushouldpursueit.”Butheisquicktoaddthiswarning:“Ifyouhavesomethingthatyouthinkisreallygood,don’tgiveyourideaaway.Don’tgotoabigcom-panyandshowittothem,becausetheywilltakeit.”Instead,headvisesphysicianinven-torswho are ready to shop their productaroundtohireaprofessionalwithexperienceinnegotiatinglicensingagreementsorsalestomedicaldevicecompanies.

“Thesedays,oneofthemostimportantquestionsfornewmedicalproductsishowis it going to reduce the overall cost ofhealthcare,”saysJerstad.“Is theproductgoingtoallowforalessinvasiveprocedureorreducehospitalstays?Thesearekeycon-siderations.”Jerstadsaysitisalsoimportanttounderstandthereimbursementrequire-mentsforthenewproduct,informationthatcanbeavitalsellingpointintoday’shealth-careenvironment.

The FDA and PrototypingUnlike other types of inventions, medicaldevicesmustpassmusternotonlywiththePTO,butalsowiththeFDA.Medicalprod-uctsthataresimilarenoughtoexistingprod-uctsmaynothavetostartatgroundzero,but may instead be able to travel themoretruncated510Kpathtoapproval.Becausetheburdenoftestingislower,thislessstringentpathhasthepoten-tialtobringnewproductstomarketfaster than the more extensive PreMarketApproval(PMA)path.

Testingisthenextstep.Fortu-natelyforlocalwould-beinventors,

theupperMidwestisanidealplaceformedi-calinnovation.“Minneapolisisarealhubforprototyping,”saysJerstad.“Aninventorcangetthisdoneforareasonableprice.Youcan get your device prototyped withouthavingtospendgobsofmoney.”Fundingforprototypingmaycomefromthephysician/inventor,theinstitutionforwhomheorsheworks, angel investors or even personalfriends.

“Ifthingsstartrollingandseemtobegettinggoing,thatwouldbethetimetoseekventurefinancing,”advisesJerstad,whosefirm specializes in obtaining suchfinancing.

“Thefurtheryouaredowntheline,themorevaluableyourinventionis,”saysDr.Asfora.“Ifyouhaveamanufacturer,haveFDAapproval,andhavedoctorsusingit,thevalueismuchhigherforacompany.Youshouldnotsellitforpeanuts.”

“Mymessagetootherdoctorswhohaveideasisnottopoopooyouridea,”saysDr.Kelly,whorecentlypresentedhismodifiedstentatameetingoftheSocietyforVascularSurgery.“Evenifit isn’t‘the’idea,itmayleadtoanotherone.Eventually,someofourideascanbecomephenomenalandcanreallychangethecourseofhealthcareforpatients.”

“Thereisasolutiontoeveryproblem,”heobserves.“Wejusthavetothinkofit.”■

“eventually, some of our ideas

can become phenomenal and can really change

the course of healthcare for

patients.”


Source: U.S. Bureau of Labor Statistics, Percent change from previous December

4.2

4.9

4.5

4.1

5.9

3.0

3.4 3.4 3.6

3.5

1.9

3.3 3.4

2.5

4.1

0.1

2.7

1.5

3.0 2.7

2003 2004 2005 2006 2007 2008 2009 2010 2011 Mar-12

Inflation: CPI-U vs. Medical Care Services Medical Care Services CPI-U

THE AVERA bREAST CENTER AT THE AVERA CANCER INSTITUTEhaslauncheda new online guide to breast cancer created byVladimir Lange,MD, an expert onhelpingpatientsandtheirfamiliescopewithadiagnosisofbreastcancer.

Avera’sBeaSurvivorwebsite iscustomizedwithover80shortoriginalvideosfeaturingAvera’sownphysiciansandstaff,describingthedifferent typesofbreastcancer,diagnostictestsandprocedures,andtreatmentoptionsandrisks.Localpatientsalsodescribetheirexperienceswithemotionandhonesty.AllthevideowasshotintheAveraCancerInstitute,locatedinthePrairieCenterontheAveraMcKennancampus.Three-Dgraphicsaredesignedtohelpeducatepatientsonallaspectsoftheirbreastcancerdiagnosisandtreatmentoptions.

Thesite,www.Avera.org/BeASurvivor,isthefirstwebresourceofitskindthatiscustomizedwithvideofromlocalphysiciansandpatients,Dr.Langewhoisalsoauthoroftheaward-winningbook,“BeaSurvivor–YourGuidetoBreastCancerTreatment.”.WhenLange’swife,whoisalsoaphysician,wasdiagnosedwithbreastcancer,bothwereoverwhelmedbythecomplexityoftheinformationtheyhadtoprocess.Dr.Langesays,“Iftwophysiciansareconfused,howisalaypersonexpectedtounderstand?”

Avera Launches first-of-its-kind Customized Website

2501 W. 26th St., Sioux Falls, SD 57105 • 1020 West 18th St., Sioux Falls, SD 57104 • 7110 Jordan Drive, Rapid City, SD 57702 www.cchs.org

Incontinence Treatment for ChildrenSioux Falls & Rapid City

Many children suffer from various problems associated with bowel and bladder control. Children’s Care offers effective relief, fast and inexpensively, through outpatient physical therapy.

Our easy and effective treatment program combines behavioral and physical therapies, aided by state-of-the-art, kid-friendly biofeedback, and muscle management techniques. Therapy is typically weekly, lasting eight to twelve sessions.

Children’s Care can treat children over the age of four who have retentive and non-retentive difficulties, including:

• Urinary incontinence • Fecal Incontinence • Dysfunctional voiding (including stool hoarders) • Constipation • Nighttime bed wetting• Regression wetting • Children never toilet trained

Covered by most insurance.

Christine Stephenson, PT, DPTRapid City

Robin Lund, PT, DPTSioux Falls

For more details, an appointment, or private consultation, call (605)782-2400 in Sioux Falls,

or (605)342-4412 in Rapid City.

