Governor’s Greetings - Tom Braithwaite

2014  –  THE  ONLY  CONSTANT  IS  CHANGE

As  we  look  back  to  2013,  and  consider   the  many   issues  that  arose  within  health  care,   it  is  difficult  to  contemplate  the  possibility   that  2014  could  be  filled  with  just  as  many   (or  more)  criAcal  issues  and  changes;  however,  that  is  almost  a  certainty.    One  doesn’t  have  to  stare  into  the  crystal  ball  for   very   long  to  come  up  with  a  host  of  things  our   industry,  the  ACP,  and  we  as  pracAAoners  will  be  asked  to  tackle,   manage,  or   simply   absorb.     To  menAon  a  few,   without  being  exhausAve:

1. The  conAnued  evoluAon  of  the  Affordable  Care  Act/Obamacare  roll-­‐out  and  implementaAon

2. Ongoing  debate  regionally  surrounding  Medicaid  expansion3. Changing  definiAons  and  requirements  as  it  relates  to  

Maintenance  of  CerAficaAon,  parAcularly  for  those  previously  “grandfathered”

4. Increasing  pressures  for  “efficiency,”  despite  ever-­‐expanding  burdensome  documentaAon  requirements

5. Progressive  impact  of  quality  reporAng  programs  including  (but  not  limited  to)  Value-­‐Based  Purchasing,  PQRS,  and  other  payer-­‐specific  incenAve  contracts

6. ConAnued  maturaAon  and  implementaAon  of  the  electronic  health  record,  and  Aed  so  closely  to  it,  Meaningful  Use  Stage  II

7. Deeper  understanding  of  all  of  the  (hidden)  implicaAons  of  the  SGR  “fix”

8. And  oh,  did  I  menAon  ICD-­‐10?????

As  I  speak  with  colleagues  about  this  assortment  of  challenges,  and  the  growing   expectaAons  surrounding   them,   it   someAmes  seems  there   is   an   unseen   force   acempAng   to   suck   the   joy   and   deep  saAsfacAon  out   of   paAent   care  that   all  of   us  as  physicians  have  experienced  and  savored.    It  is,  indeed,  a  daunAng  list.  

INSIDE THIS ISSUE:

Governor’s Greetings

Orlando Reception

SD Award Recipients

Smart Medicine

High Value Care

SHM Alliance

SD Annual Meeting

Mastership Awarded to Rodney Parry

SOUTH DAKOTA AMERICAN COLLEGE OF PHYSICIANS JANUARY 2014

South Dakota

Governor’s Greetings (continued)SOUTH DAKOTA AMERICAN COLLEGE OF PHYSICIANS JANUARY 2014

All  that   said,   and  not   intending   to  minimize  those  senAments,  or   treat   them  as  insignificant,   our   state  ACP  chapter  offers  an  anAdote  to  at  least  SOME  of  the  associated  heartburn.    In  my  own  experience  of  pracAce,  now  nearly   30   years,   two  things  have  remained   constant   joys,   or   “buoys”   in   the   turbulent   waters  of   pracAcing  medicine.    Foremost  is  unrelated  to  organized  medicine  per  se,  but  it  is  the  contemplaAon  of  the  PRIVILEGE  we  are  granted,  each  day,  by   paAents  and  their   families,   to  enter   into  their   lives  during  the  most   vulnerable  of  moments…that  is,  when  they  are  ill,  fearful,  and  overwhelmed.    The  opportunity  we  have  at  such  moments  is  extraordinary,  and  the  wonder  of  that  precious  interacAon  has  never  been  lost  on  me.    I’m  certain  it  is  much  the  same  for  all  of  you.

The  second  consistent  “life  jacket”  is  the  collegiality  and  support  of  my  peers,  and  that  is  where  the  ACP  stands  front   and  center.    Our   organizaAon,   parAcularly   here   in  South  Dakota,   has  been  a  place  where  the  joys  of  medicine  are  celebrated,  system  affiliaAons  and  party  hats  disappear,   and  we  come  together   to  support  each  other   and  work  to  advance  the  quality   of   pracAce  within  our   state.     I  would   contend  our   chapter,   and  its  leadership,  has  never  lost   sight  of   this  prime  direcAve.     I  know  I  speak  for  myself,  Kris,  commicee  leadership  and  our  Governor’s  Advisory  Council  when  I  say  that  we  will  conAnue  to  work  hard  to  preserve  the  value  of  this  organizaAon  to  each  and  every  one  of  you.    It  is,  in  fact,  why  serving  as  your  Governor  is  such  a  deep  privilege  for  me.

