MED Magazine November 2018

Advanced Liver Cancer Treatment in the Black Hills A Personal Perspective on Palliative Care

REGIONAL HEALTH’S

NEW LEADING LADY Paulette Davidson, MBA

THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

NOVEMBER

Creating a Resilient Workplace

VOL. 9 NO. 7

2018

N OVEM B ER 2 01 8

HEALTH is the state “about which medicine has nothing to say.”

—W. H. Auden

From Us to You

Staying in Touch with MED

W

ELCOME TO the November issue of MED

Magazine, the premier publication for and about healthcare professionals in the South Dakota region. As we approach the season of Thanksgiving, we are keenly aware of the many things we have to be grateful for, not the least of which is your continued readership and support!

This month, we are also giving thanks for . . .

— Our healthy families — Great advertisers and digital partners — The rich supply of innovative people and institutions that make it easy to bring you great stories!

— A newly streamlined website — MED’s steadily growing digital audience — Cozy socks, chilly days, and hot cider

In this issue, we hope you will enjoy getting to know Regional Health’s new CEO, find value in expert articles on a range of topics, and get up-to-date with our popular roundup of all the the region’s news and upcoming events.

Remember, if YOU have news to share online and in our print and digital issues, send it our way any time at Info@MidwestMedicalEdition.com.

With Gratitude, —Alex and Steff

PUBLISHER MED Magazine, LLC Sioux Falls, South Dakota

VICE PRESIDENT SALES & MARKETING Steffanie

Liston-Holtrop

EDITOR IN CHIEF Alex Strauss

GRAPHIC DESIGN Corbo Design

PHOTOGRAPHER Julie Prairie Photography WEB DESIGN Locable

DIGITAL MEDIA DIRECTOR Alyssa McGinnis CONTRIBUTING WRITERS Dan Daly

Anne Geske

Kevin Klaahsen

Sandra Melstad Mandy

Rounseville-Norgaard

Tracie Storo

STAFF WRITERS Liz Boyd Caroline Chenault John Knies

CONTACT INFORMATION Steffanie Liston-Holtrop VP Sales & Marketing 605-366-1479 Steff@MidwestMedicalEdition.com Alex Strauss Editor in Chief 605-759-3295 Alex@MidwestMedicalEdition.com WEBSITE MidwestMedicalEdition.com MAILING ADDRESS PO Box 90646, Sioux Falls, SD 57109

MED’s Steff Liston Holtrop with the SDAHO staff at September’s 92nd Annual Convention in Sioux Falls. Thanks to all of you who took the time to stop by the MED booth!

This year’s this SDAHMPR (South Dakota Association of Healthcare Marketing & Public Relations) Board. (l to r) Treasurer Paige Baskerville (Avera), Secretary Erica Clements (Madison Regional), President Jennifer Bender (Prairie Lakes), Past-President Steffanie Liston Holtrop (MED), and VP Kim Rieger (Huron Regional).

4

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NEXT ISSUE Editorial contributions due November 1 Ads due November 10 MED Magazine is produced eight times a year by Midwest Medical Edition, LLC, which owns the rights to all content.

Every effort is made to ensure accuracy, however Midwest Medical Edition, LLC, cannot be held responsibly for consequences resulting from errors or omissions. Reproduction or use of the contents of this magazine is prohibited. Copyright 2018 Midwest Medical Edition, LLC.

Inside This Issue and on the Web

LOG ON! CONTENTS MIDWEST MEDICAL EDITION.COM

VO LU M E 9, N O. 7 ■ N OV E M B E R 201 8

THIS MONTH ONLINE

6 | Prioritizing Workplace Safety How to be proactive and not reactive when it comes to the safety of your employees

New Look!

We’ve streamlined our website to make it even easier to find current and past news and events quickly and easily. If it’s been awhile, come visit!

While you’re there, be sure to join the VIP list to keep getting your print issue for FREE.

Facebook.com/MedMagazineSD

20 | Improving Population Health through the Intersection of Public Health, Healthcare, and Everything in Between

■ By Sandra Melstad

ON THE COVER

23 | South Dakota Cities Among

Regional Health’s New Leading Lady

the Best for People with Disabilities

DID YOU KNOW? You can a post your own events on our interactive online calendar – even from your smartphone.

Find the calendar on MED’s home page, click “View All” and then select “Add Your Event”.

■ By Kevin Klaahsen

26 | I NTERVIEW: Cancer Researcher Steven Powell on This Year’s Nobel Prize in Medicine The Nobel Prize has shined a spotlight on cancer immunotherapy. So what is next?

Paulette Davidson, MBA ■ By Dan Daly and Alex Strauss

Paulette Davidson, MBA, started at the bottom rung in healthcare and is now leading healthcare in the

27 | Prevention of Noise-Induced

PREMIER WEBSITE SPONSORS

Hearing Loss Risks and how to mitigate them.

It’s not just about earplugs.

Black Hills into the future with a

■ By Mandy

for patients and staff, serving the

set of initiatives aimed at improving outcomes, creating great experiences

Rounseville-Norgaard

community and staying viable well into the future.

28 | Ideas for Upgrading

PAGE

a Luxury Home

■ By Tracie Storo

16

8 | Creating a Resilient

Workplace Solving for organizational causes of burnout

REGULAR FEATURES 4 FROM US TO YOU EWS & NOTES 10 N Awards, accreditations, expansions and more!

30 [ The Question] What do you like most about working in healthcare in MED territory?

■ By Anne Geske

22 | [Technology] Regional Brings

Advanced Liver Cancer Treatment to the Black Hills 24 | A Personal Perspective

on Palliative Care A Sanford clinic director is even more deeply committed to palliative medicine after a personal experience with it this summer.

31 U PCOMING EVENTS Conferences, Symposiums and holiday events

■ By Alex Strauss

On the cover: Regional Health President/CEO Paulette Davidson, MBA. Photo courtesy Regional Health.

5

Prioritizing Workplace Safety

BY KEVIN KLAAHSEN

D

EVELOPING AND MAINTAINING an active risk management program can be a challenge for any employer. Healthcare facilities are no different and face many of the same obstacles that other industries are challenged with overcoming.

In my experience of providing risk assessments to various facilities over

“BE PROACTIVE AND NOT REACTIVE WHEN IT COMES TO THE SAFETY OF YOUR EMPLOYEES.”

the last five years I noticed an increased focus on taking safety to the next level not only for the benefit of the patient but also employees. Whether it’s through the formation of a safety committee, the implementation of a formal new hire safety orientation, or scheduling specific department meetings, there are a

E = Enforcement

number of possibilities that can be utilized.

You can have the best written safety

Understanding the environmental and vocational hazards of your individual

program and policies around; how-

workplace is key to unlocking the door to providing the proper training and

ever, if they are not enforced, they

resources needed to maintain a safe working environment for everyone. Having

provide little to no benefit. Develop a

a proper hazard assessment completed gives you the ability to see into areas

level of accountability within depart-

that otherwise may get overlooked during the course of routine business oper-

ments that allows them to actively

ations. While facilities management is an important piece of this puzzle it

encourage each other when they see

provides only a portion of what a complete risk management program can be.

a situation that is unsafe. This can

There are many variations and tools that can be utilized and I’ve created a

include a form of corrective action or

simple acronym to help you begin the process of implementing some best work

retraining if the safety violations are

practices into your safety program.

continually being violated.