Avera.org/beASurvivor

SITE AIMS TO WALk BrEAST CANCEr PATIENTS THrOUGH THE MAzE Of OPTIONS

The website is designed to help patients and their families:

k Assemble the best team of experts

to ensure successful treatment

k Decide between surgical options

k Understand how genomic

testing can determine whether

chemotherapy is needed

k Deal with side effects

of chemotherapy

k Learn about new treatments, such

as IOerT and Oncoplastic Surgery

k Consider appropriate

complementary therapies

k Communicate effectively

Beingwebbasedmakesthisresourceavailabletoallwomenthroughouttheregionandbeyond,whichisespeciallyimportanttopatientsandtheirsupportpersonswholiveinrurallocations.■


SANFORD HEALTH HAS bEGUN CONSTRUCTIONonthe multi-use sports facilitywhichwillbetheepicenterofanew sports complex in north-westSiouxFalls.ThePentagonby Sanford Health is a160,000-square-foot facilitythat includes nine basketballcourts(sixhighschoolregula-tion, two professional/collegepractice courts and the “heri-tage” court).While the entirefacilityfeaturesmoderndesignand amenities, the heritagecourt located in the center ofthe building is a premiumNBA/college size court withdesign inspiration reminiscentof1950’s/1960’sbasketball.

“SanfordHealth’smissionis dedicated to the work ofhealthandhealing,”saysNate

White,SanfordHealth’schiefoperatingofficerfortheSiouxFalls division. “While it isalwaysourgoal toheal thosewhoneedourcarewhentheyareill,itisalsoourmissiontokeep people healthy. Thatincludesgivingthemopportu-nities and resources to stayhealthy.”

The facility, as thenamedescribes, is the shape of apentagon.Floorspacecanbetransitionedfrombasketballtoaccommodate 11 volleyballcourtsaswellaswrestlingandcheer/danceevents.Thefacil-ityisfocusedonathletics,butwillalsoserveothercommu-nityneeds.

The Pentagonwill be theepicenter of the 162 acresSanfordSportsComplexwhich

ConstructionUNDErWAYon New Sports Complex

willbethehomeforSiouxFallsJunior Football league, SiouxFallsTennis,SiouxFallsICEaswellasDakotaAllianceSoccerClubwhichwilloperatefromtheSanfordFieldhouse.AnnouncedNovember2011,theFieldhouse

willprovideaccess toathleticperformance development,comprehensive functional,physiologicalandbiomechanicalevaluations,aswellasrehabilita-tionandnutritionalconsultationservices.■


by Tana Tipton

FOLLOW THESE TIPS TO SPEAk TO WOMEN✔USE LANGUAGE THAT APPEALS

TO BOOMERS. There are millions of baby boomer women (born 1946-1964) and 85 percent of them dislike the way they’re portrayed in the media. Ditch words like “elderly,” “old” or “senior” in your marketing and use “experienced,” “wise,” “mature,” “seasoned” or “enduring.”

✔ LOOk BEYOND THE ExPERTS TO cATER TO NEW MOMS. Women prefer to turn to other women like them, rather than authorities, for information they trust. New moms and those considering pregnancy are no different. feature real patient stories in your advertising in addition to physician education.

✔ DON’T FOcUS ON YOUR BRAND DIREcTLY. Instead, focus on the sense of fulfillment that comes from women’s most important values like love, health and security.

✔BE REALISTIc. Women don’t appreciate unrealistic age portrayals or body types for their age group. To gain women’s trust and advocacy, an accurate portrayal of women is a must. ■

Tana Tipton is a marketing specialist at Cassling, a Midwest healthcare company that provides

local imaging equipment sales and service, and marketing and professional services.

WOMEN TODAY MANAGE MORE ROLES THAN EVER bEFORE: spouse,parent,caregiver,breadwinnerandherfamily’schiefhealth-caredecisionmaker.Infact,90percentofAmericanadultwomenareresponsible for their household’s health-care decisions.Women also

areresponsibleinanotherrole–patient–andarethehighestconsumersofhealth-careservices,especiallyinpatientservices,accordingtotheU.S.DepartmentofLabor.

Inadditiontobeingyourorganization’scorecustomer,womenareyourtoughestcritics.AccordingtoastudypublishedinthejournalHealthServicesResearch,womentendtobelesspositiveabouttheirhospitalexperiencescomparedtomen.Researchersstudied results fromalmost twomillionHCAHPSpatientexperiencesurveys,anddiscoveredthatwomenwerelesssatisfiedoverallandratedtheirHCAHPSscoreslowerthanmen.

SinceCMSreimbursementisnowtiedtoHCAHPSscores,andwomenaremorelikelythanmentosharetheirhealth-careexperienceswithfamilyandfriendsviablog,Facebookorothersocialnetwork,it’scrucialyouknowhowtocommunicatewithwomenandcatertotheirhealth-careneeds.

not

one-SIze-FItS all

cOMMUNIcATION to Female Patients

South Dakota Medical Group Management Association Fall Conference

For the full schedule or to register, visit our website at www.sdmgma.org

August 22-24, 2012

surviving

Cedar Shore Resort Chamberlain, SD

in the ChangingHealthcare

Environment


CanCer Study SeekIng CanCer-Free PartICIPantSTHE AMERICAN CANCER SOCIETY’S EPIDEMIOLOGY Research Program is inviting men and women between 30and65yearswhohaveneverpersonallybeendiagnosedwithcancertojointheCancerPreventionStudy-3.

CPS-3isanationalgrassrootseffortthatallowslocalcom-munities to support cancer research not just throughfundraising,butalsobyparticipatingactivelyinthishistoricresearchstudy.Thegoal is toenrollat least300,000adultsfrom various racial/ethnic backgrounds from across theU.S. inorder tobetterunderstand the lifestyle,behavioral,environmentalandgeneticfactorsthatcauseorpreventcancerandtoultimatelyeliminatecancerasamajorhealthproblemforthisandfuturegenerations.

EnrollmentisavailablelocallyinpartnershipwithAveraMcKennan,SanfordHealth,theCityofSiouxFalls,CitibankandPremierBankcard.EnrollmentappointmentsarebeingofferedduringAugust.■To learn more or to schedule an enrollment appointment, go to:

www.cps3siouxfalls.org.

Geoffrey Tufty, MDPediatric OphthalmologySanford Eye Center and Optical

Sanford Children’s team is a family of pediatric specialists who offer additional expertise to physicians in need of compassionate,

partnered care for their patients with eye conditions.

Dr. Geoffrey Tufty is the only fellowship-trained pediatric ophthalmologist in the region. He specializes in the diagnosis, treatment and management of diseases and infections of the young and developing eye.

For referral information or to refer a family, call (605) 328-9200.

sanfordhealth.org

Loyal partner

500-55210-0046 5/12

Joint Program receives National recognition SANFORD USD MEDICAL CENTER IN SIOUx FALLS hasearnedTheJointCommission’sGoldSealofApprovalfor itshipfractureprogramaswellasitskneereplacement,hipreplace-ment,andshoulderreplacementprograms.Sanfordistheonlyhealthsysteminthenationtoreceiveallfourcertifications.

