2010 may/june

wanted was touse my body

All I

And I got there with Bethesda Hospital, member of HealthEast® Care System.When a 1,600-pound tree crushed Don Obernolte, he thought everything was over. But with the help of Bethesda, he’s reinvented his life. As one of the first and largest long-term acute care hospitals in the nation, Bethesda cares for chronically ill patients or victims of catastrophic accidents, with higher-than-national-average vent wean rates. So patients can recover, relearn and restart, creating a new normal for their lives.

For more information about Bethesda Hospital in St. Paul, Minnesota, visit bethesdahospital.org or call 651-232-2000.

019-1065 IMC BH MetroDoc March/April.indd 1 1/8/10 3:10:49 PM

MetroDoctors The Journal of the Twin Cities Medical Society May/June 2010 1

V O L U M E 1 2 , N O . 3 M A Y / J U N E 2 0 1 0

Contents

Page 21

2

Page 4

2 Index to Advertisers/Classified Ad

3 President’s Message Please Holster Your Boom Blitzers! By Edward P. Ehlinger, M.D., MSPH

4 tCMs in aCtion By Sue Schettle, CEO

6 Help Your Older Low Income Patients Eat Well to Be Well By Jill Hiebert and Neal R. Holtan, M.D.

8 Colleague interview EdwinN.Bogonko,M.D.

10 The Push for Health Information Technology By Paul Kleeberg, M.D.

11 HIT Assistance and Incentives Available for Minnesota and North Dakota Providers By Susan Severson

MediCal students Making a differenCe16 • ISTOP By Carolyn Bramante, Caitlin Conboy, Nathalie Lechault, Kate Birkencamp,

Emily Moody, and Ben Pederson

19 • The Phillips Neighborhood Clinic By Benjamin Willenbring and Brian Sick, M.D.

21 • Catalyst Program: Inspiring Tomorrow’s Physicians By Travis Moncrief and Alex Marston

23 • Experiencing Senior Living at Augustana Apartments By Linda Watanaskul

24 Call for Resolutions/Caucus Dates/ Physician Mentors Needed

25 Can You Give One Hour a Week? By Michael Anderson

26 New Members/In Memoriam

27 Honoring Choices Minnesota/EMMS Foundation Board

28 West Metro Medical Foundation/ Career Opportunities

32 luMinary of twin Cities MediCine VernonL.Sommerdorf,M.D.

On the cover: Medical students volunteer their time to enhance medical expertise in unique settings. Articles begin on page 16.

2 May/June 2010 MetroDoctors The Journal of the Twin Cities Medical Society

Physician Co-editorLeeH.Beecher,M.D.Physician Co-editorPeterJ.Dehnel,M.D.Physician Co-editorThomasB.Dunkel,M.D.Physician Co-editorMarvinS.Segal,M.D.Physician Co-editorCharlesG.Terzian,M.D.Managing Editor NancyK.BauerAssistant Editor KatieR.Snow

TCMS CEOSueA.SchettleProduction ManagerSheilaA.HatcherAdvertising Representative BetsyPierreCover Design byOutsideLineStudio

MetroDoctors(ISSN1526-4262)ispublishedbi-monthlybytheTwinCitiesMedicalSociety,1300GodwardStreetNE,BroadwayPlaceWest,Suite2000,Minneapolis,MN55413.Periodi-calpostagepaidatMinneapolis,Minnesota.Postmaster:SendaddresschangestoMetroDoc-tors,TwinCitiesMedicalSociety,1300GodwardStreetNE,BroadwayPlaceWest,Suite2000,Minneapolis,MN55413.

Topromoteitsobjectivesandservices,theTwinCitiesMedicalSocietyprintsinformationinMetroDoctorsregardingactivitiesandinterestsofthesociety.Responsibilityisnotassumedforopinionsexpressedorimpliedinsignedarticles,andbecauseofthefreedomgiventocontribu-tors,opinionsmaynotnecessarilyreflecttheofficialpositionofTCMS.

SendlettersandothermaterialsforconsiderationtoMetroDoctors,TwinCitiesMedicalSociety,1300GodwardStreetNE,BroadwayPlaceWest,Suite2000,Minneapolis,MN55413.E-mail:[email protected].

Foradvertisingratesandspacereservations,contact:BetsyPierre2318EastwoodCircleMonticello,MN55362phone:(763)295-5420fax:(763)295-2550e-mail:[email protected]

MetroDoctorsreservestherighttorejectanyarticleoradvertisingcopynotinaccordancewitheditorialpolicy.

Non-membersmaysubscribetoMetroDoctorsatacostof$15peryearor$3perissue,ifextracopiesareavailable.Forsubscriptioninforma-tion,contactKatieSnowat(612)362-3704.

May/JuneIndex to Advertisers

TCMS Offi cers

President EdwardP.Ehlinger,M.D.

President-electThomasD.Siefferman,M.D.

Secretary AnthonyC.Orecchia,M.D.

TreasurerMelodyA.Mendiola,M.D.

Past President RonnellA.Hansen,M.D.

TCMS Executive Staff

Sue A. Schettle,Chief Executive Offi cer (612)362-3799 [email protected] J. Anderson,Project Director (612)362-3752 [email protected] K. Bauer,Assistant Director, and Managing Editor, MetroDoctors (612)623-2893 [email protected] R. Dittmer,Executive Assistant (612)623-2885 [email protected] R. Snow,Administrative Coordinator (612)362-3704 [email protected]

For a complete list of TCMS Board of Directors go to www.metrodoctors.com.

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President’s Message

Please Holster Your Boom Blitzers!

EDWARD P. EhLINGER, M.D., MSPh

AS PRESIDENTOF theTwinCitiesMedi-calSociety(TCMS),IwaspartoftheMinne-sotadelegationtotheAdvocacyConference

oftheAmericanMedicalAssociation.AlongwithgettinganupdateonthestatusofhealthcarereformandMedicare’ssustainablegrowthrate(SGR)policy,therealpurposeoftheconferencewastogetphysicianstoCapitolHilltomeetwiththeircongressionalrepresentatives.So,withgreatanticipationandoptimismIjoinedmyMMAandTCMScolleaguesattheLongworthHouseOfficeBuildingwheremostofMin-nesota’srepresentativesreside. However,aftervisitingwithourrepresentativesmymoodhadchangeddramatically.IexpectedtheRepublicansandDemocratstobefightingwitheachotherbutIhadn’tanticipatedthehostilitythatIsensedthroughoutcongress.Nooneseemedtolikeortrustanyoneelse.TheBlueDogandtheprogressiveDemocratsweredisparagingeachotherwithgreatintensity.TheantipathybetweentheHouseandtheSenatewasevenworse.AndeveryonewasangrywithPresidentObama.IleftCapitolHilldiscouragedandwonderingifanymeaningfulhealthcarelegislationwouldgetpassedthissession. OnmywaybacktothehotelIsawasigninabookstoretoutingthebirthdayofTheodorSeussGeisel.Theday’sexperiencesmademeimmediatelythinkofoneofmyfavoriteDr.Seussbooks,The Butter Battle Book,whichbegins:

On the last day of summer, ten hours before Fall…my grandfather took me out to the wall.

For a while he stood silent. Then fi nally he said, with a very sad shake of his very old head, “As you know, on this side of the Wall we are Yooks. On the far other side of this Wall live the Zooks.”

Then my grandfather said, “It’s high time that you knew of the terribly horrible thing that Zooks do. In every Zook house and in every Zook town every Zook eats his bread with the butter side down!”

“But we Yooks, as you know, when we breakfast or sup, spread our bread,” Grandpa said, “with the butter side up. That’s the right, honest way!” Grandpa gritted his teeth. “So you can’t trust a Zook who spreads bread underneath!”

Whilethenucleararmsracewasthebasisofthatstory,Dr.Seusscouldjustaseasilyhaveusedhealthcarereformashisinspirationbecause,inWashingtonandthroughoutthecountry,peoplehaveunleashedtheirBoomBlitzers,BlueGooers,andBig-BoyBoomeroostothrowinvectivesatthosewhothinkdifferentlythantheydoabouthealthcarereform.Andwhathasitgottenus—entrenchedadversarialpositionsonthehealthcarereformbillandmutuallyassureddestructionofanyonewhotriestobringtogetherthewarringparties. Isitpossibletogetawayfromthisbrinksmanshipandfindawaytobreakdownwallsandcollaborativelydeveloprationalhealthpolicies?GiventheentrenchedpositionsinWashington,it’sprobablynotpos-siblethere.Perhapsitcanbedoneatthestatelevel;especiallyinastatelikeMinnesotawhichhasahistoryofcomingtogetherforthecommongood.Butwhocouldprovidetheleadershiptomakethishappen? The6,000membersofTCMS(includingafewYooksandZooks)embodythefullrangeofdivergentviewsonhealthcarereform.Yet,asanewly-formedorganization,TCMShasauniqueopportunitytocreateaforumthatallowsandencouragesallvoicesandperspectivesonpolicyissuestobeheardandfostersrespectfulandnon-judgmentaldebate—essentialsforthedevelopmentofrationalandeffectivepolicyrecommendations.Nowisthetimetoactonthatopportunitybecause,aswasstatedinHorton Hears a Who,anotherofmyfavoriteDr.Seussstories:

“This,” cried the Mayor, “is your town’s darkest hour!The time for all Whos who have blood that is redTo come to the aid of their country!”, he said.“We’ve GOT to make noises in greater amounts!So, open your mouth, lad! For every voice counts!”


SUE A. SChETTLE, CEO

tCMs in aCtion

TheTwinCitiesMedicalSocietyBoardofDirectorsembarkedonitsfirststrategicplan-ningretreatonThursday,March25,2010attheBroadwayRidgeBuildinginMinneapolis.Attendancewasgoodandthediscussionwasevenbetter.Theboardfocusedonthedirec-tionthatTCMSshouldtakeasitbeginsitsworkrepresentingthephysiciansofthesevencountymetroarea.Theeveningwasfacili-tatedbystrategicplanner,JerrySpicer,Ph.D.whoartfullyfacilitatedthediversegroupofleaders.MuchmorewillbewrittenabouttheresultsofthestrategicplanningmeetinginthenextissueofMetroDoctors,includingtheMissionandVisionstatementsofyourTwinCitiesMedicalSociety.

Alsolookfortheresultsofamember-shipsurveythatwassenttoallmembersoftheTwinCitiesMedicalSocietywhosee-mailaddresseswehave.Ifyoudidnotreceiveane-mailsurveyquestionnaireitislikelythatwedonothaveyoure-mail—socontactus!Somereallyinterestinginformationwasgleanedfromthismembershipsurveythat

helpedtoguidetheboardinitsdiscussionsaboutthefuturedirectionofTCMS.

American Medical Association National Advocacy ConferenceRonnellHansen,M.D.,pastpresidentoftheEastMetroMedicalSociety,EdwardEhlinger,M.D.,presidentoftheTwinCitiesMedicalSocietyandSueSchettle,CEOoftheTwinCitiesMedicalSociety,attendedtheAmericanMedicalAssociation’sNationalAdvocacyConferenceinWashington,DCMarch1-3.WithallthatisgoingoninnationalhealthcarereformitisparticularlyimportantthatTCMSleadershipbeengagedinthisnationaldiscussionbywayofcon-nectingwithourelectedofficialsandbeinginformed.TCMSleadershipmetwiththeMinnesotaCongressionaldelegationandtheirstaff.

Web siteTheupdatedwww.metrodoctors.comWebsiteisnearlyreadytolaunch.ThenewWebsitewillincludemuchmorecontentandwill

allowourmemberstobebetterinformedoftheworkthatwearedoingandoffermoreopportunitiesforyoutobecomebetterengaged.

Healthy Menus Minneapolis UpdateWiththerecentpassageofhealthreformleg-islationcomesanewnationalmenulabelinglawthatmandatescaloriestobepostedonallmenus,menuboardsanddrive-thruareas. Thelegislationappliestochainrestau-rantswith20ormorelocations,andrequiresthemtoprovideadditionalnutritionalinformationonrequest. SimilarlawshavebeenpassedintheStateofCalifornia,Maine,Massachusetts,NewYorkCity,Philadelphiaandahostofothercities.Thenewfederallawwillsuper-sedethepatchworkoflawsalreadyinplacealloverthecountry. Menulabelingallowsforfulldisclosuretoconsumerswhomightmakehealthierchoicesatthepointofpurchase.Thebillexemptssmallbusinesses,anddoesnotapplytodailyortemporarymenuitemsorcustom-izedorders.ItalsorequirestheU.S.FoodandDrugAdministrationtopromulgatespecificregulationswithinayearfromnow. HealthyMenusMinneapoliswillcon-tinuetofollowthisnewlawasitpertainstoenforcementandregulations. FormoreinformationonHealthyMenusMinneapolis,pleasecontactJenniferAnderson,ProjectCoordinator,[email protected](612)362-3752.

TheDavidGroup_May/June_Ad:Layout 1 3/26/10 8:41 AM Page 1

Those attending the American Medical Association’s National Advocacy Confer-ence in Washington, DC included (Back row from left): Robert Meiches, M.D., CEO, MMA; Benjamin Whitten, M.D., MMA President; Sue Schettle, CEO, TCMS; Blanton Bessinger, M.D., AMA Delegate; Edward Ehlinger, M.D., TCMS President; Mark Eggen, M.D. (Front row from left): Susan Meiches, M.D.; Patricia Lindholm, M.D., MMA President-elect; and Ronnell Hansen, M.D., TCMS President-elect.

TheDavidGroup_May/June_Ad:Layout 1 3/26/10 8:41 AM Page 1


help Your Older Low Income Patients Get the Food They Need to

Eat Well to Be Well

By Jill hiebert and Neal R. holtan, M.D.