KEEPER

E = Empower

R = Return to Work

Empowering staff is essential to

Having a formal and active return to

having them give constructive feed-

work policy implemented is extremely

back on safety issues and concerns.

important when dealing with any

If they don’t feel comfortable telling

form of on the job injury. Avoiding

Knowledge is power and with the

someone about a problem, they more

lost time due to an injury and being

amount of resources that are available

than likely will keep it to themselves.

willing to make light duty accommo-

in our world via the internet, your

Allowing them to be part of the dis-

dations will benefit both the employee

organization’s intranet, or material

cussion rather than the topic of

and employer. If onsite light duty is

provided by your insurance agency/

discussion will give them a sense of

unavailable be sure to inquire about

provider there is a wealth of new,

fulfillment and unity. This can be as

off-site transitional duty, if available.

fresh, and relevant training materials

simple as a discussion box in the

These are some, but not all of the basic

available. Take advantage and use

break room where they can leave

principles that can be utilized in

them for your benefit.

safety suggestions.

developing your risk management

E = Encourage

P = Proactive

Encouragement is vital for keeping

Be proactive and not reactive when it

employees thinking about not only

comes to the safety of your employ-

the safety of themselves but the safety

ees. Take care of problems right away.

of their coworkers. If they know they

Avoid waiting to provide training on

have the support, resources, and

slips/trips/falls until after it is trend-

proper training, they are more likely

ing on your losses. Provide the

than not to say something if they see

training before it becomes a problem.

something. This involves working

This also includes items such as pro-

together collectively to resolve the

viding safe patient handling/lifting

issue. Keep it positive and encourage

techniques before you see an uptick

your employees to be safe at all times.

in back strains and sprains.

K = Knowledge

6

and safety program. ❖

Kevin Klaahsen is a Loss Control Specialist with Risk Administrative Services.

MidwestMedicalEdition.com

REGIONAL HEALTH

UNVEILS NEW XI SURGICAL ROBOT Regional Health has selected the new da Vinci Xi robotic surgery system to enhance patient experience and reduce recovery times for patients across the Black Hills. The da Vinci Xi will be the second surgical robot utilized at Rapid City Hospital.

Modern robotic surgery, in the hands of a skilled surgeon, can perform complex procedures with more precision, flexibility and control than is possible via conventional surgery. And because robotic surgery requires minimal incisions, patients experience less trauma to the body, minimal scarring and faster recovery time.

Today, surgeons who operate at Rapid City Hospital perform many different types of robotically assisted procedures, including prostatectomy, kidney and bladder surgery and procedures such as hernia, bariatric, LAR and right and left colectomy.

Jacob Weasel, M.D.

Matthew Wideroff, M.D.

Regional Health General Surgery 2929 5th Street | Rapid City, SD 57701 | 605-755-5700 regionalhealth.org/generalsurgery November 2018

Patrick J. Kenney, D.O., FACS

Irony Sade, M.D.

7

“ CREATING A RESILIENT WORKPLACE:

SOLVING FOR ORGANIZATIONAL CAUSES OF BURNOUT

BY ANNE GESKE

T

”

HE DATA ARE CLEAR: there’s an upward trend of

burnout in medicine, particularly among physicians, who experience professional burnout at twice the rate of the general population.1 Burnout isn’t just a

problem—it’s a crisis. It affects patient safety, teams and organizations—and it’s costly.

So, there’s been a lot of attention on individual resiliency skills of late. But the primary drivers of burnout occur at an organizational level, so focusing solely on what individuals can do to manage stress will fall woefully short. Organizational issues include high workloads, inefficiencies related to electronic health records (EHRs), loss of meaning and social isolation at work, and loss of clinical autonomy.2,3 The stakes are high because physicians and other clinicians are voting with their feet, according to Dr. Laurie Drill-Mellum, chief medical officer of Constellation/MMIC. “Millennials stay two to four years in an organization, on average,” she says. “If they aren’t engaged in being part of something greater than themselves, if they aren’t seen for what they can contribute, they aren’t staying.

The workforce shortage plays in this, too. If we don’t treat people differently, we’re going to have to close our doors.”

Dr. Drill-Mellum’s work focuses on clinician well-being and its effect on patients and organizations. As an officer of a professional liability insurance company, she knows that clinicians who are burned out are at risk of making medical errors and therefore at risk of getting sued. And she sees the organizational drivers of burnout as eminently solvable.

WEB EXTRA

Read More

❱ P hysician Burnout: The Other Healthcare Crisis from the MED archives.

8

MidwestMedicalEdition.com

“ YOU’RE ONLY GOING TO GET SO FAR IMPROVING PATIENT EXPERIENCE, OUTCOMES AND COSTS WITHOUT ATTENDING TO THE WORK ENVIRONMENT AND EXPERIENCE OF THE PEOPLE WHO DELIVER THE CARE. ”

The first step leaders can take,

so far improving patient experience,

For true organizational resilience,

she says, is to administer a measure-

outcomes and costs without attend-

what’s needed is a leadership culture

ment tool like the “Mini-Z” Survey”

ing to the work environment and

that cares about people, engages

Minnesota Hospital Association

experience of the people who deliver

them, and does what they say they’re

members deployed for the past two

the care.”

going to do in terms of mission, vision and values. ❖

years. “Now is the time to apply

The interconnection between

a quality improvement approach

organizational culture and individual

to address burnout and promote

well-being is huge, Dr. Drill-Mellum

resiliency,” says Dr. Drill-Mellum.

says. The question to ask is: Does the

“This involves commitment from

organizational culture support indi-

REFERENCES

leadership to use a validated mea-

vidual resiliency? There are practices

surement tool, analyze the results,

to stop, like asking staff to work

1. AHA, 2018. Be Well: Cultivating Resilience to Address Health and Well-Being.

and engage those surveyed on how

double shifts. And there are those to

they want to address opportunities

start, like creating flexible scheduling,

for improvement.”

supporting people to take vacation

It’s crucial to engage the frontline clinicians who were surveyed for their ideas about how to solve any

time, and offering onsite daycare and exercise or relaxation facilities.

2. AMA Steps Forward, 2018. Creating the Organizational Foundation for Joy in Medicine.

3. The Physicians Foundation, 2016. 2016 Survey of America’s Physicians Practice Patterns & Perspectives.

MEDAd2018 v2_Layout 1 10/19/2018 8:50 AM Page 1

issues that surface. “No one group of people is going to solve this problem— it has to be done in collaboration,” Dr. Drill-Mellum states. “When working together, you find ways to solve problems. With consensus on a plan and organizational support for it, you inform everyone what you plan to do.

Then, you do it and measure again to look for impact.”

Many tools are available to tackle specific pieces of workflow issues like prescription refills, lab and image result reviews, and documentation. “It’s not rocket science,” Drill-Mellum explains. “It’s a simple quality improvement program for

Applying a Human Factors and Occupational Health Philosophy to Risk Management.

Highly Trained Team of Specialists with Expertise in: Human Factors Engineering & Ergonomics Government Compliance and Regulation Occupational Therapy Industrial Hygiene Industrial Safety Psychology

care teams. You’re only going to get

This article originally appeared in the September-October issue of MetroDoctors.

November 2018

Workers’ Compensation.

It’s what we do. It’s who we are.

RASCompanies.com

9

Happenings around the region

News & Notes

South Dakota | Southwest Minnesota | Northwest Iowa | Northeast Nebraska

AVERA A collaboration between the Avera Cancer Institute Center for Precision Oncology in Sioux Falls and the Institute for Clinical and Molecular Biology (IKMB) of Kiel University, Germany, has published a new article on targeted personalized therapy. “RNA based individualized drug selection in breast cancer patients without patient-matched normal tissue,” was published online

by Oncotarget in August. The focus of the collaboration, which has been going on for three years now, is to jointly improve cancer diagnostics. This is the second publication of this collaborative effort.

In August, Avera announced plans to build the Avera Human Performance Center on the Avera on Louise Health Campus at 69th and Louise in Sioux Falls. The $14 million, 60,000-square-foot complex will house a sports medicine clinic with staff that specialize in non-operative treatment, biomechanical evaluations and specialized instructions after injury or concussion.