On  a  more  tacAcal  and  less  philosophical  note,  there  is  much  work  going  on  within  the  chapter,  in  between  the  annual  meeAngs,  to  help  us  meet  our  objecAves.    Examples  include:

• Planning  commicee:    the  work  on  our  Fall  meeAng  in  Pierre  is  coming  along  very  well,  and  I’m  already  confident  in  saying  that  a  terrific  meeAng  awaits  us.    AddiAonally,  some  very  preliminary  work  has  been  undertaken  to  support  a  regional  meeAng  Fall  2015  in  Omaha,  NE.    Stay  tuned  for  those  early  details.

• CooperaAon  with  the  new  state  chapter  of  the  Society  of  Hospital  Medicine.    Please  see  Jeremy  Cauwel’s  arAcle  on  this  topic  further  on  within  the  newslecer.

• Bylaw’s  review:    not  undertaken  for  several  years,  our  goal  is  to  have  revised  bylaws  ready  for  membership  approval  at  our  Fall  meeAng.

• Awards’  Commicee:    first  meeAngs  already  scheduled.• Council:  review  of  Spring  2014  resoluAons  for  naAonal  BOG  will  take  place  in  early  March  at  our  Spring  

meeAng  (please  extend  your  thanks  to  the  Council  for  commilng  to  this  responsibility)

Thanks  to  all  of  you  for  your  membership,  and  parAcipaAon  within  the  ACP.    A  state  this  size  demands  that  we  all  carry   the   load,   and  such  sharing  of   the  work  is  deeply   appreciated.    Ours   is  a  model  of   teamwork  and  cooperaAon,  when  compared  to  much  larger  state  organizaAons…something  we  can  all  share  pride  in.

Please  protect  your  calendars  for  our  meeAng  in  Pierre,  September  10-­‐12,  2014.    I  hope  to  see  you  all  there,  if  not  before.

Best  personal  and  professional  regards,

Tom  Braithwaite,  M.D.,  FACPGovernor,  South  Dakota  Chapter,  ACP

SOUTH DAKOTA AMERICAN COLLEGE OF PHYSICIANS JANUARY 2014

Iowa, Kansas, Nebraska & South Dakota ACP IM 2014 Reception

Date: Friday, April 11thTime: 6:30-8:30 pm

Location: Tommy Bahama Restaurant, 9101 International Dr., #1200, Orlando, FL

Please RSVP to lauriejbraun@me.com by April 1st.

SOUTH DAKOTA AMERICAN COLLEGE OF PHYSICIANS JANUARY 2014

The South Dakota American College of Physiciansis pleased to announce its 2013 Award Winners

Early Career Physician of the Year - Michael P. Pietila, MD

Dr. Pietila is a Pulmonologist and Critical Care physician at the Yankton Medical Clinic, P.C. in Yankton, SD. He is a South Dakota native born and raised in Lake Norden. His undergraduate degrees in Chemistry and Microbiology are from South Dakota State University and his M.D. degree from the University of South Dakota. Dr. Pietila completed his Internal Medicine, Pulmonary Medicine and Critical Care training at the Mayo Clinic in Rochester, MN in 2006. Dr. Pietila is the outgoing Chief of Staff and current Vice Chairman of the Executive Board of Directors at Avera Sacred Heart Hospital in Yankton, SD where he directs ICU services. Dr. Pietila is an Assistant Academic Professor of Internal Medicine at the Sanford School of Medicine.