IT’S A CHALLENGEtogetpatientstofollowadviceaboutmakingbetterfoodchoices.Forexample,physiciansoftenhearthatpatientscannotfinanciallyaffordnutritiousfoodssuchasfruitsandvegetablesandsubsequentlytheyrelyinsteadonstarchy,sweetened,orprocessedstaples.Becauseofcost,olderpatientswithlimitedbudgetsareparticularly likelynottoeattherecommendedfiveservingsoffruitsandvegetablesperday(ICSIObesityGuide-lines2009).Combinedwithlimitedphysicalactivity,sometimesfromdisabilities, lackof

nutritiousfoodsmakeslow-incomeseniorsveryvulnerabletoprogressive,entrenchedobesity. The75,000Minnesotansover65,withincomesbelow125percentofpoverty,facetheunfortunatechoiceofpayingthebillsorbuyingenoughfood.Surveysfindthat46percentofMinnesotaseniorsspendmorethan30percentoftheirincomeonrentandutilities,leavinglittleroomforfoodintheirbudgets.Someseniorsconsiderfruitsandvegetablesaluxuryandessentiallyliveonteaandtoast. AccordingtoUSDAestimates,thefoodstampprogramservesonlyabout32percentofeligiblehouseholdswithelderlymembersinMinnesota.InJune2009,therewere17,970

enrolledoutof78,000eligiblepeopleaged65andolder,andparticipationrateshavere-mainedflatforthepast19years.Recentpro-gramchangestoreducebarriersmaysurprisemanyseniors.Forexample,theassetlimithasbeenraisedto$7,000notincludingvehicles,IRAs or tax-deferred retirement accounts.Homeboundpeoplecaneasilyenrollbytele-phoneandfamilymemberscanshopforthem.Theprogramincreasesbuyingpoweranaverageof$111amonthperhouseholdusingadebitcardthatisscannedatcheckoutlikeacreditcard.

Luckily,physicianshaveagreatnewre-sourcetohelptheirlow-incomeolderpatientsenroll intheFoodSupportProgram/SNAP(formerlyknownasFoodStamps)andassistthemingettingthenutritiousfoodtheyneedtocombatobesityandotherconsequencesofpoornutrition.It’scalledtheEatWelltoBeWellprogram.TheGreaterTwinCitiesUnitedWayandhungerrelieforganizationsdevelopedEatWelltoBeWellspecificallytoimprovethetraditionallylowparticipationrateofseniorsintheFoodSupportProgram(FoodStamps).TheycommissionedtheMinnesotaInstituteofPublicHealth(MIPH)todesignacampaigntoincreaseseniors’awarenessofthefinancialandhealthbenefitsoftheFoodSupportPro-gramandtomotivatethemtouseFoodStamps

throughposterswithappealing,whimsicalim-agesthateffectivelylinkdiettogoodhealth.Thecampaignreliesontrustedadvisorssuchasphysicianstodisplaythepostersandtear-offsheetswiththephonenumberneededtosignupforFoodSupport.

What Can Physicians Do To Help?• Talkwithyourolderpatientsaboutthe

availabilityoftheFoodSupportProgramandencouragethemtocalltheMinnesotaFoodHelpLine(1-888-711-1151)toseeiftheyqualify.

• TellseniorsthattheFoodSupportPro-gramwillenablethemtobuynutritiousfoodsuchasfruitsandvegetablesthattheycurrentlybelievetheycannotafford.

• Make patients aware that the averagemonthlybenefitforaneligibleMinnesotasenioris$111.00.

• EmphasizethepotentialbenefitsoftheFoodSupportPrograminreducingobe-sityandotherhealthissueslikeflu,infec-tions,fallsandbrokenbones,arthritis,heartdisease,anddiabetes.

• Emphasizethatpatientswithgoodnutri-tionhavefewerandshorterhospitalstays.

• OrderEatWellToBeWellposterswithtearoffpads,postcardsandtabletentstodisplayanddistributeinyourclinic.

• SharetheinformationaboutEatWellToBeWellwithyourreception,nursing,andotherstaff.

MaterialsareavailableinEnglish,Spanish,HmongandSomali.PleasecontactTanyaPrahlat(763)[email protected].

Jill Hiebert, Hunger Solutions Minnesota, and Neal R. Holtan, M.D., M.P.H., Minnesota In-stitute of Public Health.

Lluckily, physicians have a great new resource to help their low-income older patients enroll in the food support Program/snaP (formerly known as food stamps) and assist them in getting the nutritious food they need...


A Conversation With

Edwin N. Bogonko, M.D.

C O L L E A G U E I N T E R V I E W

Edwin N. Bogonko, M.D. is board certified in internal medicine currently specializing in hospital medicine as a hospitalist at St. Francis Regional Medical Center, Shakopee, MN.

In addition to providing inpatient care, critical care as well as education of medical students, PA students and nurses, his current responsibilities include: clinical director of Medicine and lead physician, Hospitalist Group. He received his MB ChB from the University of Nairobi, Nairobi, Kenya in 1993 and in 2007 completed an internal medicine residency at Hennepin County Medical Center. Dr. Bogonko is a member of the Minnesota Kenya International Development Association and serves as a mentor for foreign trained medical graduates. He is also a member of the American College of Physicians, American Medical Association, Minnesota Medical As-sociation, Society of Hospital Medicine and serves on the board and executive committee of the Twin Cities Medical Society. Questions were provided by: Drs. Macaran Baird, Edward P. Ehlinger, Donald M. Jacobs, and Elena Polukhin.

What are some of the things that you learned during your training and practice in Kenya that have been helpful to you in your U.S. practice?

Patienceinmydailywork—comingfromaresourcepoorenvironmenthasgivenmeamuchbetterperspectiveofutilizingthetoolsatmydisposaleverydaywhilestillparlayingwhatIconsidertobestrongerclinicalskills.

Focusingonthepatient—InKenya,itisanopenmarketandsoyourpatientswillonlyreturnifsatisfiedwiththequalityofyourwork.Igotusedtothatearlyandfeelitisnaturalformetokeepmypatientsatthetopofmyprioritylisteveryday. Holisticpractice—Ilearnedtotreatnotjustthepatientbutthefamilyaswell.Itismucheasierformetoaddressmostofmypatients’concernsandtakethetimetounderstandwheretheyarecomingfrom.Mostpatientshavefears,aspirationsandstrikingtherightbalancegoesalongway. Comingfromaculturethatpromotesultimatecompassiontotheillandlessfortunate,Ifeelfortunateeverydaytobeabletoextendthesametomypatients.

Many young doctors in Kenya aspire to migrate and practice medicine in the U.S. What do you tell them?

• Toconsidertheirage,lengthoftimesincegraduationandbeawareofthechallengesassociatedwithmedicallicensureintheU.S.

• Tobewellpreparedusingtherighttoolsinordertostandout.TheearlieronestartspreparingfortheUSMLEexamsaftergraduationthebetter.

• Knowtheyarecompetingwithaglobalbodyofphysicianswiththesamegoalsanddreamsofcomingstateside.

• Pursue further training elsewhere if you can before comingover—likelyanaddedplus.

• Seekadvicefromthosewhohavealreadyblazedthetrail.• Bepreparedtoworktwiceashard.

What are the primary challenges foreign trained health pro-fessionals face as they pursue medical licensure in Minnesota?

Thereareseveral:• Financial—Costassociatedwithexampreparation,feesandresi-

dencyinterviews.Mostofthedoctorswhohavealreadymigratedhereworkfulltimeinentryleveljobsastheygothroughthelicensureprocess.

• Difficultytoaccessresidencyduetolengthoftimesincegraduationfrommedicalschool.

• LackofexposuretoU.S.clinicalexperienceandgoodrecommenda-tionletters.

• Lackofalternativepathwayswherephysicianswhoarenotacceptedintoresidencycanutilizetheirknowledgeandskills.

• Learningandadaptingtoanewmedicalandpracticeculture.


In what general areas of medicine do the foreign-trained unlicensed physicians most often pursue?

Everyoneaspirestospecializeinareasoftheirchoicebutinherentlyitisdifficulttopursuehighlysoughtafterdisciplinesincludingsurgery,OB/GYN,orthopaedicsanddermatology.Asaresult,alotofforeigntrainedphysiciansoptforwhatareconsideredlesscompetitiveprogramslikefamilypractice,pediatricsandinsomemarkets,internalmedicine. Anincreasingnumberofforeigntrainedphysiciansarealsooptingforprimarycareinunder-servedareasastheyaremorelikelytobeap-preciatedthereorobtainimmigrationassistance.

Is there a group of foreign trained and licensed physicians in specific specialties who could be mentors and clinical preceptors for foreign trained unlicensed physicians who need clinical observerships to become successful applicants to various Minnesota residency programs?

Yes.IhavebeenassociatedforthepastthreeyearswiththeAfrican&AmericanFriendshipAssociationforCooperationandDevelopment(AAFACD)Inc.whichisalreadyworkingwithafewforeigntrainedlicensedphysiciansontheir individualcapacity.SomeoftheforeigntrainedphysiciansarestillinresidencybutareprovidingsomedegreeofmentorshiptotheircolleagueswhoarepreparingforUSMLE.Asaresult,wearenowlookingatasizablenumberofmentorsandevenlocallytrainedphysicianssympathetictothecauseofforeigntrainedphysicians.

How can community-based physicians host a Foreign Trained Health Professional in a clinical setting?

Byfirstembracingtheroletheforeigntrainedphysicianscanplayinmitigatingouthealthdisparitiesandlackofaccess.

ThroughorganizedprogramssuchasAAFACD,foreigntrainedphysicianscanbevettedandrecommendedtocommunitydocsforexperienceandacculturation.

Do you believe that unlicensed foreign medical graduates might work in the medical field under the supervision of U.S. licensed physicians? In what capacity? Where: in rural areas, in community clinics?

Yes.UnlicensedforeigntrainedmedicalgraduateswhoareECFMGcertifiedcanseepatientsunderthesupervisionofalicensedphysicianinanyclinicalsetting.AgoodnumberofthemhaveevenpassedUSMLEstepIIIwhichisrequiredtobestatecertified.Thosestillpreparingforexamscanshadowalicensedphysician.Atthistime,anyeffortstointegrateforeigntrainedphysiciansintoclinicalpractice—whetherintheruralsettingorinurbancommunityclinics—willgoalongwayinaddressingsomeinequalitiesofaccesstocareforexample.SomeofthephysicianscanplaytheroleofmedicalassistantsorasPAsassistingM.D.s,undersupervision. ItisunconscionablethatforalargeAfricanpopulationofnearly300,000inMinnesotaalone,thereareahandfuloflicensedphysicians

andcountlessmoreunlicensedbecauseofgraduatingelsewhere.Some-thingneedstobedoneaboutthisasweintegrateasawidercommunity.

Do you foresee the development of any official TCMS program that helps foreign medical graduates to work and provide care to people in need with limited registration? Something similar to the Ontario College of Physicians and Surgeons program “Reducing Barriers to Practice”?

ThiswouldbeawelcomeddevelopmentforitwillgivethephysiciansanopportunitytohaveexposuretoU.S.medicalcultureandpracticewhichislackingatthemoment.ThemajorityofunlicensedforeigntrainedphysiciansinMinnesotahaveimmigratedtothestatesasrefugees,per-manentresidentsorasylees.TheynowcallMinnesotahomeandareheretostay.“Reducingbarrierstopractice”forthemisawin-winsituationsincetheirexperienceisveryhelpfulinprovidingculturallyappropriatecarewithintheircommunitieshereinMinnesota. Forsuchaprogramtobedevelopedthereneedstobesupportfromthepolicymakers,healthcareproviders,healthmanagementorganiza-tions,medicalschools,professionalassociations,medicalboardandthedepartmentofhealthamongothers.Canadahasauniversalhealthservicewhichislargelyrunbythegovernmentthusthedecision-makingprocessismucheasiercomparedtotheU.S. Idonotseeanythingconceptuallywrongwithasystemthatidenti-fiesforeigntrainedphysicianswhomeettheminimumgrade(ECFMGcertification)andletsthemworkinunderservedareasunderdirectsuper-visionandthereafterbepresentedwithresidencyopportunities—evenifrestrictedtoprimarycareforastart.Thiswillinpartaddresstheloomingshortageofprimarycareaccess. Atthistime,organizationssuchasAAFACDaredevelopingpartner-shipswithstakeholders(residencyprograms,hospitalsandclinics)aswellasnon-profitssuchastheMedtronicFoundationtodevelopapathwayforidentifying,vettingandthenexposingforeigntrainedphysicianstopre-residencyexperienceopportunities.Iwouldarguethatwithsuchalargeimmigrantpopulation,justpreparingtheseforeigntrainedphysi-cianstobeattractivecandidatestoanytrainingprogramwillmeantheywillcomebacktoMinnesotaandservetheircommunities.

What role could TCMS play in helping to diversify our health care workforce?

• Supportingunlicensedforeigntrainedphysiciansbyprovidingmentorshipandclinicalexperiencesandadvocatingforpoliciestoreducebarrierstopractice.

• Supportingthedevelopmentofadiversityprogram,e.g.havingadiversitycommitteetoidentifyopportunitiesforinvolvement.

• PartneringwithorganizationssuchasAAFACDaswellas localstakeholderstodevelopalong-termplanofintegration.

• SponsoringaresolutionwithintheTCMSandtheMMAthatclearlytakesaproactivepositionabouttheplightofforeigntrainedphysiciansandourpossibleroleinprovidingleadershiptowardsomepracticalsolutions.


The Push for Health Information Technology

By Paul Kleeberg, M.D.