There will also be a modern therapy gym with an anti-gravity treadmill, Pilates equipment, isokinetic balance equipment, a gait-analysis treadmill with 3-D motion capture system, as well as an underwater treadmill and an aquatic therapy pool.

10

The Avera Research Institute’s Center for Pediatric and Community Research has been awarded a $17.1 million grant through the National Institutes of Health (NIH) for its work on a children’s health study called the ECHO Program. ECHO stands for Environmental influences on Child Health Outcomes, and its scientific goal is to better understand the effects of a broad range of early environmental influences on child health and development. The grant’s total, presented over five years, represents the largest health research funding award in South Dakota history.

Avera's new Helmsley Center in Pierre, opened last month with a gala celebration. The newest Avera Cancer Center brings enhanced oncology services to the area with infusion suites that are connected to the oncology clinic and radiation oncology services, including a fully digital Elekta Infinity linear accelerator. Other specialties housed in the 57,000-squarefoot Helmsley Center include orthopedics and podiatry; physical medicine and rehabilitation; interventional pain medicine; dermatology; ear, nose and throat; urology; and specialty outreach clinics. The center also houses telemedicine equipment for access to specialty visits through Avera eCARE. Together, donors and the Helmsley Trust are contributing $12.5 million to the $30 million dollar project.

Avera Health has received a $7.8 million dollar grant from The Leona M. and Harry B. Helmsley Charitable Trust to build a 24-hour telemedicine behavioral health team as part of Avera eCARE. With an initial focus on services for people in crisis, Avera eCARE will provide virtual behavioral health assessments as well as treatment for patients in local emergency departments and inpatient psychiatric hospitals.

The virtual team will also support behavioral health units, hospitals and outpatient primary care centers. Eventually, Avera eCARE will also provide mobile support to first responders. The three-year grant period extends from now until September 2021.

MidwestMedicalEdition.com

BLACK HILLS

SANFORD

Beginning in September, physicians at Regional Health began partnering with Regional Health Home+ to extend medical care to patients who live in long-term care facilities and nursing homes throughout the Black Hills.

This program allows patients to stay at their current living situation since they will not have to leave the nursing home to see a physician. The newly formed dedicated team will provide consistency to the patients across the Black Hills.

A $12 million dollar NIH grant that supports research at Sanford has been renewed for another five years. The Center of Biomedical Research Excellence (CoBRE) grant helped establish Sanford’s Center for Pediatric Research. The renewal will be used to fund studies on how stem cells contribute to pediatric diseases. The grant will fund up to five different labs with the goal of making them self-sustaining. Sanford Research has two other CoBRE grants, one for the Center for Cancer Biology Research and one for the Center for Population Health Research.

Mike Tilles, President Home+, Dr. Deepak Monmohan Goyal, Physician Advisor, Brandi Tackett, Director of Clinical Innovations Home+

Regional Health Rapid City Hospital began performing procedures with a new da Vinci Xi robotic surgery system in September. The da Vinci Xi is the hospital’s second surgical robot and expands on core da Vinci system features, including wristed instruments, 3D-HD visualization, intuitive motion and an ergonomic design. Surgeons who operate at Rapid City Hospital perform a number of robotically assisted procedures, including prostatectomy, kidney and bladder surgery and gynecological procedures such as hernia, bariatric, LAR and right and left colectomy.

Maggie Navarrete and Adam Drake, both RNs at Regional Health Rapid City Hospital, Have been recognized with the prestigious DAISY Award for extraordinary nursing. Navarrete was nominated by a patient’s wife and Drake by a patient’s daughter for kindness, compassion, professionalism and care.

November 2018

Gregory Nissen Vascular surgeon Gregory Nissen, MD, has joined the team at Sanford Vascular Associates in Sioux Falls.

Nissen received his medical degree from the University of Nebraska College of Medicine and did residency work at Christina Care Health Services in Delaware. He also completed a fellowship in vascular surgery at the University of AlabamaBirmingham and is board certified in general surgery and board eligible in vascular surgery.

Sanford Surgical/ Cardiovascular nurse Maxine Johnson, RN, recently received a DAISY award for outstanding nursing. She was described in her nomination as positive, respectful, humorous, encouraging and strong.

Sanford Imagenetics now offers expanded genetic testing and counseling through primary care clinics. Primary care physicians are able to use the results of the Sanford Chip genetic testing to help patients determine which medications will work best for them and help them assess their personal risks of various diseases, including breast cancer.

One blood test provides both sets of data for an out-of-pocket charge of $49. The model also offers genetic counseling for patients and guidance on how to navigate their results.

11

• Happenings around the region

News & Notes

• Happenings around the region

News & Notes

SIOUXLAND

The Physicians of CNOS in Dakota Dunes broke ground on a new site on the South Eastern (Morningside) Neighborhood of Sioux City, Iowa, in October. The 7,500 square foot clinic and therapy space is slated to be open in early December, 2019.

CNOS CEO, Nolan Lubarski says, “We are committed to continuing to provide access to high-quality healthcare services in the Morningside community via our new location.” October 2018 marked the 20th year in operation as CNOS, PC.

Siouxland golfers supported area cancer patients at the 20th Annual Pink Ribbon Golf Classic in September. The golf tournament included 37 teams who raised an all-time high of $32,575 to benefit the June E. Nylen Cancer Center with the new True Beam Radiation Technology.

Kelly Cosgrove Mercy Medical Center-Sioux City has announced the appointment of Kelly Cosgrove as Manager of Clinical Services-Obstetrics and Pediatrics. Cosgrove joined Mercy in December 2017 as the nurse educator for OB and Pediatrics. She obtained her BSN from Briar Cliff University and has 13 years of nursing experience. Her certifications include: Basic Life Support, Advanced Cardiac Life Support, Pediatric Advanced Life Support, Neonatal Resuscitation, Mandatory Reporter, National Certified Passenger Safety Technician and EFM Certification.

12

Julie Anfinson Julie Anfinson has been promoted to VP of Support Services and Human Resources at Mercy Medical Center.

Anfinson will be responsible for human resources, facilities, education, environmental services, nutritional care, safety and security. She holds a BSN from Briar Cliff University and an MHA from Des Moines University and has been with Mercy Medical Center since 1988 and has been Director of Human Resources since 1999.

Lea Greathouse Mercy Medical Center has appointed Lea Greathouse VP of Mission, Marketing, and Foundation.

Greathouse earned her BS and MSE from Wayne State College and has been with Mercy Medical Center since 2001 as Executive Director of the Mercy Medical Center Foundation.

The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) has recertified the Cardiac Rehabilitation Program at Mercy Medical Center-Sioux City. Mercy’s Cardiac Rehab program, which is located in the state-of-the-art Mercy Heart Center in Sioux City, earned the three year recertification following a rigorous review that verified its excellent clinical practices. Mercy’s Cardiac Rehab program has been in practice for 35 years.

UnityPoint Health–St. Luke’s has received the American Heart Association’s Get With The Guidelines Heart Failure Bronze Quality Achievement Award. St. Luke’s is also recognized on the association’s Target: Heart Failure Honor Roll for improving medication adherence, providing early follow-up care and coordinating and enhancing patient education.

Mercy Medical Center -Sioux City has been recognized as a high performing medical facility for colon cancer surgery by US News & World Report. Mercy’s colon cancer surgery score is based on multiple data categories, including patient outcomes, volume, nurse staffing and readmission prevention.

These rankings — determined by reputation and outcomes data, including survival and safety — are intended to help patients and families make better-informed healthcare choices.

Mercy Medical Center, in conjunction with CNOS, and Siouxland Stroke Support Network, hosted a weekend-long “Retreat and Refresh Stroke Camp” in September. This camp is a unique way to bring stroke survivors and their families together for a weekend of support, education, fun and respite.