2013

SOUTH

DAKOTA

ACP

Early Career Physician of the year - Randall B. Lamfers , MD

Dr. Lamfers is currently a practicing Hospitalist as well as the Medical Director of the Hospitalist Program at Sanford USD Medical Center in Sioux Falls, SD. In addition to his clinical and administrative duties, he also serves as Assistant Professor of Internal Medicine at the Sanford USD School of Medicine. A native of Belmond, IA, Dr Lamfers received his B.A. in Biology at Dordt College and his MD from the University of Missouri – Columbia School of Medicine. Dr Lamfers completed his Internal Medicine Residency at the University of Wisconsin, where he served as Chief Resident in his final year. After residency, Dr Lamfers joined Sanford Health practicing first as a part of the Sanford Adult Medicine Clinic until he joined the Hospitalist program in 2009.

Teacher of the Year - David R. Rossing, MD

Dr. Rossing was born in Detroit, Michigan and is a graduate of the University of Texas Southwestern Medical School in Dallas, TX. He completed his Internal Medicine residency at Emory University Affiliated Hospitals in Atlanta, GA and his Pulmonary Fellowship at the University of Texas Health Science Center in San Antonio, TX. Dr. Rossing then joined the USD School of Medicine, Department of Internal Medicine and the medical staff of McKennan, Sioux Valley and the Royal C. Johnson Veteran’s Administration Hospital in 1980. In addition to his full-time Pulmomary Medicine practice, he served in an administrative capacity at Central Plains Clinic and completed a Master’s in Medical Management from Tulane University. This year, he retired as Vice Chair, Department of Internal Medicine.

Volunteer of the Year, Michael R. McVay, MD  

Dr. McVay became a pre-med major at Northwestern University in Evanston, IL. Upon graduation he returned to the University of South Dakota School of Medicine in 1968. He transferred to Tufts University School of Medicine in 1970 and received his MD degree there in 1972. He then went on to the University of Kentucky Medical Center in Lexington, KY for his Internal Medicine residency. While there he met his wife Ellen, and they were married in 1975. They then moved to Gallup, NM where they both worked for the Indian Health Service on the Navajo Reservation, then returned to Yankton where he worked as a general internist for 2 years and then he returned to the University of Kentucky Medical Center for his cardiology fellowship. They ultimately moved back to Yankton in 1981 where he began his cardiology practice at the Yankton Medical Clinic. His practice spanned 28 years until he retired in 2009. In the past decade, much of Dr. McVay’s volunteer activity involved study and teaching in the ethics of medicine. In 2001 he received the Bush Fellowship to study the role of spirituality in medicine. This ultimately helped him create the Avera MindBodySpirit Center where he and other staff taught stress reduction programs to the Yankton community over a period of 6 years. He came to appreciate the unique role of mind-body-spirit integration in health and disease.

SOUTH DAKOTA AMERICAN COLLEGE OF PHYSICIANS JANUARY 2014

COMING  SOON:  ACP  “SMART  MEDICINE”

Tom  Braitwaite,  M.D.,  FACP

Responding  to  requests  from  large  porAons  of  the  ACP  membership,  ACP  resources  is  adding  a  point  of  care  tool  which  will  be  of  significant  value  to  physicians,  and  will  be  available  to  ACP  members  free  of  charge.   Through   collaboraAon   with   DynaMed   this  product   is  viewed   as  a  future   rival,   or   at   least   a  partner,  to  popular  databases  such  as  UpToDate.    Official  roll-­‐out  will  occur  within  the  first   quarter  of  2014,  and  you  will  all  receive  mailings  with  further  details,  but  you  can  check  this  out  now  by  visiAng  the  following  link:  hcp://www.acponline.org/clinical_informaAon/smart_medicine/.

Having  been  involved   in  some  of   the  beta  tesAng   for   this  product   I  believe  this  holds  great   promise,  although  admicedly   it   will  be  a  resource  to   you   that   will   likely   grow   in   importance  as  the  database  matures  further.    Already  I  believe  it  is  vastly  superior  to  the  ACPs  prior  acempts  within  this  arena  (PIER).    I  am  very  excited  about  Smart  Medicine,  and  I  believe  it  will  become  yet  one  more  way  that  the  mission  of  the  ACP  to  equip  its  members  with  the  latest  informaAon  needed  for  high  quality,  high  value  care  is  successfully  met.

