Sept/October 2015
Doctors MetroDoctors THE JOURNAL OF THE TWIN CITIES MEDICAL SOCIETY
Opportunities for Physicians Beyond Patient Care
In This Issue: • • • •
Is There Another Career Waiting for You? Healthiest State Summit Held 6th Annual Sharing the Experience Recap Luminary of Twin Cities Medicine
NICOTINE
MORE HARMFUL THAN YOU THINK
NO AMOUNT IS SAFE FOR YOUTH
It’s highly addictive.
It harms fetal health during pregnancy.
It may harm adolescent brain development.
IT’S TOXIC IN HIGH DOSES E-cigarettes and e-liquids contain nicotine.
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Kids are ingesting e-liquids left unattended.
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Poisonings are up for 0-5 year olds in MN.
80
E-cigarette Poisonings
60 40 20 0
2012 2013 2014
TAKE STEPS TO PROTECT YOUTH www Keep harmful products out of reach.
Call 1-800-222-1222 for Learn more online at poison emergencies. health.mn.gov/nicotine.
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Jessica Morrell, MD
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PIERRE GEORGE, MD
JOZEF LAZAR, MD
KRISTINA SHAFFER, MD
MARGARET COLLINS, MD
NOEL HAUGE, MD
JESSICA MORRELL, MD
JERRY STANKE, MD
BETHANY COOK, MD
JUAN JAIMES, MD
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Doctors MetroDoctors THE JOURNAL OF THE TWIN CITIES MEDICAL SOCIETY
Physician Co-editor Peter J. Dehnel, M.D. Physician Co-editor Robert R. Neal, Jr., M.D. Physician Co-editor Marvin S. Segal, M.D. Physician Co-editor Richard R. Sturgeon, M.D. Physician Co-editor Charles G. Terzian, M.D. Medical Student Co-editor Katherine Weir Managing Editor Nancy K. Bauer TCMS CEO Sue A. Schettle Production Manager Sheila A. Hatcher Advertising Representative Betsy Pierre Cover Design by Andrea Westmoreland MetroDoctors (ISSN 1526-4262) is published bi-monthly by the Twin Cities Medical Society, 1300 Godward Street NE, Broadway Place West, Suite 2000, Minneapolis, MN 55413. Periodical postage paid at St. Paul, Minnesota. Postmaster: Send address changes to MetroDoctors, Twin Cities Medical Society, 1300 Godward Street NE, Broadway Place West, Suite 2000, Minneapolis, MN 55413. To promote its objectives and services, the Twin Cities Medical Society prints information in MetroDoctors regarding activities and interests of the society. Responsibility is not assumed for opinions expressed or implied in signed articles, and because of the freedom given to contributors, opinions may not necessarily reflect the official position of TCMS. Send letters and other materials for consideration to MetroDoctors, Twin Cities Medical Society, 1300 Godward Street NE, Broadway Place West, Suite 2000, Minneapolis, MN 55413. E-mail: nbauer@metrodoctors.com.
September/October Index to Advertisers TCMS Officers
President: Kenneth N. Kephart, M.D. President-elect: Carolyn McClain, M.D. Secretary: Thomas E. Kottke, M.D. Treasurer: Matthew Hunt, M.D. Past President: Lisa R. Mattson, M.D. TCMS Executive Staff
Allina Health.......................................................31 American Lung Association ................................ Inside Front Cover Coldwell Banker Burnet.................................... 4 Crutchfield Dermatology.................................. 2
Sue A. Schettle, Chief Executive Officer (612) 362-3799 sschettle@metrodoctors.com
Dermatology Consultants................................. 1
Nancy K. Bauer, Associate Director, and Managing Editor, MetroDoctors (612) 623-2893 nbauer@metrodoctors.com
Entira Family Clinics .......................................30
Barbara Greene, MPH, Community Engagement Director, Honoring Choices Minnesota (612) 623-2899 bgreene@metrodoctors.com
Healthcare Billing Resources, Inc. ...............19
Emily Johnson, Marketing and Communications Coordinator (612) 623-2885 ejohnson@metrodoctors.com Ellie Parker, Project Coordinator Physician Advocacy Network (612) 362-3706 eparker@metrodoctors.com Karen Peterson, BSN Director of Program Operations, Honoring Choices Minnesota (612) 362-3704 kpeterson@metrodoctors.com
ENT Specialty Care ..........................................17 Fairview Health Services .................................31 Greenwald Wealth Management ..................17 Lakeview Clinic .................................................31 MMIC ....................................................................... Outside Back Cover Practical Dermatology ....................................... 4 Red Pine Realty..................................................27 Saint Therese.......................................................29 Senior LinkAge Line.........................................26 St. Cloud VA Medical Center ............................ Inside Back Cover Uptown Dermatology & SkinSpa................19
Crutchfield Dermatology “Remarkable patient satisfaction from quality service, convenience and excellent results”
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For advertising rates and space reservations, contact: Betsy Pierre 2318 Eastwood Circle Monticello, MN 55362 phone: (763) 295-5420 fax: (763) 295-2550 e-mail: betsy@pierreproductions.com MetroDoctors reserves the right to reject any article or advertising copy not in accordance with editorial policy. Advertisements published in MetroDoctors do not imply endorsement or sponsorship by TCMS. Non-members may subscribe to MetroDoctors at a cost of $15 per year or $3 per issue, if extra copies are available. For subscription information, contact Andrea Farina at (612) 623-2885.
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September/October 2015
Charles E. Crutchfield III, M.D.
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The Journal of the Twin Cities Medical Society
CONTENTS VOLUME 17, NO.5
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SEPTEMBER/OCTOBER 2015
IN THIS ISSUE
Opportunities Outside of Patient Care or Medicine as a Career Launchpad By Charles G. Terzian, M.D.
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PRESIDENT’S MESSAGE:
The Doctor-Patient Relationship, Looking Back to the Future By Kenneth N. Kephart, M.D.
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Page 32
Page 28
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TCMS IN ACTION By Sue Schettle, CEO OPPORTUNITIES OUTSIDE OF PATIENT CARE
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Ben Bach-Wiig, M.D. President, Abbott Northwestern Hospital
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Kathleen Brooks, M.D. Director, Rural Physician Associate Program, U of M Gregg Dyste, M.D. Expert Witness Medical Practice
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Edward P. Ehlinger, M.D., MSPH Commissioner, Minnesota Department of Health Howard Epstein, M.D., FHM, CHIE Executive Vice President and CMO, PreferredOne
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Joel Greenwald M.D. CFP® Founder, Greenwald Wealth Management Julia Halberg, M.D., MS, MPH, FACOEM VP Global Health and Chief Wellness Officer, General Mills
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Jon Hallberg, M.D. MPR Radio Personality David Hilden, M.D. WCCO Radio Talk Show Host
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Andrea Hillerud, M.D. Medical Director for Quality & Health Outcomes at BCBSMN Roger G. Kathol, M.D., CPE President, Cartesian Solutions, Inc.™
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Adam Lokeh, M.D. VP Clinical Development and Informatics, Wolters Kluwer Health Robert Moravec, M.D. Field Surveyor, The Joint Commission
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Medical Management: a Logical Next Step
Jane Pederson, M.D., MS Chief Medical Quality Officer, Stratis Health, and Geriatrician, Allina Senior Care Transitions • Brian Rank, M.D. Co-Executive Medical Director, HealthPartners and Park Nicollet Joshua Riff, M.D. SVP Consumer Products and SVP Prevention and Wellness, Optum Deborah Wexler, M.D. Executive Director, Immunization Action Coalition
By Gina Bowden Pierce
Page 24
20 22 24 26
Healthiest State Summit Sharing the Experience 2015 By Karen Peterson, BSN 1st Honoring Choices MN Community Champion Service Award
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U of MN Medical School Invites Honoring Choices to Orient Students to ACP
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Remembering the Effects of Nicotine
Page 22
MetroDoctors
Learning the Business of Medicine By Rebecca Collins
Senior Physicians Association/New Members In Memoriam/Career Opportunities LUMINARY OF TWIN CITIES MEDICINE
Brian C. Campion, M.D. The Journal of the Twin Cities Medical Society
On the Cover: Opportunities are available for physicians desiring to branch out from patient care. Seventeen colleagues share their stories. Articles begin on page 8.
September/October 2015
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September/October 2015
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BURNET
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IN THIS ISSUE...
Opportunities Outside of Patient Care or Medicine as a Career Launchpad
B
ack in the late eighties, during my fellowship the entire general internal section was involved in peer review activities — both for the then-named PRO (Physician Review Organization) and outside attorneys needing plaintiff case reviews. Subsequently, the University enlisted my help with the Medical Records Committee. This stimulated my interest in Medicare Rules and Regulations. My Epi/Bio MPH piqued my curiosity in the variations in patient care management (this was around the time of Wennberg’s classic studies on practice variations). Doing chart reviews seemed to involve significant legal concerns. Thus I enrolled in the health law curriculum at Loyola Law School. This threw me into the world of health care regulation and being enlisted as a heath care surveyor. I was intrigued by variations in health care delivery across the country and various state regulations, and dovetailed this into my desire to travel. Due to my background, I became a health information consultant. Despite my various outside activities, direct patient care is still my full-time work and being a hospitalist allows me to continue these activities. This was my journey. In this edition we are pleased to bring to our readership the paths that other physicians have traveled to their current positions. Many of our authors have been approached by their colleagues and asked how it came about that they are in their current role and what opportunities there are for them in addition to or outside of patient care. These types of questions can come about at any time during one’s career in medicine and could signal a desire to do more, expound on what they already do, or make more of a difference in the current health care environment. One author mentions he was educating his patients one-on-one in his clinic and now uses radio as a medium to spread the message to thousands. Making a difference on the health care environment can be local, statewide or on a national level. Our authors explain how this occurred — some by chance, some by passion, others by seizing the opportunity. Several By Charles G. Terzian, M.D. Member, MetroDoctors Editorial Board
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have used their medical background as a stepping stone to alternative full-time careers, while others have continued to practice medicine and do their additional careers supplementally. Despite enjoying practicing medicine, a few of our authors questioned whether they really wanted to continue in clinical medicine and felt their calling was more of an administrative role. Most did not have formal business training, but rather were in the right place at the right time, saying ‘yes’ and relying on their personal experiences as practicing physicians. “We all,” as one author stated, “have medical foundations and critical thinking skills, which are easy to build on.” In these new administrative roles physicians can help shape health care policy and improve the system through design and ultimately improve the environment in which their colleagues work. Our Luminary for this edition is a classic example of a physician who did a mid-career directional change because he was intrigued by a chance to take a leadership role and make a difference in our health care delivery system. He also helped educate other physicians who have had similar goals through the University of St. Thomas’ Leadership program. In this edition, we have presented a multitude of authors who have sought alternative practices in all aspects of medicine and society from the not so obvious such as investment counseling to directing health polices for our state. There are opportunites for all of us — we just need to look for them. When a new door opens, if you desire, you can step through it. Many people look to physicians for leadership and direction because we have inherent authority in our role in society as physicians. Seize that opportunity! The practice of medicine inspired you and will drive you to a potential new career. Change is good! Enjoy the journey! September/October 2015
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President’s Message The Doctor-Patient Relationship, Looking Back to the Future KENNETH N. KEPHART, M.D.
