2020: The Year in ReviewNov 24, 2020 07:00AM ● By Med Magazine
In a year dominated by COVID-19, it is easy to overlook the fact that there were other noteworthy events and people to talk about in 2020. Many of them graced these pages throughout the year and we are delighted to bring you this opportunity to revisit their stories (or, perhaps, see them for the first time) in this year's Year in Review.
New Decade, New Name
Rebrand Reflects Monumental Changes at Regional Health
In January, Rapid City-based Regional Health officially became Monument Health. The new name came with a new logo requiring millions of dollars of new signage for its five hospitals, eight specialty and surgical centers, and 40+ clinics and service centers. It also coincided with a new affiliation with the Mayo Clinic Care Network.
"There was a unanimous feeling that it was the right time to move forward with the new brand," Monument Health CEO Paulette Davidson told MED. "We are different than we were even three years ago. We have recruited more than 200 physicians in the last few years, transitioned to an EMR system, and are making significant investments in all of our campuses, including a 270 million dollar project here in Rapid City."
"We have approached this thoughtfully because we want to be fiscally responsible," added Robin Zebroski, Vice President of Strategic Marketing and Communication. "The money for new signs on the south side of that campus was already in the budget,"
The Monument Health name was a nod to the history and legacy of the Black Hills and a reference to the health system's commitment to stand firm, ready to weather future challenges. Davidson says the new alignment with Mayo Clinic will help them keep that commitment.
"For [our physicians] to have that world-renowned clinical knowledge and expertise available... not only improves their ability to care for people but will improve our ability to retain well-trained physicians."
Reflections on Three Decades in South Dakota Medicine
H. Thomas Hermann, MD
For 33 years, family physician H. Thomas Hermann, MD, cared for the elderly, delivered babies, took call in the ER, led community projects, and watched partners come and go. In March, we helped him celebrate his retirement from Monument Health Sturgis Clinic by inviting him to share some of his hard-won insights.
MED: You have long been active with the South Dakota State Medical Association. What do you see as some of the most positive changes in state medicine?
HTH: Moving to Electronic Health Records was a major challenge and cost us productivity for a while, but it is a huge benefit to patients. We can now have so much information at our fingertips. Another positive thing I see is that a lot more things are handled by teams now, which is good for patient care.
MED: Are there any trends that you find concerning?
HTH: More and more physicians of my generation are retiring, so we are going to have shortages of primary care physicians, which will drive up costs. We need more graduate program support to encourage more doctors into primary care.
MED: Thirty-three years is a long time to practice. Is there anything that has not changed in that time?
HTH: I think what hasn’t changed is that we continue to try to do what is right for our patients, offering quality medical care. In family medicine, we try to be good listeners and good advocates and to guide our patients in making good choices.
Care Beyond Healing
Amanda Sedlacek, DO, Palliative Medicine Specialist
As a child, Amanda Sedlacek, DO, of Yankton Medical Clinic, spent time helping to care for her aging grandmother who passed away when she was in first grade.
“My family had to deal with some really hard end-of-life issues and I remember watching how my grandmother changed as a person as she became ill,” remembers Sedlacek, whose mother was a nurse. The experience ultimately drew Dr. Sedlacek to internal medicine where she saw a chance to care for “the whole person and the whole body”, both in and out of the hospital.
“After my first year of training, one of our program directors told me he thought I would enjoy hospice medicine,” she says. Within a month of working with hospice inpatients, Sedlacek’s mind was made up.
Palliative and hospital medicine can include helping to manage symptoms such as pain, nausea, dyspnea, depression, anxiety, constipation, or diarrhea. But it can also extend to advanced care planning, lining up home services, providing medication review and recommendations and assisting with bereavement and psychosocial support.
“I feel like it is the greatest blessing to take care of people at the end of life,” she says. “Dying is something people don’t talk about. It is a time of very raw human emotions. Not just grief and sadness, but also a lot of love. I feel fortunate that I can help people go through this.”
Creating Unbreakable Bonds
Steven J. Meyer, MD, Orthopaedic Surgeon
This March, just as the attention of the world was turning to COVID-19, orthopaedic surgeon Steven J. Meyer, MD, of the CNOS Clinic in Dakota Dunes became the recipient of the 2020 American Academy of Orthopaedic Surgeons' Humanitarian Award.
The award came just three months after his 51st medical mission trip to Tanzania as part of Siouxland Tanzania Educational Medical Ministries (STEMM), the nonprofit organization he founded in 1997. STEMM is dedicated to bringing medical care and educational opportunities to the East African nation.