Camp was held at Broom Tree Retreat Center, outside of Irene, South Dakota, a site carefully chosen for its hotel-style private rooms and relaxing camp atmosphere.

MidwestMedicalEdition.com

Timothy Daugherty Timothy Daugherty has been named Mercy Medical Center's new VP of Operations and Strategic Planning. Daugherty will be responsible for business development, clinical services, and the Mercy network hospitals. Daugherty earned a BS from Illinois Wesleyan University and a MBA from the University of Illinois at Chicago and comes to Mercy Sioux City from Holy Cross Hospital in Fort Lauderdale, Florida.

Allie VanOtterloo Allie VanOtterloo, NP-C, has joined UnityPoint Clinic Family Medicine–Sunnybrook. VanOtterloo has an MS in Nursing from Briar Cliff University in Sioux City, Iowa. She is board certified through the American Academy of Nurse Practitioners. She joins providers DJ Todt, MD and Sue Handke, ARNP.

Ashlesha Kaushik Ashlesha Kaushik, MBBS, MD, with UnityPoint Clinic Pediatric Infectious Disease, has been appointed by the Stead Family Department of Pediatrics as an Adjunct Clinical Instructor for the University of Iowa (UI) Carver College of Medicine. Dr. Kaushik will serve a three year term teaching pediatric infectious diseases to UI Carver College of Medicine trainees through the Siouxland Medical Education Foundation (SMEF) residency program and serve as a resident preceptor for the program.

November 2018

OTHER Dr. Joseph Thum and Dr. Lauren Wood Thum joined Urology Specialists in Sioux Falls in August.

Joseph Thum Dr. Joseph Thum was born and raised in Sioux Falls, graduated from the University of Sioux Falls, and earned his MD from Northwestern University Feinberg School of Medicine in Chicago. After medical school, Dr. Thum completed his general surgery internship and urologic surgery residency at Cedars Sinai Medical Center in Los Angeles, California.

Lauren Wood Thum Dr. Wood Thum grew up in Newport News, Virginia and earned both her undergraduate degree and MD from the University of Virginia. She completed her urology residency at Cedars-Sinai Medical Center in Los Angeles and joined Urology Specialists in August after completing a fellowship in Female Pelvic Medicine and Reconstructive Surgery at the University of California Los Angeles. She is board eligible in both urology and Female Pelvic Medicine and Reconstructive Surgery.

13

• Happenings around the region

News & Notes

• Happenings around the region

News & Notes

The following three physicians have joined Children’s Hospital & Medical Center in Omaha in leadership roles:

John Makari John Makari, MD, Section Chief, Pediatric Urology — Dr. Makari received his MD from Ohio State, completed his residency at George Washington University in Washington, DC, and his Pediatric Urology fellowship at Vanderbilt. His areas of clinical interest include genitourinary reconstruction for patients with exstrophy/epispadias complex, neurogenic bladder dysfunction and disorders/differences of sex development.

Russell McCulloh Russell (Rusty) McCulloh, MD, Division Chief, Pediatric Hospital Medicine — Dr. McCulloh received his MD from the University of Missouri School of Medicine, completed his Internal Medicine-Pediatrics residency at University of Missouri Health Care and did an Infectious Disease fellowship at Brown University. In addition to pediatric hospital medicine, Dr. McCulloh’s clinical interests include infectious diseases.

Donald Durden Donald Durden, MD, PhD, an internationally renowned pediatric oncologist and researcher specializing in the treatment of children with brain tumors and the development of leading-edge therapeutics, joined the teams at Children’s Hospital & Medical Center and the University of Nebraska Medical Center (UNMC) in September. Durden will be the lead pediatric cancer investigator and Associate Director for Pediatric Oncology.

The first cohort of a new associate of applied science degree in nursing kicked off the semester in Huron in August thanks to an innovative collaboration between Huron Regional Medical Center Foundation, Southeast Technical Institute, Huron University Foundation, Huron Community Campus and several other partners in the region. The seven students enrolled in the program, their sponsors and community partners celebrated with a ribbon cutting at the Huron Community Campus.

14

Jonathan Schwartz Jonathan Schwartz, DO, Pediatric Hematology/ Oncology — Dr. Schwartz received his doctorate degree of Osteopathic Medicine from Touro University College of Osteopathic Medicine in Henderson, Nevada and completed his Pediatrics residency at Norton Children’s Hospital in Louisville, Kentucky. His fellowships in Pediatric Hematology/Oncology and Neuro-oncology were completed at Children’s Hospital of Michigan in Detroit. He is an assistant professor of Pediatrics at UNMC College of Medicine.

Steve Watkins LifeScape has named Steve Watkins as its new CEO. Watkins is the current CEO of Orion Foods and has worked at Orion for 31 years. He is the Chairman of Sanford Health Plan and a Board member and Past Chair of Children’s Home Society Adoption Committee. Watkins began his work at LifeScape on October 15th but the last day for the current CEO, Anne Rieck McFarland, is not until January 2, 2019.

Children’s Hospital & Medical Center in Omaha held an official ribbon cutting for its new Visionmobile in September. The Visionmobile is a mobile vision clinic designed to help address the unmet vision needs of children in the Omaha area.

The 33-foot Winnebago is uniquely retrofitted with state-of-the-art vision screen equipment and exam stations for convenient school outreach. It will target schools pre-K to high school with poverty rates of 75 percent or greater with a goal of treating 6,000 student per year.

Steven Miller Cardiologist Steven Miller, MD, has joined the cardiology staff at Prairie Lakes Healthcare System.

Dr. Miller received his MD from Creighton University and completed residency at William Beaumont Army Medical Center. He was a Cardiology Fellow at Madigan Army Medical Center. He is board certified in cardiovascular disease and joins Evelio Garcia, MD, Salem Maaliki, MD, and Jacklyn Karli, CNP.

MidwestMedicalEdition.com

Gabriel Johnson Madison Regional Health System in Madison, SD made the 66 critical access hospitals to know list by Becker’s Healthcare. Becker’s Healthcare selected the hospital based on awards and rankings from organizations including iVantage Health Analytics, The Chartis Group, the National Rural Health Association, CareChex, Healthgrades and Medicare star ratings. They also considered the hospital’s community impact and reputation for innovation. Organizations cannot pay for inclusion on this list.

Ann Roemen Ann Roemen, MBA, FACMPE, the CEO of the Accountable Care Organization AccoCare in Sioux Falls, has become a Fellow in the American College of Medical Practice Executives (ACMPE), the certification entity of the Medical Group Management Association (MGMA). Fellowship in ACMPE demonstrates mastery and expertise in the profession of medical practice management and is the highest level of distinction in the medical practice management profession. Roemen is one of only six in South Dakota who hold this designation.

Gabriel Johnson, DO, is now seeing patients at the Viborg Medical Clinic. Dr. Johnson recently finished his Residency in Family Medicine from Ocala Regional Medical Center in Ocala, Florida. He also received Residency training in OB/Gyn at St. John’s Episcopal Hospital in Far Rockaway, New York. Dr. Johnson received his DO from Des Moines University and his BS in Biomedical Sciences from Minnesota State in Mankato. He is a member of the American Academy of Family Practice.

WEB EXTRA

Yankton native Abigail Reynolds, MD, has joined the family medicine department at Yankton Medical Clinic. Dr. Reynolds earned her BS in biology and chemistry at the University of South Dakota and completed her medical education at USD Sanford School of Medicine. She completed her residency at the Center for Family Medicine in Sioux Falls.

Read More

❱G o online for links to the full-length version of each of these news briefs.