AS I WRITE THIS I AM ALSO PREPARING TO SPEAK to the incoming U of M medical
school class at their annual White Coat Ceremony on August 7. In reflecting on my own experience in 1976 when I was an entering medical student at the U, I remember only a few things. Mostly I remember the anxiety of wondering if I could actually succeed in the road ahead. It didn’t help when the Dean compared the learning in medical school to trying to drink water from a fire hydrant. I hope they aren’t still using that analogy. I got through it and was elected President of our medical school class of 1980 which included giving a speech at our graduation ceremony. My main theme was while looking ahead at all the different roads we would take that would differentiate us, we should remember the four common years of experience that we will always share. Membership in our state and component medical societies shares that common experience. We are all physicians. We all share common goals of providing the best care for our patients and providing leadership for the health of our communities. What should I say to this group of incoming physicians? I will of course invite them to become engaged in TCMS. I will inform them of their student membership and mention some of our activities and opportunities for them to get involved. But what should I say about the current practice of medicine? I think of all that has changed in our profession. New treatments and diagnostic tests, to be sure, but also the fundamental change in how medical care is delivered. We have gone from a hospital medical staff model with most physicians in small private practices, to large systems of hospitals, clinics and mostly employed physicians. While some lament this change and long for the “good old days,” others have embraced it and enjoy the security of a dependable paycheck and no worries about the “business” of medicine. Other changes are also occurring. Many other “doctors” are competing for patients — from nurses and chiropractors to Doctors of Chinese Medicine. Many patients are using the internet to not only get health care information but also health care. What will the medical landscape look like for these incoming students in 7-10 years? Needless to say much more will have changed but I am confident in my belief that the core of what we do will continue to be of value to our patients. We will continue to advance the science of medicine with new and better treatments. We will continue to apply this new knowledge through public health initiatives but more importantly one patient at a time. This sacred doctor-patient relationship has withstood the test of time and has shown its power to heal and help our patients as they go through their life and ultimate death. Through all the changes we need to keep our eye on this ball and make sure all we do enforces, not harms, this relationship. I believe our medical society has recognized this and it is reflected in our policies and activities. I am somewhat comforted in this belief by looking at past speeches to incoming medical students. One I particularly like was written and given by Dr. Francis W. Peabody to Harvard medical school students. He begins by commenting on the criticism the medical schools are under regarding their curriculum changes. He says “ The most common criticism made at present by older practitioners is that young graduates have been taught a great deal about the mechanism of disease, but they are too “scientific” and do not know how to take care of patients.” He goes on to describe in detail the current hospital-based training the students receive around specific organic diseases. He also stresses the importance of the personal relationship needed to help with the care of the patient. He closes with this: “The good physician knows his patients through and through, and his knowledge is bought dearly. Time, sympathy and understanding must be lavishly dispensed, but the reward is to be found in that personal bond which forms the greatest satisfaction of the practice of medicine. One of the essential qualities of the clinician is interest in humanity, for the secret of care of the patient is in caring for the patient.” This talk was published in JAMA, Vol 88, pp 877-882, Mar. 19, 1927. 6
September/October 2015
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TCMS IN ACTION SUE A. SCHETTLE, CEO
Very Well Attended Healthiest State Summit Thanks to the great work of Thomas E. Kottke, M.D., moderator and program chair, and Nancy Bauer of the TCMS staff, the Healthiest State Summit was a huge success. The event was held on Thursday, August 6 at the University of Minnesota Continuing Education and Conference Center in St. Paul with 115 people in attendance to work toward solutions for Minnesota to reclaim our #1 ranking as the healthiest state in the nation. Commissioner Edward Ehlinger, M.D., MSPH, was the keynote speaker with experts from education, business, housing and human services all participating in a dialogue on “health in all policies.” See related article on page 22.
Keynote Speaker MDH Commissioner Edward Ehlinger, M.D., MSPH.
A Victory at the Legislature TCMS can claim victory for an appropriation of $250,000 over the biennium to support a state-wide advance care planning resource organization. The appropriation will be administered through the Minnesota Department of Health. Honoring Choices MN will MetroDoctors
apply for the funding when the RFP becomes available this fall. TCMS Legislative and Policy Committee Tackles Prescription Fraud TCMS convened a workgroup to look at the problem of Rx fraud. Members of the workgroup included TCMS physicians, Minnesota Board of Pharmacy, local DEA, Prescription Drug Monitoring program, and others. We started the meeting with a story — of Marie Olseth, M.D. — a TCMS member whose DEA number had been stolen, and the inordinate steps that she needed to take to resolve the case herself. More details will be forthcoming on this workgroup with a recommendation likely forwarded to the TCMS Board of Directors. Honoring Choices National Network Continues to Expand The Honoring Choices brand continues to grow and grow. The state of Idaho is our 12th “Honoring Choices” national network partner. In addition to Idaho, other Honoring Choices states include Minnesota, Wisconsin, North Dakota, Virginia, Alaska, Hawaii, Oregon, Washington, Florida and Massachusetts. We also have Honoring Choices Napa Valley as a national partner. TCMS receives an annual royalty fee for the use of our trademarked name. It shows good progress for the advance care planning movement and for TCMS’ bottom line. TCMS Physician Advocacy Network Grows Ellie Parker, MPH, is the project coordinator for TCMS’ work on educating
The Journal of the Twin Cities Medical Society
physicians on what we know about e-cigarettes and then engaging the physicians in local policy through the Physician Advocacy Network. Ellie has engaged over 150 physicians, medical students and allied health professionals in her work in just a few months. There is still much to learn about e-cigarettes, and our goal is to educate our members on this topic. Ellie has created CME modules that can be delivered live and via Webinar. Please contact Ellie if you’re interested in learning more, eparker@ metrodoctors.com. Honoring Choices Minnesota The 6th annual Sharing the Experience conference brought together 160 members of the health care, palliative and hospice community on July 16. This event provides an opportunity for attendees to share their learnings while gaining new knowledge and insights for advance care planning. See related article on page 24.
Palliative care physician leaders Howard Epstein and Joe Amberg attended Sharing the Experience conference.
September/October 2015
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Opportunities Outside of Patient Care
Opportunities Outside of Patient Care Editor’s Note: In this issue of MetroDoctors several physicians who have elected to pursue opportunities outside of patient care, on either a full- or part-time basis, as a career or a complement to an existing practice, were invited to provide a brief narrative of the role(s) they are filling.
Ben Bach-Wiig, M.D. President, Abbott Northwestern Hospital
I loved the practice of medicine, particularly being a positive part of patients’ lives by developing healing relationships. I got my start in leadership at North Clinic in Robbinsdale, first as Medical Director then as President. The primary skills that helped me make the leap to leadership were being a fast learner, curiosity about how our business works and listening/synthesizing skills that allowed me to process other points of view. I also led the medical staff at North Memorial Medical Center and was a member of their Board of Trustees and at Medica Health Plan. I moved into full-time leadership in 2009, joining Allina Health as Abbott Northwestern’s Vice President of Medical Affairs, then as President in October 2012. As a physician in leadership, I take the lessons learned during my time with patients and apply them to leadership. Active listening, differential diagnoses, evidence-based decisionmaking and making decisions with incomplete information are skills that translate into leadership roles. Other important skills include developing teams, conducting business analytics and understanding the influence of leadership in complex organizations. Two experiences helped me develop essential skills. First, the North Clinic administrator left abruptly so I took a leave from my practice to run the clinic for six months. I became keenly aware of the operational details of running a business. 8
September/October 2015
I vowed I would never again not know how the business I worked for was being run. The second experience occurred while I was on the Medica Health Plan board. I was asked to lead the Audit Committee, a position usually held by an accountant or someone with a strong business background. I sought training from the CFO and auditors so I could be comfortable reviewing the financial statements and understanding that business at a deeper level. The time I spent serving on boards of directors taught me about how teams function, how to lead through influence in an organization and that you need to learn to be thoughtful about the comments you make. I would advise colleagues or medical students who might be interested in an administrative path to understand the operations behind the work you are doing. Do not underestimate the leadership skills you’ve learned being a clinician. It’s a question of adapting those tools you’ve learned at the bedside to a leadership role. Finally, keep your head up. There are opportunities to lead all over the place but you have to have your eyes open to see them.