"When I went for the first time in 1996, they were sterilizing instruments with a hot plate and a cast iron pot. I was operating with makeshift instruments and going to the hardware store to get screws to put in people," Dr. Meyer told MED.
Eight years later, Meyer performed the country's first hip replacement in that same hospital. Two years after that, he and his team also did the first knee replacement.
"The STEMM mission opened up a new avenue of high level ortho surgery for the entire country," he says.
Today, orthopaedic surgery is just one aspect of STEMM. The organization also runs an orphanage and feeding programs, provides funding for education, and has built roads, buildings, and a birthing center.
"This is not necessarily where you would expect a phenomenal mission to be born," says Meyer. "We are a different culture, a different color, and mostly blue collar. But people here have demonstrated a great heart for this mission."
The Year of the Nurse
Celebrating Nursing in the Time of COVID
Two hundred years after the birth of Florence Nightingale, the World Health Organization designated 2020 the International Year of the Nurse and Midwife. But thanks to COVID-19, what was supposed to have been a celebratory year all but slipped by without much celebration. The timing of Certified Nurses Day on March 19th was particularly unfortunate; that was the week most states began to see their first cases of coronavirus.
"If there is anything good thing that has come out of COVID, it is an improved sense that nurses are so important and that physicians and nurses have to be a team," says Deb Fischer-Clemens, President of the South Dakota Nurses Association and Director of the Avera Center for Public Policy. "I think more physicians are recognizing how important it is to have that nurse at the bedside assisting them every way they can."
Fisher-Clemens says the value of this mutual appreciation goes way beyond fostering a positive working environment. She believes that relationships between nurses and physicians, nurses and administrators, and nurses and other nurses or uncertified caregivers will be critical for navigating the uncharted waters of South Dakota's healthcare future.
"The bottom line is that you have to talk about and support your nurses, which includes making sure that they can feel safe" says Fischer-Clemens. "We have to demonstrate that we understand how important their role is to all of us. It is only becoming more so."
Better Breast Cancer Odds Through Better Detection
Frederick "Joe" Severs, MD, Breast Radiologist
Nationwide, the breast cancer detection rate stands at about 4.7 per 1,000 mammograms. Among mammograms read by breast cancer specialists at Sanford, that figure is 45 percent higher, and climbing. Frederick Severs, MD, a fellowship-trained breast radiologist and Medical Director of Breast Radiology at Edith Sanford Breast Center says the difference is fellowship training.
"As breast radiologists, all we do is breast cancer, so our skills are very honed," he says. Breast radiologists do an additional year of immersion in breast cancer after their general radiology training, resulting in 15 to 17 months of total breast cancer radiology training.
In large university medical centers, most screening mammograms are read by fellowship-trained breast radiologists. But Severs says it is unusual for a city the size of Sioux Falls to offer this level of expertise.
As the size of Sanford's breast radiology team has grown, so have breast cancer detection rates. Sanford's specialists are finding 30 to 35 percent more breast cancers than the general radiologists do and 25 percent more of the hardest-to-detect tumors under 1 cm.
"These are very unlikely to have spread to the rest of the body and they approach about 100 percent cure rate. So these are really the cancers that you want to be finding for better outcomes," says Severs.
Thanks to two mobile mammography units, 31,000 women were screened through Edith Sanford Breast Center in 2019. Including mammograms, ultrasounds, MRIs, and procedures, there were more than 43,000 total studies.
Envisioning the Future of Medical Education
Timothy Ridgway, MD, Dean of the Sanford School of Medicine
On September 1st, Sioux Falls gastroenterologist and USD Sanford School of Medicine graduate Tim Ridgway, MD, was named Vice President of Health Affairs and the medical school's new dean. We spoke with him after his first month on the job for the November issue.
"I am not a person who said 'I want to be a dean' and applied to deanships around the country," Dr. Ridgway told MED. "But when this position came up, I just knew that I wanted to be dean of this school because the school gave a small town kid from Ravinia, South Dakota the chance to pursue a dream."
Despite the challenges of providing high quality medical education during a pandemic, Ridgway said the year has been a learning experience for both the school and the students. Online classes have allowed the school to better utilize the expertise of teaching faculty from around the state. And moving to virtual staff meetings has improved participation. But Ridgway says the lessons are bigger than logistics.
"If COVID has taught us anything, it is the value of a public health knowledge base," he said. "We are seeing the need for experts in public health firsthand. The curriculum needs to evolve. Physicians today need to be more than just providers of healthcare. They also need to have the tools, knowledge and language to help direct how that healthcare is delivered so that this new generation can help shape future healthcare policy."