“AchievingJointCommissioncertificationinhipfracture,hipreplacement, knee replacement and shoulder replacement isextremelychallenging,”saysCharlesP.O’Brien,MD,president,SanfordUSDMedicalCenter.“Thecertificationsservetovalidateourcommitmenttoongoingqualityandourfocusoncontinuingtoraisethebar.”

Aspartofthevoluntaryprocess,SanfordHealthrecentlyunderwentrigorouson-sitesurveysforeachofthesefourprograms.AteamofJCAHOsurveyorsevaluatedSanfordforcompliancewithstandardsofcarespecifictotheneedsofpatients,includinginfection prevention and control, leadership andmedicationmanagement.

“Thisisnotjustaone-timeevent,butratherhowweprovidecare to our orthopedic patients on a day-to-day basis,” saysO’Brien.■

MEDQuotes

To array a man's will against his sickness is the

supreme art of medicine. ~Henry Ward Beecher


Nursing News from Around the region

The Nurses’ Station

avera SaCred Heart HoSPItal named aS aCtIon CoalItIonAVERA SACRED HEART HOSPITALandAveraEducationandStaffingSolutionshavebeenselectedasanActionCoalitionbytheFutureofNursing:CampaignforAction,coor-dinated through theCenter toChampionNursing inAmerica (CCNA), an initiative ofAARP,theAARPFoundationandtheRobertWoodJohnsonFoundation(RWJF).AveraEducationandStaffingSolutionsisworkingwiththecampaigntoimplementtherecom-mendationsofthelandmarkInstituteofMedicine(IOM)report,TheFutureofNursing:LeadingChange,AdvancingHealth.FormoreinformationabouttheCampaignforActiongotowww.thefutureofnursing.org.■

POPPE REcEIvES 10TH ANNUAL LORI ScHREMPP MEMORIAL NURSING ScHOLARSHIP MOUNT MArTY

COLLEGE NUrSING STUDENT AND AVON NATIVE MEGAN

POPPE,hasreceivedthe10thAnnualLoriSchremppMemorialNursingStudentScholarship.TheawardisinmemoryofLoriAnnSchrempp,RN,a22-yearveteranofAveraSacredHeartHospitalwhodiedinaLifeFlighthelicoptercrashin2002.

ThescholarshipfundisadministratedthroughtheAveraSacredHeartFoundation, thephilanthropicarmofAveraSacredHeartHospital.Poppe’shusband,Jeff,presentedtheawardtoher.■

crandall, koch NAMED SISTEr CLEOPHA Scholarship WinnersMEAGHAN CRANDALL (left), RN, Avera Sacred HeartHospital,andCANDACE KOCH(right),RN,AveraSacredHeartHospital,aretherecipientsofthe2012SisterCleophaScholar-

shipforContinuingEducation.TheSisterCleophaScholarshipwasestablishedasascholarshipfornursingstaffofAveraSacredHeartHospitaltoattendworkshops.CrandallwillbeusingthescholarshiptoattendaperinatalcareconferenceandKochwillbeusingthescholarshiptopurchaseaCDtolearnhowtowriteeffectiveappealletterswhenyourclaimshavebeendenied.TheawardwaspresentedtoCrandallandKochbyFraniKieffer,ExecutiveDirectoroftheAveraSacredHeartFoundation.■

RAPID cITY REGIONAL HOSPITAL (RcRH) recently honored eight outstanding employees with Nursing Star Awards, rec-ognizing excellence in nursing. The Star Awards, developed by RcRH’s Nurse Shared Governance council, encourage employees to nominate their fellow nurses.

♦ Guiding Star Mentor Award JudithAmo,RN,NICU

♦ Gold Star Service AwardGretchenErrea,RN,InfusionServices

♦ Shining Star community AwardVirginaEspeland,RN,WoundCare

♦ Rising Star Novice AwardMelindaWells,RN,ClinicalCoordination

♦ Super Star Expert AwardJoannStock,CRN,ICU

♦ Blazing State Advanced Practice Nurse AwardCarolDugan,AdvancedPracticeClinician,RegionalHeartDoctors

♦ The Supportive Star AwardNellieIsaacs,HealthUnitClerk,Ortho/Neuro/Surgicalarea

♦ The Luminary Nurse Advocate Award KeshavPanday,MD,Hospitalist

neW dIreCtor for MERcY PATIENT REFERRAL PROGRAM/MERCY MEDICAL CENTER IN SIOUx CITY has named cassandra “cassie” Twillman, rN, BSN to direct the

2Mercy initiative. 2Mercy gives physicians a one-

call, hassle-free process for direct patient

admissions to Mercy. Twillman joined Mercy in

2011 after nine years in the Sanford Health

System. Most recently she worked with Dr. David

Lucke in Mercy Internal Medicine. Twillman will

work with local and regional physicians to facili-

tate their patient admissions to Mercy.■

rCrH Nursing Start Award Winners: Back row, pictured left to right: Dr. keshav Panday, Carol Dugan, Melinda Wells, and Virgina Espeland. Front row: Joann Stock, Gretchen Errea, Judith Amo, and Nellie Isaacs.

Be part of Research at Regional Health.

15809-0612

Research provides opportunities to build the foundation for the future of health care. Everyone is affected by research in one way or another. Our physicians are invested in your best health opportunities and we are at the forefront of these treatment options. Before these discoveries can happen community volunteers like you are needed.

It takes you to find a cure. www.regionalhealth.com/research

(605) 716-3982


Bankers Trust Companyof South Dakota

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

(605) 338-5033

ProvidingExperienced & Personalized

Trust Services

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

JOHN TErBEEST HAS rECEIVED THE fIrST DAISY AWArD fOr

ExTrAOrDINArY NUrSES AT rAPID CITY rEGIONAL HOSPITAL (RCRH.)TerBeestisaRegisteredNurseintheIntensiveCareUnitandhasworkedatthehospitalfor19years.DAISYisanacronymfor“diseasesattackingtheimmunesystem”andhasgrownintoanon-goingrecognitionprogram,nowinsevencountries,thatcelebratestheskillandcompassionofdirectcarenurses.Apatient’sfamilydescribedTerBeestas,“afriend,anurse,andaverydevotedmantohisjob.”Heisrecognizedforhisrespect,comfortingnature,andcommitmenttoprovidingexcellentcaretopatientsandtheirfamilies.RCRHhascommittedtotheDAISYAwardprogramandwillbehonoringoneextraordinarynursepermonth.■

TERBEEST HONORED WITH RAPID cITY

REGIONAL HOSPITAL’S

First daISy

award

MEDQuotes

I defy the tyranny of precedent. I go for anything

new that might improve the past.” —Clara Barton

18

As thousands of baby boomers reach retirement age every day while the

world’s population continues to surge, the need for primary care providers

– the so-called ‘gatekeepers’ of healthcare – is greater than ever. In the first

part of our two-part series (“The fate of Primary Care – Part I”, June 2012), we

explored some of the reasons why the American Academy of family Physi-

cians predicts a critical shortage of primary care doctors in the next 8 years.

