MED-Midwest Medical Edition-April/May 2012

MedicinePersonalized

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

April

May

2012Vol. 3 Issue 3

ContentsApril / May 2012

Midwest Medical Edition

In RevIewMusicophilia By Oliver Sacks, MD

page 32

RegulaR FeatuRes

2 | From Us to You

5 | Meet a MED Advisor – Daniel Todd, MD

29 | The Grapevine: ‘Chasing’ a Historic Zinfandel

30 | Complementary Therapies: Hypnosis

36 | News & Notes: News from around the region

37 | Learning Opportunities: Upcoming Symposiums, conferences, CME Courses

In thIs Issue 5 | Personal Health Records

6 | Data, Data Everywhere By Dave Hewett

9 | Avera Receives Environmental Awards

10| Former Med X-Ray Docs Join Local Hospitals

12 | Securing and Protecting Electronic Medical Records By Lizabeth Brott

18 | Go Mobile or Go Home By Tana Tipton

21 | Farewell to the Institution: USDSM’s Dean Parry Looks Back

23 | Anderson to Lead Family Physicians

24 | Sensory Processing Disorders Through the Lifespan By Theresa Parish

25 | Survival Story Featured at National Conference

26 | Heart Hospital Installs 4D Flash CT

34 | Smoothing the Path Achieve and the Developmentally Disabled

The AverA InsTITuTe for humAn GeneTIcs

Personalized Medicine

Cover photo credits:DNA strand: Comstock/Thinkstock • AIHG lab photos: Kristi Shanks

Genetics and genomics are shaping the future of medical care and the Avera Institute for Human Genetics is on the leading edge of that movement. This six-year-old lab is not only conducting breakthrough research on pharmacogenetics and behavior, but they have even attracted the attention of international researchers. With high-throughput capabilities, experienced leadership, and the ability to craft their own gene arrays, the AIHG is poised to take an even bigger role in the quest to personalize medicine.

Cover Featurepage 14

Midwest Medical Edition 2

CONTACT INFORMATION

Steffanie Liston-Holtrop, VP Sales & Marketing

605-366-1479 [email protected]

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

Fax 605-271-5486

MAiLiNG ADDrESS PO Box 90646 Sioux Falls, SD 57109

WEbSiTE MidwestMedicalEdition.com

Jan/Feb Issue December 5

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April/May Issue March 5

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July/August Issue June 5

Sep/Oct Issue August 5

November Issue October 5

December Issue November 5

2012 Advertising / Editorial Deadlines

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©2011 Midwest Medical Edition, LLC

Midwest Medical Edition (MED Magazine) is committed

to bringing our readership of 3500 South Dakota area

physicians and healthcare professionals the very latest in

regional medical news and information to enhance their

lives and practices. MED is published 8 times a year by MED

Magazine, LLC and strives to publish only accurate informa-

tion, however Midwest Medical Edition, LLC cannot be held

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

PUBLISHER MED Magazine, LLC Sioux Falls, South Dakota

VP SALES & MARKETING Steffanie Liston-Holtrop EDITOR IN CHIEF Alex Strauss DESIGN/ART DIRECTION Corbo Design COVER PHOTO & DESIGN Darrel Fickbohm PHOTOGRAPHER Kristi Shanks WEB DESIGN 5j Design CONTRIBUTING EDITOR Darrel Fickbohm

CONTRIBUTING WRITERS Heather boysen Lizabeth brott Dave Hewett richard Klein Theresa Parish Tana Tipton

STAFF WRITERS Liz boyd Caroline Chenault John Knies

From Us to YouStaying in Touch with MED

Write

to us!We accept

reader

submission

A letter from the vP

A letter from the editor

THiS iSSUE OF MED is one of contrasts. on the one

hand, there are the futuristic concepts of genomic

medicine, mobile websites and EHR security… On the

other hand, the medical school is saying goodbye to

a man who has shaped three decades of medical students.

On the one hand, there is advanced new equipment like

Avera’s new 4D Flash CT scanner… On the other hand, the

local organization Achieve is proving that sometimes the ‘low

tech’ hands-on approach is the surest ways to improve

medical care.

On the one hand, MED is devoted to bringing you timely,

local relevant health news… On the other hand, MED invites

you to share your hobbies, talents and opinions with your

colleagues in these pages. (Thank you, Dr. Klein, for this

month’s book review!)

We hope you will enjoy the contrasts in this issue and that

the contrasts in your own practice and personal life will make

both richer, more successful and more interesting. —Alex

Alex Strauss

Steffanie Liston-Holtrop

ONE OF THE PErKS of producing the area’s only

local medical community magazine is the

opportunity to get involved with organizations

that are having a real impact on the health of our

community. Organizations like the American Heart Associa-

tion, which sponsors the Go Red for Women movement. As a

member of this year’s Go Red Executive Leadership Team, I

had the chance to help raise funds and awareness – and

represent MED – at the annual Sioux Falls Go Red for Women

luncheon. Not only was I proud to be

helping fight the number one killer of

women in our community, but I also

had a great time. (See photo – that's

me on the far right) Thanks to everyone

who served this great cause with me,

and thanks to all of you health profes-

sionals who are helping to fight heart

disease and heal damaged hearts in our

region every day. Our hearts go out to

all of you!— Steff

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TOTAL jOinTREPLACEMEnTBETTER PATiEnT OUTCOMES

Healthcare Groups Issue New Guides to Using

Personal Health Records

12

CLINICIA N GUIDE TO A PERSONA L HEA LTH R ECORD

Introduction................1

Important.reasons..

for.having.a.PHR.........2

Benefits.of.access..

to.a.PHR......................3

Controlling..

designated.access..

to.a.PHR......................4

PHRs.and.other..

electronic.health..

information.sources....5

Additional..

information.on.PHRs... 6

Testimonials................7

PHR.Screen..

Examples.....................9

Glossary.....................13

Participating..

organizations.............14

A PHR can be an excellent tool for patients and their caregivers to track chronic conditions and

ongoing metrics. These metrics may include lab values and screening results. As an example, weight

management can be a key factor for effective diabetes management and control.

In the examples below, the PHR tells the user which health information is being tracked on the first

screen, and it graphs the weight results over several months on the second screen. This data may be

self-entered, captured by home-based, web-enabled scales or from the EHR information gathered

from a clinic visit and/or hospital stay.

PHR Screen Examples (Continued)

KEY HEALTHCArE OrGANizATiONS are teaming up to help take the mystery out of using personal health records (PHR) by rolling out two new informa-tional brochures to help promote the understanding and use of PHRs among consumers and clinicians. The new bro-chures: “Your Personal Health Record,” and “A Clinician's Guide to a Personal Health Record,” will be available online at BCBS.com.

PHRs are online tools for making more informed healthcare decisions and enhanc-ing care coordination. The brochures, which include screenshots of PHRs, user testimo-nials, and an informative Q&A, were created through a collaboration of health-care groups including the Blue Cross and Blue Shield Association (BCBSA), the American Health Information Management Association (AHIMA), the American Cancer Society (ACS), the American College of Physicians

(ACP), the American Diabetes Association (ADA), the American Heart Association (AHA), the American Osteopathic Associa-tion of Medical Informatics (AOAMI), and MGMA-ACMPE.

As recent reports show, when more healthcare data is available to consumers, their caregivers and doctors, it can help improve the coordination of care. By making these brochures available, key healthcare stakeholders hope to increase the adoption and use of PHRs by showing consumers how they can use PHRs to store health information such as medical condi-tions, allergies, medications, and doctor or hospital visits in one convenient and secure place. For clinicians, the brochures describe the benefits of using PHRs to help them deliver quality care to their patients and make their practices run more efficiently.

With PHRs, individual patients and their designated caregivers can take charge of their healthcare choices by viewing and managing their own health information. PHRs also enable patients to quickly and readily share healthcare information with their providers, which allows for better tracking of chronic diseases and helps their provider determine the most appro-priate treatment plan.. ■

For more information about PHRs or

to download copies of the PHR

Quick Reference Guides for

consumers or providers, please

visit:

www.bcbs.com/phr_brochure,

http://www.aoami.org/phr_brochure.

cfm

or

http://www.mgma.com/

phrguide/.

brochures will help consumers and clinicians better utilize

PHrs to manage their healthcare

April / May 2012 5MidwestMedicalEdition.com

A talk with MED Advisor

Dan Todd, MD

Q: You are an otolaryngologist but you spend a lot of your time on allergies. Why?I did my residency at the University of Missouri where they were doing sophisti-cated allergy work. We had a lot of patients and we did allergy skin tests and allergy shots. They also had a strong early sinus surgery program which is where I started doing endoscopic sinus surgeries. Some patients have an allergist, a plastic surgeon, and a sinus surgeon. But you shouldn’t really need three doctors for one nose.