One  More  Benefit  of  ACP  Membership  –  Free  CME  and  MOC  Points  –  and  Learn  More  About  High  Value  Care

Tom  Braithwaite,  M.D.,  FACP

The  ACP,  as  part  of  its  campaign  to  promote  high-­‐value  care  (HVC)  has  created  learning  modules  surrounding  5  relevant  topics:

1. Avoiding  unnecessary  tesAng

2. Judicious  use  of  emergency  services  and  hospital  level  care

3. Improving  outcomes  through  health  promoAon  and  disease  prevenAon

4. Prescribing  medicaAons  safely  and  cost  effecAvely

5. Overcoming  barriers  to  high-­‐value  care

These  modules  can  be  done  online,  and  take  approximately  30-­‐60  minutes  per  module.    It  is  available  to  all  ACP  members,  and  completed  modules  provide  both  CME  and  ABIM  MOC  points.    And  it  is  free!!                                                                                                                                        Check  it  out  today  at  hcp://hvc.acponline.org/physres_cases.html.  

One  of   the   greatest  challenges   facing   the  ACP   in   the  coming  years  may   involve  another   group   of   internists…at   least   mostly   internists.     The   Society   of   Hospital  Medicine  has  rapidly  become  a  very  large  and  in@luential  group  on  the  national  internal  medicine  scene.    As  a  fellow  in  both  organizations  I  have  discovered  that  the  SHM  is  a  group  looking  for  an  identity,  they  are  (at  least  somewhat)   about  making  themselves  different   than   general   internists.     Rightly   or  wrongly   the   SHM   is   a   group   that  many  hospitalists  identify  with,  potentially  to  the  exclusion  of  the  ACP.   At   our   state   ACP   meetings   this   has   been   an   area   of   concern,   and   all   of   our  Governors   that   I   have   gotten   the   chance   to   work   with   have   been  working   hard   to  include  hospitalists  like  me  in  the  ACP.   Knowing  this  I  am  happy  to  inform  you  that  the  state  of  South  Dakota  has  formed  its  own  chapter  of  SHM,  and  that  we  will  be  working  closely   together.    The  inaugural  meeting  was  this  winter  in  Rapid  City  and  of@icers  have  been  elected.    Robert  Houser  of   Rapid   City   was   named   the   president   of   the   new   group.       I   was   elected   as   vice  president  and  our  secretary/treasurer  is  Craig  Hart.       One  of   our   @irst   items  of   business  was   to   examine  our   link   to   the  ACP   and  all  agreed  that  in  South  Dakota  we  would  like  to  make  the  State  ACP  meeting  and  the  State  SHM  meeting   run  concurrently   and   hopefully   in   coordination  with  each  other.     The  hope  would  be   the   same  place,   around   the   same   time,   so   that   people   can   be   active  members  of  both  groups.    The  details  are  still  to  be  worked  out.   Overall,   as   a  double  agent   for   the  ACP  Early   Career  Physicians  and   the  SHM,  I  hope   to   be   able   to   help   bring   both   groups   of   internists   together,   especially   here   in  South  Dakota.    I  invite  anyone  who  has  ideas,  requests,  or  comments  to  let  me  know  at  any  time.    You  can  reach  me  at:    Jeremy.Cauwels@Sanfordhealth.org

ACP Alliance with SHM - Jeremy Cauwels, MD, FACP

2014 Annual Scientific MeetingRamkota Best Western

Pierre, SD

September 10 - 12

It is a great privilege and pleasure to announce to you that Dr. Rod Parry, recently retired Dean of Sanford USD School of Medicine, has been named a Master of the American College of Physicians. The title of MACP is the highest and most distinguished honor our College can bestow, and in the case of Dr. Parry it is so very well deserved. This designation is reserved for an extremely small percentage of the overall membership, and is utilized to honor those individuals whose careers have exemplified the highest levels of achievement in the values that are core to our organization—clinical excellence, education, scholarship, and service. Dr. Parry joins other past Masters from South Dakota including Drs. (Jack) Barker, Humphreys, Nettleman, Talley, and Zawada. You will be seeing press releases announcing this in the very near future, but I wanted our membership to be amongst the first to know. Please join me in extending heartfelt congratulations to Dr. Parry for this significant achievement!

SD ACP Welcomes MACP Rodney Parry