Medicalstudentdebt,growingworkload(read, longhours), lowerreimbursementsandsalaries,andevenastigmaagainstthespecialtyinsomeofthenation’smedicalschoolsmayallsharepartoftheblame.Andwithastateratioof769primarycaredoctorspercitizen(thenationalbenchmarkis631to1),SouthDakota’sprovidersmaybeworkingevenharderthantheircolleaguesinotherpartsofthecountry,makingprimarycareevenlessattractive.

Yet,despitethedownsides,morethan850SouthDakotadoctorsdopracticeInternalMedicine,FamilyMedicineorPediatrics(www.statehealthfacts.org)andtheSanfordSchoolofMedicineturnsout4percentmoreFamilyMedicinegraduatesthanthenationalaverage.InPartIIofourseries,weexplorewhatbringsphysicianstothesefieldsinourarea,andwhatkeepsthemthere.

A TAsTe for VArieTyDavidBarnes,MD,aFamilyMedicinespecialistwiththeYanktonMedicalClinic,initiallyplannedforacareerinorthopedics.“Myinterestinorthopedicsiswhatgotmeintomedicineinthefirstplace,”herecalls.ButafterspendingtimeprovidinggeneralmedicineservicesfortheIndianHealthService,payingoffhismedicalschooldebt,hefoundthathe“didn’twanttogiveupanything”.Likemanyprimarycarephysicians,itwasthediversity–ofproblemsandofpatients–thatultimatelyhookedhim.

The fate of Primary Care

2Dr. Wallace “Skipper” fritz, family practitioner, Sioux falls

Rodney Parry, MD, retired dean, USD Sanford School of Medicine

Part

Primary care allows one to interact with patients at a much different level.

“ ”

July / August 2012 19MidwestMedicalEdition.com 19

“Thereisenoughvarietytoreallykeepyouonyour toes,” saysDr.Barnes,whodoesn’thesitatetoturntohisspecialistcolleagueswhenheneedsto.“Itcanbeachallengetostayuponsomanythings,butitalsoensuresthatyoudon’tgettoocom-fortableandmisssomething.”

Sioux Falls pediatrician SamSchimelpfenig, MD, thought hewouldbeanadultcardiologist.Butthatchangedafteramid-winterpedi-atricrotation.“JanuaryandFebruaryarethebusiestmonthsforpediatrics,buteverydayIwasexcitedtogoinandseekids.”Andwhataboutthosemedicalschoolloans?“Icaremoreaboutpeoplethanapaycheck,”hesays.Afortunatethingforhisgrow-ingpatientbase.

Long Term reLATionshiPs“Primarycareallowsonetointer-actwithpatientsatamuchdifferentlevel,” explains retired SanfordSchoolofMedicineDeanRodneyParry,MD.Theschoolhasastatedmissiontoproducemoreprimarycare graduates, especially thosewillingtopracticeinunderservedareas.“Thesedoctorsreallygettoknow their patients on adeeperlevel, andare able togivemorecomprehensivecare,overalongerperiodoftime.Soprimarycarecanbeveryrewarding.”

ThenumberofprimarycaregraduatesfromUSDSMtypicallyhoversaroundthenationalaverageof39%,buttheschoolishopingtoraisethatnumber.Thecurricu-lumhasbeenalteredtointroduceclinicalexperienceearlier in thestudent’smedicaleducation.Eachstudentwillalsohavetheoppor-tunity to follow patients for an

entireclinicalyear,exposingstu-dents to the longitudinalaspectsofprimarycare.

“Ourhope is that, bygivingstudents more relevant clinicalexperienceearlier,andgivingthemthechancetofollowpatientslonger,theywillhavemoreselfconfidencetogointoprimarycare,wherethebody of knowledge must be solarge,”saysDr.Parry.

“Iwasmost attracted to thewell-roundednessofpatientcare,”saysKristaHoyme,DO,athird-yearresidentwiththeSiouxFallsFamilyMedicineResidencyPro-gram.“Ilovetheideaofbeingabletobeinvolvedinthecareofpatientsfrom baby care to the nursinghome.It is truethatyouhavetohaveahugebodyofknowledge,butyouhavetoweighthatagainstthecontinuityofcareandtherela-tionshipsthatyougettodevelop.”

SiouxFalls family physicianScottBoyens,MD, sumsuphisapproachtoprimarycarethisway:“Mostof the timethe importantthingis just tobehumanandtoreallylistentopeople.”

sAVing PrimAry CAreFew dispute the necessity ofprimarycare,orthefactthatthenumbers of providers are dwin-dling.Butopinionsvaryastotheanswer.Oneplacetostart,saysDr.Schimelpfenig,isbyreducingtheburdenofdebtthatcanmakeotherspecialtiesmorealluring.Accord-ing to the AMA, most medicalstudentsleavemedicalschoolasaverageof$156,000indebt.

“Thecollegeloans,themedicalschoolloans,andthenecessitiesoflifeallcomedueatthesametime

theymaybestartingafamily,too,”saysDr.Parry.AccordingtoDr.MarkSchwartz,authorofamajorInternalMedicine study and anassociateprofessoratNewYorkUniversity Medical School, thetotalsalarydifferencebetweenacardiologistandageneralinternistovera40-yearcareerisalmost$3.5million.Whenfacedwithachoicebetween twoequally interestingspecialties,somestudentsfeeltheyhavelittlechoicebuttotakethebetter-payingpath.

“It is a hard pill to swallow,especially for people who wantto go into primary care,” saysSchimelpfenig.“Ifdebtmanage-mentcouldbeimproved–eitherbymaking medical school moreaffordableononeendorprovidingbetterreimbursementontheotherend–itwouldbeeasierforpeopletojustifygoingintoprimarycare,especiallyinaruralsituation.”