Q: Here on the brink of allergy season, is there anything new on the horizon?Allergy drops are beginning to gain acceptance as an alternative to allergy shots. Like the shots, allergy drops rely on desensitization. Frankly, I think part of the resistance from the medical community is because of the money made on allergy shots. But the drops are effective and easier for certain patients, especially children.

Q: A runny nose is annoying, but what about life-threatening allergies like food allergies?Food allergy desensitization is an up and coming thing. Because of the risk of a serious reaction, this has to be done in an intensive care setting. But it has been very successful where it has been used in some large centers, particularly for common allergies like peanuts. The patient will likely never be able to eat a lot of peanuts, but if he does happen to eat a couple, he is much less likely to die.

Q: You also do sinus surgery. Anything new there?Drug eluting stents that are left in the sinus cavity have proven to be helpful in keeping polyps from reforming after sinus surgery. It is great to have all of these tools in our bag, to help people solve their sinus and allergy problems in whatever way is best for them.

OTOLArYNGOLOGiST


HEALTH CArE iS AWASH iN data. From what is charged to what is paid for care; from how well procedures are per-

formed to how satisfied our patients are with the services they are provided; from how safe patients are while under our care to how well they recuperate – there’s a number or numbers for it.

It wasn’t long ago that most of our infor-mation was cost related. Now it’s that plus so much more – patient satisfaction, follow-ing best practices, hospital readmissions, mortality, patient safety, etc. For now most

of those numbers are impacting the institu-tional providers including hospitals, nursing facilities and home health agencies. But we also know that the Physician Quality Reporting System (PQRS) is in its formative stages with a de facto requirement that all physicians be participating in that program by 2015. (That’s when nonparticipating physicians will see their Medicare reim-bursement cut 2 %.)

So how are we doing so far? A compos-ite analysis of hospital data suggests that South Dakota has achieved above average scores in most all of the major categories

and ranks in the top quartile among all states.

The numbers are important because the public is looking and they can impact reim-bursement. In this more transparent world, our challenges are twofold: first, what num-bers we should be concerned about and focused on; second, who should be monitor-ing and working on improving these numbers.

First, the “what”. There are literally hun-dreds of quality and patient safety indicators. They tend to be lumped into four or five cat-egories (see below). First, I propose that an

Data, Data everywhere by Dave Hewett , President/CEO, SDAHO


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organization can only be effectively working on four or five of those indicators at once and the selection of those indicators is influenced by an indicator’s relative public prominence and its impact on how the provider is viewed by the public and paid by third party payers. I’m also going to look inside each of the general cat-egories and find those areas that offer me the greatest opportunity for improvement. For example, if I know that 30% of my quality incentive payment is based on patient satisfaction I will focus on improving my HCAHPS score. To improve that number I will select those measurable areas (communication with physi-cian, quietness of the room, etc.) where my scores are lowest relative to others.

Second, the” who”. You guessed it, it starts with physicians. Study after study show that numbers improve when physicians lead a team effort focused on the goals at hand – reducing readmissions, improving patient satisfaction, following best practices, and improving patient safety numbers. But it is the emphasis on “team” and a thorough understanding and commit-ment to the metric that makes improvement happen.

One other observation about the graphs. Notice please just how little variation there is between what passes for “average”, the top 10%, and South Dakota’s numbers. In most cases improving numbers is not about wholesale change. Rather, it’s about team effort to improve what we do at the margins. The new health information system affords us that opportunity. ■

MED QuotesThe doctor of the future will give no

medicine but will interest his patients in the care of the human frame, in

diet and in the cause and prevention of disease.~Thomas Edison


AVErA MCKENNAN HOSPiTAL & UNiVErSiTY HEALTH CENTEr has received two Green Globe awards for its efforts in maintaining sustain-ability and overall environmental per-formance of the Prairie Center, located on the Avera McKennan campus. The Prairie Center is home to the Avera Cancer Institute and the Avera Sur-gery Center.

“We started pursuing this certifica-tion as part of the planning process of the Prairie Center,” says Garrett Peters, director of Facility Development at Avera McKennan. “Green Globes was a good fit for how we wanted to pursue acknowledgement of our efficient, sus-tainable building.”

Green Globes is a revolutionary green building guidance and assess-ment program that offers an effective, practical and affordable way to advance

the overall environmental performance and sustainability of commercial build-ings. Essential elements of the Green Globes system include:

u Comprehensive environmental assessment protocol

u Software tools that speed and simplify online assessment

u Best practices guidance for green construction and operations

u Qualified assessors with green building expertise

u Rating/certification system

Green Globes software tools and ratings/certification measures environmental impacts on a 1,000-point scale in multiple categories, including:

• Energy • Indoor Environment

• Site • Water • Resources • Emissions • Project/Environmental Management

After achieving a threshold of at least 35 percent of the total number of 1,000 points, new and existing com-mercial buildings can pursue Green Globes certification that assigns a rating of one to four globes. Third-party assessors (with expertise in green building design, engineering, construc-tion and facility operations) interface with project teams and building owners during the assessment process by reviewing building documentation and conducting on-site walk throughs.

While the Green Globes are similar to LEED certification, Peters says Avera McKennan chose to pursue Green Globes because it was an established program for healthcare buildings. The LEED healthcare program is a new initiative which was not in place until construction on the Prairie Center was near completion. ■

aveRa ReceIves

Environmental Awards


THE DiSSOLUTiON OF MEDiCAL X-rAY Center, PC, in Sioux Falls has netted both Sanford Health and Avera large groups of new radiology providers. Both hospitals announced their new doctors in March.

Sanford added 13 former Med X-Ray radiologists, expanding the Sanford radiol-ogy group to 21 physicians, 10 of whom are fellowship trained. Sanford says it expects to add another five radiologists before the end of the year.

At the same time, Avera announced its new doctors by announcing the addition of ‘Avera Medical Group Radiology Sioux Falls’ to its team. The group includes twenty physi-cians and a physician assistant.

In addition to the new providers, Avera also assumed ownership of the Avera Veradia Vein Center located in Plaza 2 on the Avera McKennan campus and the former Midwest Regional PET-CT Center on Sharon Avenue in Sioux Falls. Both had formerly been oper-ated by Med X-Ray.

Shannon Gray, manager of the newly named Avera Pet-CT Center, says the staff will remain the same, including physicians who serve on a rotating schedule, and CT technologists from Avera McKennan.

Med X-Ray had been operating as an independent private practice in Sioux Falls since 1961 and included more than 30 physicians. ■

Sanford Radiology Physician GroupBryan Barness, MD

John Reinschmidt, MD

Patsy Uken, MD

Chris Fischer, MD

David Ellis, MD

Robert Crank, MD

Charles Flohr, MD

David Bean, MD

Gary Famestad, MD

Cameron Stokka, MD

Thomas Free, MD

Edward Czarnecki, MD

Lisa Hinckley, MD

Khalil Yousef, MD

Terry Yeager, MD

Janet Dubois, MD

Susan Duffek, MD

Thomas Cink, MD

Melinda Talley, MD

Chris Fischer, MD

Fred Lovrien, MD

Julia Prescott-Focht, DO

Avera Medical Group Radiology, Sioux FallsJosie Alpers, MD

Jeffery Baka, MD

Matthew Casey, MD

Sabina Choudhry, MD

Daniel Crosby, MD

Christopher Gregory, MD

Matthew Helgeson, MD

Ryan Jepperson, MD

Joseph Jordahl, MD

Michael Kihne, MD

Jonah Luzier, MD

Thomas Masterson, MD

Patrick Nelson, MD

Brad Paulson, MD

Matthew Pardy, MD

Joshua Plorde, MD

Daryl Rife, MD

Andrew Soye, MD

Randal Welter, MD

Suzanne Woodward, MD

Derek Sitter, PAC

Former Med X-Ray Doctors Join Local Hospitals

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We honor a legacy of care.The Year of the Nurse at Sanford Health.They’re called to be caregivers, advocates and leaders. The backbone of our organization. Humble heroes always putting their patients first. And we are grateful for all they do at the bedside, in the clinic, in the corporate offices, in research and in our communities.

At Sanford Health, we show our appreciation. This day. Every day. The Year of the Nurse at Sanford Health.

yearofthenurse.sanfordhealth.org

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wHeRe ARe THey nOw?