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The Journal of the Twin Cities Medical Society
Kathleen Brooks, M.D. Director, Rural Physician Associate Program, U of M
I serve as the Director of the Rural Physician Associate Program (RPAP) at the University of Minnesota Medical School. It has been a privilege to lead this program over the last 7+ years. RPAP is a 44-year-old program designed to nurture third year medical student interest in rural primary care by placing students in rural communities for nine months to live and learn medicine. My site visits to teach students and interface with talented community preceptors increased my understanding of challenges and rewards of rural practice. My personal journey to this job started when I trained as a family physician and practiced in the Twin Cities. I became interested in the business side of medicine in the early 1990s, obtained an MBA from the University of St. Thomas and began more administrative work. My health policy course at St. Thomas captivated my interest in that bigger picture. This led me to receive a Bush Fellowship and an MPA degree from Harvard University’s Kennedy School of Government. Subsequently I pursued a combination of health policy work with federal and state government programs, teaching, administration and
Gregg Dyste, M.D. Expert Witness Medical Practice
I was first approached by an attorney representing a neurosurgeon in a malpractice case approximately 10 years ago. While somewhat apprehensive initially, I agreed to review the case and was able to provide support for the care he had provided that resulted in the case being dropped. If you haven’t had a malpractice case against you, you can’t imagine the angst, guilt, loss of sleep and diminished productivity that you experience. I had helped alleviate that stress for a colleague in a malpractice case that did not have merit. This accomplishment felt very different and novel. In most cases I find the physician’s actions to be easily supported. But not always and this isn’t necessarily what either side is looking for from an expert witness. What the attorneys need are physicians willing and capable of providing honest, objective and fair opinions about their case. Can you support the care provided or not? Does the case have merit or not? My belief is that if we want medicine to remain an honorable profession, physicians need to be involved in this process. The review process involves all of the medical records, pertinent literature and often some discussion with colleagues on points pertinent to their specialties. I interact with the attorneys to help generate my affidavits and will spend hours MetroDoctors
The Journal of the Twin Cities Medical Society
clinical practice, varying the amount of each over the ensuing years. Approximately 10 years ago while teaching part-time at the University of St. Thomas’ Physician Leadership College I realized how much I loved working with learners. This led me back to my medical school to work and to learn how to teach. Here I have enjoyed positions as assistant and associate dean and director, teaching and leading medical school programs. RPAP is an internationally known program, representing a strong educational and workforce development model. My work involves administration of and teaching in the program, representing the program and our medical school externally, and consulting to other medical schools about implementing such programs. My career path has been eclectic and evolved as I followed my interest in primary care, and in building solid health systems including addressing physician workforce and access.
reviewing records and depositions in preparation for testifying. I have particularly enjoyed the challenge of live testimony in court. The mental aspect of anticipating questions while formulating a response that supports my position using language that the lay jury will understand is challenging — but fun. There hasn’t been any formal training to prepare for live testimony but in each of these cases the attorneys have provided a framework on how best to respond to questions. After 26 years of active practice plus six years of residency, much of what we do and see is repetitive — rewarding, but repetitive. I found that this work layered nicely onto my practice at a time in my career when I was looking for something different. I know that I’ve made a difference in the lives of the physicians and patients that I’ve helped with my reviews. It certainly isn’t a part of practice that I planned for 32 years ago, but it has been very rewarding. Any physician with interest in this line of medical work should contact their malpractice provider to express their interest. September/October 2015
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Opportunities Outside of Patient Care Edward P. Ehlinger, M.D., MSPH Commissioner, Minnesota Department of Health
Within months of beginning my clinical practice in a small rural town, I came to the stark realization that I could be busy treating patients every day of my medical career without significantly improving the overall health of the community. The forces of ill health — poverty, inadequate education, tobacco and alcohol use, unsafe work environments, poor nutrition, dysfunctional relationships, unsafe sexual activities, etc. — were overwhelming my efforts. Even though I could impact the health of the individuals in my practice, I couldn’t treat the town into health. I decided then to focus my career on integrating clinical care with public health — balancing the need for prevention and treatment by addressing the clinical, environmental, and social determinants of health. That decision influenced my decision to get additional training in public health and my choices of where to practice — the Minneapolis Health Department (which at the time did both clinical care and public health) and Boynton Health Service (a primary care clinic within a public health organization). Although the Minnesota Department of Health doesn’t provide clinical care, my position as Commissioner of Health allows me to develop and advocate for policies and programs
Howard Epstein, M.D., FHM, CHIE Executive Vice President and Chief Medical Officer, PreferredOne
When I was in medical school thinking about which specialty was right for me and imagining my future career, becoming a “certified health insurance executive” was definitely not in the picture. As the late Jerry Garcia said, “What a long, strange trip it’s been.” My first several years in practice included attending on inpatient IM and FP residency medical teams, outpatient clinic, nursing homes, urgent care and even the ED. After 3½ years and a strong exposure to the adult “continuum of care,” I was tapped to help start a new program at Regions Hospital called Hospital Medicine. Even then, I recognized this as a definite fork in the road for me. I was fortunate to have had senior leaders, supervisors and a corporate culture that encouraged interested physicians to expand their professional skill sets to include leadership, quality and process improvement, and systems-based thinking. Training through local and national groups like ICSI, the former ACPE and SHM’s Leadership Academy also provided valuable educational content, professional development and networking. My hospitalist career paved the way toward medical administration in case and disease management, utilization review, program development and exposure to what is often referred to as “the business side of medicine.” It also created a paradigm 10
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that integrate clinical care with public health efforts at a statewide level — essential if we are to improve both individual and community health. Although a master’s degree in public health was not a requirement for any of those positions, the public health perspective that the additional education helped provide was essential. The credential was a shorthand way to demonstrate my public health competence. Most physicians go into medicine to make a difference in the health of their community. Adding a public health component to a clinical practice advances that goal. I have been blessed with opportunities to do both clinical care and public health throughout my career — a career that has been tremendously satisfying. I encourage all physicians entering the field and those who’ve been physicians for a long time to add a public health component to their professional lives. It’s never too early or too late to do that because the opportunities are endless and the need is great.
shift for me from caring for patients one by one, to seeing a potentially larger impact by helping to improve the system of care for hundreds of hospitalized patients. Eventually, this led to my recruitment as a medical director at Blue Cross Blue Shield. I often refer to this as my “second residency,” as it was soon obvious that there was a lot more to “the business side of medicine” than I could have ever imagined. That experiPhoto by Kathryn Forss ence, and further exploration of the changing healthcare landscape with providers, payers, employers and patients/consumers during several years at ICSI, certainly helped prepare me for a position as the senior medical executive at PreferredOne. I find it fascinating and somewhat miraculous that, with the exception of starting the Palliative Care Team at Regions, I never purposefully planned for any of these career moves. Rather, I believe it was a commitment to lifelong learning, openness to new trends in medicine, being blessed with extraordinary support from colleagues and mentors, and a willingness to take educated risks that has served me well throughout my career. MetroDoctors
The Journal of the Twin Cities Medical Society
Joel Greenwald M.D. CFP® Founder, Greenwald Wealth Management
I completed my Internal Medicine residency at the University of Minnesota in 1990 and practiced at HealthPartners for 11 years. The stresses of a two-physician household on our growing family prompted my wife and me to consider alternative career options. She was a Radiation Oncologist and passionate about her work, while I was an Internist who enjoyed my job. With outside forces increasingly intruding on patient care, we wondered if it made sense for both of us to continue practicing medicine. I decided to explore financial planning. I completed six courses and passed the Certified Financial PlannerTM exam, while practicing as a full-time physician. The more I studied investments, insurance and estate planning the more enticing I found it! I began building my new practice in 1998, working three days as a physician, and two days as a financial planner before transitioning to full-time financial planning. While retaining my license, I haven’t practiced medicine since 2000. This occupation parallels practicing medicine in many ways. Previously, patients came to me with their health concerns, asking for diagnosis and treatment. Now, physicians and dentists come to me with their financial concerns: Are they on track for retirement? Can they afford their children’s dream
Julia Halberg, M.D., MS, MPH, FACOEM VP Global Health and Chief Wellness Officer, General Mills
As Vice President of Global Health and Chief Wellness Officer of General Mills, I lead the company’s global approach to preventive care, health education, and well-being programs including medical advocacy. Supporting our employees and their families by listening to their health concerns, providing reputable resources, and encouraging second opinions when appropriate empowers them to ask the questions that will provide them with the information needed to make the best decision for their health and well-being. It has been the most rewarding part of my career since joining General Mills in 2001 as the Medical Director of Health Services. After finishing an internal medicine residency, I completed a fellowship in occupational medicine that included spending two months with the General Mills Health and Human Services team. I learned about the roles and responsibilities of the department with outreach to 17,000 employees. Both company physicians became mentors to me throughout my career while working in both private practice and hospital-based occupational medicine clinics as well as with insurers. Since that time, the scope has grown with the company global expansion MetroDoctors
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college? Do they have adequate life and disability insurance? Can they save money on taxes? I relieve their financial worries, freeing them to concentrate on their practices and personal lives. Skills that make a good physician — attention to detail, an inquisitive nature and capacity to listen — are also central to being a good financial planner. Whenever contacted by physicians considering making this type of transition, I happily share my insights. Financial planning is rewarding once one is established and has a solid client base. But getting established — marketing one’s services and attracting clients, is more difficult than you’d imagine! Although I’ve taken a circuitous path to financial planning, my medical training and experiences as a physician weren’t wasted. They’ve provided me invaluable insights when working with my dental and physician clients. Securities and advisory services offered through Commonwealth Financial Network®. Member FINRA, SIPC, a Registered Investment Adviser. Greenwald Wealth Management, 1660 South Highway 100, Suite 270, St. Louis Park, MN. (952) 641-7595.