“Mostfamilypracticepeopledon’tgointoitforthemoney,butit’sdefinitelyanimportantconsid-eration,”saysDr.Barnes.Barnessays the ability of primary careproviderstoassesswhichpatientsneedspecialtycareandwhichdon’tsavestimeforoverworkedspecial-istsandmoneyforthehealthcaresystem.AsWashingtonlooksforasolutiontothenation’shealthcaredilemma,Barnessayslawmakerswoulddowelltopayattentiontotheplightofprimarycare.

“Whateversolutionwecomeupwith to boost the numbers, it isgoingtotaketenyearstogetitupandgoing,”hesays.“ThepeopleinWashingtonneedtobeawarethat family practice is limpingalong.Itisnotlikesomespecialtieswhere ten people apply for oneposition.”■

Dr. Angela Meyer, family practitioner, Sioux falls

I love the idea of being able to involved in the care of patients from baby care to the nursing home.

“

”Krista Hoyme, DO


THERE WAS BOTH GOOD NEWS AND BAD NEWS IN THIS SPRING’S ANNUAL PHYSIcIAN cOMPENSA-TION REPORT FROM MEDScAPE. According to 24,216

physicians across 25 specialty areas, about half are making

slightly less this year than they did last year. radiology and

Orthopedics continued to be the highest-paying specialties

on the list with average annual compensation of $315,000.

Internal Medicine, family Medicine and Pediatrics – the three

primary care specialties – were at the bottom of the list in a

range from $156,000 to $165,000.

But the news wasn’t all bad for primary care. All three

primary care specialties made the list of those whose com-

pensation levels were increasing, albeit slightly. At the same

time, radiology and orthopedics saw a nationwide drop in

compensation of 10% while general surgeons are making

12% less than they did last year. Physicians in single-specialty

group practices tended to earn the most, followed by those

employed by healthcare organizations.

When asked if they feel fairly compensated, half of doctors

surveyed (51%) said they did. But the number was lower for

primary care doctors; only 46% felt they were fairly compen-

sated. regardless of their compensation level, a fair number

of doctors apparently feel it’s not worth it. Citing the frustra-

tion of increased regulation and documentation, 46% said

they would not choose medicine as a career again, if they had

their lives to live over. ■

Study details can be found at www.Medscape.com.

Physician Compensation Study

reveals

of Medicine

Half of doctors surveyed feel fairly

compensated


HAVE YOU THOUGHT AbOUTyourestateplan recently?Doyouneedtocreateone. . .orupdate one?Any estate plan-

ningtodayinvolvesamyriadofchallenges.How should one react to skyrocketinghealthcarecosts,theeverincreasingAmer-ican deficit, the extreme stock marketvolatility, the likelihood of longer lifespans, the constantly changing familydynamicsandthelistgoeson?Addtothoseconcerns the fact that financial plannersand advisors are unable to offer any longtermadvicesincethecurrentfederalestateandtransfertaxissettoexpireatyear’sendandwehavenoideawhatthenewtaxlawswill look like. It is very unlikely that wewill see a congressional resolution giventherecentlackofbipartisanco-operation.

DoingnothingshouldNOTbeanoptionyou choose. Every plan you executemustincludeasmuchflexibilityaspossibletobeabletoaddresswhateverhappens.Fortunately,South Dakota is nationally recognized ashavingsomeofthebesttrustlawsinthenation.Manyofthetaxadvantagescanonlybegainedwithirrevocabletrusts;but,thatdoesnotmeanyouloseflexibility.HB1045whichwassignedbythegovernorandwillbecomethelawonJuly 1 contains several amendments andenhancementstoouralreadyflexiblelawssothatsomeoftheconcernoverestateplanningunknownscanbeeliminated.

HIGHLIGHTS OF THE NEW LAW ARE:SouthDakotaallowsapersonwhocreatesatrusttobebothacreatorandbeneficiaryandstillachieveassetprotectionfromcredi-tors.Thelawgivingcreditorsthreeyearstobringaclaimwasamendedtotwoyears.Now,acreditormustbringsuitagainstthetrustwithintwoyearsofanycontributioninorderto reach those assets.Once that timehaspassed,allclamsarebarred.Thelawspecifies

thewrittennoticeacreditormustgivetothetrusteeinordertodisgorgedistributionsmadebeforeitsclaimwasfiled.

Thedecantingstatute,alreadyattractiveforallowingatrusteetodecantwheretherewasanydiscretionoverthetrust,wasfurtherrefined.Now, the trustee in drafting thesecondtrustcanindirectlyextendthetrust’sdurationbygivingthebeneficiarythepowertoappointassetstocontinueintrust.

Anewstatuteaddressestherightofatrustbeneficiaryto“contest”thetrust.Thelawvalidatestheuseofsuchclauseswhichpenalizeapersonwhoobjectstothetermsofthetrust.Thelawstillauthorizescertainclaimsiftheyarebaseduponundueinfluenceor in instances where a beneficiary wasactivelyinvolvedinthedraftingorexecutionofthetrust.

SouthDakota’sdirected truststatuteswerealsomodifiedtoclarifytherolesofthetrusteewhenthetrustappointsadistributiontrusteeorinvestmenttrustee.Itisnowclearthatifanadministrativetrusteecarriesout

theinstructionsgivenbytheinvestmentordistribution trustee, the administrativetrusteehasnodutytorevieworquestionthedirectiveandcannotbeheldliableforanylosscausedbyfollowingthedirective.Thissameclarificationappliestotheretentionoflifeinsurance.Anadministrativetrusteehasnodutytoreviewthestabilityoftheunderly-ingcompany.Thesameguidelinealsoallowstheadministrativetrusteetorelyonataxreturnpreparedbyothers.The trustee isrelievedofadutytoindependentlydeterminetheaccuracyofthereturn.

Thenewamendmentsand lawsofferadditionalflexibilitytoanyonewhoiscon-sideringthe implementationorchangeinan estate plan. Take advantage of theseattractiveplanningoptionsnowsincethefederaltaxexemptionsaresettoexpireonDecember31.ThetimetocreateyourestateplanisNOW!■

Alice rokahr, JD, is the Wealth Planning Officer

at Bankers Trust Company of South Dakota.

Now is the Time to estate Planby Alice Rokahr, JD

PROTECTING RESOURCES, SERVING PEOPLE

www.rascompanies.com1.800.732.1486

Workers’ Compensation.our Focus. Your opportunity.sm

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

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

Quarter Page Horizontal 3.875 x 5.275 MAR 2012 ISSUE - FINAL 2012-02-02_Layout 1 2/2/2012 9:41 AM Page 1


Passionate Pursuits Outside the Office

Off Hours

Tell us about your

own ‘passionate pursuits’ outside

the office.