Tracie Storo Broker Associate | RE/MAX Professionals, Inc | 605-321-6987

November 2018

15

• Happenings around the region

News & Notes

REGIONAL HEALTH’S NEW LEADING LADY

PAULETTE DAVIDSON, MBA

“ If you set out every day to make things better for people, 16

I

T’S AN INTENSELY BEAUTIFUL BLACK HILLS MORNING, and Paulette Davidson is outside her home grooming Jess, the gentle mare that’s been part of her life for the past 18 years.

Nearby, Davidson’s husband, Dru Davidson, trims the mane on his mule. Their

hyperactive Australian Shepherd, Cali, runs circles around horses, people, fence posts, photographers and anything else she can corner. The Davidsons have lived in their log house near Rockerville for less than three years, but they seem completely at home in the Hills.

Davidson loves to take Jess on long rides on the trails near their home.

“Jess and I have these amazing conversations,” she says. “Jess is a great listener, and she helps me make good decisions.”

The two have a lot to talk about these days.

In September, Paulette Davidson became President and Chief Executive Officer of Regional Health, the largest employer in western South Dakota. She’s responsible for five hospitals, dozens of clinics, 5,000 employees and the healthcare needs of nearly half a million people. Meanwhile, the business of medicine is seeing major changes nationwide.

Fortunately, Davidson has more than 35 years of experience in healthcare to prepare her for the inevitable challenges of her new position.

Over the years, she has seen first-hand that quality care is the shared responsibility of every single caregiver, regardless of their job. Even the person who empties trash cans and cleans rooms can help create a good patient experience, she says. In her first job, she was that person.

While in high school, Davidson worked in a hospital housekeeping department in Illinois. She cleaned toilets, scrubbed floors, changed bedding and cleaned operating rooms. Not glamorous, but important work, and a great education.

“I loved it,” she recalls. “It was an environment where I could work with really brilliant people who were making a difference.”

EARLY WORK ETHIC Davidson grew up in a working family in Waukegan, Illinois., on the shores of Lake Michigan halfway between Chicago and Milwaukee. Her dad was a machinist for Outboard Marine Corp. making parts for boat motors. When the plant closed, he went to work as a custodian at one of the elementary schools.

When Davidson started kindergarten, her mom went to work as well. Paulette became a classic latchkey kid, with one tasty exception -- her mom worked on the production line at a plant that made Kraft Macaroni & Cheese.

“I thought it was the greatest thing,” Paulette declares with a broad smile. “I am a product of Kraft Mac & Cheese.”

By the time she got to high school, Davidson’s parents made it clear that if she wanted spending money, she had to get a job. That’s when she went to work in hospital housekeeping.

Even though her job was to clean rooms, she often found herself interacting directly with patients and their families. She also realized that in a hospital setting, people feel anxious, afraid, isolated and sometimes angry. Everyone in healthcare, regardless of

BY DAN DALY AND ALEX STRAUSS

we’ll make significant progress over time.”

November 2018

17

Photos courtesy Regional Health.

Davidson, pictured with Dr. Deepak Manmohan Goyal (left) and Dr. Behnan Sahin, took the helm of Regional Health in September.

their work, needs to reassure, show compassion and ease the emotional burden that illness and injury bring to families.

Davidson also had a chance to see the skill of doctors, nurses and technicians as they put their patients and families at ease.

“These families are in situations that are not always pleasant, and it’s amazing to see how our teams come together, reassure a patient and help them with decisions that they have

“I was able to earn my tuition by

Regional Health. She later added the

to make,” she says. “They create the

working in healthcare, and expand

responsibilities of the President of the

moments that people remember for

my knowledge and grow within

Rapid City Hospital and market, the

their lifetime. It’s an art form, and I’m

healthcare,” she says.

largest of Regional Health’s five hos-

still in awe of the people who can do that so well.”

After earning her MBA, Davidson

pital communities.

worked in healthcare administration

MAKING A DIFFERENCE

After high school, Davidson

across the Midwest, including Mid-

enrolled in the University of Wiscon-

western Regional Medical Center and

In conversations with caregivers

sin in Kenosha. She continued to work

Cancer Treatment Centers of America

at the various hospitals, clinics and

in healthcare 30 hours per week while

in Zion, Illinois, Indiana University

offices throughout the network,

taking a full load of classes. She

Health Goshen Hospital, in Goshen,

Davidson and her team keep asking

earned her bachelor’s degree at the

Indiana, Bellevue Medical Center in

the question, “What is your ‘why?’

University of Wisconsin. From there,

Bellevue, Nebraska, and Nebraska

What brought you to healthcare?”

she continued to work in healthcare

Medical Center in Omaha.

assuming a variety of different roles

“So many people say they want to make a difference,” says Davidson.

and gaining experience — everything

THE ROAD TO THE BLACK HILLS

“Honestly, it connects with me, as

from switchboard operator to clinic

Davidson’s first introduction to

well. When I had to ask myself: What

administrator to hospital leadership

the Black Hills was a trip to the Stur-

is my why? I know I want to make

roles. Along the way, she also earned

gis Motorcycle Rally. Later, she and

something better, and leave the world

an MBA from the University of Notre

Dru drove out from Omaha with their

better than it was before. If you set

Dame.

horses to ride the trails in Custer State

out every day to make things better

Park — something that had been on

for people, we’ll make significant

their bucket list for years.

progress over time.”

It was Dru who saw the Regional

Davidson has already been instru-

Health job posting for a Chief Oper-

mental in making things better at

ating Officer. “He said, ‘You should

Regional Health. During her tenure

apply for that job. We could live in the

as COO, she helped define the orga-

Black Hills’,” says Davidson.

nization’s priorities, a set of five focus

During the interview process, the

areas, ratified by the health system

couple spent time in Rapid City and

board, that make up a sort of “road

other Black Hills communities where

map” for the future.

they were struck by the friendliness

“We are on a journey and we know

of the people they met in shops,

there are going to be turns in the

restaurants and on the streets

road,” says Davidson. “Having this

downtown.

‘road map’ means that all of our strat-

In November 2015, Davidson became Chief Operating Officer for

egies are going to support our five top priorities.”

Since moving to the Black Hills in 2015, Davidson and her husband Dru have embraced the outdoors culture of the region. They are active in horseback riding, hiking, fishing, skiing and kayaking.

18

MidwestMedicalEdition.com

“ We have moments throughout every single day when we can touch someone’s life forever.”

Davidson, pictured during a television interview with "Oyate Today" host Richie Richards, has made it a priority to foster a good relationship with the Native American community.

NAVIGATING THE ROAD MAP

“We want to stay competitive with com-

During Davidson’s time at Regional

pensation and benefits, but also other things

Health, the system has improved clinical

like environment, values, and the ability

outcomes with initiatives like the implemen-

for caregivers to have a voice in how we

tation of the system-wide EPIC EHR platform,

solve challenges,” says Davidson, who has

expansion projects in Rapid City, Custer, and

been hosting a series of Town Hall-style

Sturgis, standardization of sepsis care, and

meetings to outline her vision and invite

the establishment of new protocols for anti-

feedback.

biotic and opioid use.

The final two priorities focus on commu-

As part of their focus on creating a caring

nity involvement and longevity. Regional

environment, Regional has developed and

Health incentivizes volunteerism among

delivered a curriculum on service delivery,

caregivers, has implemented community

including cultural diversity training. Their

projects like a clinic-based food pantry, and

efforts to improve service specifically for the

partnered on Pennington County’s new

Native American community, including the

social-service complex which opened in

construction of a new round conference room

September.

to accommodate native ceremonies, has

“Community healthcare is vital for

earned them recognition from the American

industry. It is the economic engine of the

Hospital Association.

community,” says Davidson. “Our intention

“We have moments throughout every

is to be here to take care of our grandchil-

single day when we can touch someone’s life

dren and our grandchildren’s grandchildren.

forever,” says Davidson. “It can be a hand

That means we have to make good deci-

held when delivering difficult news or a hug

sions so that we can support the other four

in a moment of relief. This will be our focus.”

missions.”