to 42,000 employees with markets in over 100 countries on six continents. There is specific knowledge required relating to benefits strategy, quality of our products and processes, health promotion, and protection of our employees specific to the food manufacturing industry. In addition, building an environment conducive to healthy behaviors such as walking work stations, healthy meal options, on-site clinics specializing in preventive care and resiliency services have nurtured a culture of health at General Mills. Having the ability to advocate for the health and well-being of our employees and their families while creating a culture of health and well-being allows us to work toward our goal of making employees’ time at work the healthiest and safest part of their day. To my colleagues interested in branching out, follow your passion and you will define your purpose. Embrace change and new opportunities and your career will lead to lifelong learning. September/October 2015
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Opportunities Outside of Patient Care Jon Hallberg, M.D. MPR Radio Personality
I serve as the regular health and medical analyst on the regional “All Things Considered” program on Minnesota Public Radio (MPR). I started this work in 2003 and I’ve appeared over 400 times since then. My spots typically air on late Tuesday afternoons during drive-time, lasting four to five minutes. We’ve added a podcast (“Hallberg’s Picture of Health”) this year, which is a longer version of our conversations. Our producer, Jayne Solinger, used to work at Twin Cities Public Television (TPT) on a show called “Health Diary.” I started working on that show when it began in 1998, reading some of the scripts for medical accuracy, and I appeared on camera a few times doing a short segment called “Second Opinion.” When that show lost its funding in 2002, Jayne went to work at MPR. The new host of “All Things Considered” wanted to have a few regular sections (like health care) and Jayne thought of me. We did one spot as a bit of an audition — and I passed. I love radio. Working there was a nobrainer — and a dream-come-true! I don’t have any special skills other than having an inherent sense of curiosity and a love of good conversation. Being a generalist (a family physician) is certainly an asset given that we discuss all topics, covering all ages.
David Hilden, M.D. WCCO Radio Talk Show Host
I am an internist and the Assistant Chief of Medicine at Hennepin County Medical Center. I also host “Healthy Matters,” a weekly live radio talk show on WCCO 830 AM, now in its seventh year. The format is an informal mix of health information with lots of listener interaction by way of call-ins and text messages. HCMC was looking to expand into radio broadcasting and needed a host. Two of my colleagues suggested I audition, both noting that I have a tendency to never stop talking. I was named the show’s host in 2009. I remember being called into the CEO’s office who basically said, “You’re the voice of the hospital now . . . don’t blow it.” I started out with no media experience. The show requires me to rapidly respond to a virtually unlimited range of questions, to be able to actively listen to real people, and to be able to speak in a conversational way into a microphone — trusting that some tens of thousands of people are listening to what I say. By far the biggest skill set I needed to develop was in communication. The show has brought me an increased amount of visibility at HCMC. This has led to opportunities for me to do 12
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I’m in clinic five to six days a week, providing direct patient care, something I’ve come to think of as ”micro” medicine, caring for individual patients one at a time. Doing my spot with MPR allows me to reach nearly 35,000 people (“patients”) at a time, something I think of as “macro” medicine, a form of public health, to be sure. I love that! The only downside is that I know that many physicians and many intelligent listeners are tuning in at any given time; I really need to do my homework before heading over to the studio. There’s a great need for quality health communication and radio is a great way to communicate in a thoughtful way. If this kind of work appeals to physicians, reach out to a local radio (or television) station. It’s surprising how receptive producers and hosts are to this kind of offer. After all, there’s a lot of “air” to fill any given day, and when there’s good, quality information and wisdom to be shared, people are more than willing to listen.
more community outreach, public speaking, and even some writing (I am currently in the early stages of writing a book based on “Healthy Matters”). All of this has been an important balance to my clinical and administrative work — I have developed a connection to people on a scale that feels relevant to me. To my colleagues interested in branching out, don’t be hesitant to go outside your comfort zone. Doctors build their credibility first and foremost by being clinicians so don’t move out of clinical practice too much. But maintaining a busy clinical practice for your entire career may not be sustainable for long. Look for ways to be active and visible in whatever community to which you belong — whether that be in volunteering, community outreach, teaching — whatever! Finding balance in your life is so very important.
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Andrea Hillerud, M.D. Medical Director for Quality & Health Outcomes at Blue Cross Blue Shield of Minnesota
I practiced full spectrum family medicine including obstetrics until shortly after the birth of my youngest child, and have always found the long-term relationships with patients and their families, through both good health and challenging times, to be most rewarding. After I became a shareholder with Marshfield Clinic, the multi-specialty physician-owned group I practiced with in Wisconsin for well over a decade, I was recruited to develop and enhance wellness, disease management and quality improvement programs for our clinic-owned health maintenance organization on a part-time basis. Our group practice had a long history of commitment to healthcare access for the underserved, particularly in rural areas, and founded the first HMO in Wisconsin back in the early 1970s. Through this experience, I gained some understanding of the payer side of health care delivery, and I appreciated the chance to design and initiate our first Medicaid P4P program for our network physicians and allied providers. I did not have any prior formal business nor health plan experience when I started doing work on behalf of our HMO — just my personal experience as a practicing physician in Canada, where I grew up and trained, and in my adopted country of citizenship, the United States of America.
Roger G. Kathol, M.D., CPE President, Cartesian Solutions, Inc.™
After working 20 years as a jointly trained and now full-time Professor of internal medicine and psychiatry at the University of Iowa, I decided to start a consulting company that helped stakeholders in health care integrate medical and psychiatric services. I reasoned that, by doing so, I would be able to make my greatest contribution to patients with concurrent illness during the remainder of my professional career. At that time, there were few that understood the destructive elements of segregated medical and psychiatric service payment and delivery. Daily work in integrating care for complex patients with comorbid illness at the University gave me special insight into the challenges of maintaining financial solvency when independent “medical” and “behavioral health” insurers competed to divert payment for treatment from their funding pool. Solving the problem of Descartes’ historical separation of mind and body had to do with more than just providing concurrent care. After business preparation by becoming a Certified Physician Executive, I incorporated Cartesian Solutions, Inc.™, a consulting company dedicated to assisting hospitals and clinics, health plans, government agencies and businesses providing integrated services to their patients, members, enrollees, and employees with complex health issues. Now in its 18th year, MetroDoctors
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Two years ago I got the opportunity to join Blue Cross and work on projects to help improve health outcomes for Blue Cross members. It has been gratifying to build and implement initiatives like our Medicaid member incentive program, which promotes healthy behavior by financially rewarding Medicaid patients when they and their family members pro-actively seek preventive care and better health, such as completing the recommended complement of childhood immunizations or attaining a satisfactory diabetic A1C level. For my colleagues who are interested in branching out, I suggest keeping an open mind about opportunities available outside of direct patient care which can have a positive impact on health outcomes. One way to discover these opportunities is through active participation in professional organizations. My prior roles as president of my local county medical society, and as a board member of my state medical society, provided me a view of how physicians can make a positive difference on a larger scale population-based level.
over 100 consultations have been performed. Further, understanding gained during the consultations has allowed me to contribute as a part of numerous national and international health advisory groups and to continue to publish new knowledge on integrated care and payment in peer-reviewed journals. Over the years a number of unexpected lessons have made my transition from clinical to administrative medicine even more rewarding. The most important of these include: 1) understanding alternatives to segregated financing of medical and behavioral services;, 2) appreciating the contribution that integrated case management can play in augmenting care for complex comorbid patients; and 3) recognizing the importance of transition to integrated medical and behavioral health care delivery in reaching health reform’s Triple Aim. Each of these lessons has allowed me to make unique contributions that will hopefully improve the health and lives of some of the most challenged patients, including those in Minnesota. September/October 2015
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Opportunities Outside of Patient Care Adam Lokeh, M.D. VP Clinical Development and Informatics, Wolters Kluwer Health
Most of my adult life, I thought of nothing other than making a full-time career of practicing medicine. Twenty-five years later, I find myself representing Wolters Kluwer Health as a VP of Clinical Development and Informatics while maintaining practice as a plastic and reconstructive surgeon at Twin Cities Plastic Surgery. The opportunity to moonlight for a medical school classmate’s start-up during my residency introduced me to the world of medical software development and health informatics. Then, it was simply a means to augment my meager resident salary. Later, as a newly minted plastic surgeon waiting impatiently for my practice to grow, I was invited back to the organization which by then, had been acquired by Wolters Kluwer Health. This time, beyond additional income, it provided me an outlet to exercise my lifelong interest in all things IT. I considered it an avocation that I was paid to enjoy. A series of life-altering events led me to re-evaluate the pace of my life as a reconstructive surgeon at a Level 1 trauma center. I had to make a change. While not intentional, I found myself taking on progressively more responsibilities with Wolters Kluwer while simultaneously re-establishing my clinical practice in a more sustainable way. I’ve subsequently returned to trauma reconstruction; this time as part of Children’s
Robert Moravec, M.D. Field Surveyor, The Joint Commission
Helping hospitals to attain a state of consistent excellence, I have been a Field Surveyor for The Joint Commission (TJC) for 2½ years now. I find it to be the most interesting position I have ever had. While most physicians might say that this is the ultimate “Dark Side” (worse than hospital administration), I find it to be very satisfying and pertinent to everyday healthcare. Approximately five years ago, TJC changed their mission to include the statement, “…evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.” With this change in the approach, I was intrigued by the opportunity to join TJC team. The opportunity to be part of the improvement process for many different organizations across the country was one that I could not pass up. By approaching the survey in a collaborative and consultative manner, I am able to assist the staff with improvements and increase patient safety and quality of care. The team brings key principles of high reliability and Robust Process Improvement® to each organization. My past roles as a Medical Director for two different 14
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Hospital’s Level 1 trauma program. The flexibility I’ve been afforded by the leadership at Wolters Kluwer has been key to my success in maintaining a surgical practice. What I’m able to give back to the organization are the insights and experience of a practicing physician. I’m able to provide a perspective on usability and the likely reception our clinical decision support tools will receive in the workplace. As a result of my slow transition to this new profession, I was privileged to have a lot of time for on-the-job training and education. Becoming board certified in medical informatics by the American Board of Preventive Medicine has served to formalize my years of experience. My advice to anyone thinking of pursuing an alternate path to clinical medicine would be to pursue something you truly enjoy. While the path I have followed is one I never could have predicted, I remain pleasantly surprised each day at the level of satisfaction I have in my professional life. Most critically I remain grateful to my family for supporting me while I forge my new professional path.