Probablyoneofthemostoverusedpairofwordsinsomecirclesinthepastyearhasbeen“MeaningfulUse.”Ifyouhaveyettohearaboutit,Iwould

beverysurprisedifyoudon’tinshortorder.Ithasawholebunchoffolksveryexcitedandformanyofyou,itwillbeworthknowingabout. Theessenceofitisthis:Ifyouareabletodemonstratemeaningfuluseofacertifiedelectronichealthrecord,youcouldbeeligibleforupto$44,000inincentivemoneyfromthegovernment.IfyouarenotabletodemonstratemeaningfuluseofacertifiedEHR,youmaybesubjecttopenaltiesof1percentormoreofyourMedicarereimbursementstartingin2015.Hospitalsalsohaveincentivesaswell,butwewillfocusontheproviderincentiveshere.

First Background:AspartoftheAmericanRecoveryandReinvest-mentAct(ARRA),CongresssetasidemoniestoincentivizetheuseofinteroperableElectronicHealth Records (EHR)s. An interoperableEHRisonethatcansharepatientinforma-tionwithadifferentEHRatanotherlocationofcare.Therewerefivedifferentprogramsthatwereinitiated.TwotoassistintheadoptionofEHRs,onetofacilitatetheexchangeofhealthinformationamongproviders,onetoaddressthewelldocumentedproblemstotheadoptionofhealthinformationtechnology(HIT)andonetoencourageprovidersandhospitalstobecomemeaningfulusersofcertifiedEHRs.Takentogether,theseprogramsareintendedtojumpstarthealthcareintothe21stcenturyandtomakepatients’ informationavailablewheneverandwhereveritisneededwhilepro-tectingtheirprivacy.

Stimulating AdoptionThefirstprogrammeanttostimulateadoptionistheHealthInformationTechnologyExten-sionCenter.Asofthiswriting,32havebeenapprovedwiththegoalofcreating70acrossthecountry.ThefocusoftheHITExtensionCentersaretoprovidediscountedconsulta-tivesupporttosmallprimarycarepractices,orpracticestreatingcertainunder-servedpopula-tionsinorderthattheymayadoptEHRsandbecomemeaningfulusersofthem.AnarticledescribingindetailtheMinnesotaandNorthDakotaHITExtensionAssistanceCenterfol-lowsonpage14. TheotherprogramdesignedtofacilitateadoptionistheHITWorkforceTrainingpro-gram.ThisisintendedtoprovidetrainingtoindividualsatboththeUniversityandcom-munitycollegelevelssothattheymayassistprovidersintheadoptionandimplementationofEHRs.AnumberoffacilitiesacrossMin-nesotaincludingthemetroareahaveappliedforthesefunds.

Stimulating ExchangeStatesarealsoreceivingstimulusfundstosetupsecuremethodstoexchangepatienthealthinformationamongdifferentpointsofcarewithinthestate.TheseHealthInformationOrganizations(HIOs)willenablethesecurelookupandretrievalofhealthinformationinordertofacilitateamoreunifiedrecordforthepatient.Noteveryonewillchoosetohavetheirinformationavailableviatheexchange,sinceitwillrespectindividual’swishestoparticipate,butforthosewhodo,itwillbethefirststepinhavingtheirrecordavailablewhereverandwheneveritisneeded.MN-HIEintheTwinCitiesisplanningtoapplytobeanHIOandtherearelikelytobeothersinthestate.TheMinnesotaLegislatureiscurrentlyworkingondefinitionsofanHIO,ahealthdataintermedi-ary(HDI)thatwillalsoaidintheexchangeoftheseclinicaltransactionsandagoverningbodythatwillcertifybothHIOsandHDIs.RefertoanarticlebyMikeUblonMinnesotaHealthInformationExchange(MN-HIE)intheMarch/April2010issueofMetroDoctors.

Addressing the ProblemsTheStrategicHealthinformationtechnologyAdvancedResearchProjects(SHARP)willfundprojectstoconductresearchfocusingonbreak-throughadvancestoaddresswell-documentedproblemsthathaveimpededadoptionofhealthITandtoaccelerateprogresstowardachievingnationwidemeaningfuluseofhealthIT.Oneareaofresearchisthechallengeofharness-ingthepowerofhealthtechnologysothatitintegrateswith,enhances,andsupportsclini-cians’reasoninganddecision-making,ratherthanforcesthemintoamodeofthinkingthatisnaturaltomachinesbutnottopeople.Inmymind,thatmeansanintuitive,physician-friendlyinterface.Hooray!


(Continued on page 12)

Encouraging “Meaningful Use”TheareathathascreatedthegreatestbuzzamongprovidersandhospitalshasbeentheCMSincentivestofacilitatetheadoptionandmeaningfuluseofcertifiedelectronichealthrecords.TheseproposedruleswerereleasedonDecember30,2009,andthecommentperiodremainedopenuntilMarch15.CMSiscurrentlyworkingonrevisionstotheproposedrulesandintendstoreleasethefinalrulesome-timethisspring.Takentogetherwiththerecov-eryact,itdefinesseveralthings:Theproviderswhoareeligibleforincentives;thehospitalsthatareeligible;themethodsforcalculatingtheincentives;andthecriteriaonemustmeetinordertodemonstratemeaningfuluse.

The Specifi cs of Meaningful Use

Who is Eligible for Incentives?Identifyingeligibleprovidersisoneofthear-easbeingdebated.Congresshadintendedittobeanyphysicianwhowasnotprimarilyhospitalbased.Theyusedtheexamplesintherecoveryactofapathologist,anesthesiologistoranemergencyphysicianasbeinghospital

based.CMSinterpretedtheruleinsuchawaythatitwouldalsoexcludeclinicsthatarepartofanintegrateddeliverysystem.ThiswouldhaveahugeimpactontheTwinCitiesandisoneofthemosthotlydebatedissues.Notonlywouldthishaveafinancial impact, itwouldcauseadelayofachievingthevisionofhavingapatient’sinformationavailablewhereverandwheneveritisneededbycausinghealthsystemstofocusresourcesonimplementationseligiblefortheincentives.

What are the Criteria?Theproposedrulesidentified25stage1criteriaforproviderstomeetinordertobeeligiblefortheincentivedollars.Thesecriteriaincludedthingssuchasdocumentingproblems,aller-gies,medicationsandvitals inthepatient’schart,providersdoingdirectentryoforders,theabilitytoprovideinformationtopatientselectronically,andthebeginningstepsinin-formationexchange.Bymeetingthestage1criteriaineither2011or2012,providerswillbeabletoachievethefullamountoftheincentivedollars.Thestage2criteria(for2013)andstage3criteria(for2015)willbedefinedlater.In

ordertoreceiveanyincentives,providersmustachievestage1by2014;however,allproviderswillneedtoachievestage3by2015inordertoavoidpenalties.Ascurrentlyproposed,pro-viderswillneedtoachieveallthe25criteriaforstage1buttherehasbeendiscussionastowhethertheall-or-nothingruleisappropriate.Again,wewillneedtowaitandseewhatisinthefinalrule.

What are the Incentives?ForMedicare,physicianscanreceive75percentoftheirMedicarechargesuptothepaymentyearlimit.Iftheprovider’sfirstpaymentyearisin2011or2012,thatamountis$18K.Asthepaymentyearsprogressandifone’sfirstpay-mentyearisafter2012,themaximumamountdecreases.However,ifby2015aproviderisnotatstage3,theywillseetheirMedicarechargesdecreaseby1percentin2015,2percentin2016and3percentin2017.

TherearealsoincentivesfromMedic-aid.Ifaproviderhasmorethan30percentMedicaid,orisapediatricianwithmorethan20percentMedicaid,orservesinafederally

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Health Information Technology

(Continued from page 11)

qualifiedhealthcarecenterwithmorethan30percentneedyindividuals,thereareMedicaidfundsavailable.ProvidersmustchooseeitherMedicareorMedicaidbutmayswitchonceduringtheprogram.Oneparticularlyattrac-tivefeatureoftheMedicaidincentiveisthatthefirstpaymentyearcanbeusedtocoverthecostofpurchasingorupgradingEHRsoftware.Medicaidpaymentscanalsobehigher(upto$63,750)andonecanreceivethefullincentivebystartingaslateas2016withthelastpaymentin2021.

What about Hospitals?Sincemanyofyouwillbeseeingpatientsinthehospital,IthoughtIshouldatleastmentionthehospitalincentives.HospitalsareeligibletoreceivebothMedicareandMedicaiddollarsiftheyqualifyforboth.Theyalsohavecriteriaverysimilartotheprovidercriteriasotheywillbeaskingyoutohelpthemachievetheirincentivesbydocumentinginthechartandusingthecomputertomanageyourorders.Their incentivesalsostart in2011buttheycanreceivetheirfullincentiveiftheyfirstmeetthestage1criteriain2011,2012or2013.Aswiththeproviders,theymustmeetallofthecriteriatoqualify.

MinnesotaTheMinnesotalegislaturealsocreatedaman-datein2007forprovidersandhospitalstohaveinplaceaninteroperableEHRby2015.Thoughthepenaltiesformissingthismandatearenotdefined,itstartedmanyofourprovidersontheroadtoadoptinginteroperablehealthrecords.Theincentives intheRecoveryActareanicebonus.

So What Does This all Mean for Your Practice?Takenalltogether,IthinktochoosenottohaveaninteroperableEHRinyourpracticeby2015willbeabadbusinessdecisionforthefollowingreasons:1. Practiceswilluseitasamarketingtool

andpatientswillbegin to see itasanexpectation.

2. Referringphysicianswilltendtorefertootherswhofacilitatetheexchangeofpa-tientinformationstreamliningthereferralprocessandpostconsultationfollow-upcare.

3. ThoughyoumaynothaveMedicarepa-tientsandconsequentlynotbesubjecttoMedicarepenalties, it isnotunrea-sonabletothinkthatotherpayerswillchoosetoreducepaymentsinconcertwithMedicare.

4. Thepenaltiesforfailingtomeetthestatemandatehaveyettobedefined.

5. Ifyouwishtosellyourpractice,youwillneedtohaveanEHRinplaceifyouwantittobemarketabletoayoungphysician.

Tochoosetotaketheleap,itwillmeandecreasedincomeforaperiod,butmostallsaytheyarebacktotheirnormalpatientloadbysixweeksandbysixmonthscanhavebothbetterbillingandreducedtranscriptioncosts.Thereistheaddedbenefitofaccessingthechartremotely(orevenfindingitforthatmatter)and,whenourreferralnetworkiscapableofexchange,knowingwhenourpatientappearsinthehospitalorwhathappenedtothemwhentheywereupnorthatthecabin.Thereisnodenyingthattheimplementationperiodishardwork.Ihavetheexperienceofdoingitinalargesystemandhavetalkedtosolopractitionerswhohavedoneitontheirown.Mostcutbackto50percentpatientloadfortwoweeks,thengraduallyincreaseafterthatwithafullloadbyaboutsixweeks. Tometheexcitingvisioniswhathealthcarewillbelikewhenweareallconnected.Essentiallyweareinthepre-internetdaysofthe80s,withstand-alonemachinesthatareprettygoodatwhattheydobutareisolatedfromeachother.Thencamethestand-alonenetworks,CompuServe,AOL,Prodigy,Del-phi,etc.withtheirpay-by-the-minutebusinessmodel.ItwasnotuntilWebbrowserscamealongthatuseoftheInternetbegantoexplode.ThentheuseofAltaVistaandthenGooglecoupledwithunlimitedonlinetimeputtheworldofinformationatourfingertips.Now,withsmartphones,itisinmanyofourpockets.Asaresult,wearemuchmoreefficientatmak-ingrestaurantreservations,findingdirections,payingbillsandgettinganswerstoquestions.Imaginewhatitwillbelikewhenitwillbeaseasytoretrievehistoricalinformationonthatcomplicatedpatientweareseeingforthefirsttime.

Glossary:Meaningful Use: DefinedintheAmericanRecoveryandRein-vestmentActastheuseofanelectronichealthrecordtoelectronicallycapturehealthinforma-tioninacodedformat,usethatinformationtotrackkeyclinicalconditions,communicatethatinformationforcarecoordinationpurposes,andinitiatethereportingofclinicalqualitymeasuresandpublichealthinformation.

Certified EHRDefinedasanEHRthathasbeentestedbyanaccreditedbodyanddeemedtoofferthenec-essarytechnologicalcapability,functionality,andsecuritytohelpthemmeetthemeaningfulusecriteriaestablishedforagivenphase.Thetestingprocessisalsointendedtoallowpro-vidersandpatientstobeconfidentthattheseelectronichealthITproductsandsystemsaresecure,canmaintaindataconfidentially,andcanworkwithothersystemstoshareinforma-tion.Todate,theonlygroupthatwastestingandcertifyingelectronichealthrecordswastheCertificationCommissionforHealthInforma-tionTechnology(CCHIT).However,withtheRecoveryAct,ONChasproposedanewprocessforEHRcertificationthatiscurrentlyopenforcomment.Theyarehopingtoinitiatethenewprocessbeforethissummer.

Health Information Technology Regional Extension CenterFundedbyagrantfromtheRecoveryAct,thesecentersaredesignedtooffertechnicalassistance,guidanceandinformationonbestpractices to support and accelerate healthcareproviders’effortstoadoptandbecomemeaningfulusersofElectronicHealthRecords(EHRs).Atotalof70ofthesewillbefundedacrosstheUnitedStates.REACHistheexten-sioncenterforMinnesota.

HIT Workforce Training ProgramThereareseveralcomponentstotheworkforcetrainingprogram.Amongthemare:1. Providegrantstocommunitycollegesto

rapidlycreatehealthITeducationandtrainingprogramstoestablishintensive,non-degreetrainingprogramsthatcanbecompletedinsixmonthsorless.

2. ProvidegrantstoinstitutionsofhighereducationtosupporthealthinformationtechnologycurriculumdevelopmentandasetofhealthITcompetencyexaminations.


3. Provideassistancetoindividualstorap-idlyincreasetheavailabilityofindividu-alsqualifiedtoserveinspecifichealthinformationtechnologyprofessionalrolesrequiringuniversity-leveltraining.