Write to us!

Dr. Boyens in center.

FAMILY PRAcTIcE PHYSIcIAN,

SCOTT bOYENS, MD, has anunusual way of spending his offhours,foradoctor.Infact,hecan

thinkofonlyoneotherphysicianinthestateofSouthDakotawho isalsoahighschoolfootball referee. Dr. Boyens is easygoingaboutthesubject.Andwhetheryoulikethesportornot,it’snothardtobedrawninbyhis enthusiasm for a hobby that started bychanceandgrewintoaseriouspastime.

“Along-timerefhereintownaskedmetodoit,soIsaidI’dgiveitashot,”recallsDr.Boyens.“Ijustlikefootballandwhatbetterwaytoseethegamesthanrightdownonthefield?IalsoplayedfootballatWash-ingtonHighSchoolandthenAugustana.Butreally, there’s just nothing better than aFridaynightfootballgameinsmalltownSouthDakota.Nothinglikethatfeeling.”

Because refereesareatapremiuminSouthDakota,Boyenssayshehastobereadytofollowthegames–wherevertheymaytakehim.

“Wherevertheyschedulethegames,wegetinthecarandgo.Weneverknowwherethenextassignmentis.It’sanescape.AndonFridaywestartoff to thepreparationtime.SorightawayI’mintoacompletelydifferentthing.”

Totheobviousquestionofhavingtorunalotwhileoutonthefieldhereplies,“Ohno.I’mtheguyinthemiddle—wedon’tmovemuchbutyoustillwanttostayinshape,notbecauseoftherunning,”helaughs,“buttheuniform.Thestripesaregoingthewrongwaytomakeyoulookthin.”

Asamedicalstudent,Boyenscouldn’timaginehavingtimefor“anylifeoutsidetheoffice”.Infact,peopleareoftensurprisedtohearabouthisunusualandsometimestime-consumingavocation.But,likemanyotherphysicians,thisbusyfatheroffourhasfoundhis hobby to be awelcome rest from thedemandsoffamilylifeandfamilypractice.

“Ithinkmybiggeststressor[inmedicalpractice]isthepossibilityofmakingamis-take,”hesays.“There’snotadocouttherewhowantstohurtanybody.Wedon’twanttomissanythingbutwe’rehuman,too,andwemakesomanydecisionsaday.Itcanbestressful.Soithelpstogetout.”

Andwhataboutstressorsinthegameitself?Someconsidertherefereeanunderap-preciatedorevenabusedfigureinsports.Dr.Boyensconsiders.

“Well, thegamemovespretty fast todwellonabadcall.Butmypetpeeveisthatfansdon’trealizetherearedifferentrulesforhighschool,college,andthenpro,

so if they’ve just come fromwatchingcollege football they sometimes don’tunderstanditwhenyoumakeacertaincallinahighschoolgame.Theimportantthingis,doesthecallhavetodowithsafetyoroutcomeoftheplay?Thosearethedeci-sionswehavetogetright.”

Asformemorablemoments,Dr.Boyenssaystherehavebeenmany.

“I’vegottenrunoveracoupleoftimes,ormoreoften.SinceI’mnotasmallguymyself,playerswillrunintomeandtheyfallandIdon’t.

“I especially remember things liketheAberdeen/Washingtonchampionship.Thatwasquiteanight.Butit’salwaysasateam(ofreferees)thatwetendtobemostsatisfied when we’re considered to havedoneagoodjob.You’reacrew.Andwhenyou’rechosen forplayoffgamesandchampionships—that’swhatyou’rehopingfor.

Sometimes it’so v e r w h e l m i n gdownon thefield,though.Youthink:I’mlookingattenguys—andthey’reallmoving!”■

Puttin’ on the Stripesby Darrel Fickbohm

I’ve gotten run over a couple of times, or more often. Since I’m not a small guy myself, players

will run into me and they fall and I don’t. “ ”

100-11395-3255 2/12

For Michelle McGregor, RN, BSN, being a good nurse is about finding your passion then applying it. She loves learning and finds reward in sharing that with other nurses. As a cancer survivor she understands the patient perspective and she shares that with the new generation of nurses. It’s work that’s not for everyone. To make a difference through education. For Michelle and all of our nurse educators, we thank you for sharing your knowledge.

yearofthenurse.sanfordhealth.org Michelle McGregor, RN, BSN

The Year of the Nurse.

100-11395-4166 6/12

Today I educate.


Grape Expectations

Confessions of a Wine glass Snobby Heather Taylor boysen

I AM A WINE GLASS SNOb. I’mperfectlywillingtoadmititanditisanafflictionthatItrytosharewithas many people as possible. It all

beganabout11yearsago,shortlyafterwehad opened ourwine shop and I hadmyfirstexperiencewithRiedelstemware.

MyexperiencewithwineglassestothispointhadbeenWaterfordcrystal,badres-taurantglassesanddareIsaytheoccasionalplasticcup.OnedayacustomercametothestorelookingforstemwarecalledRiedel(pronouncedRee’dal,notRye’dellikethehighschool).AlthoughIhadheardofit,wedidn’thaveadistributorinthemarketandIwasatalossastowheretofindit.

Aftersearchingontheinternet,Iwasintrigued.AlloftheinformationregardingRiedelstemwareIcouldfindclaimedthatthesewere thebest things thathadhap-penedtowinein100years!AccordingtotheRiedelwebsite,ClausRiedel,over30yearsago,wasthefirstpersoninthelonghistory of the glass to design its shapeaccordingtothecharacterofthewine.“Heisthustheinventorofthefunctionalwineglass.”Ireallyneededtogetaholdofthisstemware!

Imaginemyastonishmentwhenacoupleofweekslateroneofmywinesalespeopletoldmehercompanywasgoingtobeginselling Riedel to accounts next week

and a Riedel

representativewascomingintoSiouxFallstoconductacomparativeglasstasting.NotonlydidInotknowwhatacomparativeglasstastingwas,IalsohadnocluethatthisglasstastingwouldchangethewayIdrinkwinefortherestofmylife.

Ifyou’veneverdoneaRiedelglasstast-ing,itisreallyanextraordinaryexperience.Therearefourglassesplacedinfrontofyouon a tasting placemat. The four RiedelglassesonthematincludetheBordeaux(Cabernet,Merlot),Burgundy(PinotNoir),Montrachet(Chardonnay)andtheSauvi-gnonBlanc.Throughoutthetastingyouareconstantlyputtingonetypeofwineintoeachoftheglasses.Forexample,youbeginwiththeSauvignonBlancglassanditsmatchingwine.Thenyousmellthewine,noticethecolor,thenyoutaste.Withthesamewine,youthenpouritintotheotherglassesandproceedtosmellandtastefromeachglass.The tasting proceeds through all of theglassesusingfourmatchingwines.