The third priority is also about creating a positive experience — for staff.

Pictured during the June 2017 groundbreaking ceremony for the new $200 million addition to Regional Health's Rapid City Hospital, Paulette Davidson was Chief Operating Officer at the time.

Fortunately Jess, the mare with the great listening skills, is always there to help. ❖

INFRASTRUCTURE | UNIFIED COMMUNICATIONS | DATA CENTER | SECURITY | SERVICES

605.789.5700

November 2018

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HighPointNetworks.com

19

Improving Population Health through the Intersection of Public Health, Healthcare, and Everything in Between

BY SANDRA MELSTAD

C

OLLABORATION OF PUBLIC HEALTH, healthcare, and diverse sectors are necessary ingredients to improving population health.

Unfortunately, despite increasing healthcare costs projected

to reach $5.5 billion by 2030, “health outcomes in the United States continue to fall behind other developed countries”.1 Over the past twenty years the global burden of mortality and morbidity has shifted from communicable diseases to noncommunicable diseases and associated risk factors. Specifically, rural America, which comprises a majority of the Midwest, is disproportionately affected by health outcomes due to social, economic, and environmental factors.

While healthcare was once considered the sole method to improve health,

“ Evidence-based

strategies that are proving effective and critical to moving the needle are upstream, collaborative efforts between public health and healthcare. ”

this method is only one tool to improve the health of populations and communities. Research is proving time and time again that social determinants of health (SDOH), “the structural determinants of and conditions in which people are born, grow, live, work, and age”, are the key predictors of health outcomes.2 In short, a person’s zip code determines their health outcomes. To effectively shift the needle on health outcomes, efforts must focus on addressing these SDOH’s and achieving health equity. After all, if an individual does not know when their next meal is going to be or lacks transportation, how can they be expected to improve their health if those factors are not addressed?

Addressing population health through a public health lens is important to achieving health equity, centered on multi-sector collaboration and com-

Sandra Melstad, MPH, is the CEO of SLM Consulting, LLC, in Sioux Falls.

munity engagement. Public health is the science of protecting and improving the health of people and their communities and is credited with adding 25 years to life expectancy of Americans, including immunization, seat-belt use, or safer foods. While public health cannot alone fix population health, it can 3

reduce the burden of disease and risk for disease in populations.

Evidence-based strategies that are proving effective and critical to moving the needle are upstream, collaborative efforts between public health and healthcare, bridging gaps to transform the health system.

Data sharing across sectors, cross-sector collaboration, value-based payment models, addressing SDOH and engaging vulnerable populations, provider referrals to chronic disease management programs, and utilizing a population health approach through the community health assessment and community health improvement process have been successful to improve population health. Moreover, according to the American Public Health Association, we achieve health equity by valuing all people equally – optimizing conditions in which people live, work, learn and play.4

WEB EXTRA

❖

REFERENCES Partnership to Fight Chronic Disease. (n.d.). “What is the impact of chronic disease on South Dakota?”

Heiman, H., & Artiga, S. (2015, November). Beyond health care: the role of social determinants in promoting health and health equity.

The Kaiser Commission on Medicaid and the Uninsured.

Morbidity and Mortality Weekly Report. (2011, May 11). Ten Great Public Health Achievements — United States, 2001—2010.

Centers for Disease Control and Prevention, 60(19);619-623.

American Public Health Association.

(2018). Health Equity.

Read More

❱ F ind a link to the references and read more of Melstad’s insights on the intersection between healthcare and public health.

20

MidwestMedicalEdition.com

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21

[ T E C HN O L O G Y ]

Regional Brings Advanced Liver Cancer Treatment to the Black Hills

BY ALEX STRAUSS

C

HARLES VOIGT, MD,

this option were travelling

Radiology. “After that is

an interventional radiol-

five hours to Sioux Falls

done, we can determine

ogist at Regional Health

to get it, which is hard on

whether or not to proceed

Rapid City Hospital is

patients and families.”

with the procedure.”

now offering a type of radiation

Because it involves

Certain arteries may

therapy for inoperable liver cancer

radioactive material, the

be embolized to keep as

that is new to the Black Hills.

procedure requires a great

much Y90 as possible

Known by several names, includ-

deal of careful planning

in the liver. Finally, the

ing Selective Internal Radiation

and is very much a team

liver is treated, one lobe

Therapy (SIRT), radioembolization, or

effort. First an angiogram

at a time, about a month

simply “Y90”, it is a minimally inva-

is performed to map out

sive procedure that involves injecting

the arteries feeding the

tiny resin beads filled with the radio-

liver. Then a diagnostic

active isotope yttrium Y-90 inside the

material is used along with a camera

licensed to do this through the

blood vessels that feed liver tumors.

to determine how much of the Y90 is

Nuclear Regulatory Commission,”

The spheres, which are just 20 to 60

likely to stay in the liver and how

says Lowell Husman, Director of

microns in diameter, stay in the body

much could migrate to other parts of

Nuclear Medicine. “There are many,

indefinitely but lose their radioactiv-

the body.

many safety aspects that need to be

ity within a couple of weeks.

apart.

Charles Voigt

“A clinical representative from the

“It was a long and arduous process to get

followed but we have been found to be in full compliance.”

The purpose of the treatment is

company [SIRTeX] comes out and

two-fold; the microspheres block the

helps us with the setup and delivery

The team has treated four liver

tumor’s blood supply, causing it to

of the angiogram,” explains LaNae

cancer patients since the procedure

shrink, while the radioactive isotope

Hamblet, Supervisor of Interventional

was first available in January. ❖

makes its way into cancer cells to destroy them. It can be used to treat inoperable tumors that originate in the liver, as well as those that have metastasized to the liver from other

A comparison of Y90 resin microspheres to a human hair.

Photo courtesy SIRTeX

parts of the body.

Although the procedure itself is not new, this year marks the first time it has been available in Western South Dakota, thanks in part to the efforts of Dr. Voigt and his colleagues in radiology and nuclear medicine.

“The truth is that this is just one more tool for us to use in combating liver cancer, but we felt it was important to bring here because, once cancer happens inside the liver, systemic chemotherapy is not usually very effective,” explains Dr. Voigt. “So our liver cancer patients who needed

22

MidwestMedicalEdition.com

South Dakota Cities Among the Best for People with Disabilities

S

IOUX FALLS CAME IN 3RD AND RAPID CITY 7TH among 182 US cities evaluated by the personal finance site WalletHub for their disability-friendliness.

Noting that people with disabilities have a longer list of things to consider when searching for a place to live, WalletHub analyzed cities across the US in 31

key disability-related metrics. The data set ranged from wheelchair accessibility to facilities per capita to rate of workers with disabilities to quality of the public hospital system.

Here’s how the numbers break down for Sioux Falls (1-Best, 91=Avg.)

12th – Employment Rate for People with Disabilities 81st – % of People with Disabilities in Poverty 22nd – Family Doctors & General Practitioners per Capita 22nd – Share of Young Buildings 29th – Share of Uninsured Population Other cities in our region which ranked high on the list are Bismarck, North Dakota at 9th and Minneapolis, Minnesota at 12th. Overland Park, Kansas was the highest rated city for people with disabilities and New Haven, Connecticut came in last. ❖

WEB EXTRA

Read More

❱ See our website for a video summary and link to the full report.

November 2018

23

A PERSONAL PERSPECTIVE on PALLIATIVE

CARE

BY ALEX STRAUSS

t improves “ Iquality of life

and decreases the cost of care.

Why would we not want to use it whenever we can for every appropriate patient?

”

Thomas Asfeldt with his wife Karen Meland Asfeldt and late father-in-law Norris Meland

T

HIS SUMMER, Thomas Asfeldt,

determined that it would probably not give

RN, BAN, MBA, Director of

him more than about a month of extra life,”

Outpatient Cancer Services at

says Asfeldt.