Health Information Organizations (HIOs)“Healthinformationorganization”isdefinedinMinnesotastatuteasanorganizationthatoversees,governs,andfacilitatestheexchangeofhealth-related informationamongorga-nizationsaccordingtonationallyrecognizedstandards.

Health Data Intermediary (HDI)“Healthdataintermediary”isdefinedinMin-nesotastatuteasanentitythatprovidestheinfrastructuretoconnectcomputersystemsorotherelectronicdevicesusedbyhealthcarepro-viders,laboratories,pharmacies,healthplans,third-partyadministrators,orpharmacybenefitmanagerstofacilitatethesecuretransmissionofhealthinformationinwhichuniformstandardsareusedforsharingandsynchronizingpatientdataacrosssystems.Thestandardsmustbecompatiblewithfederalefforts.

Strategic Health Information Technology Advanced Research Projects (SHARP)FundedbytheRecoveryAct,thepurposeoftheseawardsistofundresearchfocusedonachievingbreakthroughadvancestoaddresswell-documentedproblemsthathaveimpededadoptionofEHRs:1)SecurityofHealthIn-formationTechnology;2)Patient-CenteredCognitiveSupport;3)HealthcareApplicationandNetworkPlatformArchitectures; and,4)SecondaryUseofEHRData.

Paul Kleeberg, M.D., FAAFP is the president of The Itinerant CMIO, LLC, which assists hospitals and clin-ics to become meaningful users of electronic health re-cords. Dr. Kleeberg has over 16 years experience working as a family physician and in information technology.

Dr. Kleeberg received his medical degree from Stanford University School of Medicine in Stanford, California and completed his residency in family medicine at the University of Minnesota. He is board certified in family medicine, is a fellow in the Ameri-can Academy of Family Physicians (AAFP) and the Healthcare Information Management and Systems Society (HIMSS). He serves on several committees for HIMSS and chairs their Computerized Provider Order Entry (CPOE) Workgroup. He is also involved in the Minnesota eHealth Advisory Committee and currently co-chairs their Meaningful Use and Exchange Work-group and has given presentations on the HITECH meaningful use criteria.

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HIT Assistance and Incentives Available for Minnesota and North Dakota Providers

By Susan Severson

HEALTH CARE PROvIDERScannowre-ceivehealthinformationtechnology(HIT)educationandtechnicalassistancetoimprovethequalityandvalueofcaretheydeliver⎯andbecomeeligibleforbonuspaymentsfortheirMedicareandMedicaidpatients—bytappingintotheexpertiseandservicesoftheRegionalExtensionAssistanceCenterforHealthInfor-mationTechnology(REACH)forMinnesotaandNorthDakota.

Organizations likeREACHarebeingestablishedacrossthecountryaspartoftheAmericanRecovery andReinvestmentAct(ARRA)of2009.KeyHealthAlliance(KHA)hasappliedtoserveasthefederallydesignatedHITregionalextensioncenterforMinnesotaandNorthDakota.KHAisapartnershipofStratisHealth,theRuralHealthResourceCen-ter,andtheCollegeofSt.Scholastica. REACHwillworkwithhealthcarepro-viderstoimprovecarethroughtheadoptionandmeaningfuluseofhealthinformationtech-nology,specificallyelectronichealthrecords(EHR).

Regardless of where providers are onthecontinuumofHIT/EHRadoptionandutilization—whethertheyarejustbeginningthesearchforanEHRorhaveimplementedanEHRandareworkingtowardmeaningfuluse—theregionalcentercanworkwiththem.REACHeducationalandtechnicalassistanceservicesareavailabletoalltypesandsizesofprovidersinallsettingsofcare,includingthosewhoalreadyhaveanEHRandthosewhodonot.CertainprimarycareprovidershavebeendesignatedbytheOfficeoftheNationalCo-ordinator(ONC)forHITtoreceivefederallysubsidizedtechnicalassistance,includingsmallurbanandruralpracticesservingmedicallyunderservedpatients.

JohnWhisney,RidgeviewMedicalCen-terclinicdirector,believesthattheregionalextensioncenterwillbeacriticalresourceforinformationandguidanceinRidgeview’sef-fortstogetthemostoutofitsEHR.AswithanythingasnewandcomplexasHIT,clinicsneedaresourcetheycanturntowhenques-tionsarise—especiallywhenworkingthroughtherulesandregulationstoensuretheyare

meetingrequirements.“Weareprobablylikemostorganizations.Wearereviewinginforma-tionandidentifyingwhatweneedtodoandhowtodocumentwhatwearedoing.Hereiswherearesourcegroupwillbemosthelpful,”saysWhisney. TohelpmeetnationalHITRegionalEx-tensionCenterProgramgoals,REACHplanstoprovidetechnicalassistanceservicesandsupportto5,100priorityprimarycareprovid-ersinMinnesotaandNorthDakotaoverthenextfouryears,with3,600providerstargetedinthefirsttwoyears.REACHcurrentlyhascommitmentfrom4,628providersrepresent-ing417practicestoparticipateintheprogramandreceivetechnicalassistanceservices.“Weareexcitedtobeabletoofferassistancetothosepracticesthatcanreallybenefitfromit,andthelevelofinterestandengagementbyprovidersacrossthetwostateshasbeenextraordinary,”saidJenniferLundblad,presidentandCEOofStratisHealth,afoundingpartnerofREACH.

InadditiontoleadingREACH,thethreepartnerorganizationsofKHA—StratisHealth,theRuralHealthResourceCenter,andtheCollegeofSt.Scholastica—willdirectlyservetheneedsofMinnesota.NorthDakotaHealthCareReview,Inc.,andtheUniversityofNorthDakotaCenterforRuralHealthareworkingwithKHAtomeettheuniqueneedsoftheNorthDakotaprovidercommunityandbuildacohesiveandeffectiveprogramacrossbothstates.

KHApartnershavealonghistoryofwork-ingtogethertoimprovehealthcare.Eachor-ganizationhasuniqueexpertiseandexperienceinhealthcarequality,education,patientsafetyinitiatives,andhealthinformationtechnology.Collectively,thethreeorganizationshaveserved

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thousandsofprovidersandorganizationsinadvancingHIToverthepastfiveyears.Thispartnershipformalizesthecommitmentofeachorganizationtoalongterm,ongoing,workingrelationship.ServingastheregionalextensioncenterwillaccelerateandexpandtheworkKHAisalreadyengagedin.

REACHhasestablishedstate-basedcoun-cilsinMinnesotaandNorthDakota,whichin-volveNorthDakotaHITAdvisoryCommittee,MinnesotaDepartmentofHealth,MinnesotaDepartmentofHumanServices,UniversityofMinnesotaAcademicHealthCenter,andUniversityofNorthDakota.Withtheinvolve-mentofmanyotherMinnesotaandNorthDakotaorganizations,REACHwilluseanopenandcollaborativeapproachindevelop-ingandimplementingtheregionalextensioncenter,leveragingexistingcommittees,profes-sionalandtradeorganizations,andhealthcarenetworksineachstatetoadvisetheprogram,reachproviders,anddisseminateinformation.

General Assistance and Technical AssistanceTheREACHprogramofferstwolevelsofassis-tance:generalsupportandtechnicalassistance.Generalsupport willbeofferedtoallprimarycareproviders andwillincludeoutreach,educa-tion,workforcesupport,tools,andresourcescoveringallaspectsofHIT/EHRadoption,implementation,andachievementofmean-ingfuluse.

Technicalassistancewillinvolveavarietyofapproachesdependingontheareaofserviceandtheprovider,butgenerallywillprovidein-depth,hands-onconsultationandassistancetoprovidersastheyworktowardadoptionandmeaningfuluseoftechnology.Fieldstaffandsubjectmatterexpertswill leadandmanagechangewithprovidersinassignedgeographicareas,offerindividualizedtechnicalassistance,andhelpprovidersutilizeHITasatooltoimprovequalityandperformance.REACHwillworkcloselywithotherregionalcentersacrossthenationtosharebestpractices,toolsandinformation.

Technicalserviceswillprimarilybeof-feredthroughon-sitevisitsbyregionalcenterstaff,includingassessment,consultation,train-ingandmentoring,Thecustomizedtechnical

assistancewillbesupplementedbyprovidereducationcollaborativesandnetworks.Tech-nicalassistanceandsupportwillfocusonthefollowingareas:• Providerreadinessandleadershipsupport• Processmappingandworkflowredesign• EHRtechnicalspecifications• Vendoridentification• EHRimplementationandproject

managementsupport• Privacyandsecuritypractices• Healthinformationexchange• EHRoptimizationandmeaningfuluse

Inthefirsttwoyearsoftheprogram,technicalassistancewillbesubsidizedforpriorityprimarycareproviders,withnearly90percentofthefundingforservicescomingfromtheREACHgrantand10percentfromfeespaidbypartici-patingproviders.Forexample,ifapracticehasfiveto10physicians, itmayreceiveservicesvaluedat$25,000-$50,000,butpayafeeofonly$2,500-$5,000.Forallotherprovidersandforpriorityprimarycareprovidersafterthefirsttwoyears,afeescalebasedonservicesneededwillbeapplied.

DefinedbyONC,priority primary care providers arephysicians(internalmedicine,familypractice,osteopathy,obstetrics/gynecol-ogy,pediatrics)andhealthcareprofessionalswithprescriptiveprivileges(physicianassistant,nursepractitioner,nursemidwife)focusedonprimarycareinthefollowingsettings:• Individualandsmallgrouppractices(10

orfewerprofessionalswithprescriptiveprivileges).

• OutpatientprimarycareservicesofferedatpublicandCriticalAccessHospitals.

• Community health centers and ruralhealthclinics.

• Othersettingsthatpredominantlyserveuninsured,underinsured,andmedicallyunderservedpopulations.

As Stratis Health’s Director of Health Information Technology Services, Susan Severson is responsible for implementation of all contracts in this area and for setting the strategic direction of the Health Information Technology Services Center. She has led the successful adoption of HIT and electronic health records in a variety of settings, guiding providers through the process.


M E D I C A L S T U D E N T S M A K I N G A D I F F E R E N C E

ISToP

Why a group of health professional students from the University of Minnesota is spending time on the streets…and why they need your help.

I delivered dinners to a man and his brother who had set up residence under a bridge in Cleveland. The man had a raised red gash above his right eye, and to my untrained eye it looked badly in-fected. This was not the first such infection I’d seen while delivering dinners to persons experienc-ing homelessness. As I moved on to start medical school years later, the thought stayed with me that physicians have the tools to treat disease but often not the ability to reach those in need of care. This experience was the inspiration for creating ISTOP, a street-outreach program delivering basic medical care to the underserved of Minneapolis and St. Paul. Carolyn Bramante, second year medical student and founder ISTOP.

In2006,9,200ofourstate’sindividualswerehomeless—35percentwerefamilieswithchil-dren,andanother10percentwereyouthunderage22(WilderResearch,2006).Afterspeakingwithseveralcommunityorganizationsaboutwhetherthereweremedicalstreet-outreachprogramsthatIcouldjoin,theconsistentan-swerwasthatthereisdireneedformoreofsuchefforts.Theideaofstudent-organizedand preceptor-supervised delivery of basic

medicalcarewasenthusiasticallyreceivedbycommunitypartners,students,andfacultyattheUniversityofMinnesota,andthusbeganISTOP—Inter-professionalSTreetOutreachProject.

Instartingthiseffort,weworkedwithmanyrolemodels,mentorsandexistingorga-nizations.Amongthemisourfacultyadvisor,Dr.JohnSong,whohasworkedtoimproveaccesstoandqualityofcareforhomelessin-dividuals;andDr.KenMcMillen,whohasbroughtmedicalcaretohomelesscampsinMinneapolisforthelastdecade.Otherphysi-cianshaveenthusiasticallymadeoureffortspossible,includingourtwoResidentadvisors,KaraDennyandAshleyBalsam,whohaveguidedmanyinitiativestoimproveISTOP’sservices.

WebeganworkingwithStreetworksCol-laboration,anorganizationthatsendsoutreachworkerstothestreets,shelters,andsoupkitch-ensofthemetroareatoconnectwithhomelessyouth.Streetworkshelpsthemaccessresourcesandsocialprograms,whileencouragingthemtoreduceinvolvementinharmfulbehaviors.BecauseStreetworksdoesnotoffermedicalcare,theywereexcitedtopartnerwithustoexpandtheirservices,andwewereluckytobuildontheirexistingrelationshipswiththepeoplewewerehopingtoreach.Anotherpart-nerisHealthcarefortheHomeless,anationalorganizationthatoperatesclinicsandstreetoutreachmedicalcareforhomelessindividu-als.Bothorganizationsledtrainingsessionstopreparestudentsforworkingwithhome-less individuals,which includeddiscussing

By Carolyn Bramante, Caitlin Conboy, Nathalie Lechault, Kate Birkencamp, Emily Moody, and Ben Pederson

Medical student volunteers from left: Katie Theisen, Stewart Decker, Allie Berger, Kathy Mahan, Jacob Feigal, Gina Mittelstaedt, and Brian Park.

Editor’s Note: University of Minnesota medical students were invited to submit an article describing unique volunteer activities they are engaged in throughout the community. This is the first of four programs highlighted in this issue of MetroDoctors.



thefactthathomelessnessisoftenatransientstate,ratherthanapermanentconditionthatseparatesindividualsfromtherestofsociety.Theyalsoemphasizedthatdemandforhealthcareoutstrippedsupplyandaccess,andthattherewasgreatneedforoutreach-basedbasicmedicalcare.