Emergency Medicine departments and for St. Joseph’s Hospital in St. Paul have helped me immensely to transition to the role as a surveyor. But additional training is needed. The transition from acute care physician to a surveyor is approximately three months. There are several precepted surveys in the field with an established team and didactic training to demonstrate competency as a surveyor. In addition, annual face-to-face training and ongoing periodic webinars are required to keep current. My own personal goal during a survey is to foster the best practices I see all over the country to help each individual hospital improve their delivery of care for their patients. I look at each survey as an opportunity to inspire the organizations to excel and improve, and I know that they are a safer organization at the end of the survey than they were at the moment we walked in the door.
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Jane Pederson, M.D., MS Chief Medical Quality Officer, Stratis Health, and Geriatrician, Allina Senior Care Transitions
When I worked fulltime in clinical practice, I enjoyed patient care but found myself asking “why do we deliver care the way we do?” There had to be ways to make improvements that would benefit both patients and providers. During my Master’s degree program in Health Services Research and Policy at the University of Minnesota, the work of Avedis Donabedian and quality improvement resonated with me. I wanted to better understand how to improve processes in a way that made work more efficient and could lead to better outcomes. One day I got a call asking if I would consider a position designing projects focused on health care quality improvement. I’m still with Stratis Health 19 years later. I continue to work as a clinician in the assisted living setting. Much of quality improvement is about systems thinking. My training as a physician prepared me well for that. I apply this thinking in projects like developing root cause analysis training and on a larger scale when developing the national Quality Assurance Performance Improvement approach for nursing homes. I need to present information in a way that walks people
Brian Rank, M.D. Co-Executive Medical Director, HealthPartners and Park Nicollet
I am Co-Executive Medical Director for the HealthPartners and Park Nicollet care organization, along with Dr. Steve Connelly. I’ve loved my clinical role in supporting patients with cancer and blood disorders for the past 30 years, but I’m equally passionate about teaching and making care better for patients and us clinicians. I got my first taste of this as director of the Internal Medicine Residency Program at HCMC. It fascinated and energized me. It made me want to do more, and I’ve found even more opportunity as a leader at HealthPartners and now the combined HealthPartners and Park Nicollet, where we’re working to transform care and create “Triple Aim” outcomes. For patients, I’m most passionate about driving better clinical outcomes and experience of care while improving affordability. For clinicians, my goals are to support increased satisfaction, sustainability and joy in what we do. To be successful in this job, I learned that first it takes a sense of humility in recognizing how often health care today fails those we serve. It takes immense respect for the hearts and minds of clinicians and administrators who care deeply and work hard for their patients’ health. It takes balancing MetroDoctors
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through why something is important, illustrates how something can be done and then helps them learn how to apply it to their work. In clinical medicine you need to seek out the expertise of others to better inform your own work. I’ve needed to expand my network of colleagues across a variety of different roles, including CMS program staff and association leadership. Just like in clinical medicine, I get satisfaction from making someone’s life better. On top of that, I love the creativity in constantly looking for new ways to help clinicians and other providers take care of patients. Quality improvement cannot be done in isolation — so most of my work is done with my Stratis Health team or with others in the community. As physicians, our medical foundations and critical thinking skills are easy to build on. If you have an idea that makes you excited — pursue it.
impatience for improvement with diplomacy. It takes a willingness to listen, hear and honor different perspectives. And it takes remembering the real-world, point-of-care physician/patient relationship when considering how to innovate. It’s been immensely satisfying to work with so many wonderfully talented colleagues with like-minded interests in transforming care. It’s rewarding to work in Minnesota, where collaboration between care delivery systems, employers and payers is second-nature. It helps us all learn and improve. Interested in exploring new opportunities? Start where you are, in your own clinic or department. Work with your local leaders to improve something important. If that’s satisfying, and you have the aptitude, offer to lead more improvement. As you do, seek to understand and embrace both the technical aspects of improvement and the human aspects of change, and develop the ability to work with others to lead change. Critical factors for a successful career: stay curious, focused on results; and build a great team with common vision. September/October 2015
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Opportunities Outside of Patient Care Joshua Riff, M.D. SVP Consumer Products and SVP Prevention and Wellness, Optum
I currently work for Optum where I have a few roles. The first is SVP of Consumer Products. In this role I am creating products and solutions that we can sell directly to individuals to improve their health and wellness. This idea was born out of the increased role of the consumer in health care. I am also the SVP of Prevention and Wellness. In this role I lead the teams that help Optum consumers live their best lives. Our portfolio includes running corporate fitness centers, biometric events, wellness coaching, and digital wellness products including employee assistance programs. I was attracted to this role to fulfill my commitment to medicine, which is to really help people achieve their potential. As a board certified ER doc I spent the majority of my clinical time dealing with problems that were 100 percent preventable. In my role today I get to prevent them from ever happening. I am incredibly lucky to be able to use both my MD and my MBA in the pursuit of my passion. The decision to leave full-time clinical medicine is one I struggled with. I loved clinical practice but I also realized that it was not fulfilling in the long run. Being in Emergency Medicine was incredibly rewarding in terms of “saving the day” but it was hard to make systematic changes that could improve the system. Going into management (first to Target as their Chief Deborah Wexler, M.D. Executive Director, Immunization Action Coalition (IAC)
My work has always been based in community medicine. During my family practice residency through the University of Wisconsin – Madison, I provided care to many Hmong patients affected by hepatitis B. When I later joined “La Clinica” (West Side Health Center) in Saint Paul, I saw many other Hmong refugees who had received few or no immunizations, including for hepatitis B. When measles became a national public health crisis during 1989-1991 and three local Hmong children died from the lack of MMR vaccination, I realized it was time for more concerted community health action. So we began providing vaccination services and immunization education at local Women, Infants, and Children (WIC) clinics in Saint Paul and published a monthly vaccination newsletter for medical clinics and public health departments. If you have an issue you care deeply about, it is a good rule to find others who share your passion. Working together becomes contagious as others catch on to the combined passion. In 1990, I began talking with a Saint Paul Public Health epidemiologist about hepatitis B prevalence in Saint Paul’s Hmong community and it led to the founding of the Immunization Action Coalition (IAC). In 1995, IAC became a nonprofit organization and 16
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Medical Director and now to Optum) gave me the opportunity to have “continuity of care” and to see ideas come to life. While I do miss the “great saves” and difficult diagnoses of clinical medicine, I am truly satisfied and lucky to have found roles that allow me to leverage my love of health care with my desire to improve the system. Often I am contacted by doctors or MD/MBA students who ask about “the other side.” Medicine requires a lifelong commitment. The best doctors love what they do, they love the system, they love their patients. But the minute you question whether you really want to be a clinical doctor or in administration it is clear that you need to branch out and explore. So my advice is simple; raise your hand. Call your hospital administrator, entrepreneur, or payer. Let them know you are interested and give it a try. You have looked patients in the eye when you have made a terrifying diagnosis, you see what it is like to be on the receiving end of a poorly conceived system, and you know how to make it better. You won’t regret it.
soon received its first Centers for Disease Control and Prevention (CDC) grant for $750,000 over three years. Today, IAC is the largest national nonprofit organization dedicated solely to protecting people across the age span from vaccine-preventable diseases. I consider myself to be a physician who is still deeply involved in clinical medicine because IAC’s mission is grounded in patient and community-centered care. Today 25,000 visitors per day access our websites and more than 5 million immunization PDFs are downloaded each year. Our library of Vaccine Information Statements (VIS) in 40 languages is the nation’s central repository for these documents that describe the benefits and risks of vaccines and are required by the federal government to be handed to patients with every vaccination. I am grateful that my passion has only increased over time and I now have the honor of working closely with national vaccine and immunization leaders who are equally committed to saving lives through prevention of disease. MetroDoctors
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Opportunities Outside of Patient Care
Medical Management: A Logical Next Step for Physicians Looking Beyond Clinical Work The CPE credential helps physicians gain an edge in management skills and knowledge
A
s momentum increases for physician leadership across health care nationwide, doctors are taking on administrative roles in greater numbers. The unique vantage point of physicians makes them ideal choices as effective leaders. “Physician leaders can provide critical insight about the clinical implications of business decisions, guide organizational changes and performance improvement initiatives, ensure continued prioritization of care quality despite the increased focus on cost and efficiency, and they can successfully advocate for patients, as well as for all types of patient care providers in a balanced fashion,” says Peter Angood, M.D., FRCS(C), FACS, MCCM, President and CEO of the American Association for Physician Leadership®. Management in health care can be a great fit for physicians who want to mentor other care givers or lead improvement initiatives as they transition out of fulltime clinical roles. But clinical expertise offers little help when a doctor is called upon to juggle the complexities of health law or evaluate a financial spreadsheet. Since 1997, about 200 physicians a year have pursued and completed the
By Gina Bowden-Pierce
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Certified Physician Executive (CPE) credential, which not only engages them with law and finance, but also high-level management and communication skills. Electives for the CPE credential focus on key aspects of the business of health care, including health IT. There are currently about 2,200 CPEs. “I was interested in acquiring formal training in leadership skills to enable me to advance my career within my organization and felt that the CPE program was designed to do this while enabling me to obtain a well-recognized certification,” says program participant Varsha Moudgal, M.D., CPE, FACP, FIDSA, infectious diseases fellowship program director and infectious diseases section head at St. Joseph Mercy Hospital in Ann Arbor, Michigan. “Skills learned during the course of my CPE training
have enabled me to understand more about quality, finances, negotiations, etc., and have resulted in my becoming a more capable leader in my institution. In addition, I am considering joining an MBA program and the CPE serves to fulfill MBA prerequisites.” Faculty for the program are drawn from both academia and the business world, which allows participants an overview from both perspectives. “The program’s faculty has a unique perspective coming from some of the leading business universities in the country,” says program participant Richard J. Juda, M.D., CPE, President of Innovative Healthcare Group LLC in Naples, Florida. “An integrated business curricula based upon the challenges administrators deal with every day creates a learning environment for student success.” Participants also learn from each other. “The professional network of colleagues, which you interact with during the sessions, expands your horizons to develop your maximal career potential,” Juda says. “The colleagues whom I have met have become excellent resources for future collaborative development of the business of medicine.” To be eligible for the CPE program, an M.D. or D.O. must have a current license to practice medicine in the United States or its protectorates, be or have been board certified and in
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good standing and have three years of practice in that specialty and a year of management experience. Applications must be submitted through the Certifying Commission in Medical Management website: ccmm. org. To complete the program, candidates must have 150 hours of tested management education or a graduatelevel management degree and must pass the 3½-day capstone. The capstone includes pre- and post-event assignments, participation in group exercises and video-recorded presentation evaluations. Other requirements also apply. To recruiters, the CPE credential is a plus. “In a competitive market, it is a differentiator between you and other qualified candidates,” says J. Larry Tyler, president of Tyler & Co. executive search consultants. “It gives you a decided edge.” For complete eligibility requirements, visit the CCMM website: ccmm. org. The CCMM is a nonprofit corporation chartered by the American Association for Physician Leadership® to establish and maintain the standards for certification. For more information on the CPE credential program, call toll-free, (800) 562-8088, or contact Tina Ramsey, manager, advanced credentials, by email at tramsey@physicianleaders.org.