U SE OF ELECTrONiC medical records (EMRs) is steadily increasing. The National Center for Health Statistics

estimates that in 2011, fifty-seven percent of office-based physicians were using some type of medical record system that was all or partially electronic (excluding billing systems). This estimate compares to only eighteen percent in 2001. By state, percent-ages ranged from a low of forty percent in Louisiana to a high of eighty-four percent in North Dakota. Average EMR usage in South Dakota was fifty-five percent.1

If your office has adopted or is consider-ing an EMR, it’s important to address the privacy and cyber liability risks associated with this technology. Network security, inter-net viruses, and electronic data breaches are relatively new issues for many medical prac-tices. But failure to safeguard against these risks can result in dire consequences for medical practices and patients alike.

Concerns regarding EMRs and patient privacy are not unfounded. A recent study of large healthcare organizations found ninety-six percent of respondents had experienced at least one data breach in the preceding 24-month period. The top three causes of breaches were: lost or stolen computing devices, third-party error (e.g., by a business associate), or unintentional employee action.2

Fortunately, there are steps you can take to reduce the likelihood of a data breach. Two crucial drivers of information security include having an effective security strategy in place and being proactive in using it.3

Implementing a strictly enforced elec-tronic security/privacy policy is your first line of defense. Consider including the following in your security policy:

✔ an initial risk assessment with periodic

follow-up assessments (consider using

external experts)

✔ regular system testing and security

updates

✔ comprehensive clinician and staff training

on your security policies and procedures

and the importance of protecting

patient data

✔ specific policies for use of personal devices

including laptops, home computers,

mobile devices and social media

✔ use of passwords and encryption for

personal devices

✔ agreements with business associates

outlining data privacy and security

requirements

✔ an incident response plan

✔ varying levels of access for employees

on a need-to-know basis

✔ complex passwords and frequent

required password changes

✔ physical placement of computer screens

with special attention to visibility of social

security numbers

✔ root cause analyses of major data

breaches.

✔ interactions with your EMR should take

place over a secure, encrypted network.

1. Hsiao CJ, Hing E, Socey TC, Cai B. Electronic health record systems and intent to apply for meaningful use incentives among office-based physician practices: United States, 2001-2011. NCHS Data Brief. November 2011; No. 79. National Center for Health Statistics, Centers for Disease Control and Prevention.

2. Ponemon Institute. Second annual benchmark study on patient privacy & data security. Ponemon Institute Research Report. December 2011.

3. PricewaterhouseCoopers International Limited. Eye of the Storm—Key Findings from the 2012 Global State of Information Security Survey®.” PricewaterhouseCoopers International Limited. New York; September 2011.

Securing and Protecting Electronic Medical Recordsby Lizabeth F. brott, J.D.

You Take Care of yourpatients, we’ll take care

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We pride ourselves in our ability to proficiently handle the needs of physician practices large and small. We understand the complexities of your business and work as a team to facilitate sound decision making, reduce practice costs and maximize profits.

WE CAN HELP YOU WITH: ✢ EMR Solutions: Intergy - Implementation and Training

✢ Contracting and Credentialing Services

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Contact Carla Campbell or Kay DeWitt for an initial assessment 800-658-3901

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Taking proactive steps to secure your EMR will go a long way toward protecting patient data; however, even the best managed system can be vulnerable to data breaches. Cyber liability insurance can help cover expenses associated with this risk. Most cyber liability policies include protection for:

NETWORk AND SECuRITY PRIvACY bREACHES

— virus attacks, patient identity theft, online and offline data breaches REGuLATORY FINES AND PENALTIES — defense costs for governmental investigations (including HIPAA), and payment of regulatory fines and penalties

PATIENT NOTIFICATION AND CREDIT MONITORING

COSTS — payment of legal and other expenses incurred to notify patients of an information breach, and payment of credit monitoring costs for persons affected by a breach

DATA RECOvERY COSTS — payment for costs of recovering or replacing data that is lost, erased, stolen, or corrupted. ■

Lizabeth F. brott, J.D., is Regional Vice President of Risk Management for ProAssurance, a national provider of medical professional liability insurance.

14

Personalizing

1

The Avera Institute for Human Genetics

Medicine


Genetics and genomics, The comPlex InTerAcTIons

beTween Genes And TheIr ImPAcT on dIseAse, Are

TrAnsformInG The PrAcTIce of medIcIne. sInce The

mulTI-bIllIon dollAr GlobAl efforT known As The

humAn Genome ProjecT GAve The world ITs fIrsT look AT The com-

PleTe humAn Genome In 2001, few AreAs of medIcIne hAve been

unTouched by The knowledGe.

“The sTrIkInG PArT AbouT The humAn Genome ProjecT Is ThAT we

leArned so mAny ThInGs AbouT ourselves ThAT we never knew

before,” sAys moleculAr GeneTIcIsT GAreTh dAvIes, Phd, scIenTIfIc

dIrecTor of The AverA InsTITuTe for humAn GeneTIcs And Professor

In The PsychIATry dePArTmenT AT usdsm.

“we leArned, for InsTAnce, ThAT we hAve fewer Genes ThAn we

fIrsT exPecTed. we knew ThAT A mIcroscoPIc worm hAs AbouT 10,000

Genes, so we were surPrIsed To fInd ThAT humAns only hAve AbouT

20,000.”

we Also leArned ThAT humAns shAre AbouT 50% of TheIr Genes

of A bAnAnA. And from one Person To The nexT, we Are 99.9% IdenTI-

cAl. buT, As dr. dAvIes And The scIenTIfIc mInds flockInG To The fIeld

of moleculAr GeneTIcs know, A world of knowledGe And dIscovery

– Indeed The fuTure of medIcIne ITself – Is conTAIned noT only In The

myrIAd of Genes we shAre, buT Also In ThAT mysTerIous .1%.

by Alex Strauss

2

3

4

1 Molecular geneticist Gareth

Davies, PhD, Scientific Director

of the Avera Institute for Human

Genetics and Professor in the

Psychiatry Department at

USDSM.

2 Post doctoral fellow Ueshan Hu

and PhD student Erik Ehli with

the Affymetrix GeneChip

Scanner. When loaded with

pre-made arrays, such as the

DMET panel, the machine

allows the lab to conduct GWA

studies such as those being

conducted on DNA from the

Netherlands Twin Registry.

3 DNA extracted from blood is

loaded into the DNA sequencer.

4 Genetics Research Associate

Kelly Nelson prepares a DNA

sample for sequencing.

ph

oto

s by

Kri

sti S

hank

s


An Economic SuccESS StoryThe economy may be struggling, but the field of genetics and genomics continues to grow at a phenomenal rate. According to new research sponsored by the American Clinical Laboratory Association, genetic and genomic clinical laboratory testing generates 116,000 U.S. jobs and contributes $16.5 billion annually to the U.S. economy.

“This industry is one of American’s true economic success stories,” says Alan Mertz, ACLA President. “it is not only helping us beat cancer and other diseases, but it is also building strong economic growth in a field of innovation where the U.S. is and always has been the leader.”

The report said that the industry’s ability to innovate and produce cutting-edge genetic testing services and products supports about 44,000 direct jobs and generates about 73,000 jobs in key supplier industries and wholesale trade businesses.

“As we build on the mapping of the human genome, genetic and genomic testing is enabling one of the country’s great medical and economic transformations,” says Jen bowman, ACLA’s VP of Policy and regulatory Affairs.”i also think it is important to recognize that a significant amount of that is coming from the small, innovative start-up labs throughout the U.S.”

The report goes on to say that, for these economic oppor-tunities to continue, the genetic and genomic clinical testing industry must be able to operate in a business environment that encourages continued research and facilitates profitable business operations.

“The Human Genome Project has opened up what is essentially a new science for us,” says Davies, whose six-year-old lab was established to the impact of genes on behavioral medicine. “What this has done is allowed us to think about taking a much more personalized approach to medical care. If we can look at a person’s DNA, we can begin to understand why that person becomes sick. These kinds of questions have excited a whole new generation of scientists and medical students.”

And no wonder. Instead of practicing by the law of averages, administering treatments that work for most, but not all, patients, physi-cians armed with genetic data may finally be able to accurately predict treatment responses. Custom-tailored treatments have the potential to dramatically improve out-comes in virtually every disease process, from colds to cancer.

“Our lab concentrates on pharmacogenet-ics as it relates to pain, chemotherapy and depression, but my expectation is that every-one is going to eventually appreciate that this knowledge is going to help every type of patient,” says Dr. Davies. “From diagnosis to treatment to prevention. It is going to be a revolution.”

CliniCal StudieSPhysicians like Dr. Tim Soundy and Dr. Mat-thew Stanley, psychiatrists with the Avera Behavioral Health Institute, have already joined that revolution. The two have been part of groundbreaking clinical research through the Avera Institute for Human Genetics, in the burgeoning field of pharma-cogenetics and psychiatric treatment. One recent clinical study focused on patients at the South Dakota Development Center in Redfield, a residential program for the devel-opmentally disabled, where the average number of medications administered to indi-vidual patients is 17.