On an average Wednesday night in the basement of a Minneapolis church, dinners are being served to about 200 people free of charge. There is no requirement for proving need; nutritious meals are given to all who come and guests are only asked to maintain a respectful atmosphere. We set up a table on one side of the room and lay out samples of our simple supplies: adhesive bandages, sterile gauze and medical tape, antibiotics, blood pressure cuffs and glucose monitors, and over the counter medicines for cough, cold, and upset stomach. We set out fliers for facilities with free care, patient education, and drape a sign over the edge of the table. It reads: “Questions about your health? Have any open sores? Diabetic foot ulcers? Need any band-aids? Have a cold or cough? Stop by! We have a doctor, medical supplies, and are happy to answer any questions you have. No charge.” As families and individuals settle down with their food, we mill around letting people know that we are there and happy to help. Come talk to us. A young man visits us at our table a few minutes later. “Can you tell me what’s wrong with my finger?” he asks, showing us a fungal-infected nail. Another man tells us he has a rash on his chest. He doesn’t wait to step behind the screen we’ve assembled for privacy, or the empty room the church gave us, but immediately pulls his shirt over his head for an examination. We give out bandages and supplies to people who ask for them. Some choose to talk to us while others seem wary. We hope that by returning week after week we will build relationships and instill comfort in those who avoid us today. Over the course of weeks, the encounters run the gamut from minor wounds to serious medical conditions. An older gentleman gets an elevated blood sugar reading in the diabetic range. A young woman asks questions about rela-tionship violence. A big part of our mission here is to identify people who need help beyond what we can provide and give them information and encouragement to seek appropriate help.

ISTOPservesanimportantneedbecausemanypersonsexperiencinghomelessnesseithercan’t

makeittoexistinghealthcareser-vices,eveniffree;don’tseekthembe-causeofundignifiedtreatmentthey’vereceived in thepast;or faceotherbarriers tocare, suchasattendingtoimmediateneedsincludingfoodandsafety.Alargepartofourmis-sionistoprovidehealtheducation;wehaveansweredquestionsaboutgoodhygieneduringfluseason,pre-natalcare,concernsaboutSTIs,andmuchmore.Dr.KirbyClarknotedthatatoneoutreachsite,halfadozenpatientshavesaid“IwasabouttogototheERbeforeItalkedtoyouguys.”Additionally,merelyreachingoutandgoingtothemisanactofsupportthatpatientshaveappreciated.OnourfirstnightatSt.Mark’s,15homelessyouthcameuptoussayingtheywerefineatthemomentbutjustwantedtothankusforbeingthere.

Atanothersite,avolunteerexpe-rienceismuchlikeadayinafamilymedicineclinic,excepttheexamtableisthefloororachairandthesimplelabconsistsofUAstripsandpreg-nancytests.Momsandtheirkidscometouswithsorethroats,headaches,backpain,rashes,questionsaboutmedicationsandeverythinginbetween—suchaswonderingifitisOKtobegivingtheirkidsadultdosesofibuprofen,andluckilywecarrychildren’smedicationsthatwecangivethem.Oneofourpatientsisaboywithsevereeczemaandasthma,whosemomisworriedbecausehehasbeeninandoutofthehospital.Lookingathismeds,weseetwoseparateinhaledcorticosteroids,prescribedbydifferentphysicians.Heisn’tusingaspaceranddoesn’thaveaccesstohisnebulizerbecauseheandhismotherhadtoleaveaviolentsituationathomewithouttimetopack.Weareabletoworkwithhimonhisinhalertechniqueandcounselhismomaboutwhattocoverinhisnextcheckup.Continuityofcareisdifficultinsuchsituations,andwetrytohelpbridgethegapsincareduringunstableperiodsoflife. ISTOPisaninter-professionalprogramincludingmedicine,publichealth,physicaltherapy,nursing,pharmacy,andveterinarymedicine.Thegoalistoprovideawiderangeofservicestopatientswhilelearningforour-selves how to approach health issues with

interdisciplinarycollaboration.Forexample,apatientexperiencingchronicbackpaincanbeseenbybothamedicaldoctorandaphysi-caltherapist.Themotivationforincludingvetmedicineamongourservicescamefromhear-ingfromhomelessindividualsthatmanyhavepetsthatmeanagreatdealtothembutactuallykeepthemfromgettingmedicalcarebecausethepetscan’tbeleftaloneortakenwith.Inanefforttoaddressthisbarrier,wearework-ingwiththeSchoolofVeterinaryMedicinetobeginprovidingadjunctveterinarycare.

ByvolunteeringwithISTOP,wegaintheopportunitytodevelopmedicalskillsworkingalongsidevolunteerphysiciansandstudentsinotherfields,andweareintroducedtoagroupthatisunderrepresentedintheclinicsandhos-pitalswherewewilltrain.MeetinghomelesspersonsoutsidethecontextoftheEmergencyDepartmentisuniquetothisprogramandwehopeitwillfostergreaterunderstandingofthechallengesthathomelessnesscreatesandhowwemightbetterservehomelesspatients.


Asstudents,werecognizethatoneofthemostvaluablepartsofourmedicaleducationattheUniversityofMinnesotaisourlocalphysi-ciancommunity,whichhasworkedtoimprovethequalityandaccesstohealthcareintheTwinCities.Youprovideuswiththetoolstotacklethecomplexclinicalproblemswewillfaceinourfuturecareers.ISTOPpresentsanexcellentopportunityforphysicianstomentormedi-calstudentsoutsideatypicalclinicalsetting,helpingusframeourworkinasocialcontext,fosteringanappreciationofcommunityserviceinarisinggenerationofphysicians.Asstudents,wehavebuilttheframeworkthroughwhichservicecanstrengthenthehealthofourcom-munity,andnowwedependonlocalphysicianstohelprealizeourvisionofprovidingcaretothosewhoarefrequentlyoverlooked. Weareveryexcitedabouthowourworkisgoingsofar,andaboutthepossibilityofansweringStreetworks’suggestionthatweex-pandtonewsites.Wehaveinspiringinvolve-mentfromstudents,residents,andfaculty,butweneedmorepreceptorstomakeitpossiblefortheprojecttocontinueandgrow.Oncelicensed,residentscanpreceptandhaveap-preciatedthefactthatouroutreachshiftslastbetweenjustoneandoneandahalfhours.Weappreciatetheirtimeconsideringtheirrestric-tiveschedules. If interestedinservingasapreceptor,[email protected].

Carolyn Bramante is a second year medical student at the University of Minnesota and the founder of ISTOP. Caitlin Conboy, Kate Birken-camp, Nathalie Lechault, Emily Moody, and Ben Pederson are student leaders and volunteers with ISTOP. Dr. John Song is their faculty advisor and a lifelong proponent of health care and human rights for persons experiencing homelessness.

Link, BG, et al. Lifetime and five-year prevalence of homelessness in the United States. Am J Public Health. 1994 Dec;84(12)1907-12.

Wilder Research. Overview of Homelessness in Minne-sota 2006. Amhurst Wilder Foundation. March 2007.

Wilder Research. Long term homelessness among individuals and families in Minnesota in 2006. Amhurst Wilder Foundation. September 2007.

Volunteer Physician Mentors Needed

ISTOP(InterprofessionalSTreetOutreachProject)isanewprojectintheAcademicHealthCentersinceJanuary,2009,providingbasichealthcare,information,andsup-pliestoindividualsexperiencinghomelessness.Thissite-basedoutreachisincoordina-tionwithoutreachworkersfromexistingcommunityorganizations,allowingpotentialpatientstoapproachISTOPwiththesecurityofastreet-outreachworkertheyalreadyknow.

ISTOPalsoseekstoeducatestudentsontheuniquechallengesthathomelessindividu-alsface,forexamplehomelesspersonsoftendon’torcan’tmakeittofacilitieswithfreemedicalcare,frequentlybecauseofundignifiedtreatmentthey’vereceivedinthepast.

OneofISTOP’sgoalsistoanswerquestionsandconcernspatientsmighthave,includ-ingwhetheranillnessneedstobeseenimmediatelyorcanwaittobeseeninafreeorsliding-scaleclinic,andgentlyencouragepatientstoseekmedicalcarefromanappro-priatefacility.Apreceptoratjustonesitenoteda“halfdozen”patientswhohavesaid“IwasgoingtogototheERbeforeItalkedtoyouguys.”

ISTOPcurrentlyhasstudentsfromallschoolsintheAHCinvolved,providingauniqueinter-professionalexperience,aswellasavaluablechancetolearnfrompreceptors.

As a preceptor, you make this basic medical care and learning possible.

Outreachsitesare:ST. MARK’SPopulation:youthages12-25.When:EveryotherMonday,6-7p.m.Where:519OakGroveSt.,Minneapolis,MN

HOLY ROSARYPopulation:AllagesWhen:EveryotherWednesday,5:30-6:30p.m.Where:242418thAveS.,Minneapolis,MNWebsite:www.loavesandfishesmn.org

WOMEN OF NATIONSPopulation:womenandyouthWhen:EveryotherSaturday,9:30-11a.m.Where:73LeechSt.,St.Paul,MNWebsite:www.women-of-nations.org

Pleaseconsiderservingasapreceptorforthisprogram.Youcanvolunteerforoneshiftormakeanongoingcommitment.Registerandscheduleyourshiftonlineat:http://spreadsheets.google.com/viewform?key=p_HjtOKv5p715KOD98e-ccA

Thankyou!!

[email protected]

[email protected]

ISTOP



By Benjamin Willenbring, and Brian Sick, M.D.

The Phillips Neighborhood Clinic

THE PHILLIPS NEIGHBORHOOD CLINIC(PNC)startedwiththevisionofDr.JohnSong,anassistantprofessorofmedicineandbioethicsattheUniversityofMinnesota.Dr.Songsawanopportunityforstudentstohelpcreateandoperateafreehealthcareclinicfortheunin-suredandunderinsuredofMinneapolis.Theearlyyearsoftheclinicinvolvedastruggletofindspaceandconsistentsourcesoffunding.In2003,theclinicfoundanewhomeinthebasementofOliverPresbyterianChurchandanewname:thePhillipsNeighborhoodClinic.Duringthe2006-2007schoolyear,thePNCunderwentanorganizationaltransitionfromaCommunityUniversityHealthCareClinic(CUHCC)satelliteclinictoajointpartnershipbetweentheUniversityofMinnesotaPhysi-cians(UMP)andtheUniversityofMinnesotaMedicalSchool.TheclinicreopenedinJune2007underthemedicaldirectionofDr.BrianSick,anassistantprofessorofmedicineandpediatricsattheUniversityofMinnesotaandthemedicaldirectorfortheUniversityofMin-nesota’sPrimaryCareCenter.

Whilesomeofthedetailsofouroperationandlocationhavechangedovertheyears,themissionofthePNCremainsthesame.Wearecommittedtoprovidingaccessible,culturallyappropriate,andinterdisciplinaryhealthcareservicesandeducationtoallofourpatients.Atthesametime,weseektoprovidehealthprofessionalstudentswiththeskillstheyneedtoeffectivelyandcompassionatelyserveun-derinsuredanduninsuredpopulations.Thismissionhas ledtotheinvolvementofover300volunteersfromtheUniversityofMinne-sota’sSchoolsofMedicine,Nursing,Pharmacy,

PhysicalTherapy,PublicHealthandSocialWork.Together,thesevolunteersprovideadiversesetofservicestoourpatientsinclud-ingmedicalcare,physicaltherapy,nutritioncounseling,afreepharmacy,labtesting,mentalhealthcounseling,andguidanceforMedicalAssistance,MinnesotaCare,andGeneralAs-sistanceMedicalCareapplicationforms. AtleastonevolunteerfromeachoftheinvolvedschoolsisalsoamemberofthePNCadministrationboard.TheboardworkswithDr.Sickandtherestofthevolunteerbodytoprovidedirectionandvisionfortheclinic.In2009,itwastheeffortofthePNCadministra-tionboardthathelpedtheclinicexpandtotwonightsofserviceseachweek.ThisresultedinthePNCserving1,100patients in2009,whichmorethandoubledthe512patientsseenin2008.

One of the strengths ofthePNCistheinterdisciplin-arycharacterofeachcareteam.Patientsinneedofmedicalcareareseenbyanadvocate,aphar-macycarestudent,anutritionstudent,amedicalclinicianandthephysicianpreceptor.Thepa-tientadvocateroleprovidesanexcitingopportunityforfirstyearvolunteerstogainexposuretodi-rectpatientcarewhileprovidingimportantreferralresourcesforpatientswhohaveneedsbeyondthecapabilitiesofthePNC.Therestofthestudentsinvolvedinthecareteamaresecondyearstu-dentswhoworktogethertoin-terviewthepatientanddevelopaplanofcare.

Thedesignofthecareteamandclinicflowprovidesaparticularlyexcitingopportunityforsecondyearmedicalstudents.Inourroleasmedicalclinicians,weoftenseethepatientbeforethephysicianpreceptor.Followingourpresentationofthepatient’scaseanddiscus-sionregardingthedifferentialdiagnosis,thepreceptorwillthenjointhecareteaminseeingthepatienttoclarifyanyremainingquestionsthrough further interviewor examination.


Medical students discuss patient evaluation.