I’veneverbeeninaroomfullofpeoplethatgoescompletelysilentwith thefirsttransferofwinefromtheappropriateglasstoanotherglassontheplacemat.Thenacollective gasp followed with outrightexclamationsofdisbelief.Thechangeinwine,allofthewine,fromglasstoglasswasastonishingandmagical.Itislikethisstemwaregiveswinethelifethatitneedstodanceacrossourpalatesandperformwith theutmostvibrancyforoursenses.AsRobertParkerJr.ofTheWineAdvocatestated,“thefinestglassesforbothtechnicalandhedonisticpurposesarethosemadebyRiedel.Theeffectoftheseglassesonfinewine is profound. I cannot emphasizeenoughwhatadifferencetheymake.”

Riedelstemwarehasbecomeanobses-sionwithmeandmyhusband.Wewere

watchingTVtheotherdayandtheshowhadcharactersdrinkingwinefromRiedelglasses.Itwassatisfyingtonoticethattheywere usingRiedel. Itwas nice productplacementforRiedeluntilthecharacterintheshowpouredPinotNoirintotheMon-trachet glass. I couldn’t believe theproducers of the show hadn’t done theappropriateresearchintowhatglassshouldhavebeenused!

Cabinetshavebeenbuilt inourhomespecificallytohouseourcontinuallygrow-ingRiedelstemwarecollection.OurfriendsareamazedasmyhusbandandItakeoutnewglassesforeverycourseofwineservedinourhome.Washingthatmanyglassesisthepricewearewillingtopayforsippingalovelywinefromtheappropriateglass.Itisrespectfulofthewineandaddssomuchpleasure to the wine experience. Inmyworld,therearenoexceptions.PinotNoirjustdoesnotbelonginaChardonnayglass,notevenontelevision.■


ExPOSURE TOCERTAIN chem-icalsintheworkplacecancauseor contribute to serious healtheffects or may create serious

safety hazards.Healthcare employees haveexposures to chemicals such as disinfec-tants,hazardousdrugsandpesticides.Asanemployee,itisyourrighttoknowaboutthechemicalsyouworkwithintheworkplace.

OSHArequiresawrittenHazardCommu-nicationprogramthatprovidesworkertraining,warninglabelsandaccesstoMaterialSafetyDatasheets.OSHAalsoregularlyenforcesthestandard.TheHazardCommunicationStandardisthe#2mostcommonlycitedregulationforhealthcare facilities in the last year to theBloodbornePathogenstandard.

TheHazardCommunicationStandardischangingtoincorporateinternationalstan-dards.Allemployersmustmakechangestotheirhazardcommunicationprogramoverthenextfewyears.

The primary benefit of theGHS is toincreasethequalityandconsistencyofinfor-mationprovidedtoworkers,employersandchemicalusersbyadoptingastandardizedapproachtohazardclassification,labelsandsafetydata.TheGHSprovidesasinglesetofharmonizedcriteriaforclassifyingchemicalsaccordingtotheirhealthandphysicalhazardsandspecifieshazardcommunicationelementsforlabelingandsafetydatasheets.UndertheGHS,labelswouldincludesignalwords,

pictograms,andhazardandprecautionarystatementsandsafetydatasheetswouldhavestandardizedformat.

Thesechangeswillnotchangetheframe-workandscopeofthepriorHCSbutwillhelpensureimprovedqualityandmoreconsistencyintheclassificationandlabelingofallchemi-cals.Thiswillenhanceworkercomprehension,resultinginappropriatehandlinganduseofchemicals. The harmonized format of thesafetydatasheetswillenableworkerstoaccesstheinformationmoreefficiently.Inaddition,currentlymultiplelabelsandsafetydatasheetsmustoftenbedevelopedforthesameproductwhenshippedtodifferentcountries.Thiscre-atesamajorcomplianceburdenforchemicalmanufacturersandthoseinvolvedininterna-tionaltrade,increasingthecostofprovidinghazard information.TheadoptionofGHSwillminimizethisburden.

TIMELINE SUMMARY OF THE HAzARD cOMMUNIcATIONS cHANGES:

♦March 26, 2012FinalRulewaspublished

♦May 25, 2012 Rulegoesintoeffect

♦ December 1, 2013 EmployeesmustknowhowtoreadandunderstandthenewlabelsandSDS’s

♦June 1, 2016 CompletetrainingonallupdatestoyourHazComprogram

PREPARING FOR THE cHANGE YourcurrentMSDSlibrarywillneedtobecompletely replaced by the new SDS’s.Vendorsshouldalreadybeprovidingthisnewinformation.Ifnot,youshouldbecon-tactingyoursuppliers.Thisdutyisonyourshoulders.YouneedtoensureyourcompanyhasasysteminplacetocollecttheSDS’sasthey come in, and that theyget to thoseresponsiblefortheprogram.

WHERE DO YOU BEGIN? Thethoughtofthischangecanbedaunting.Werecommendthatyoustartwithbitesizepiecessuchasconductinganoverallchemicalinventoryreview.Useacopyofyourcom-pletedlistasa“checklist”toensurethatyouhavetheSDS’sforeachofyourchemicals.You also need to begin planning youremployeeSDSandlabeltrainingandsetatargetdatebeforeDecember2013tohaveeveryoneuptospeed.Thebottomline,youneed to be fully transitioned to GlobalHarmonizationbyJune2016.■

For more information, you can visit the

OSHA website at http://www.osha.gov/

dsg/hazcom/index.html.

Terry Dell is a risk Analyst/Loss Control Specialist and John Gold is a Loss Control Specialist with rAS, a provider of workers’ compensation in the Upper Midwest, headquartered in Sioux falls, SD.

(gHS) the globally Harmonized System What it Means for Your Office

by Terry Dell and John Gold, CSHM


One thing I am certain about is my malpractice protection.”

“As physicians, we have so many unknowns coming our way...

Professional Liability Insurance & Risk Management Services

ProAssurance Group is rated A (Excellent) by A.M. Best. www.ProAssurance.com • 800.279.8331

Medicine is feeling the eff ects of regulatory and legislative changes, increasing risk, and profi tability demands—all contributing to an atmosphere of uncertainty and lack of control.

What we do control as physicians: our choice of a liability partner.