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Opportunities Outside of Patient Care
Learning the Business of Medicine
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r. John Cumming built his career as a surgeon at Hennepin County Medical Center, performing emergency surgeries and providing critical care for victims of trauma. As he approached his 50s, he remained dedicated to his work but increasingly came to realize that his specialty was really a younger person’s game. “My surgery shift would be from 7 a.m. to 7 p.m. and then I would stay and finish out the regular workday,” Cumming said. “This meant that I would often work 30 to 34 hours straight and it became harder to recover from these shifts. I started to look for opportunities that would allow me to reinvent myself for the next iteration of my career.” Cumming first considered a law degree, then decided that a masters of business administration would make the most sense for him and enrolled in the Health Care MBA program at the University of St. Thomas. As a physician with years of medical training and experiences on the front lines of patient care, he knew he was uniquely suited to take on a leadership position in health care but needed to close the gap between his physician’s skill set and those necessary for an administrative role, including human resource management, financial decision making and knowledge of current regulations and legislation. As the health care industry and the laws governing it become increasingly complex, clinics and hospitals rely on professionals who not only understand all facets of the industry but who can clearly communicate with patients, staff, By Rebecca Collins
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providers, business partners, insurance companies and regulators. Increasingly, physicians find that knowledge of the business side of health care, along with solid leadership skills, are as valuable as their medical training. Business and leadership training can take several forms. The Opus College of Business at the University of St. Thomas offers physicians the option of enrolling in its Physician Leadership College, a non-degree certificate program that focuses on developing leadership skills over the course of 13 months, or its Health
new concepts and methods for care and explains how the Affordable Care Act impacts employees and the hospital. He often helps physicians at the hospital navigate an increasingly complex industry. Increasingly, physicians are responsible for understanding nuanced regulations while also meeting high benchmarks for customer care and positive outcomes. The way care is delivered and afforded by patients is an ever-changing landscape, one that can be best managed with a grounding in business in addition to medical training.
Care MBA, a 21-month degree program with an intense focus on the business side of health care. Alumni of both the Physician Leadership College and the Health Care UST MBA are employed by Allina, Essentia, UnitedHealth Group, HealthPartners and Fairview Clinics. Dr. Mark Matthias, vice president of medical affairs for St. Cloud Hospital, began his career as a family physician but eventually saw the need to augment his medical training with experience in business and finance when he decided to take on administrative roles in hospitals. He earned his Health Care MBA from St. Thomas in 2014 and now puts what he learned into practice in his position overseeing the physicians at the hospital — a role he describes as being “a physician in charge of other physicians.” Matthias conveys the reason behind changes in practice to the medical staff, introduces
“The industry is changing so rapidly,” Matthias said, “that we need to keep up with the changing standards of quality of care, which are luckily very high in Minnesota, while at the same time learning how to best talk with patients about the cost of that care.” Meanwhile, he adds, “medical professionals need to focus on the great need for efficiency and excellence in all aspects of that care.” An MBA can also be of benefit to physicians in practice for themselves, as they develop a broader perspective from which to view their business. Finding ways to reduce costs or manage personnel are as integral to operating a successful business as providing outstanding patient care. After completing the Health Care UST MBA program, Dr. Donna Block launched Clinic Sofia in Edina, and later in Maple Grove, specifically to nurture a community of confident, healthy women,
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had,” Cumming said. “It met every expectation I had because through the program I was encouraged to go interview executives at HCMC, to find out what they do and how they view the industry. I talked to people like the CFO and the director of human resources and it got around the executive suite that I was pursuing this degree and they became very interested in me.” He was asked to join a few key committees at the hospital, which allowed him to start to contribute to administrative decisions. Then, when the position of vice president for medical affairs became available, Cumming applied for the job and got it. “None of this would have happened if I was not enrolled in the program at St. Thomas,” Cumming said. He started his
The Journal of the Twin Cities Medical Society
new position July 1 and will graduate from UST in November 2015. Cumming credits the degree program with allowing him to have the best of both worlds when it comes to his career. He remains clinically active by continuing to perform surgery on a part-time basis — although he’s happily escaped the long shifts — and is able to affect change and directly impact policy at HCMC based on what he’s seeing and experiencing in his work as a clinician. “Other executives at the hospital view this as a very valuable perspective,” he said. “It really helps them to do their jobs. I’m able to see things both as a surgeon and an administrator, which is not only unique but highly beneficial.”
Photo by Mike Ekern, University of St. Thomas
expanding the traditional definition of “women’s health.” “I really wanted to establish an environment where women were not only treated for medical issues but were made to feel that their concerns and fears were heard,” Block said. To her, a strong business sense and clear understanding of the financial picture is just as important as the care provided in order to ensure that the organization remains vital. She credits the MBA program with her ability to successfully implement and manage what began as a good idea but needed to be treated and maintained as a business in order to thrive. One unexpected benefit of such programs is the opportunity to bond with a cohort that moves through the program together, sharing a variety of perspectives and experiences that often combine to form a much clearer understanding of what’s happening in the industry overall. “What I loved most about the program was the culture,” Block said. “My cohort was made up of administrators and practitioners with diverse experience. That helped us develop a common language and has helped me, overall, in the business, by providing an insight into the different perspectives in any situation.” Matthias also valued his time with his cohort, which comprised professionals working in all aspects of the field — physicians, nurses, administrators and pharmaceutical executives — who offered support and insights to which he would not otherwise have had access. “One of the best things was the cohort,” he said. “Especially because of the intensity of the program. We all learned from each other and it made it a fun experience. It’s not for everyone, but it’s definitely for people who really desire a leadership role in health care.” In addition to giving physicians a grounding in business principles and management tools, a health care MBA often helps them to shift their focus from helping individual patients to the organization as a whole, making it possible to see ways in which to strengthen the overall structure. “The Health Care MBA has been the most tremendous experience I’ve ever
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Healthiest State Summit Kicks Off Dialogue to Improve Health Equity
T
o a packed house, MDH Commissioner Dr. Edward Ehlinger delivered the opening address setting the stage for the Healthiest State Summit. One hundred-fifteen members of the medical, public health, business, education and health and human services communities listened and engaged in the dialogue surrounding the topic of health and health equity. Dr. Ehlinger claimed that while “reclaiming Minnesota’s #1 health ranking” is a nice tagline, the reality is we want every state to be the healthiest it can be. We want Minnesota to be as healthy as possible, because disparities — local or national — affect everyone. He further noted that Minnesota was ranked #1 in 1992, and if we look back to see how that came about, we see that the leaders at that time invested in the public good, and emphasized cooperation. Wise investments and wise policy decisions were made back then that led to a healthy state. We didn’t reach the #1 spot by accident. Now, in 2015, Minnesota is trending in the wrong direction. Our income and healthcare disparities are getting greater. It’s a question of social justice and math. We need to recognize how conditions affect one another, how changes in one area,
such as parental leave, can affect another area, such as longevity. Looking at and sharing the data and statistics can help us make needed changes to improve the overall community health. We need to understand the difference between equity and equality, and equity needs to be the basis of starting all conversations about healthy communities. To quote the late Senator Paul Wellstone, “everyone does better when everyone does better.” Following this presentation, Commissioner Ehlinger moderated a panel of four community leaders. Each described what barriers they see for Minnesota to reclaim its spot at the top, and what role their sector is playing to identify and address these disparities. Panel members were: Andriana Abariotes, Executive Director, Local Initiatives Support Corporation (LISC); Sameerah Bilal-Roby, Director, African American Babies Coalition; Jim Chase, CEO, MN Community Measurement; and Lucas Nesse, Health Policy & Grassroots Director, Minnesota Business Partnership. Jerry Noyce, CEO of HERO (Health
Panel discussion facilitated by Commissioner Ehlinger.