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Phillips Neighborhood Clinic


Thecareteamthenmeetsagaintodiscussthetreatmentplanandanyappropriatelabs,prescriptionsorotherinformationthatwillhelpbesttreatthepatient.ThisteamapproachchallengesstudentstoworktogetherandhelpscreatetheinterdisciplinaryenvironmentwebelieveisimportantforthePNCandthede-velopmentoffuturehealthcareprofessionalswhoarecomfortableandexperiencedworkingwithprofessionalsfromavarietyofdifferenteducationalbackgrounds. TheinvolvementofourvolunteersinthelifeofthePhillipsNeighborhoodalsoextendsbeyond6:00-9:00p.m.onMondayandThurs-dayevenings.Manystudentsareinvolvedinfund-raisingfortheclinic,whichincludesactiv-itiesliketheGrantsCommitteeandourannualsilentauctionattheWeismanArtMuseum.Allvolunteersalsoparticipateincommunityoutreachprojectsthroughoutthesemester.ThispartofthePNCvolunteerexperienceprovides

studentswithamorenuancedunderstandingofthecommunityweservewhilealsoallow-ingthePNCtoprovidevaluablevolunteerstoimportantcommunityorganizations.StudentsareinvolvedwithavarietyofdifferentserviceopportunitiesincludingtutoringattheFrank-linPublicLibrary,conductinghealtheducationgroupsforyoungpeopleattheMinneapolis

AmericanIndianCenter,andworkingwithOpenArmsofMinnesotatodelivermealstohomeboundcommunitymembers.OneofthePNC’scommunityoutreachprojects,ClubSugar,hasevenbeenusedbyFairviewHealthServicesasamodelfordevelopingbetterdia-betesgroupeducationprograms. ThePhillipsNeighborhoodClinichascomea longway since2001.Thanks toapassionateandcommittedgroupofstudents,preceptorsandcommunitymembers,wehavedevelopedaclinicthatprovidesavaluableser-vicetothecommunityandstudentvolunteers.Aswelookforward,wehopetocontinuetodeveloptheservicesweprovideforpatientsandthecommunitywhileensuringthattheclinicisstillaformativeeducationalexperienceforUniversityofMinnesotahealthprofessionalstudentsofthefuture.

Benjamin Willenbring is a second year medical student and Brian Sick, M.D., is the medical director of the Phillips Neighborhood Clinic.

Meet, greet and triage of patients is another responsibility of medical students.

Interdisciplinary discussions occur with each patient encounter.


CATALYST IS A STUDENT GROUPattheUniversityofMinnesotaMedicalSchoolde-votedtointroducinghighschoolstudentstomedicineandthebiomedicalsciences.OurfacultymentorisJoPeterson,Ph.D.,directoroftheMinnesota’sFutureDoctorsprogram.Highschoolandmiddleschoolstudentsareinvitedtothemedicalschoolforahands-onexperiencethatincludesworkshopsincardio-pulmonarydisease,neurology,andsuturing.Eachworkshopstationutilizesavarietyofdiagrams,models,andgrossspecimenstoin-troducethebasicphysiologyandpathologyoftheseorgansystems. Thestudentsfindthecollectionofgrossspecimensespeciallyfascinating,andweusethesetohighlightsomeofthedifferencesbe-tweennormalanddiseasedorgans.Examplesillustratingthepathologicdifferencesbetweenthelungsofasmokerandanon-smokerandahealthyheartandonewithheartdiseaseareavailable.Althoughtheheartandlungspeci-mensmakealastingimpression,moststudentsfindthebrainworkshoptobemostcompelling.FevenBelaehenwrites,“Myfavoritepartwasthebrain.Iwassointerestedbythat!”Thisexercisecomparesthegrossbrainspecimensofseveralanimals,includingafrogandcow,withthatofahuman.Thestudentseasilynotethedifferenceinbrainvolume;however,bypointingoutthespecificareasofthebrainthatareresponsibleforhumans’amazingabilitytoprocesscomplexproblems,thestudentsdevelopadeeperappreciationforjustwhatsetsusapartfromtherestoftheanimalkingdom. Duringtheworkshopswestrivetomakesurethelessonsareinteractivebymaximiz-ingthehandsoninstruction.This includesatutorialonsuturingwherebananasserveas

eachstudent’spatient.Thestu-dentsevenacquiretheskillstoconductaminiphysicalexam.At theendof themorning,thestudentscantakebloodpressuremeasurements,useastethoscope,suture,andelicitseveral reflexeswitha reflexhammer. After finishing up thethreeworkshopstations thestudentsattendalunchpanelwithmedical students.Thisprovidesanopportunityforthestudentstoaskanyques-tionstheymayhaveabouttheday.Naturally,manyofthese

By Travis Moncrief and Alex Marston

Catalyst Program:Inspiring Tomorrow’s Physicians

(Continued on page 22)Derek Smith, second year medical student, discusses neurology with an interested group of Humboldt High School students.

Annie Portilla and Mollie Lyle, both first year medical students, teach Humboldt High School students about the structure of the brain using gross specimens from the Pathology Department.



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Adult EpileptologistsDeanna L. Dickens, MDJulie Hanna, MDEl-Hadi Mouderres, MDPatricia E. Penovich, MD

Pediatric EpileptologistsJason S. Doescher, MDMichael D. Frost, MDFrank J. Ritter, MD

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questionspertaintomedicineandwhattheeducationalrequirementsareforbecomingadoctor.Morebroadly,thelunchdiscussionisanopportunityforthestudentstoseehowhighereducationcanprovideaccesstoamazingopportunitiesandbeameansforattainingtheirdreams.

CatalystinvitesstudentsfromMinneapo-lisandSt.Paulpublicschoolstothemedicalschoolfourtimesperacademicyearwithabout50studentsattendingeachevent.Mostre-cently,wehaveworkedcloselywithGEARUPandthisyearwehostedtwoeventsforstudentsintheGEARUPprogramfromHumboldtandHardingHighSchoolsinSt.Paul.GEARUPisafederallyfundedprogramthatworkswithstudents,parents,teachersandcommu-nitymemberstoraiseeducationalexpectationsthroughtutoring,extracurricularactivities,andpersonaldevelopment.Theprogramalsosponsorsfieldtrips,collegevisitsandprovidesfinancialaidadvicetoencouragestudentstoembracetheirdreamsandtheirfuture.

Currentfirstandsecondyearmedicalstudentsteachtheworkshops,whichisquiteacommitmentasmosthavetomisslectureinordertosharetheirknowledgeandenthusiasmaboutmedicinewiththevisitingstudents.Thetimeawayfromlectureiswellworthitbe-causeCatalystprovidesapositiveexperienceformedicalstudentsbycreatinganopportunitytoreflectonmeaningfulpastexperienceswhilesharingtheirloveofmedicine.

Althougheachstudenthasdifferentin-terestsandgoals,westrivetoprovideauniqueandinteractiveexperiencethatisnotsimplyeducational,butalsoinspiring.KyawKyawLwinwrites,“WhenIseethisIwanttolearnharderthings.Youguysreallymakemewanttotryhardtoachievemygoal.”

Wehopetheskillsthestudentslearnintheworkshopprovidethemwithanelevatedsenseofconfidenceandadesiretocontinuetheireducationbeyondhighschool.Furthermore,withabitofluck,wehopetohelpmotivatesomeofthestudentstopursuehighereducationinscienceandmedicine.ForArnoldMejía,Ibelievewehavedoneexactlythat;hewrites,“IreallyadmireyouguysandsomedayIwishtobeattheUniversityMedicalSchoollikeyou.”

Travis Moncrief and Alex Marston are both second year medical students.

Catalyst Program





Experiencing Senior living at Augustana Apartments

I FIRST HEARD ABOUT THE UNIQUElivingexperienceatAugustanaSeniorApart-mentsthroughDr.EdRatneroftheUniver-sityofMinnesota.Duringoneofoursecondyearcourses,wewererequiredtoattendoneWednesdayafternoonatAugustanatomeetasenior.Mostoftheseniorsthatwemetwereincrediblyhealthyandhadauniqueandposi-tiveoutlookonlife.Theywereextremelygoodteachersandfeltthattheyhadaninvestmentinyoungdoctors.IrealizedthatIhadhadlittlecontactwiththesehealthyseniors.Asafuturedoctor,itcanbediscouragingtoseeapatientwhomyoucannot“fix,”andIhadseenmanyofthesepatientsintheclinicsandhospitals.IwascuriousabouttheprogramanddecidedthatIhadnothingtoloseandalottogainbythisexperience.

Iwascurrentlylivingwithmyfiancé,nowhusband,atthetime,andhisfirstimpressionprettymuchwent,“Youwanttolivewhere!?”Yes,theideaoflivingataseniorhousingcom-plexmayhaveseemedstrangetomosttwentysomethingyearolds.Mostyoungadultsmyagewouldfeelstrangewheretheironlyneigh-borscouldrelatemoretotheirgrandparents

thanthemselves,wherereadingnewspaperswasstill thenorm,anddinnerbeganataroundfourintheafternoon.However,thiswasauniqueopportunitythatpresenteditselfanditwasonceinalifetime.IwoulduseallthesenewexperiencesanddifferencesIencounteredtohopefullybeamore relatable clinician tomyolderpatients.

IhadmanyquestionsbeforemovingintoAugustana—somemore logistical than others. Iwondered what the residentswouldthinkofa24-year-oldneighbormov-ingintotheirseniorcommunity.Wouldtheylikeme?WouldIbeaccepted?Wouldthey

thinkI'mloud?ThenIhadotherquestions.Iwonderedwhatitwouldbeliketostrikeupaconversationwithmyneighbor.Ihadsomepertinentquestionstoanypersonmov-ingintoanewenvironmentdowntosomesillyquestionssuchas“Woulditsmellold?”ThenIwondered,asamedicalstudent,wouldIhaveenoughtimetofulfillmycommitmentatAugustana.Sometimesitishardenoughtostudyduringmedicalrotations,letalonehavetimetoeatdinner.Fortunately,Iwasassured

thatIwouldhaveayeartocompletemyservicecommitmenttoAugustanaandthatIcouldbecreativeinfindingwaystodoso.Idecidedtotaketheplunge. DuringmyfirstmonthoflivingatAugus-tana,Iwasinmysurgeryclerkship.Iseldomsawmyneighbors,orevenmyfiancé,asIwasusuallyatthehospitalby5a.m.andbackhomesometimeafterdinner.LivingatAugustanameantthatIwasenrolledinacourseattheUniversityofMinnesotaentitledGeriatricsServiceLearning.Thiswasthefirstprogramofitskindwithlittleguidelines.Iwasn’tquitesurewhatwasexpectedofme,andthroughDr.Ratner’sguidance,IfoundactivitiesandprogramswhereIcouldbeofuse.IattendedgamenightonTuesdaysandThursdaysandmettwolovelyladiesthattaughtmethedicegameof“Tenthousand.”Ialsohelpedgiftwrappresentsfora localshelterwithsomeoftheresidents.Icallmyselfaspeedygift-wrapperbutIlearnedtohelpneighborswhomayhavehadarthritisorvisionchangesthatneededalittleextrahelp.Oneofthemostimportantlessons

By Lindy Watanaskul

GLindy Watanaskul visits with her neighbor and friend, Ethel. Photo by Emily Jensen, AHC Communications Dept. at the U of M.

getting to know ethel reinforced the core reason of why i decided to live at augustana. i truly wanted to connect with a generation that i felt so distant from.


I’velearnedhereisto“takeiteasy.”Thewayoflifeisabitslowerpacedhere.Butsometimesithastobewithalifeofwheelchairs,walkersandcanes. Oneofmymostrewardingexperienceshasbeenmeetingmy101-year-oldfriendandneighbor,Ethel.Atfirstglanceyoumayseeanold,fraillady.Afternumerouscoffeeandcookiedatesoverthepastseveralmonths,IhavelearnedthatsheisoneofthestrongestwomenIhaveevermet.Atfirstitwasalittlenerve-wrackingtomeetsomeonewhowassohardofhearing.Iwasn’tcomfortablewithspeakingsoloudlyorfeltitdifficulttohavetoenunciatemywordsandlipssocarefully.Myvocalcordshadneverreceivedsuchaworkout. GettingtoknowEthelreinforcedthecorereasonofwhyIdecidedtoliveatAugustana.ItrulywantedtoconnectwithagenerationthatIfeltsodistantfrom.And,asafuturemedicalprovider,Iwantedtoknowthedifferentbar-riersandobstaclesthatourseniorsface.Etheltaughtmeaboutthestrugglesshehasjusttogetaroundherapartment,callfordoctorappoint-ments,andsocial isolation.Ihavebeenabletohelpherwithsmalltaskssuchaswateringherplants,vacuumingthefloor,andpickinguphermail.Tometheseareminortasksthattakeafewminutes,buttoheritisthesmalldifferencetobeacontinuingfunctionalandindependentadult. Overthepastseveralmonths,IhavehadtheextraordinaryexperienceandprivilegetobeapartoftheAugustanacommunity.Ihavebeenabletolearnmoreaboutthe“senior”wayoflifethananyclassroomorcliniccouldteachme.Althoughimmersingyourselfbylivingataseniorcommunitymaynotbetherightdecisionforeverymedicalstudent,itshouldbeapossibilityworthconsidering.Regardless,everymedicalstudentshouldhavetheexperi-enceofworkingwithseniorsextensivelyandthoroughlynomatterwhatfieldofmedicinetheyareinterestedin.IamextremelythankfulfortheopportunitiesandexperiencesIhavehadoverthepastyearandbelievethattheyhavegreatlyimpactedmymedicallearning.

Lindy Watanaskul is a third year medical student.

ConnectionsMedical Students — Community PhysiciansTheConnectionsMentoringProgram,designedtoprovidephysicianmentorsforallstudentsattheUniversityofMinnesotaMedicalSchool,isapartnershipbetweentheMedicalSchool,theTwinCitiesMedicalSociety,andtheUniversityofMinnesotaMedicalAlumniSociety.Thementoringrelationshipmightinvolvehavingthestudentoverforameal,meetingforaninformalchat,ordiscussingthestateofmedicineandtheworldfromyourviewpoint.Theinteractionscanbeasfrequentoraslongasthementorandstudentdesire.Mentoringcanre-energizeaphysician’sinterestinmedi-cineandsupportsthedevelopmentofanewgenerationofcommittedphysiciansserv-ingourcommunity.Toregistertobeamentor,visitwww.mmf.umn.edu/goto/mentor.

Shadow a Physician ProgramFirstandsecondyearmedicalstudentsareinvitedtopersonallyexplorethevariousspecialtiesofmedicineandsurgerythroughanopportunityto“shadowaphysician”inthatspecialtyforoneday.Individualrotationsareassignedbasedonyourexpressedinterestandavailability,e.g.vacation,breaksfromschool,weekends,orweekdays.ContactKathyDittmer,TwinCitiesMedicalSociety,[email protected](612)623-2885.