“Many of these patients are being treated with anti-epileptics, anti-psychotics, etc.,” explains Dr. Soundy. Soundy genotyped

Redfield’s top 50 medication consumers using the DMET chip, a $500 panel of arrays and reagents, to examine the genes for drug metabolism.

“When we sat down as a team and ana-lyzed the results, we found that some of these patients were having toxic side effects because they were not metabolizing their medications properly,” reports Dr. Soundy. “This is especially troubling in non-verbal patients. We found one patient who, because of his genetic makeup, was on the equivalent of 16 mg of a substance that was supposed to have been 3 mg. Without this technology, you could not know this.”

Dr. Matthew Stanley plans to conduct a similar study on South Dakota Medicaid patients, another population that consumes large numbers of psychiatric drugs. “The neat thing about genetics is that your genes don’t change,” says Dr. Stanley. “So what we learn about your genes today is still going to apply ten years from now.”

Another upcoming Avera research project involves analysis of the genetic makeup of patients in the Drug and Alcohol Treatment Center in Yankton to predict response to anti-craving medication. Pending grant approval, Avera will be one of four sites to conduct such research.

The Avera Institute for Human Genetics is also a leader in the genetics of childhood behavioral issues. The lab has amassed a database of young psychiatric patients, along with their parents and siblings, for ongoing genotype studies. New findings on ADHD and genetics have made it possible for Avera doctors to choose the most appropriate ADHD medication for their young patients using a simple mouth swab. And thanks to research published recently by Dr. Davies and his team, they can feel confident that buccal cells are as effective as blood for this type of testing.

“We are doing what a lot of major medical centers are beginning to do,” says Dr. Soundy. “Right now, most psychiatric patients who come into the Mayo Clinic have their genes analyzed for the major pathways

Child and adolescent psychiatrist Timothy Soundy, MD,

AIHG Director Ryan Hansen and Gareth Davies, PhD.


for psychiatric drugs. I would eventually like to see every patient who comes into the Avera system, whether they are seeing the family doctor, the pediatrician, the cardiologist, or the psychiatrist, have their genes analyzed. Drug metabolism is a good place to start.”

SMall lab, big CapabilitieSThis relatively new lab of just six research-ers is already making a name for itself internationally. With its high throughput gene analysis capability and expertise, the AIHG has signed an exclusive agreement to conduct ongoing longitudinal studies of DNA from the Netherlands Twin Registry at the University of Amsterdam. These genome-wide association (GWA) studies involve the examination of thousands of samples for common genetic variants to determine if those variants are associated with particular traits.

“Many common diseases that have a genetic component like schizophrenia, dia-betes, ADHD, etc., are the result of not just one gene, but many, as well as the environ-ment,” says Dr. Davies. “When we do GWA studies, we have to test many, many samples to give us the statistical power we need to verify our results. We are very excited to have been chosen as the designated lab by the Netherlands Twin Registry.”

The lab’s relationship with the Netherlands Twin Registry, the largest registry of twin DNA in the world, has made possible some of its most important research to date. Con-trary to the long-held belief that identical twins share identical DNA, Dr. Davies and his colleagues have recently shown that twin DNA can have differences in the number of copies of certain genes and that these numbers can have a dramatic impact on behavior.

“We call this Copy Number Variation. We found that in identical twins with differ-ent behavioral problems, one twin might have two copies of a particular gene and the other might have three,” explains Dr. Davies, whose breakthrough research has just been

approved for publication in the European Journal of Human Genetics.

More research like this is coming. Using state-of-the-art equipment, the AIHG is capable of designing ‘made-to-order’ genetic tests for any group of genes, giving clinical researchers at Avera and elsewhere the tools to design and implement a virtually unlim-ited range of genetic studies.

a bright FutureAccording to the American Clinical Labora-tory Association, Labs like the Avera Institute for Human Genetics can expect to stay very busy for the foreseeable future. [See sidebar] As clinicians press for genetic tests that will help them tailor their patient care, labs like this one are seeing phenom-enal growth. Davies says he gets as many as ten inquiries a week from people who want to work in the AIHG, a significant challenge in a field where necessary equip-ment is often outdated within a few months of purchase.

“I would love to hire everyone who applies, but I need to be able to fund it,” says Davies. “We are growing as fast as we can.”

In the meantime, Dr. Davies says his Avera team is as capable as any he worked with at Oxford or NIH, and is up for what-ever challenges lay ahead. One of those challenges is already on the horizon. Now that the human genome has been sequenced, a new race is on to create fast, affordable individual genome mapping.

“When the human genome was sequenced, it took thousands of machines from all over the world tens of billions of dollars,” says Dr. Davies. “Now, I believe we are getting to the stage where, in the next few years, it will cost just $1000 to sequence one person’s genome. I used to tell my stu-dents ‘not in my lifetime, but in yours.’ But now I believe it will be much sooner.”

“When that happens, it is going to completely revolutionize the practice of medicine.” ■


aL M OS T 8 0 PERCEN T O F physicians recommend patients go online for help managing their health conditions. That’s

good news if your marketing efforts have been spent enhancing your organization’s website with wellness tools and apps. It’s bad news if you don’t have a mobile version of your website, because you’re missing an opportunity to engage your patients.

There are 530 million mobile web users. Many are patients accessing your website from their phones, whether or not your site is mobile-optimized. Without a mobile ver-sion of your site, graphics are difficult to see, text discouraging to read and links impos-sible to tap. That’s a problem since today’s patients want a clear path to relevant, credible health information.

If you don’t provide a positive mobile experience, it’s time to change. According to a Morgan Stanley report, more people will access the web from mobile devices than from computers as early as 2015.

Fortunately, your efforts to build-up your main website were not in vain. With smart-phone adoption booming, you simply need both. Plus, mobile sites are cost-effective to create since they’re a simplified version of your full site.

FOLLOW THESE TIPS FOr OPTiMiziNG YOUr MObiLE SiTE

♦ uSE ONE-TOuCH PHONE NuMbERS. Visitors to your mobile site are already on their phone, so this is essential. Phone num-bers should require just a tap to call. Have safety information at the top of your Contact Us page, like calling 911 for an emergency.

♦ kEEP CONTENT SHORT. Don’t list your board of directors, annual reports, history or other lengthy content on your mobile site; it’s not conducive to reading on a small screen. List helpful information like locations, maps and directions.

♦ LINk TO YOuR MAIN SITE. Make it easy to access information that’s not included on your pared-down mobile version, such as bill pay, job listings or volunteer opportunities.

♦ LIMIT PICTuRES OR IMAGES. They take too long to load. Focus on strong branding and easy-to-scroll text pages with big buttons.

♦ EMPLOY MObILE-FRIENDLY APPS. With more than 9,000 consumer health apps in the iTunes store alone, there’s plenty of inspiration to get creative with apps for your mobile site. Look at your most visited pages and create apps that

solve problems for patients and quickly get them to the information they need.

♦ INCLuDE FACEbOOk AND TWITTER buTTONS. Users already interact with most social media sites via their phone. Only link to these social sites if you routinely update them with dynamic content and proactively monitor activity.

♦ ADD SEARCH FuNCTIONALITY. A search bar allows users to easily find more information and gives you flexibility to not display every component and page from your main site. However, it can be a lot of work—if you commit to adding search functionality, the bulk of the content on your full site should be searchable on your mobile site. ■

Tana Tipton is a Marketing Specialist with CQuence Health Group.

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Farewell to the Institution


IT WAS 1976 AND Dr. rODNEY PArrY was just finishing his pulmo-nary medicine residency at the Mayo Clinic when the University of South

Dakota School of Medicine was transi-tioning to a 4-year medical school. Chair of Internal Medicine, Dr. Robert Talley, approached Parry, who’d grown up in Canis-tota, about the possibility of joining the growing medical school faculty and moving back home.

“I was intrigued with the idea of teaching and being part of the medical school,” recalls Dr. Parry. “But the truth is, Dr. Talley misled me. He told me that, as part of the medical school faculty, it was going to be important for me to have some time in my schedule just to think and to plan.”

“But it didn’t quite work out that way,” he laughs.

In fact, Dr. Parry hit the ground running as USDSM’s head of pulmonary medicine and the only lung specialist in eastern South Dakota. At the same time he was developing the school’s pulmonary medicine curricu-lum, Dr. Parry was also treating veterans with pulmonary conditions like bronchitis and emphysema in his half-time job at the

VA Hospital. It was under Dr. Parry’s guid-ance that the hospital first began using portable oxygen.

“I remember that people were very wor-ried at first that it would be a fire hazard,” he recalls. “But with their help, we were able to develop a good pulmonary medicine pro-gram there.”