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Keynote Speaker MDH Commissioner Edward Ehlinger, M.D., MSPH
Enhancement Research Organization) a collaborator, disseminator of information and research, described the work his organization does in partnership with the Robert Wood Johnson Foundation to engage business in creating a culture of health. Participants selected two of five breakout sessions to attend on topics that have affected the decline in Minnesota’s healthiest state ranking from #1 (in 1992) to #6
Thomas E. Kottke, M.D. Program Director and Emcee
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(by 2014). (Ref: America’s Health Ranking) Expert speakers and facilitators led discussions on binge drinking, housing, poverty and livable wages, education and structural racism. Questions pondered included: why are some populations more affected than others? What historical roots have led to current conditions? And, how could you or people from your organization work with people who are trying to have a positive impact on this issue? Jackie Boucher, MS, RD, Senior Vice President and CEO, Minneapolis Heart Institute Foundation, described a preventive care model of a community coming together to improve its overall health. The Heart of New Ulm Project is a 10-year initiative designed to reduce the number of heart attacks that occur in New Ulm, MN. Residents have made lifestyle changes at restaurants, grocery stores, schools and at home to make healthy choices the easiest choice. The day ended with breakout session facilitators presenting unique insights learned including identification of possible
steps with new partners to become familiar with critical aspects of improving our state’s health. Program chair and emcee, Thomas E. Kottke, M.D., MSPH, called
Andriana Abariotes Housing Expert Speaker
Melanie Peterson-Hickey, Ph.D. Poverty and Livable Wages Expert Speaker
Stephen Nelson, M.D. Structural Racism Expert Speaker
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Jackie Boucher, MS, RD CEO, Minneapolis Heart Institute
for all participants to “think differently and create health in all policies so that all residents of Minnesota can enjoy the benefits of good health that make the state a great place to live.” A final proceeding of the Healthiest State Summit is being prepared for publication and distribution.
Dave Golden Binge Drinking Expert Speaker
Don Samuels Education Expert Speaker
Jerry Noyce, CEO, HERO
September/October 2015
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Sharing the Experience 2015
T
he largest crowd in six years joined together to focus on Advance Care Planning (ACP) at this year’s Honoring Choices annual conference. More than 160 people from across Minnesota and a handful of attendees from seven other states spent the day together listening to keynote speakers, reports and updates, and learning about new tools, resources, and activities. TCMS President Ken Kephart, M.D., also the Medical Director for Honoring Choices, served as emcee for the day. “This conference is so important to our efforts in expanding advance care planning beyond our hospital systems,” Kephart stated. “This year, to see so many people here, and to see the enjoyment they have reconnecting with one another — it’s a great thing to be a part of.” Kephart’s sentiment was echoed by many at the conference who have come to see this annual event as something to look forward to all year long. On the event evaluation survey, many people list “networking” as the top feature of the day. An Honoring Choices volunteer, Lynn Betzold, shared that watching the crowd “was like watching a reunion of people who understand they are connected in some way, and are so happy to see each other again — even if they are meeting for the first time!” Because TCMS has been deliberate in making transparency and collaboration keystones in its Honoring Choices program, there is not a feeling of competition or a need to guard trade secrets when it comes to advance care planning. Sue Schettle, TCMS CEO, By Karen Peterson, BSN
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Ken Kephart, M.D., TCMS President, and Medical Director for Honoring Choices.
to both speakers, commenting that hearing personal stories like these make them understand, from a different perspective, how important the ACP work they do as health care providers is for their patients. Other highlights of the conference included the announcement that the Honoring Choices National Network recently added another state — Alaska — bringing the network to 11 states; the awarding of the inaugural Honoring Choices Volunteer Champion Award; updates on what three of Minnesota’s largest systems are doing with their internal ACP programs; sharing of new tools and resources; and reports from representatives of Minnesota schools of medicine and nursing (see related articles on pages 26 and 27). In addition, representatives from several state and nonprofit groups who work with various population groups throughout the state were on hand to share their resources with
highlights this atmosphere of sharing and finding strength in working together as one of the program’s primary strengths. Keynote speakers in 2015 were Kris Maser, an attorney specializing in elder law and a legal champion of ACP (she shared how everyone working at her firm is required to complete a health care directive) and Ruth Bachman, an author and motivational speaker. Each of the speakers shared their personal stories of working through cancer diagnoses, and how their lives have changed. Audience members reFrom left: Miguel Ruiz, M.D., Muaj Lo, M.D., and Shukri Hassan, sponded positively Community Health Worker. MetroDoctors
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attendees, further promoting collaboration and networking. Attendees declared the 2015 Conference a total success. Satisfaction was seen on their faces, heard in their conversations, and read in their evaluation comments. The presentation slides from most speakers can be found on the MetroDoctors website (search on 2015 Sharing). Thank you to all who attended and helped make the day so worthwhile. Mark your calendars now for the 7th Annual Conference, to be held Thursday July 21, 2016 in Minneapolis. Karen Peterson, BSN Director of Program Operations, Honoring Choices Minnesota. From left: John Maycroft, Honoring Choices Wisconsin, Sue Schettle, TCMS CEO, Carol Robinson and Carolyn Stramecki, Michigan.
Medical Student Ryan Holton.
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DNP students Leah Habicht and Elizabeth McLean.
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Attorney Kris Maser.
September/October 2015
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1st Honoring Choices Minnesota Community Champion Service Award The Twin Cities Medical Society announces the 1st Honoring Choices Minnesota “Community Champion Service Award” (2015), a statewide award given to recognize an outstanding volunteer in Minnesota who has provided exemplary advance care planning (ACP) education, community engagement and action on a community level. Honoring Choices Minnesota is a statewide initiative of the Twin Cities Medical Society that began in 2008 to make ACP accessible for all Minnesotans over 18 years of age through collaboration between healthcare systems and local communities. Shari Koll of the Mayo Clinic Health System in Springfield, MN received the award on July 16 at the annual statewide Honoring Choices Minnesota conference in Minneapolis. Ms. Koll was one of
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Springfield’s first ACP facilitators trained occurs. We are pleased to offer this year’s first award to Ms. Koll who keenly recto provide local ACP community educaognizes that the ACP conversation is one tion. Ms. Koll has worked across Springfield’s community to educate persons of of the greatest gifts anyone can give their all ages at public events, senior center profamily and loved ones.” grams, and faith community workshops. According to Sue Schettle, Chief Executive Officer of the Twin Cities Medical Society, “There are dedicated ACP volunteers working in many communities to inform people of the importance of making their wishes understood before a Honoring Choices Minnesota Medical Director Ken Kephart M.D. healthcare emergency (left), award recipient Shari Koll and physician award presenter David Bonham M.D.
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U of MN Medical School Invites Honoring Choices to Orient Students to ACP
F
ourth year medical students at the University of Minnesota are hearing from Honoring Choices as a part of their ICU rotation orientation. In a new partnership developed jointly between Honoring Choices Medical Director Ken Kephart, and University of MN faculty Briar L. Duffy, M.D. and M. Colin Turner, M.D., the basics of a physician’s role in advance care planning is being presented to all students. Following the first session in June, Dr. Turner said, “It really seems like this has been a success so far. I thought your talk was great, and right on target with what medical students needed.” The talk he referred to is a 20-minute intense presentation delivered by Honoring Choices Director of Program Operations Karen Peterson, BSN, followed by time for students to ask questions and share experiences. Students at the University are introduced to advance care planning, Honoring Choices, and healthcare directives several times throughout their educational pathway, and this latest addition is seen as providing a strong reminder and boost for students as they move into the clinical environment, working with ICU patients and families. The Honoring Choices orientation stresses 1. the physician’s role in the ACP process 2. how to find ACP information in the EMR 3. what resources are available to assist physicians as well as patients/families 4. common issues with the ACP process In addition, students are given copies of the Honoring Choices health care directive which is the primary ACP document MetroDoctors
used in Twin Cities hospitals, and a Minnesota POLST form. Following the Honoring Choices portion of the class, local palliative care doctors led the students through an introduction to successful care conferences. Students learn components of communication and take part in two roleHonoring Choices Program Director Karen Peterson discussed the role playing exercises to of ACP to fourth year medical students at ICU rotation orientation. try out their new partnership is meeting all hopes and expecskills. As students role-played, they imtations, which should lead to an ongoing mediately had the opportunity to use the expanded connection between Honoring ACP information just shared. Choices, TCMS, and the School of MediOne student, Ryan Holton, had the cine. opportunity to use the ACP information the day following his orientation. Assigned to an ICU patient, he read the ACP information in the EMR, noted some room for additional information, and felt ready to begin the conversation with the patient LAKE SUPERIOR HOMEand his family. Ryan shared that while GRAND MARAIS. Enjoy the nervous about initiating a conversation big lake & great convenience to about such a serious topic, he felt prepared town from this one-level, 3 bdr because of his knowledge of ACP refreshed at the orientation. lake home. Warm wood paneling, During the 2015-16 school year Honcomfortable space makes for a cozy oring Choices will continue to be involved atmosphere. Secluded shoreline with in the fourth-year orientations. At the end outstanding views. Excellent vacaof this initial year the program will be tion rental history. $559,000. Red evaluated for continuation and possible Pine Realty 800-387-9599, info@ adaption to a webinar or other online redpinerealty.com. format which would allow it to be shared widely. Judging from early responses, the
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Classified Ad
September/October 2015
27
Remembering the Effects of Nicotine
Would knowing if your patients are using e-cigarettes and nicotine (the main ingredient used in e-cigarettes) affect the treatment and care you provide? Are you aware of ‘Big Tobacco’ tactics e-cigarette manufacturers use to market and promote ecigarette use among kids? These questions were used for discussion at the most recent Physician Advocacy Network training July 28 with the Stearns Benton Medical Society. Physicians and medical professionals spent the evening learning about the health impact of new tobacco products like e-cigarettes, hookah, cigars, and cigarillos, and the importance of engaging in patient conversations about other forms of nicotine delivery and tobacco usage beyond conventional cigarettes. Discussions and trainings will continue across the state as the Physician Advocacy Network continues to increase physician awareness of new tobacco products.
Pete Dehnel, M.D. (left corner) leads discussion about the health impacts of e-cigarettes and nicotine at the Stearns Benton Medical Society training.