Physician Mentors Needed

East Metro:Wednesday, May 12

6:00p.m.TCMSExecutiveOffice

BroadwayPlaceWest1300GodwardStreetNE,Suite2000

Minneapolis,MN55413Contact:KathyDittmer,(612)623-2885,

[email protected]

Call for Resolutions

West Metro:Wednesday, May 19

7:00a.m.BroadwayRidge

3001BroadwayStreetNE,ConferenceRoomD(lowerlevel)

Minneapolis,MN55413Contact:KathyDittmer,(612)623-2885,

[email protected]

AllmembersoftheTwinCitiesMedicalSocietyareinvitedandencouragedtobecomeengagedinsettingtheprioritiesandnextyear’sagendafororganizedmedicine.Memberscansubmitresolutions,participateinthemedicalsocietycaucusesandattendtheannualmeetingoftheMMAHouseofDelegates,September15-17,2010,atBreezyPoint,MN.

TheTCMSmembershipwillbedividedbygeography:

East Metro –physicianslivingand/orworkinginRamsey,Washington,oreasternDakotaCounty;and

West Metro –physicianslivingand/orworkinginAnoka,Carver,Hennepin,ScottorwesternDakotaCounty.

Resolutions are due in the TCMS offi ce by MONDAY, MAY 3, 2010.

SAVE THE DATES

CAUCUS DATES:

Experiencing Senior Living



Everyweek,peoplefromallwalksof lifearegivingasmallamountoftimethatismakingabigdifferenceinthelivesofSt.

Paulchildren.Theyarevolunteerswhodevoteanhoureachweektotutoringchildreninneedofextraacademichelp,aspartoftheSaintPaulPublicSchoolsFoundation’sTutoringPartnershipforAcademicExcellence.

TheTutoringPartnershipbringstogethertutoringproviders,educatorsandcommunitystakeholderstoincreasethequantityandqualityoftutorsandtutoringprograms.Establishedin2007,itisdrivenbyabeliefthatsupportingaca-demicexcellenceforallstudentsisacommunity-wideresponsibility.

“Thedoctors,teachers,accountants,plumb-ers,carpentersandscientistsoftomorrowarestudentsinourSt.Paulschoolstoday,”saidMikeAnderson,executivedirectoroftheSaintPaulPublicSchoolsFoundation.“It is inourbestinteresttohelpeverychildachievehisorherfullpotential.”

JamesHart,M.D.,aninternistwhoteachespublichealthmedicine,concurs,believingthateducationisoneofthemaindeterminantsofbothindividualandcommunityhealth.“Asphysicians,takingpart ineducationthroughthiskindofefforttohelpchildrensucceedacademicallyisapowerfulwaywecanpersonallyaffectcommunityhealth,”hesaid.

OnefocusoftheTutoringPart-nership is recruitingand trainingnewvolunteersonbehalfof its21community-based tutoringpartners and nine schoolsiteprograms.

Gina Jacobsen, forexample,isapoliceofficerwho tutorsonceaweekatJacksonElementarySchoolwithProjectS.P.I.R.I.T.,anafter-schoolenrichment

programforAfricanAmericanstudents.“IliveinSt.Paulandmyinterest inthiscommunityrunsdeep.Ithinkthepublicschoolsdoagreatjob,butIknowtutorsareneeded.Ilovechildrenandenjoyworkingwiththem,”shesaid.“I’mgladtobringwhateverIcantothetable.”

Inretirement,tutoringmaybearewardingoptionforphysicians,Dr.Hartsaid.“Manyofusmaywanttogivebacktothecommunityinareasotherthanmedicinethroughaprogramlikethis.”

Big Target, Big ImpactTheTutoringPartnership’stargetisapersistentachievementgapintheSt.Paulschooldistrict.Bythetimestudentsreach3rdgrade,40percentcannotreadattheirgradelevel.By8thgrade,lessthan60percentofthestudentsarecapableofcompletinggradelevelmath.

Thegoodnews?Tutoringdonewellcanhelpturnthosenumbersaround.

Independentevaluationsof tutoring in-terventionsbyTutoringPartnershipprovidersprovideevidenceofitsimpact.Forexample,ina2008studybyWilderResearchoftheEastSideLearningCenter,over70percentofallstudentparticipantsgainedinreadingcomprehensionatJohnA.JohnsonandBruceVentoElementaryschools.Inanotherstudyreleasedin2009,datafromtheMinnesotaReadingCorpsshowedstu-dentsexceededarateofoneyear’sgrowthinoneyear’stimeandmadesignificantgainsinMin-nesotaComprehensiveAssessment(MCA)tests

afteroneyearofintervention.Eightypercentofthoseparticipatingchildrenwhosuccess-

fullyexitedfromtheMRCprogrammetorexceededstatestandardsinreading.

Volunteer Tutors NeededAccording to theSaintPaulPublicSchoolsdistrict,an

estimated5,000studentsneedextraassistancetoachievegrade-levelproficiencyinreadingandmath.Currently,some4,000childrenarebe-ingservedthroughtheTutoringPartnership’sproviders. “Weneedmorecaringadultstoassurethatallstudentsinneedofextraacademicsupportreceiveit,”saidKarenWoodward,programdirec-toroftheTutoringPartnership. Volunteersareaskedtocommittoatleastonehourperweek,ideallyforaschoolyear,andcanchoosefromavarietyoflocations,programsandgradelevelsthatmatchtheirinterest.Trainingandcurriculumareprovided.

What Can You Do?FindoutmoreaboutvolunteertutoringandjointheTutoringPartnershipranks!Formoreinfor-mation,gotowww.sppsfoundation.organdclickonTutoringPartnership,orcall(651)325-4205,[email protected].

Michael Anderson, executive director, St. Paul Public Schools Foundation.

Can You Give One Hour a Week?How doctors can make a positive impact on student achievement

Through the St. Paul Public Schools Foundation’s Tutoring Partnership for Academic Excellence, these and dozens of other volunteer tutors are helping children in St. Paul improve their academic achievement, thus greatly increasing their chances of success in school and in life.


New MembersIn Memoriam

Edwin N. Bogonko, M.D.AllinaMedicalClinicShakopeeInternal Medicine/Hospitalist

Jessica L. Grajczyk, D.O.Obstetrics,Gynecology&Infertility,P.A.Obstetrics and Gynecology

Amy M. Kelly, M.D.St.Kate’sHealthandWellnessCenterPediatrics

Richard J. Migliori, M.D.UnitedHealthGroupGeneral Surgery, Transplant Surgery

Eric A. Nagle, M.D.RidgeviewWestonkaClinicAnesthesiology

Jennifer H. Rysso, M.D.RidgeviewWestonkaClinicInternal Medicine

Stephen R. Setterberg, M.D.Prairie-CarePsychiatry

Edward T. Su, M.D.SummitOrthopedics,Ltd.Hand Surgery, Orthopedics

Mary M. Trites, M.D.RidgeviewWestonkaClinicInternal Medicine

HECTOR MASON BROWN, M.D.diedonJanuary18,2010attheageof86afterayear-longbattlewithcancer.Dr.BrowngraduatedfromCornellUniversityMedicalCollege,NewYork,in1948andpracticedfamilymedicine.

HENRY DAHLMAN, M.D.diedMarch11,2010afterthreemonthsofpost-opcomplications.Hewas66.HegraduatedfromtheUniversityofMinnesotaMedicalSchool.Dr.Dahlmanspecializedinemergencymedicine,andheservedintheU.S.AirForce.

DONALD J. DUMMER, M.D. passedawayFebruary12,2009attheageof83.HeservedintheU.S.ArmyAirCorpsasanavigatoronaB29intheWesternPacificduringWWII.FollowinghisdischargefromtheArmyhetookpre-medcoursesattheUniversityofMinnesotaandultimatelygraduatedfromCreightonUniversityMedicalSchoolinOmaha,NEin1951.HewasonthemedicalstaffatUnityHospitalandSilverLakeClinic.

RICHARD J. JOHNSON, M.D.diedonNovember9,2009,at90yearsofage.Hewasintheclassof1945attheUniversityofMinnesotaMedicalSchool.HespecializedinorthopaedicsurgeryandpracticedinSt.Pauluntilhisretirementin1984.Dr.JohnsonservedonthemedicalstaffsforBethesda,MoundsPark,GilletteandtheVAHospitals.

WARREN L. KUMP, M.D.diedrecentlyattheageof83.HegraduatedfromtheUniversityofKansasSchoolofMedicinewherehegraduatedPhiBetaKappaandAlphaOmegaAlpha.HeservedasamedicalofficerwiththeTenthMarineRegimentduringtheKoreanWar.AfterhisresidencyinradiologyattheUni-versityofMinnesota,Dr.KumppracticedatNorthMemorialMedicalCenterinMinneapolisfor39years,servingformostofthattimeaschiefofradiology.Healsoservedaschiefofthemedicalstaffandchairmanoftheboardoftrustees.In1998thenewradiologydepartmentatNorthMemorialwasnamedinhishonor.Inthe1960sDr.Kumpdescribedafeatureofthedistaltibia;thatfeaturehascometobeknownintextbooksandmedicalliteratureas“Kump’sbump.”

FRED A. LYON, M.D.passedawayFebruary10,2010inTucson,Arizonaattheageof81.HegraduatedfromtheUniversityofMinnesotamedicalschoolin1957.Dr.LyonwasanemeritusclinicalassociateprofessorintheUniversity’sDepartmentofObstetrics,Gynecology,andWomen’sHealth;amentortostu-dents;andamemberoftheMinnesotaMedicalFoundation’sboardoftrustees.Healsoservedasaconsultantinhisfieldnationallyandinternationallyaswellasanadvocateforreproductivefreedom.

PAUL G. POLSKI, M.D.,age97,diedonJanuary25.HegraduatedfromtheUniversityofMinnesotaMedicalSchoolin1941withadegreeingeneralpractice.Dr.PolskiwasaphysicianatSt.John’sHospitalandDivineRedeemerandhadhisownclinicinWestSaintPaul.

GEORGE E. SCHAFFHAUSEN, M.D.,age74,passedawayquietlyononeofhisfavoriteholidays—SaintPatrick’sDay(March17,2010).HereceivedhismedicaldegreefromtheUniversityofMinnesotaMedicalSchoolin1961,withaspecialtyinobstetrics&gynecology.Dr.Schaffhausenalsoworkedasabusi-nessownerandoperatorwithhisfamilyattheirdesignandremodelingfirm.

Visit us at www.metrodoctors.com

and

forum.metrodoctors.com

To fi nd new career opportunities, past issues

of MetroDoctors and information on the latest

news, events and legislative issues!


EMMS Foundation Board Appoints Two New Directors

TheEastMetroMedicalSocietyFoundation(EMMSFoundation)Boardispleasedto

announcetwonewdirectorswhohaverecentlybeguntwo-yearterms.

Frank Indihar, M.D.isaretiredinternistwhohasservedinnumerousprofessional,academicandcivicleadershiprolesandisveryactivewithorganizedmedicine.In2008,heretiredfromhispositionastheCEOofBethesdaHospital.

John Diehl, J.D.,ofLarkinHoffmanAttor-neys,hasbeeninvolvedintheMinnesotaStateBarAssociation’sHealthLawSectionforover25yearsandhassignificantexperienceworkingforhealthcareorganizationsandresearchinghealthcarerelatedcases.

TheTwinCitiesMedicalSociety,throughtheleadershipoftheEastMetroMedical

SocietyFoundation,isworkingonacommu-nity-wideadvancecareplanningproject.TheefforthasbeennamedHonoring Choices Min-nesota andismodeledaftertheinternationally-recognizedprogram,RespectingChoices.

HonoringChoicesMinnesota(HCM)hasexperiencedgreatgrowthandsuccessinthelastyearasnumerousclinics,hospitalsandhealthplanshaveallagreedtocollaborate,aswellashospicegroups, long-termcaregroups,andothersimilarorganizations.Significantly,theHCMAdvisoryCommitteecreatedahealthcaredirectivedocumentforuseacrossallsys-tems,whichisavailablepubliclyonourWebsiteathttp://www.metrodoctors.com/choices.cfm.TrainingsessionswereheldinNovemberand45healthcareprofessionalswerecertifiedtofacilitateadvancecareplanningconversa-tionswithpatientsandtheirlovedones.Teninstructorswerealsocertifiedtoteachfuture

trainingcourses,allowingHCMtogrowandmovetowardbecomingself-sustaining. Several local hospitals and clinics arecurrentlypilotingHonoringChoicesMin-nesotaandasecondsetofpilots isplannedforJanuary-June2011.Trainingsessions,ledbyRespectingChoicesfaculty,willtakeplacethisfalltopreparenewpilotsites.HealthcareorganizationsinthemetroareaareinvitedtoconsiderpilotingHonoringChoicesMinnesotaatoneofthreelevels:

• First Steps — Advance Care Planning Facilitator Certifi cation

Thisprogramteachestheskillsnecessaryforbasicadvancecareplanningdiscus-sionswithanyadultandtheabilitytoassistwiththecompletionofhealthcaredirectives.

• Next Steps — Disease-Specifi c Advance Care Planning Certifi cation

Thisstageisforprofessionalstolearn

techniquesofadvancecareplanningforpatientswithchronic,progressiveillnesses,whoarebeginningtoexperiencedeclineorcomplications.

• Last Steps — Physician Orders for Life-Sustaining Treatment (POLST) Facilita-tion Certifi cation

Thisprogramgivesparticipantsthetoolsfordiscussionswithfraileldersorthoseinlong-termcarefacilitiesandtohelppatientstransfertheirendoflifedecisionsintomedicalorders.