Soon, Dr. Parry found himself devel-oping pulmonary medicine programs for both McKennan and Sioux Valley Hospi-tals. When Dr. Talley invited Dr. Parry to serve as his assistant in the early 1990’s, the newly-created position did not even have a title. They decided call him the Executive Dean, a position he held until he become Vice President and Dean upon Dr. Talley’s retirement in 2004.

A Proud TenureSince that time, there have been many

changes at the USD Sanford School of Medi-cine (including the name change in 2006) of which Dr. Parry is proud.

Class sizes have expanded in recent years from 50 to 56. The school has also added valuable and unique new programs, including a new rural medicine track which starts in the summer of 2012, an MD/PhD program, a pediatric residency, a cardiac fellowship which starts this year, and a geriatric fellow-ship which will produce its first graduates this fall. A residency program focused on ‘rural surgery’ is now in the works.

As VP and Dean, Dr. Parry also over-sees the school’s growing Health Sciences curriculum.

Farewell to the Institution

AfTer 36 yeArs devoTed To The universiTy of souTh dAkoTA’s school of Medicine, dr. rodney PArry is hoPing To finAlly geT soMe TiMe for hiMself.

The new Simulation Center named for Dr. Parry will be housed in the

USDSM Health Science Center/Wegner Library building in Sioux Falls.

Continued on pg. 22


“Frankly, I am very proud that were able to get this organized as a school,” says Dr. Parry. “Health Sciences includes ten dif-ferent programs, including a health science undergraduate degree. This is a degree for people who want to be involved in health care, but aren’t certain exactly what they want to do. It may be used to prepare for a PT or a PA program. Or it could be used by prepare for education as a radiology tech or some such. So I think it meets the needs of many people.”

During Dr. Parry’s tenure, the school’s Physical Therapy program began offering a doctoral degree, and the Nursing pro-gram, which had offered only an associate degree, now offers a bachelor’s degree program. But Dr. Parry says the most significant change at the USD Sanford School of Medicine has been the dramatic transformation in the curriculum for medical students.

Instead of a curriculum centered on subjects like anatomy and physiology, students will study organ systems, beginning with skin and skeletal in their first year. And instead of two full years of basic science classes, students will begin getting clinical experience in the middle of their sophomore year. They will also spend a year participating in ‘longitudinal care’, following their patients from clinic to hospital, as needed.

“This allows students to get more clinical exposure, allows for more small group interaction and gives them more experience with longitudinal care, which we believe is a more practical preparation for the kinds of situations they will face,” says Dr. Parry. “This should allow them to feel more comfortable practicing in a community of any size.”

Beyond the medical school, Dr. Parry has been a leader in treating Cystic Fibrosis. He served on the national Cystic Fibrosis advisory committee and helped in the development of Sanford’s nationally-recognized Cystic Fibrosis Research Center.

looking forwArdIn his retirement, Dr. Parry says he hopes to find a little of

that ‘time to think and plan’ that he was promised so many years ago. He and his wife, Ruth, plan to stay in Sioux Falls near their grandchildren and he would like to indulge in his hobbies of gardening and travelling.

The Sanford School of Medicine will honor Dr. Parry’s years of service by naming a new Simulation Center after him. The “Rodney R. Parry, MD, Clinical Skills and Simulation Center”, located in the lower level of the medical school library building in Sioux Falls, will feature advanced simulation technology for teaching and testing students. The Center will be a shared facility with the VA Hospital. Construction began in March.

The school’s new VP/Dean, Dr. Mary Nettleman, will assume her duties April 2nd. ■

An open house will be held in Dr. Parry’s honor on Friday,

April 20th from 4:00 to 5:30 pm in Room 106 of the Health

Science Center in Sioux Falls.

Farewell to the Institution continued from Page 21


Anderson to Lead SD Family Physicians

CANiSTOTA FAMiLY PHYSiCiAN SuSAN

ANDERSON, MD, with Sanford Clinic has been elected by her peers to serve as President of the South Dakota Academy of Family Physicians, a group of over 290 Family Physicians from the state. Dr. Anderson has served on the Board of Directors for 4 years, three of those as Vice President and she most recently held the position of President Elect.

The SDAFP is a constituent chapter of the American Academy of Family Physicians, which is a national organization

comprised of 94,000 members in 50 states, D.C., Puerto Rico, the Virgin Islands and Guam. The Academy was founded in 1947 to promote and maintain high quality standards for family doctors. The South Dakota Academy was established in 1951 to carry out the mission of the AAFP at the state level.

Dr. Anderson attended medical school at USD in Vermillion and completed resi-dency at the Sioux Falls Family Medicine Residency where she served as chief resi-dent. Currently, she is Associate Professor

of the Department of Family Medicine and the Director of Introduction to Clinical Medicine at the USD Sanford School of Medicine.

Dr. Anderson practices with the Sanford USD Physicians Clinic in Sioux Falls and has an outreach clinic in Canistota. She is also the Medical Director of the Canistota Good Samaritan Center, a member of the Society of Teachers of Family Medicine, and president of the Canistota School Board.

The office of President is a one-year term which began in February. ■

MED QuotesMan may be the captain of his fate, but is also the victim of his blood sugar.

~Wilfrid G. Oakley

Introducing Avera Heart Hospital’s new FLASH CT scanner.

nSpeed. The Somatom Definition FLASH scans a 6-feet-6-inch tall person in five seconds.

nSafety.Our registered CT technologists can increase image quality while reducing the amount of dose radiation.

nQuality. The FLASH CT scanner offers the clearest images possible with the highest resolution.

Diagnosis in a f lash.

Physicians can order a FLASH CT scan for their patients by contacting the hospital. The new CT will also be used for Planet Heart screenings to help assess risk for heart and vascular disease. If you have any questions, call the radiology department at (605) 977-7323.

-Drs.NagelhoutandGordon,NorthCentralHeartInstituteDavidA.Nagelhout,MD,FACC,DSCCT

MarkR.Gordon,MD,FACC

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“This new CT allows us to scan the heart in one heartbeat using the lowest possible dose necessary.


TiMES ArE CHANGiNG AND people are hearing more and more about sensory processing disorders. Parents, teachers,

and caregivers of individuals from birth to death are taking the initiative to take sensory processing treatment into consid-eration to improve the lives of the people in their care. In infancy, parents may be dealing with an inconsolable baby, a fussy eater, or a baby that doesn’t sleep. In a school setting, there may be some chal-lenging behaviors that get in the way of the goal of teaching. Sitting still, paying attention, and even temper tantrums are

impeding children from learning skills and knowledge.

As these children age, they may have more difficulty in certain environments and learning disabilities emerge. Children and teens often get diagnosed with ADHD or even Bipolar disorder. Some of these chil-dren become violent and end up in juvenile detention centers, psychiatric wards, or even out on the streets. Adults with sensory pro-cessing disorders have difficulty with relationships, maintaining employment, and even with participating in their activities of daily living skills.

Our sensory processing abilities decline

naturally through the aging process. Diffi-culties are often noticed in assisted living facilities and nursing care facilities espe-cially with individuals that have dementia or Alzheimer’s disease.

So what does all this have to do with you as a health care professional? Every-thing. People are searching for answers to why these challenging behaviors are hap-pening, and they will be looking to you to get them the help they need. It all begins with awareness that the basis for all behav-ior is sensory processing, and if you can make an impact there, many people’s lives will be forever changed.

Sensory Processing Disorders Through the Lifespanby Theresa Parish, OTr/L, CEES

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Medications may help, but at times they are just a Band-Aid. For an individual, a referral to an occupational therapist who is a specialist in sensory processing disorders is very beneficial. Treatment includes adding the power sensations laced throughout a person’s day to enhance brainstem chemicals that affect our ability to respond to incoming sensations instead of reacting. This is easy to do once there is an understanding of the techniques and benefits. However, it takes a “village” to make a lasting change. So we all must work together.

Change can be very difficult, but with an understanding of what is going on and the steps to help alleviate the behaviors, lasting impact can be gained. All brains benefit from sensory processing input, therefore, it is easy to treat everyone with sensory techniques and improve their well-being.

To help an individual within a classroom, the teacher can be educated on what can be done differently to impact the student or students having difficulty. These techniques can be utilized in the entire classroom, thus impacting the learning success for all stu-dents. Challenging behaviors will be reduced which keep students, aides and teachers safe from harm. To impact an entire school, all teachers and aides can be educated.