For more information or to schedule training contact Ellie Parker, Project Coordinator at (612) 362-3706 or eparker@ metrodoctors.com. Physician CME Webinars Now Available
Participate in the free Physician Advocacy Network ‘Up in Smoke’ webinar modules; three, 30-minute pre-recorded webinars, worth .5 AMA PRA Category 1 Credit(s)™ each. Pete Dehnel, M.D., PAN Medical Director, and Stu Hanson, M.D., PAN physician ambassador, are the webinar facilitators. Webinar topics include e-cigarettes, hookah and other tobacco products, and e-cigarette patient conversations. To view webinars visit www.metrodoctors.com or contact Ellie Parker at eparker@metrodoctors.com. Minneapolis City Council Bans Sweet Flavors
The Minneapolis City Council voted unanimously on July 10 to restrict the sale of flavored tobacco products other than menthol, to adult-only tobacco shops. The Council also increased the price of cigars to $2.60 per stick. The new policy significantly decreases the number of tobacco vendors allowed to sell candy-flavored tobacco; now only about 15 places will be able to sell compared to the previous 400. Stores must derive at least 90 percent of their revenue from tobacco and be adult-only at all times to be eligible for selling these products. Council Members Blong Yang (Ward 5) and Cam Gordon (Ward 2) co-authored the ordinance in response to input from youth in the Minneapolis Youth Congress and the Breathe Free North program at NorthPoint Health & Wellness.
E-cigarette Training Dates
August 12 – Essentia Pediatric Grand Rounds (Duluth, MN) August 20 – Mayo Clinic Family Medicine Grand Rounds (Rochester, MN) August 25 – Native American Community Clinic (Minneapolis, MN) August 27 – Community Health Worker Peer Network (Minneapolis, MN) September 11 – Essentia Grand Rounds (Duluth, MN) October 5 – LungExpo (Bloomington, MN) October 8 – Essentia Grand Rounds (Fargo, ND) 28
September/October 2015
Youth and other supporters celebrate the Council’s decision to restrict the sales of flavored tobacco.
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Senior Physicians Association
S
ue Leaf presented at the July 14, 2015 Senior Physicians Luncheon on her book A Love Affair with Birds a memoir of Thomas Sadler Roberts, M.D. A Love Affair with Birds is the first full biography of Thomas Sadler Roberts — bird enthusiast, doctor, author, curator, educator, and conservationist. Roberts, along with his family, moved to Minnesota at the age of 9 due to his father’s deteriorating health and instructions from the doctor to get fresh air to help his tuberculosis. Roberts studied medicine at the University of Minnesota. In 1881 he developed tuberculosis and traveled north to live in a tent to reap the benefits of fresh air. While there, he started photographing birds. Later, he served as Director of the Bell Museum of Natural History at the University of Minnesota from 1915 until his death in 1946. Dr. Roberts is remembered not only for his medical practice but also through his photographs that capture Minnesota’s character during his time. Ms. Leaf ’s other books include Potato City: Nature, History, and Community in the Age of Sprawl and The Bullhead Queen: A Year on Pioneer Lake (Minnesota, 2009).
She is president of the Wild River Audubon Society of east-central Minnesota, has a Biology degree from Gustavus Adolphus and an MS, Ph.D. in Zoology from the University of Minnesota. The next Senior Physicians Luncheon will be on Tuesday, September 15, 2015 with presenter Lynn Blewett who will be giving a summary of health reform comparing other developed countries to the United States. For more information or to register contact Emily Johnson at tcms@metrodoctors.com or (612) 623-2885.
New Members Brendon M. Cullinan, M.D. Whittier Clinic – HCMC Family Medicine Stephen C. Nelson, M.D. Children’s Clinic – Minneapolis Pediatric Hematology/Oncology Demeka Y. Campbell, M.D. Regions Internal Medicine Bernarda M. Zenker, M.D. Trinity Integrative Medicine Family Medicine/Integrative Medicine
Saint Therese Rehab
Strengthening. Therapeutic. Results.
The STR Aquatics program incorporates various warm-water therapy techniques for your senior patients to enhance and maximize their physical function. STR offers: • • • • Dr. Stuart Hanson and guest speaker Sue Leaf.
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Individualized programming Aquatic physical therapy Support for all abilities Handicap accessibility
• 1:1 Personal training • Group fitness classes • Inpatient/outpatient therapy services
To learn more call 763.531.5037 or visit sttheresemn.org/str. September/October 2015
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In Memoriam ROBERT P. GRUNINGER, M.D. passed away on June 24, 2015. He received his Medical Degree from New York Medical College. His years in Minnesota were spent at the VA, University of Minnesota, St. Paul Ramsey and HCMC. He moved to Worchester, MA practicing at St. Vincent Hospital and retired from Duke in 1998. JAMES C. MANKEY, M.D. passed away on May 25, 2015. Dr. Mankey was a Navy physician in the Pacific Theater during WWII. He was a founding member of Southwest Internists, PA. Throughout his career Dr. Mankey was very involved in organized medicine, serving as President and Chairman of the Board of Hennepin
CAREER OPPORTUNITIES
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County Medical Society, Vice-President and Treasurer of Minnesota Medical Foundation, President of the U of M Medical School Alumni Assoc., and President of the Hennepin County Medical Foundation. Dr. Mankey became a member in 1949. ELMER J. MARTINSON, M.D. passed away on June 27. He received his Medical Degree from Loma Linda University in California before joining the Air Force. Following this service he completed a surgical residency at the University of Minnesota and joined his father’s medical practice at Martinson Clinic in Wayzata. He practiced at both Abbott Northwestern
Hospital and Metropolitan Medical Center in Minneapolis. Dr. Martinson joined TCMS in 1947. JOHN EDWARD MIDDLEBROOK, M.D. passed away on May 25, 2015. Dr. Middlebrook joined the U.S. Navy in 1944 and, upon return, entered medical school at the University of Minnesota. At the same time he also enlisted in the U.S. Army, achieving the rank of Captain. Dr. Middlebrook was an internal medicine specialist, and formed the practice of Hedrick, Mullin & Middlebrook. He served as the team doctor for the U of M Varsity Basketball Team from 1955-1974. He joined TCMS in 1995.
See Additional Career Opportunities on page 31.
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CAREER OPPORTUNITIES
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serve. We have a variety of opportunities that allow you to focus on innovative and quality
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31
LUMINARY of Twin Cities Medicine By Marvin S. Segal, M.D.
BRIAN C. CAMPION, M.D.
I
t has been said that preparation can make a dull person bright and a smart person brilliant. Dr. Brian Campion comprehended the gist of those words early in his professional development — and it helped lead him to a career punctuated with both clinical and administrative successes. A St. Paul lad, he earned his M.D. degree from our U of M Medical School. After a rotating internship and a two-year stint in the U.S. Navy Medical Corps during the Vietnam War, he returned to Minnesota’s Mayo Clinic for an Internal Medicine Residency and a Cardiology Fellowship. When Brian was recently asked why he chose the clinical subspecialty of Cardiology, he responded, “I was fascinated by the physiology of cardiovascular medicine and the chance to one day be involved in caring for patients, teaching and doing research in that field.” Those attractive aspirations were certainly realized when a mentor, Dr. Howard Burchell, chose him to lead the Cardiology Department at the U of M’s affiliated St. Paul Ramsey Hospital. He continued in that position for nearly 20 years while participating in the training of countless resident and fellows as an integral member of his alma mater’s Department of Medicine faculty. While at Ramsey, he also served as the founding Medical Director of the highly acclaimed St. Paul Fire Department Paramedic Program — one of the earliest such programs in the Twin Cities. A mid-career directional change came about for Brian in the late ’80s coincident with his two Bush Fellowships and a sabbatical from the Medical School. Again, a question was recently posed as to why he chose to explore the possibility of further spreading his professional wings. His reply: “I was intrigued by the chance to make a systemic difference, while never losing sight of a primary patient-focused approach.” There followed “a wonderful year” at the Harvard University Kennedy School, which lead to the Masters of Public Administration degree that effectively prepared him for his next leadership post in LaCrosse, Wisconsin. Dr. Campion became the President and CEO of the Franciscan-Skemp Healthcare system in 1990, a position he held for eight years. That organization blossomed and grew under his guidance and was integrated with the Mayo Health system midway through his tenure. His graduate school experience had stimulated an interest in an organizational efficiency 32
September/October 2015
model and an appreciation for being well grounded in the business/financial aspects of health care delivery. Preparation has played a pivotal role in his career development, and soon after his retirement from FranciscanMayo, Brian embarked upon the new adventure of preparing other physicians to lead as he assumed the Directorship of St. Thomas University’s Center for Healthcare Affairs. There, he co-founded the Physician Leadership College as it became clear to him that “one needs more than just common sense to become a true leader.” He believes that “effectively building skills in management includes formal curricular education, appropriate reading, coordination with understanding mentoring, self-directed introspection and just plain hard work.” The College, a smashing success, was crafted to include all of those elements . . . and more. Though our Luminary formally retired a few years back, his mind and activities remain active. He notes with interest the movement that he helped to develop — medicine moving into integrated delivery systems with its business related aspects — is now standing shoulder to shoulder with its patient centered clinical elements. When Dr. Campion isn’t spending quality time with his wife of 55 years and their close-knit family, he continues to provide principled guidance to current health care professionals. He wisely states, “Both physician and nursing leadership are important for the medicine of tomorrow, and if you wish to be engaged beyond clinical practice, adequately prepare.” This last page series is intended to honor esteemed colleagues who have contributed significantly to Twin Cities medicine. Please forward names of physicians you would like considered for this recognition to Nancy Bauer, managing editor, nbauer@metrodoctors.com.
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At MMIC, we believe patients get the best care when their doctors feel calm and confident. So we put our energy into creating risk solutions designed to eliminate worry. Solutions such as medical liability insurance, physician well-being, health IT support and patient safety consulting. It’s our own quiet way of revolutionizing health care. To join the Peace of Mind Movement, give us a call at 1.800.328.5532 or visit MMICgroup.com.