Sanford USD Medical Center,

So the family decided to meet with San-

lost his 87-year-old father-in-law to meta-

ford’s palliative care team, experts devoted

static lung cancer. The Wallace, South

to preserving quality of life by managing

Dakota area farmer had been a life-long

symptoms during, after, or — as in Asfeldt’s

non-smoker and the unexpected diagnosis

father-in-law’s case — instead of treatment.

this past May hit the family hard.

“The palliative care team really helped us

“He had extensive disease burden which

clarify what his goals were for the last months

really limited his options,” says Asfeldt. After

of his life,” says Asfeldt. “It became clear that

considering all of the possible therapeutic

another month of life didn’t mean anything

routes, including targeted therapies and

to him if he had to spend it tired or tied to

clinical trials, it was decided that the only

chemotherapy sessions.”

viable treatment was chemotherapy — and that was not an attractive prospect.

“In conversation with his oncologist, we

WEB EXTRA

Instead, what Norris really wanted was to spend those last months on his farm, in as little pain as possible, visiting with his

Read More

❱ Learn more about the Palliative Care and Hospice Education and Training Act

24

MidwestMedicalEdition.com

children and grandchildren, and

encouraging other team members

As a volunteer for the American

maybe even driving his tractor a

to engage the palliative medicine

Cancer Society, Asfeldt has been

few more times.

team early for the benefit of the

a long-time advocate of the pro-

“So his ‘treatment’ was to opt for

patient,” says Asfeldt. “We don’t

posed Palliative Care and Hospice

palliation and just let the cancer

always do that so well in medicine.

Education and Training Act (Senate

take its course,” says Asfeldt. “It was

We tend to continue to treat the

Bill 693), a national initiative to

the palliative care team that helped

patient aggressively, forgetting that

bolster understanding, access, and

us make those decisions and get us

the palliative medicine team can

utilization of palliative medicine

on the right trajectory to manage

help us along the way while we’re

which

as the disease progressed.”

treating the patient.”

support.

has

wide

bipartisan

Asfeldt has been around pallia-

Asfeldt points to research

“The idea is to enable physicians,

tive medicine in his position at

demonstrating the ability of

nurses and other members of the

Sanford for more than 13 years,

palliative medicine to simultane-

healthcare team be advocates for

but he says it wasn’t until he went

ously improve quality of life while

using palliative medicine like

through this deeply personal family

reducing the cost of care, not only

my family did,” says Asfeldt. “It

experience that he truly under-

at the end of life, but also during

improves quality of life and

stood the value of this underutilized

active treatment. “Palliative med-

decreases the cost of care. Why

approach to supportive care.

icine and active treatment often go

would we not want to use it when-

hand-in-hand,” he says. “The two

ever we can for every appropriate

are not mutually exclusive.”

patient?” ❖

“Going forward I’m definitely going to be more assertive about

November 2018

25

[ INTERVIEW ]

Cancer Researcher Steven Powell on This Year’s Nobel Prize in Medicine

L

AST MONTH, THIS YEAR’S NOBEL PRIZE in Physiology or Medicine was awarded jointly to James Allison of the US and Tasuku Honjo of Japan for conducting the research that helped give rise to immunotherapy. The two are credited with paving

the way for the first checkpoint inhibitors that are now routinely used in cancer immunotherapy.

But as Sanford researcher Steven Powell, MD, observes in a recent interview

with MED, their work, pivotal as it is, has only scratched the surface of what might be possible in this quickly evolving medical field.

MED: Is cancer immunotherapy a new field?

MED: And yet immune checkpoint

SP: Not entirely. We have known that

inhibitors are not a cure for cancer.

the immune system is important in

Why not?

cancer for over 100 years. The first

SP: The problem is that not all

work in cancer immunotherapy was

cancers use these mechanisms

done by a researcher and physician

to survive. Some use different

who was injecting patients with puss

mechanisms. In my lab, we look

in the hope of spurring an infection

for biomarkers to help identify

and causing a massive immune

which patients are likely to

MED: What is next for cancer

response. That was a crude way

benefit from immunotherapy

immunotherapy?

of using immunotherapy and it was

and which aren’t.

SP: We now have about a half

not very successful.

MED: Why isn’t a “strong immune

dozen trials looking at other immune checkpoints, besides the

MED: What is the significance of

system” the most important factor is

Allison and Honjo’s work?

warding off cancer?

SP: These guys found a piece of the

SP: The immune system is incredibly

trials involve combinations of

puzzle that was integral to making

complex. It is like the body’s military.

drugs, because sometimes the

immunotherapy work. They discov-

It has to attack when it is supposed

immune system needs a little bit

ered how checkpoints, these immune

to but it also has to recognize when

of a push and sometimes it needs

system braking mechanisms in the

it needs to back off. People talk about

a brake. We are also trying to learn

body, can be turned off so that cancer

taking supplements to “strengthen

how to use immunotherapy with

can’t use that to survive. Their work

immunity.” But you don’t need your

chemotherapy, radiotherapy and

has led to a massive interest and

immune system to be overly active;

other treatments to get the most

discovery of other aspects of the

you need it to be specifically active.

out of it. The only way it is going

ones identified by Allison and Honjo. In addition, some of our

immune system. My personal feeling

to happen is to get more people

is that they absolutely deserve the

involved in clinical trials. That is

Nobel Prize.

what we hope to do. ❖

WEB EXTRA

Read More

❱ Read about Dr. Powell’s involvement in the KEYNOTE immunotherapy trial 26

MidwestMedicalEdition.com

PREVENTION OF NOISE-INDUCED HEARING LOSS

BY MANDY ROUNSEVILLE-NORGAARD

H

EARING LOSS CAUSED by noise can

The way to prevent any noise-induced hearing loss is

occur in people of any age. It may happen

to use hearing protection. There are two main types of

suddenly or gradually. How soon it

hearing protection available, and which one you choose

happens, how long a person is exposed

is a matter of preference. The first is passive noise pro-

to the noise, the source, and the intensity of the noise

tection, such as earplugs or earmuffs. These work by

all can effect how much damage is done. Noise-induced

muffling noise and reducing the decibel level that is able

hearing loss, or NIHL, is actually one of the most common

to reach the inner ears.

forms of hearing loss. NIHL can be immediate or it can

For noise that exceeds 105 dB, such as gunshots, wear-

take a long time to be noticeable. It can be temporary or

ing earmuffs and earplugs together is the best bet. Both

permanent, and it can affect one ear or both ears.

earmuffs and earplugs come with a noise reduction rating,

Even if you can’t tell that you are damaging your hear-

or NRR; obviously higher is better. Some hunters, however,

ing, you could have trouble hearing in the future, such as

dislike the fact that passive hearing protection muffles

not being able to understand other people when they talk,

not only the gunshots, but also sounds they want to hear,

especially on the phone or in a noisy room. Regardless of

such as conversation with fellow hunters or the sounds

how it might affect you, one thing is certain: noise-induced

of approaching animals.

hearing loss is something you can prevent; NIHL is the

The alternative is active hearing protection, also known

only type of hearing loss that is completely preventable.

as electronic hearing protection, which allows hunters

The most common cause of noise-induced hearing loss

the best of both worlds. Through a process called destruc-

in this area is hunting or target shooting. A study from

tive interference, which is basically countering an incoming

the University of Wisconsin found that men between the

sound wave with an inverse sound wave produced by the

ages of 48 and 92 who hunted on a regular basis were much

headphones, the harmful noise is subdued.

more likely to experience high-frequency hearing loss,

These high tech earmuffs come in a range of price

and that the risk of hearing loss increased by 7 percent for

points have the advantage of enhancing environmental

every 5 years a man had been hunting.

sounds while at the same time decreasing the dangerous,

Hunters who don’t use hearing protection say it is

high decibel sounds. The Walker Game Ear, for example,

because they feel like earmuffs or earplugs interfere with

blocks any noise above 85 decibels but enhances regular

the noise they actually want to hear, such as the rustling

sounds. And built in microphones in these devices even

of a deer or the flapping of ducks wings. In other words,

allow a hunter to pinpoint which direction a sound is

they don’t wear hearing protection because they are afraid

coming from.

of missing something important. The good new is, there

The good news is that if you protect your hearing now,

is an option for hunters to prevent hearing loss and still

you’ll be able to enjoy those sounds of nature for years to

enjoy their favorite activity.

come. ❖

WEB EXTRA

Read More

❱ L earn more about noise-induced hearing loss and see a list of activities that increase the risk for you and your patients.