Programs for educating staff and care-givers at schools, daycares, nursing care facilities, teen help centers, and develop-mental disability centers are available. It all begins with awareness of how Sensory Processing Disorders impact people’s lives and identification of a need for an individual being served or for the entire facility to be trained. As a healthcare professional, you can be that link to an occupational therapist who can help. ■Theresa Parish is an ergonomic and loss con-trol specialist/sensory processing specialist with RAS, a provider of workers’ compensation in the Upper Midwest, headquartered in Sioux

Falls, SD.

WATErTOWN rEALTOr FOrrEST “MiCK”

STANTON was one of South Dakota ‘Mis-sion: Lifeline’s’ first success stories. After suffering a heart attack in Henry, S.D., last summer, he was transferred to Prairie Lakes Hospital in Watertown. Within 19 minutes of arrival, Stanton had two block-ages in his heart opened, epitomizing the goal of the ‘Mission: Lifeline’ program.

Because of his experience, Stanton was invited by the national office of the Ameri-can Heart Association (AHA) to share his heart attack survival story at the AHA Scientific Sessions in Orlando. The annual Scientific Sessions is the country’s largest gathering of scientists and healthcare professionals devoted to the science of car-diovascular disease and stroke.

The immediate treatment received by Stanton at Prairie Lakes Hospital was made possible by a grant from the Helmsley Charitable Trust and the AHA’s ‘Mission: Lifeline’ program. In April, 2010 the Helmsley Charitable Trust awarded the AHA an $8.4 million grant to build a STEMI system of care in the

state of South Dakota. ‘Mission: Lifeline’ is using the grant to purchase equipment, implement processes, and close commu-nication gaps that separate heart attack patients from timely access to appropriate treatments.

Part of the grant funding was used to outfit ambulances throughout South Dakota with electrocardiogram (EKG) monitors that have the ability to transmit EKG readings to designated STEMI-receiving hospitals. Prairie Lakes Hospital has been designated a STEMI-receiving hospital because of its ability to provide life-saving treatment to patients suffering heart attacks.

The ambulance Stanton was transferred in was equipped with this technology and his EKG reading was transmitted to Prairie Lakes Hospital where it was read by inter-ventional cardiologist Dr. Salem Maaliki. This enabled Dr. Maaliki and the cath lab team to be ready for Stanton when he arrived and restore blood flow to Stanton’s heart well under the 90 minute recommended timeframe set by the Society for Cardiovas-cular Angiography and Interventions. ■

Survival Story Featured at nATIOnAL COnFeRenCeA WATErTOWN MAN’S STOrY OF HEArT ATTACK SUrViVAL LANDED HiM iN THE SPOTLiGHT iN FrONT OF SOME OF THE NATiON’S TOP HEArT DOCTOrS AND rESEArCHErS.

Pictured from left to right: Shelley Stingley, Helmsley Trust; Jodi Doering, South Dakota Mission: Lifeline Director;

Walter Panzirer, Helmsley Trust; Craig Kruse, Watertown Fire/Rescue paramedic; Star Jones; and Mick Stanton.


THE AVErA HEArT HOSPiTAL has installed a Siemens SOMATOM Definition Flash CT, one of the world’s fastest computed tomography (CT) scanners with the lowest possible radiation dosage. The new CT will aid in improving diagnosis and treatment of heart and vascular disease.

The effectiveness of CT has led to an increase in the number of scans being performed, which means more expo-sure to radiation. Avera Heart Hospital chose the new Flash CT because it is designed to reduce radiation exposure. The machine has features that help shield organs and areas of the body that are more sensitive to radiation.

In less than one second, the new CT can produce high-definition images of

the heart including the smallest blood vessels. These high resolution images can reduce the need for more invasive studies, decrease the time to diagnosis, speed urgent medical care and shorten hospital stays. ■

Other benefits of the Flash CT:

• Patients receiving a calcium score will

receive a reduction in radiation dose

of approximately one-third

• Radiology technologists can perform

an exam on a 6-foot-6-inch tall

person in about 5 seconds

• Patients with irregular or fast heart

beats may not need to take beta

blockers (mediations that slow their

heart rate) before a Coronary

Angiogram CT scan.

Heart Hospital Installs 4-D Flash CT ScannerNEW IMAGING TECHNOLOGY INCREASES SPEED, REDUCES DOSE

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

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

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Grape Expectations

‘Chasing’ a Historic Zinfandelby Heather Taylor boysen

April / May 2012

MY HUSbAND AND i recently visited the beauti-ful state of California for a quick Valentine’s Day

vacation and I was lucky enough to visit some well-know (and not-so-well-known) wineries during our brief four day sojourn.

Since we cannot commute to most wine-growing regions regularly, (I have a business to run and children to get to school) I often meet with sales people from wineries around the country. They come to our store, armed with samples and information, and intent on placing their products on our shelves.

Although not all of the wines are my ‘cup of tea’, I have made many friends in the wine industry from across the U.S., many of whom are anxious for us to visit their facilities.

But this trip was different. Instead of scheduling tastings at wineries with which

we already do business, I took advice from friends who are extraordinary collectors and have a wine cellar that would be coveted by most oenophiles. My husband and I were invited to their wine tasting party and were blown away by the samples we tasted. So I asked permission to photograph the bottles and made it my mission to visit at least a couple of these wineries and invite them to let me carry their wines in our shop.

Our first visit was to a winery that has been in production for five generations. The history of this winery and its founding family is impressive. According to the Chase family, “In 1874, Sarah Ester Chase Bourn, wife of a wealthy businessman, purchased a small vineyard in Napa Valley. Upon the death of her husband, management of the estate was turned over to her son William Bourn II, who was as industrious as his mother. William perpetuated Sarah’s impact on the area by selling the family grapes to Napa Valley’s first winemaker, Charles Krug. It was the start of what would become a long-standing family tradition.

Not content to only sell grapes, William wanted to produce wine and create a place to do so for himself and his neighbors. The answer was to build a co-op for wine produc-tion and storage. In 1888 he built Greystone Cellars, the historic and formidable stone building at the northern end of St. Helena. In 1903 William’s sister, Maude and her hus-band William Alston Hayne planted the eponymously named vineyard with Zinfan-del, and other varietals. Today, the Zinfandel vines still thrive. The head-pruned Zinfandel vines are dry-farmed in the sandy-gravelly

soil that produces Napa Valley’s most exuberant and robust Zinfandel grapes.”

We called the winery to ask if we

could come to visit. I was absolutely itching to see Zinfandel vines that were over 100 years old! Unfortunately, they were moving barrels out of the barrel room that day and suggested that we might prefer to come later in the afternoon when they were done with the move. I don’t care if its grapes or corn, when a farmer has work to do, guests must wait!

Walking though their vineyard, seeing the gnarly old vines, and learning the amaz-ing history of this place was worth the entire trip. The tasting itself reaffirmed what I had learned from my friends: These were truly very special wines. And you wouldn’t have to ransom your first born to buy a bottle!

The tasting was spectacular and I hadn’t been wrong in my enthusiasm for this wine when we tasted it back home. We are now in the process of working with the folks at Chase and one of our local distributors to bring their wine to South Dakota. Small case production, top level juice, and five generations of wine making is a trifecta in the wine world! ■

“ . . . seeing the gnarly old vines, and learning the amazing history of this place was worth the entire trip.”


MED: Many people still associate hypnosis with mind control and secrecy, but you say the hypnotic state is something most of us have experienced. What do you mean?

RW: Hypnosis is actually a state that many of us are in several times a week or even several times a day. When you are immersed in a project and so focused that you fail to notice things going on around you, that’s a hypnotic state. When a person undergoes hypnosis in my office, he is in control the entire time. It is really more about my teaching people how to talk to themselves in more positive ways. It is a very natural process that is not unhealthy or dangerous in any way.

MED: Are there certain types of problems that lend themselves to being helped by hypnosis?

RW: Clinical hypnosis can be used to

help overcome all sorts of psychological problems, but I specialize in helping people with generalized anxiety, panic attacks, specific phobias and traumatic stress disorders. These conditions are very common. According to the National Institute of Mental Health, anxiety is the number one mental health issue in the US. Statistics show that about every other person has suffered from depres-sion and every 3rd patient has anxiety. I have had very good success with these kinds of issues.

MED: How does hypnosis work?

RW: My process is pretty unique in that I focus on a technique called ‘regression’. It is a desensitization process during which you go over and over things with the client that have caused them rage or anxiety. Essentially, you talk about these things until they are bored. Every time

we experience an event, a file is created in the mind. When we create boredom around an event that had strong emotion attached to it, the file becomes neutral-ized and so does the anxiety that went along with it.

MED: How can this process comple-ment a patient’s medical treatment? Do you see hypnosis as an alternative to medication?