I selected ProAssurance because they stand behind my good medicine. In spite of the maelstrom of change, I am protected, respected, and heard.

I believe in fair treatment—and I get it.

make-a-Wish

South dakotaSINCE 1984, MAKE-A-WISH SOUTH DAKOTA HAS bEEN

granting wishes to children with life-threatening medicalconditions across the state. During 28 years, more than 950wisheshavebeengranted.Whilethewishesrangefromtripstoshoppingspreestomeetingcelebrities,thewishkidsandtheirfamilieshaveonethingincommon:thewishisapositiveexpe-rienceduringaverydifficulttime.

Arecentnationalsurvey*ofwishchildren,parents,volunteersandmedicalprofessionalsconcludesthatthepositiveeffectsofwishesincludeemotionalandsocialbenefits,lifeenrichment,socialawareness,inspiration,enhancedresilienceandcopingability,gratificationand–forwishchildren–improvedstrengthanddesiretoovercometheirillnesses.

Responses from medical/healthcare professionals regarding the impact of a wish on a child’s well-being include:

u 96% believe that a wish improves the wish

child’s mental and emotional health.

u 79% see increased feelings of hope in wish children.

u 75% see decreased feelings of depression or

sadness in wish children.

u A recurrent theme from the medical professionals

is that children who receive a wish are motivated

to overcome their illness and endure treatment

“Wishesallowchildrenandfamiliestohaveanormalexperi-enceandbeafamilyhavingapositiveexperiencewithouthavingtothinkaboutthediseasethatisamajorfocusoftheirlivesatallothertimes.Itisaninvaluableexperienceforpatientsandfamilies!”saysonedoctorsurveyed.

“ManyofthewishchildrenIhaveworkedwith‘rally’physi-callybeforethewish(fromexcitement/anticipation)andduringthewish(funandjoyofthewishexperience)beyondwhatwouldhavebeenexpectedorthoughtpossiblegiventhenatureoftheillnessandstatusoftreatment”observesanotherphysician.

MedicalprofessionalsarekeyreferralsourcesforMake-A-Wish.■To learn more about qualifying conditions for a wish or to refer a

child, please contact Make-A-Wish South Dakota at 800.940.9198

or 335.8000.

*2010,2011WishImpactStudy,Make-A-Wish®America.

MEDQuotes

People pay the doctor for his trouble; for his

kindness they still remain in his debt. ~Seneca


TITLE: OJIBWAY rIVEr ARTIST: CHrIS POWELL LOcATION: PrAIrIE CENTEr, WEST rIVEr

The less cancer there is, the more birthdays there will be. Patients count on you to remind them of what they can do to prevent cancer. Remind your patients of appropriate screenings and healthy lifestyle choices.

You can help create a world with more birthdays. Visit morebirthdays.com.Or call 1-800-227-2345. Together we’ll stay well,get well, fi nd cures and fi ght back.

© 2

010

Am

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ance

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THERE ARE 24 NEW SCULPTURES ONdisplayontheAveraMcKennancampus,partof this year’s annual SculptureWalk. AveraMcKennan began hosting Sioux Falls’ firstindoorSculptureWalk inMay2008.Avera’sindoorSculptureWalk is anextensionof thedowntown SculptureWalk, and visitors areencouraged to see the wide range of sculp-turesondisplayatbothlocations.

AtAveraMcKennan,brochuresdirectingvisitorsthroughthewalkareavailableinthefrontlobbyorinrackslocatedonmostsculp-tures.Interestedin thehealthof thewholeperson,AveraMcKennanhasdesignedtheone-milewalkasahealthyjourney.

Sculptures,ownedbytheartists,areon

loantotheexhibitforoneyear.Employeesareencouragedtojointhepublicinvotingfortheirfavoritesculpture,andAveraMcKennanwillpurchasethePeople’sChoiceandaddittoourpermanentartcollection.Votebypaperballotoronlineatwww.Avera.org/art

“Thehealingpowerofartisveryprofound,”saidDr.DavidKapaska,regionalpresidentandCEOofAveraMcKennan.“Arthasthepowertocalmournerves, sootheour spirits, andrestorefeelingsofhopeandcourage.Wewantto share the healing power of artwith ourpatients,visitorsandstaffineverywaypos-sible,andsowehosttheindoorSculptureWalkinadditiontohavingourownoriginalartcol-lectionsthroughoutourvariousfacilities.”■

now on display at avera mckennanHOSPITAL HOSTS fIfTH ANNUAL THE INDOOr SCULPTUrEWALk.

new Sculptures

TITLE: C ARTIST: MATT MILLEr LOcATION: PLAzA 4, fIrST fLOOr LOBBY

Learning Opportunities

August / September 2012

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 [email protected].

August 13 Avera Behavioral Health Services Update9:00 am – 3:00 pm Location: Avera Education Center Auditorium Information & Registration: [email protected] or call 322-8950

August 22-24 SDMGMA Fall conference Location: Cedar Shore Resort, Chamberlain, SD Information: www.SDAHO.org

September 13 - 14 37th Annual South Dakota Perinatal Association conference Location: The Lodge at Deadwood Registration and information: www.sdperinatal.org, 333-5210

September 14 community Response to child Abuse Location: Sanford Information: [email protected]

September-December Sanford Perinatal Nurse Fellowship – Multiple Dates Information: 328-6353 Sept. 21-22 2012 Avera cancer Institute Oncology Symposium Location: The Prairie Center Information: www.AveraMcKennan.org; click on Events Calendar Registration: [email protected] or call 322-8950

September 27 – 28 2012 Upper Midwest Regional Pediatric conference Location: The Marina Inn & Conference Center Information: www.umrpconference.com or (712) 279-3235

September 28 Avera Transplant Institute Symposium8:00 am – 2:00 pm Location: The Prairie Center Information: www.AveraMcKennan.org; click on Events Calendar Registration: [email protected] or call 322-8950

October 4 Avera Rural Health conference8:30 am – 4:00 pm Location: Sioux Falls Convention Center Information: www.AveraMcKennan.org; click on Events Calendar Registration: [email protected] or call 322-4645

October 17 28th Annual cardiology conference9:00 am – 3:00 pm Location: Sioux City Convention Center Information & Registration: www.stlukes.org/professional-education

November 2 30th Annual North central Heart Fall cardiac Symposium8:00 am - 5:00 pm Location: Sioux Falls Convention Center Information: www.northcentralheart.com Registration: [email protected], 605-977-5316

I-29 and West 12th Street - Sioux Falls - 888-339-5060

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