Mandy Rounseville-Norgaard, AuD, practices audiology at Sioux falls Audiology Associates

November 2018

27

Ideas for Upgrading a Luxury Home

BY TRACIE STORO

T

HE WINTER MONTHS ARE SOON APPROACHING so time spent inside will be increasing.

Here are some potential upgrades to your home that may make your time inside more enjoyable.

CREATE YOUR OWN SPA-LIKE

a saltwater aquarium, collect

might also get some overhead

SPACE BY IMPROVING YOUR

tropical fish to add some color

screens to keep score for the com-

BATHROOM.

to your new-found space. For a

petitive types. You can also dress

Convert your shower into a steam

little adventure you could add a

up your alley with colorful bowl-

shower by adding a steam gener-

hidden passageway to another

ing balls and black lights to make

ator and seal off the shower to be

room or hidden space.

it glow for a little younger feel.

perks such as mood lighting,

ENJOY ENTERTAINING

FOR THE REALLY ACTIVE

music and essential oils for the

FRIENDS AND FAMILY?

TYPE, CONSIDER ADDING

full spa experience. Exchange

Create your own family entertain-

A ROCK-CLIMBING WALL

your mirror with a hidden TV

ment center by putting in your

TO YOUR HOME.

mirror to enjoy your favorite

own theater room. All you need

Paths can be created for the begin-

shows while prepping for the day.

is a projector, sound system, seat-

ners all the way up to the avid

While you’re at it, replace your

ing, Blueray player and darkness.

climbers. These walls can be put

flooring with a heated tile floor

I suppose you would need a

up right over your existing wall

and add towel warming drawers

collection of movies as well. This

and even your ceiling to make it

for a complete transformation.

space would provide hours of

more difficult. Be sure to hire a

entertainment for people of all

professional when installing your

HAVE AN EXTRA ROOM/OFFICE

ages. Movies not your thing? You

climbing wall, you want all your

THAT NEEDS A MAKEOVER?

could also get a gaming system

structural needs to be met while

Make your own personal library

and spend just as much time play-

constructing your new hobby.

by finding some bookshelves or

ing video games.

fully enclosed. Include some extra

creating a wall of shelves to put

Tracie Storo is with RE/Max Professionals in Sioux Falls.

There are many ways to

your collection of books. Add

LIKE MORE ACTION WITH

upgrade your home. Hopefully

some comfy furniture and blan-

YOUR COMPANY?

some of these unique ideas piqued

kets for lounging and snuggling

A bowling alley would surely be

your interest and you are one step

up with your next read. A fire-

striking in your family room.

closer to setting your home apart

place with a stone surround could

A little more space would be

from the rest. Remember to

be a great addition to your new

required here since the length of

always consult an expert before

room. Upgrade your space with

the lane is just shy of 63 feet. You

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Your

TEE TIME is waiting.

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Schedule an appointment today.

CNOS.net | 605-217-2667

November 2018

Neurology Neurosurgery Orthopaedics Podiatry Rheumatology Spine

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The South Dakota medical community presents unique opportunities and challenges for the professionals who work here. We asked some of them,

What do you like most about working in healthcare in MED terriory?

—JILL FULLER, retired hospital President/CEO Care in a rural area is very personal. People know each other or of each other. This added level of connection enriches our healthcare experience and strengthens our commitment to serve.

—ELIZABETH HARTMAN, MD, neurologist I love the Midwestern mentality! We work hard, don’t complain (except about the weather) and make the best of tough situations. In my field of Neurology, this means that I see amazing recoveries after a stroke, individuals and their families who turn a disability into a strength, and I get to help individuals navigate a fulfilling life despite setbacks.

—JESSICA TVEDT, CNP, nurse practitioner I enjoy getting to know each of my patients...It is rewarding knowing patients from around the region trust in me to provide them cardiology care.

—BRANDON PETERSON, DPT, physical therapist I feel that healthcare in our region is second to none because we treat and respect everyone as if they are our family. This includes the patients we serve and the colleagues we work with.

—CAROL DONAHUE, DPM, foot surgeon What I like most about practicing medicine in this region is the amiable, charming personalities of my Midwest patients, the hard-working, honorable work ethic of the Midwest healthcare staff/team who helps me treat patients, the low malpractice rates, and of course the minimal traffic/commute time, which for me is 13 minutes.

—KRISTI EGLAND, PHD, researcher Doing cancer research in our region is inspiring because of the willingness of patients to participate and support my translational research program.

As a scientist, I enjoy interacting with local physicians to determine what is missing in diagnostics and treatment and to generate ways to improve healthcare for our community.

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MidwestMedicalEdition.com

November

Upcoming Events NOVEMBER 2 |

8:00 am – 5:00 pm

36th Annual North Central Heart Cardiac Symposium

5:00 – 8:00 pm Thursday 7:30 am – 3:00 pm, Friday

Location: Sioux Falls Convention Center

Sioux Falls Cancer Symposium 2018

Information and Registration:

Location: Sanford House, Sanford Center

averacontinuingeducation@avera.org

Information: amber.allen@sanfordhealth.org

Call: 605-322-8950

NOVEMBER 2 |

Registration: sanfordhealth.csod.com

8:00 am – 3:30 pm

CNOS FOundation Orthopaedic & Sports Medicine Symposium Location: RIver’s Bend Conference Center, Sioux City Information: CNOS.net/events

NOVEMBER 3 |

6:00 pm – 11:30 pm

Mercy Medical Center’s Mission Possible Gala Location: Marina Inn Conference Center

NOVEMBER 9 |

8:15 am – 4:30 pm

Sanford Behavioral Health Symposium Location: The Delta Hotel by Marriott, Fargo, ND Registration: sanfordhealth.csod.com

NOVEMBER 27 |

9:00 am – 4:00 pm

6th Annual Avera and Hazelden Betty Ford Foundation Symposium Location: Holiday Inn Downtown, Sioux Falls

Ticket Information: mercysiouxcity.com/mercy-foundation-gala

NOVEMBER 6 |

NOVEMBER 8–9

8:00 am – 4:00 pm

Avera Palliative Care and Ethics Symposium

Information and Registration: averacontinuingeducation@avera.org Call: 605-322-8950

Location: Sioux Falls Best Western Ramkota

GOT AN UPCOMING EVENT?

Information and Registration:

Add it to MED's online calendar for free at MidwestMedicalEdition.com/calendar.

averacontinuingeducation@avera.org, Call: 605-322-8950

HEAR. BETTER. NOW. ASK ABOUT OUR VETERAN, FIRST RESPONDER & TEACHER DISCOUNT.

CALL US TODAY! Au.D.

TREATMENT FASTER THAN EVER BEFORE BREAST INTRAOPERATIVE RADIATION THERAPY (IORT) Patients with early-stage breast cancer may be able to complete both surgery and radiation treatment at the same time. This means she can be back in your complete care faster with either a single radiation treatment immediately after surgery or as a supplement cutting her radiation sessions by one third.

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