RW: Physicians need to know that hypnosis will not interfere with any other treatment. It does not require any changes in medication. In fact, I don’t ever suggest that a patient stop treatment with their medical provider. That is a conversation they need to have with the other professionals in their lives. Hypnosis is simply an additional tool to support what the doctor is doing. I get referrals from counselors and

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Ar

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Th

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sTHE CONCEPT OF COMPLEMENTARY OR ALTERNATIvE THERAPIES

HAS BEEN GAINING MOMENTUM NATIONWIDE IN RECENT YEARS, AS PATIENTS

SEARCH FOR NEW WAYS TO MAINTAIN OR REGAIN THEIR HEALTH IN THE FACE OF

RISING HEALTHCARE COSTS. AS A RESULT, THE NUMBER OF ALTERNATIVE MEDICINE

PRACTITIONERS AND PROGRAMS IN THE SOUTH DAKOTA REGION HAS ALSO

GROWN DRAMATICALLY. SOME ARE OFFERED WITHIN A TRADITIONAL HEALTHCARE

SETTING SUCH AS A MEDICAL CLINIC OR HOSPITAL. OTHERS ARE STAND-ALONE

BUSINESSES. IN THIS NEW COLUMN, WE WILL TAKE A CLOSER LOOK AT SOME OF

THE NEW (AND SOMETIMES ANCIENT) THERAPIES BEING OFFERED IN OUR REGION

AND MEET THE PEOPLE WHO PRACTICE THEM.

Name Rebecca Weiner, CCH

TiTle Consulting Hypnotist and Anxiety

Relief Spe0cialist, in practice for 8 years

BusiNessHeal with Hypnosis, Sioux Falls

c o M P l e M e n T A r y T h e r A P i e s


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psychologists, as well as physicians. Many of my clients have told their doctors that they are doing this and the doctors have been very supportive. That kind of support is important for helping patients make positive life changes.

MED: How can a potential client or a referring healthcare provider identify a “good” hypnotist?

RW: A good hypnotist will follow the ethics and codes established by the National Guild of Hypnotists. They will NOT say that they can cure things in one session. (Most problems require at least 6 two-hour sessions.) And the client needs to have a comfort level with the person they are going to work with. They need to ask ‘how will this work?’, ‘what can I expect?’, etc. The same kinds of questions you would ask your doctor.

MED: Is there anything else you feel the medical community should know about what you do?

RW: There is so much that we still do not know about the brain. For those who are skeptical, I would ask, ‘How can you say for sure that this won’t help?’ You owe it to yourself and your patients to do some exploration. Professionals like me are always happy to talk with providers about how their therapy might help. Also, in my practice, I always start with a free consultation to determine whether or not I am a good fit for the client. ■


In ReviewWhat You’re Reading, Watching, Hearing

DiD YOU KNOW THAT WHEN certain people hear musical chords, they see different colors, and that certain colors

represent specific chords? It’s call synesthesia.Were you aware that Leon Fleisher, a

renowned concert pianist, developed a condi-tion called dystonia in which the fourth and fifth fingers of his right hand would curl under, and until he learned pieces written for the left hand, this condition almost ended his career?

These and other fascinating conditions are described in Oliver Sacks’ book, Musicophilia: Tales of Music and the Brain (Alfred A. Knopf, 2007). Dr. Sacks is a professor of Neurology and Psychiatry at Columbia University School of Medicine. He is probably best known for his book “Awakenings”, which was later made into a movie.

In his inimitable style, he describes many

neurologic and psychiatric conditions, both normal and pathological, related to aspects of music. How are we able to distinguish the sound of a clarinet from that of a flute or an oboe? This is called timbre, and is a different characteristic from melody, pitch, contour and rhythm. Not only can we distinguish these different sounds when we hear them, but when we remember a piece of music, the timbre rings true.

Dr. Sacks explains to us exactly how this happens. He uses case reports of his own patients, and many who are referred to him. Case reports are always fun to read, but at times, his explicit details become a little tedious. All in all, however, this book is very entertaining, and I am sure you will find it enjoyable and enlightening. ■Dr. Richard klein is a urologist practicing in Sioux Falls.

reviewed by richard Klein, MD

Author Dr Oliver Sacks

Musicophilia Tales of Music and the Brain

Write to us!

Do you have a

media review?

A book, film, or article?

Send us a note

Alex@

MidwestMedicalEdition.com

We offer a team approach to head and neck cancer treatment. Our expert team delivers superior survival rates and restorative surgical options that provide the best quality of life outcomes. We are proud to help patients recognize victories through every stage of their cancer journey.

For mastery, innovation and personalized care.

(605) 328-8200cancer.sanfordhealth.org keyword: head and neck cancer

For all the you seekHead and neck treatment at Sanford Cancer

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100-11395-3072 2/12

Our team:Jennifer Schmidt, RN, NavigatorLaurie Gromer, CNPChad Spanos, MDBonnie Tschetter, LPNJohn Lee, MD


ANY PHYSiCiAN WHO has ever provided medical care for a patient with a developmental disability knows that it can

present some unique challenges. Depend-ing on the disability, the patient may be fearful, confused, resistant or even bellig-erent toward their doctor or healthcare provider – even when the care is badly needed.

In addition, patients with disabilities may have trouble communicating, making or keeping appointments, interacting appropri-ately with other patients and staff, or complying with treatment recommendations. It can be a frustrating situation for both patient and provider.

“One basic problem I see with patients that have developmental disabilities is that they may not be able to tell the doctor how they’re doing or may not be able to tell the complete story,” observes Sioux Falls family physician Patty Peters, MD, who knows the frustration of caring for such patients.

This is where the professionals at South Dakota Achieve can help. The 54-year-old Sioux Falls-based non-profit provides ser-vices to adults with disabilities ranging from support to live independently, communicate, expand their social network, find work, and live healthier lives. In addition to supporting healthy eating and exercise, this includes making sure the people they support have regular checkups, routine tests, and needed medical care.

“What we have found is that it is some-times hard to find doctors or dentists who are willing to provide services to people with disabilities,” says Achieve’s Director of Health Services, Liz Blais. “It may be hard

Smoothing the Path

to communicate with these patients or hard to calm them. Unfortunately, most physicians get little or no training in how to deal with these kinds of challenges.”

Fortunately, people supported at Achieve can get many of their day-to-day healthcare needs met in house. A staff of 17 nurses and restorative technicians provide services such as physical therapy, dietary consultation, stretching and mobility exercises, medication monitoring, treatment for everyday illnesses and help with eating disorders. But when any of their more than 468 people supported from 22 counties do need medical care beyond what Achieve staff can provide, the company

has developed systems to make the whole process easier and more productive for every-one involved.

“We have support people who can help make that medical appointment, then go with the person to that appointment and be right there to help the doctor understand what their needs are,” says Blais. “With that kind of support, not only do patients get the care they need, but doctors get paid for their time since there are fewer missed appointments, etc.”

“I have found it very helpful to have an Achieve support person there at the appointment,” says Dr. Peters. “For one thing, that person knows the patient well and

TREATMENT FOR PATIENTS WITH DEVELOPMENT DISABILITIES IS NOT JUST A STRESS ON THE PATIENT

by Liz boyd

Achieve provides basic health care services to the people it supports.

Here, Ashley Hoss, RN, asseses David Johnson.


Bankers Trust Companyof South Dakota

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

(605) 338-5033

ProvidingExperienced & Personalized

Trust Services

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

- Let’s Talk! • Dates: May 21-24 • Time: 9:00-11:00 amA camp using Augmentative & Alternative Communication devices.

- Breakfast Club • Dates: June 4, 7, 11, 14, 18, 21, 25, 28 • Time: 7:45-9:00 am For children that are picky eaters.

- Power Mobility Camps • Call for more informationMobility skills with the latest technology in power wheelchairs.

CHILDREN’S CARE HOSPITAL & SCHOOLwww.cchs.org

Call (605)782-2400 for more details or to register!

Insurance may apply!

Medical-Based Summer Camps for Kids!

7:00 p.m. . Saturday, April 14, 2012Sioux Falls Orpheum Theater

Tickets: $18 • Reserved Seating • Reception FollowsCall (605) 782-8500 or go to www.cchs.org

· Rick Holm, MD, with the Hopeful Spirit Chorale.· Dennis Knutson, MD, with the Augustana Flute Choir. · Terri Peterson-Henry, DO · Marian Petrasko, MD· Ronald Rossing, MD · Kirke Wheeler, MD · The Crabgrass Crew· Dr. Jack Billion, Master of Ceremonies

I can trust what they tell me about how the patient is really doing at work or at home. Also, the patient often feels more at ease with a familiar person in the room, so that can help the interview and exam go much more smoothly. I always feel that I can do a better job with that patient because that support person is like family to them.”

Because unfamiliar situations can be especially stressful for people with developmental disabilities, they sometimes need support to ‘build up’ to a healthcare appointment. Blais says this desensitization process can be as simple as an Achieve staff member sitting with the person in the waiting room or accom-panying them to the exam room a time or two before the actual appointment takes place. This simple approach can not only ease fear for that first appointment, but may also help that patient form a comfort level with the provider that will keep them coming back.

“We want to reach out and form partnerships with physicians in the community,” says Blais. “Our goal is to educate and promote understanding.” ■

MED QuotesTime is generally

the best doctor. ~Ovid


News & NotesHappenings around the region

Physician RecruiterMindy Schwitzer(605) [email protected]

Avera Sacred Heart Hospital has positioned itself as a regional health care center since 1897, serving 120,000 residents in 15 counties.

500 West Summit Street ~ Yankton, South Dakota

SEEKING ED MEDICAL DIRECTORBE/BC Emergency Medicine or BC Primary Care Physician with EM experience ready to lead an advanced Emergency Department currently seeking Trauma III Certifi cation. Yearly volume of 10,000 patient encounters with superior staff and speciality care back-up.

Teaching hospital with excellent compensation and benefi t package. Medical Directorship responsibilities plus seven 24-hour shifts per month and three Saturdays per year. NO STATE INCOME TAX.

Prairie LakesAlison Gilbertson has been named director of the Prairie Lakes Healthcare Foundation. As

director, Gilbertson will work to fulfill the organization’s mission to support and advance the health services available to the Watertown area through Prairie Lakes Healthcare System. She will be responsible for the management of day-to-day operations of the foundation.

Gilbertson was executive director of Golden LivingCenter in Lake Norden, S.D. since 2008. Gilbertson holds a master’s degree from the University of South Dakota and a bachelor’s degree from South Dakota State University.

The National Kidney Foundation, Inc., (NKF) serving Minnesota, the Dakotas and Iowa, is honoring Tina

Melanson, MD, FNKF, of Prairie Lakes Healthcare System with the 2012 Friend of the Foundation Award. Dr. Melanson presented the award at the annual Feast of the Great Chefs in Sioux Falls on Sunday, March 11, 2012. Dr. Melanson is board certified in Nephrology and Internal Medicine. She practices nephrology at Prairie Lakes Healthcare System in Watertown and serves as medical director of the Prairie Lakes Dialysis Units. Dr. Melanson has led the way to establish the first annual Watertown Kidney Walk, Fun Run and Bike-a-Thon to be held in May.

regionaLSpecial treatment for head and neck lymphedema is now available at Regional Rehabilitation Institute. Head and neck lymphedema can affect vision, eating, speaking and breathing. Therapy includes manual lymphedema drainage, compression garments for day and/or night, compression mask, facioplasty support or taping and decongestive exercises. Therapists will also teach the patient to perform necessary techniques themselves at home. For more information regarding this program or other Regional Rehabilitation Institute programs, please call (605) 719-1100.

The Children’s Miracle Network (CMN) raised $98,222 during a two-day Radiothon broadcast Thursday, March 8 and Friday, March 9 on New Rushmore Radio Stations Magic 93.9, KAT 98.7, The FOX 100.3 and KKLS 97.5 and 920 AM. The Radiothon took place in the lobby at Rapid City Regional Hospital. With money raised through special events, such as the Radiothon, CMN is able to purchase medical equipment and fund programs for children’s services. One hundred percent of the money raised locally stays in our area.

sanfordSanford Health nurse practitioner, Lori Wegehaupt, NNP, is receiving the 2012 AANP Nurse Practitioner State Award

for Excellence. This award is given annually to a nurse practitioner in each state who demonstrates excellence in his/her area of practice. A nurse for 26 years, Wegehaupt has worked for Sanford Health her entire professional career. The past 20 of those years, she has served as a neonatal nurse practitioner in the neonatal intensive care unit at Sanford USD Medical Center. Wegehaupt will be recognized at AANP National Conference in Orlando in June.

Clayton Van balen, MD, F.A.A.F.P. of Sanford Health Occupational Medicine & Walk-in Clinic has achieved

the Degree of Fellow of the American Academy of Family Physicians (AAFP). This fellowship entitles Dr. Van Balen to use the honorary designation, “Fellow of the American Academy of Family Physicians,” or “F.A.A.F.P.” and places him among 29,000 distinguished recipients nationwide since the degree’s establishment in 1971.AAFP is the national medical association representing nearly 100,300 family physicians, residents and medical students. The AFFP Degree of Fellow recognizes family physicians “who have distinguished themselves through service to family medicine and ongoing professional development.”

Sanford Children’s Specialty Clinic in Sioux Falls has added two new pediatric specialists. Steven Cochran, MD, is a board certified Child & Adolescent Psychiatrist. Dr. Cochran is a graduate of the Loma Linda University School of Medicine and

completed a fellowship at the University of Colorado School of Medicine.Dr. Catherine Avery is a Pediatric Psychologist. She is a graduate of the Illinois Institute of Technology in Chicago and completed an internship at Pine Rest Christian Hospital in Grand Rapids, Michigan.

oTHerThe South Dakota Affiliate of Susan G. Komen is moving its 2012 Race for the Cure breast cancer fundraising event from Vermillion, South Dakota to downtown Sioux Falls on September 30th. Organizers believe the new location will help the event grow by making it easier for more participants from across the state to attend. Seventy-five percent of the funds raised through the race stay in South Dakota for breast health education, breast cancer screening, treatment programs and research to prevent, treat and cure breast cancer. The remaining 25 percent supports national breast cancer research. Since 2008, the South Dakota race has raised more than $800,000.

Learning Opportunities

April / May / June 2012

MED reaches more than 5000 doctors and other healthcare professionals across

our region 8 times a year. If you know of an upcoming class, seminar, webinar,

or other educational event in the region in which these clinicians may want to

participate, help us share it in MED. Send your submissions for the Learning

Opportunities calendar to the editor at [email protected].

APRIL 13 Avera Childbirth Educator Workshop8 am – 4:30 pm Location: Avera Education Center Classroom 3 Information & registration: [email protected],

Phone: 322-8950 Website: www.AveraMcKennan.org; click on Events Calendar

APRIL 13 – 14 GI Nursing ConferenceLocation: Sanford Information and Registration: [email protected] Phone: 328-6353

APRIL 19 Living With Grief: End-of-Life Ethics12:30 pm – 4 pm Location: Avera Education Center Auditorium Information & registration: [email protected]

Phone: 322-8950 Website: www.AveraMcKennan.org, click on Events Calendar

APRIL 19 Pediatric Trauma Conference7:30 am – 4:45 pm Location: Sanford Center, Dakota Room Information: [email protected] Phone: 328-6353

APRIL 20 Diabetes update 20128:30 am – 5 pm Location: Avera McKennan Prairie Center Information and Registration: [email protected] Phone: 322-8950 Website: www.AveraMcKennan.org, click on Events Calendar

APRIL 21 Sanford Oncology Clinic Oncology updateLocation: Sanford USD Medical Center, Schroeder Auditorium Information: [email protected] Phone: 328-6353

APRIL 24 Ophthalmology Education Workshop5:30 pm – 7:30 pm Location: Avera Education Center, Classroom 3 Information and Registration: [email protected]

Phone: 322-8950 Website: www.AveraMcKennan.org, click on Events Calendar

APRIL 25 Transplant Education Day8:30 am – 3 pm Location: Sanford USD Medical Center, Schroeder Auditorium Information: [email protected]

Phone: 328-6353

MAY 1 20th Annual Trauma Symposium: Excellence in Trauma and Surgical Critical Care7:30 am – 4 pm Location: Sioux Falls Convention Center Information and Registration: [email protected] Phone: 322-8950

MAY 4 17th Annual North Central Heart vascular Symposium8 am – 5 pm Location: Sioux Falls Convention Center Information: [email protected] www.northcentralheart.com Phone: 605-977-5316

MAY 11 6th Annual Sanford Sports Medicine Symposium7 am – 5:15 pm Location: Best Western Ramkota Hotel, Sioux Falls

Information and Registration: [email protected] Phone: 328-6333

MAY 23 1 South Dakota Workers’ Compensation Summit10:30 am – 7:30 pm Location: Best Western Ramkota Hotel, Sioux Falls Presented by: Howalt McDowell Insurance, MAY 24 7 am – 5 pm Risk Administrative Services, Inc. Information and Registration: www.workcompsd.com

SAvE THE DATE: JuNE 15 – 16 black Hills Pediatric Conference Location: The Lodge at Deadwood Registration:childrens.sanfordhealth.org keyword: BH Pediatric Symposium


Documents

MED-Midwest Medical Edition-April/May 2012