OnTuesday,July20,2010,HCMwillholdaneventcalled“SharingtheExperience—Honor-ingChoicesMinnesotaConference”topresentprogressupdatesandsharegoalsoftheinitia-tive.Formoreinformationonthisconference,[email protected](612)362-3704.

Honoring Choices Minnesota Summer 2010 Conference and 2011 Pilots

John Diehl, J.D.Frank Indihar, M.D.


C A R E E R O P P O R T U N I T I E S see additional Career opportunities on page 29.

formofresearchorsignificantcontributiontothefieldofmedicine;andinnovationsand/orimprovementsinhealthcaredeliveryarethecriteriafollowedwhenselectingtheawardrecipient.Inaddition,theWMMFhasservedasthe

fiscalagentoftheThomasW.andMaryKayHobanScholarshipFund,establishedthroughdonationsinhonorandrecognitionoftheexten-siveandexemplarycareerofthe25-yearChiefExecutiveOfficerofthethenHennepinMedicalSociety,ThomasW.Hobanandhiswife,MaryKay.With80post-graduatestudentsreceivingscholarshipssince1993,theHobanScholarshipFundwillsunsetfollowingtheeducationalforuminthespringof2010.

In2009,over$15,000ingrantsweregiventothefollowingcommunityprogramsandscholarships:• ClarionInterprofessionalStudent Competition(UniversityofMinnesota)• GreaterMinneapolisCrisisNursery• PhysiciansServingPhysicians• MinnesotaVisitingNurseAgency/Club100• SubSaharanAfricanYouthProgram• ThomasP.Cook-Medical StudentScholarship• WestMetroMedicalSocietyAlliance

FormoreinformationontheWestMetroMedicalFoundationortomakeadonation,pleasecontactNancyBauer,TwinCitiesMedicalSociety,at(612)[email protected].

SUPPORT FOR MEDICAL EDUCATIONandcommunityhealthprogramsprovidedtheim-petusforcreatingtheHennepinCountyMedicalFoundation(nowWestMetroMedicalFounda-tion)inNovember1964.Itwasestablishedasa501(c)(3)philanthropicorganizationwithbroadgeneralpurposestoadvance,foster,andpromotemedicalscience,education,andpublichealth.Itsactivitiesovertheyearshaverangedfromgrantingscholarshipstomedicalstudents,toprovidingsupporttocommunityprogramsandprojects.

The West Metro Medical Foundation(WMMF)servesasthephilanthropicarmofthewestmetrogeographiccomponentoftheTwinCitiesMedicalSociety(namedasaresultofthemergeroftheEastMetroandWestMetroMedicalSocietiesonJanuary1,2010.)Theinitialfundingforthefoundationcamethroughestategivingandproceedsfromamassrubellaimmunizationprogram.Fundingtodaycontinuestobereceivedthroughmemorials,estategiftsandtheannualsolicitationofthemedicalsocietymembershipandcommunityhospitals.

TheWMMFhasthehonorandprivilegeasservingastheexecutorofseveralawardsandrecognitions.• CharlesBollesBolles-RogersAward—An

engravedsterlingsilverRevereBowlisgiventoaphysician,who,intheopinionofthemembersoftheselectioncommittee,byrea-sonofhis/herprofessionalcontributiononthebasisofmedicalresearch,achievementorleadership,hasbecometheoutstandingphysicianofthisandotheryears.

• FirstaPhysicianAward—Throughhis/herdedicatedanduntiringservicetotheprofessionofmedicine,thisunsungherohas made an outstanding contributiontocommunityservice;workedonpublicpolicyissues;playedasignificantroleinthegovernanceandsuccessoftheTwinCitiesMedicalSociety;orothernoteworthy(local)volunteermedicalservice.

• Shotwell Award—Dedicated service tomankind;significantbreak-throughinsome

West Metro Medical Foundation

Color

By Richard K. Simmons, M.D., Chair

Fairview Health Services

fairview.org/physicians TTY 612-672-7300EEO/AA Employer

Opportunities to fit your life Fairview Health Services seeks physicians to improve the health of the communities we serve. We have a variety of opportunities that allow you to focus on innovative and quality care. Shape your practice to fit your life as a part of our nationally recognized, patient-centered, evidence-based care team.

Whether your focus is work-life balance or participating in clinical quality initiatives, we have an opportunity that is right for you:

AllergyCardiologyDermatologyEmergency MedicineEndocrinologyFamily MedicineGastroenterologyGeneral SurgeryGeriatric MedicineHematology/OncologyHospitalist

Internal MedicineMed/PedsOb/GynOrthopaedic SurgeryPainPalliativePediatricsPsychiatryPulmonology/Critical CareUrgent Care

Visit fairview.org/physicians to explore our current opportunities, then apply online, call 800-842-6469 or e-mail [email protected].

Sorry, no J1 opportunities.


C A R E E R O P P O R T U N I T I E S

see additional Career opportunities on page 29.

see additional Career opportunities on page 30.Thank you to the following physicians for your donation to the WMMF:

Bonnie K. Adkins-Finke, M.D.Howard J. Ansel, M.D.Thomas R. Arlander, M.D.Macaran A. Baird, M.D.Daniel R. Baker, M.D.Lee H. Beecher, M.D.Stuart H. Bloom, M.D.Peter J. Boardman, M.D.John L. Canfield, M.D.Robert R. Cooper, M.D.Diane A. Dahl, M.D.Robert E. Doan, M.D., CMDDale T. Dobrin, M.D.Frederick E. Drill, M.D.Hugh A. Edmondson, M.D.Edward P. Ehlinger, M.D., MSPHE. D. Engstrom, M.D.David L. Estrin, M.D.vincent F. Garry, M.D., MS, DABTReinhold O. Goehl, M.D.Stanley M. Goldberg, M.D.Joseph I. Hamel, M.D.John N. Heinz, M.D.Charles S. Hoyt, M.D.Gerald D. Jensen, M.D.Shirley Kaplan Mark R. Koller, M.D.Laurel A. Krause, M.D.James R. Larson, M.D.Jonathan M. Larson, M.D.G. Patrick Lilja, M.D.Charles E. Lindemann, M.D.John H. Linner, M.D.Richard C. Lussky, M.D., MPHJames C. Mankey, M.D.Deane C. Manolis, M.D.H. B. Midelfort, M.D.Anne M. Murray, M.D., MSCFrederick Muschenheim, M.D.Duane L. Orn, M.D.Mark L. Ostlund, M.D.Sotirios A. Parashos, M.D., Ph.DRichard A. Pfohl, M.D.Harley J. Racer, M.D.John A. Reichert, M.D.Richard D. Schmidt, M.D.David E. Schneider, M.D.Burton S. Schwartz, M.D.Martin A. Segal, M.D.Marvin S. Segal, M.D.Ralph S. Shapiro, M.D.Richard K. Simmons, M.D.Edward A. L. Spenny, M.D.John A. St. Cyr, M.D., Ph.DTierza Stephan, M.D.Farrell S. Stiegler, M.D.Michael B. Stiegler, M.D.Jens A. Strand, M.D.Richard W. Swenson, M.D.John A. Tobin, M.D.Joseph M. Tombers, M.D.Robert M. Wagner, M.D.

Color

The David Group216-687-1818

Media Order: 322003Size: 4.8125” x 4.625”Publication: Metro DoctorsSection: Help WantedRun Date: May/June 2010Notes to Pub:

A Journey of Leadership

www.healtheast.org/careers

Medical Director - Maplewood Clinic

HealthEast® Care System in St. Paul, Minnesota is looking to develop and support a progressive physician leader ready to make a difference in the areas of patient satisfaction, employee engagement, clinical quality and operational effi ciency in this multi-specialty Clinic. If you are an Internal Medicine or Family Medicine physician interested in collaborating with an innovative health system recognized for excellence in improving patient outcomes, a rewarding journey awaits you!

For more information about physician leadership opportunities, please contact Michael Griffi n at: mjgriffi [email protected] or call 651-232-2227.

THE STRENGTH TO HEAL and get back to what I love about family medicine.

©2009. Paid for by the United States Army. All rights reserved.

Do you remember why you became a familyphysician? When you practice in the Army or ArmyReserve, you can focus on caring for our Soldiers andtheir Families. You’ll practice in an environmentwithout concerns about your patients’ ability to payor overhead expenses. Moreover, you’ll see yourefforts making a difference.

To learn more about the U.S. Army Health Care Team,call SFC Daniel Ebbers at 952-854-8489,email [email protected], orvisit healthcare.goarmy.com/info/e928.


C A R E E R O P P O R T U N I T I E S Please also visit www.metrodoctors.com for Career opportunities.

Introducing the“Career

Opportunities”section of

MetroDoctors!

A great avenue forprofessionals to learnabout job opportunitiesAND a perfect place forrecruiters to promoteopenings!

Care

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Recruiters, call for ourspecial recruitment rate.

Betsy Pierre, ad sales763-295-5420

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Great Partners, Great Staff, Great Patients, Excellent Income & Lifestyle

FOR MORE INFORMATION PLEASE CONTACT:Paul Berrisford, 2025 Sloan Place, Suite 35, St. Paul, MN 55117651-772-1572 • email: [email protected]

Family HealthServices Minnesota, P.A. is looking for

several Board Certified/Eligible Family Physicians to fill full-time, part-time or

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Join our Independent Group of 64 physicians serving 13 clinic sites.


B y M a r v i n S . S e g a l , M . D .

luMinary

VErNoN l. SoMMErDorF, M.D.

of Twin Cities Medicine

This last page series is intended to honor esteemed colleagues who have contributed signifi cantly to Twin Cities medicine. Please forward names of physicians you would like consid-ered for this recognition to Nancy Bauer, managing editor, [email protected].

Wekickoffthisnew“lastpagesegment”ofMetroDoc-torsbyintroducingDr.Sommerdorftothoseofyouwhodidn’thavethepleasureofknowingandwork-ingwiththisremarkablecitizenphysicianpriortohisrecentdeathatage88.Hewastrulya“manforallseasons”whogaveselflesslyofhimselfthroughouthislong,diverseanddistinguishedlife. HewasanativeUpperMidwesternerwithhumbleruralroots,hailingoriginallyfromBrownton,MinnesotabeforemovingtohisbelovedSt.Paulasayoungman.HisinterestinmedicinewastriggeredbyearlyserviceintheCivilianConservationCorpswhereheaidedadoctorinhisweeklyroundingvisits.AfterathreeyearstintasaPharmacistMateintheU.S.NavyduringWWII,heattendedtheUniversityofMinnesota,receivinghisM.D.degreein1952.HisSt.Paulmedicalpresencewasforgedbyanintern-shipattheoldAnckerHospitalfollowedbyafamilypracticecareerspanningover50years.Hesuspendedfulltimepracticein1993whilemakingafullrecoveryfromHodgkinslymphoma,thoughreturnedtoparttimeactivityoverthenextdecadeattheUniversityofMinnesotasponsoredWilderGeriatricClinicandSt.Mary’sHealthClinicwherehecaredmainlyforanuninsuredworkingpoorpopulation. DoctorSommerdorfservedSt.Paul’sEastSideintheMinnesotaHouseofRepresentativesfrom1964to1972whiletirelesslycontinuinghisnumerousotherresponsibilities.HeandNorma,hiswifeof63years,raisedfouradoptedchildrenwhopresentedthemwithmanygrandchildrenandgreatgrandchildren.Addi-tionally,theywelcomednumerousfosterchildrenand

students—whomtheycalledshortandlongtermguests—totheircloseanddedicatedfamilyconstellation.Hewasdevotedtotheassuranceofqualitycarefortheseniorpopulation,andinlateryearsservedasatranspor-tationvolunteer—providingmanyelderlyfolkswithneededridestoandfromhealthrelatedappointments.Heplayedanimportantleadershiproleinhischurchactivities,andonmorethanoneoccasionplayedSantaaspartofholidayfestivities. Theprideanddedicationheexpressedforthemedicalprofessionplayedaparamountroleinhislife.Theleadershipactivitiesinwhichheplayedapromi-nentroleinourmedicalcommunityandnationallyarewelldocumented.HewasthechiefofstaffofMoundsParkHospital,andservedaspresidentoftheRamseyCountyAcademyofGeneralPractice,theMinnesotaAcademyofMedicineandoneofourpredecessororga-nizations,theRamseyCountyMedicalSociety.Formanyyears,hewasadelegatetotheMinnesotaMedi-calAssociationandtheAmericanMedicalAssociation,andwasaninvitedparticipantattheWhiteHouseConferenceonHealthin1965. Thisenergeticphysician’smultifacetedtalents,caringapproachtothepeopleofhiscommunity,ami-abledemeanorandsuperbprofessionalismhasresultedintheawardingofmanyaccoladesandtributes,per-hapsthemostnotableofwhichbeingtheprestigious2005RamseyMedicalSocietyCommunityServiceAward.ThestarofDr.VernonSommerdorfshinesbrightlyasourfirstLuminaryofTwinCitiesMedicine.

students—whomthey

population,andinlateryearsservedasatranspor-tationvolunteer—providingmanyelderlyfolkswithneededrides

The only constant we see is change.

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Primary carePalliative care Symposium for Primary caremay 11, 2010This one-day conference will outline both clinical practice processes and patient management strategies as they pertain to palliation of patients with advanced symptom challenges and end-of-life issues

Family medicine may 12 – 14, 2010Update on common topics and on infection & respiratory, cancer, and common hospital and ER topics

SUrGery Lillehei cardiology Symposium april 19 – 20, 2010Designed to serve the cardiovascular educational needs of all clinicians who care for patients with diseases of the heart and blood vessels

Bariatric education 2010 may 26 – 27, 2010An overview for maximizing success with bariatric surgical procedures, while minimizing complications and readmissions

advances in Hepatic, Biliary, and Pancreatic Surgery June 2 – 5, 2010Top US surgeons will provide comprehensive updates on Hepatic, Biliary, and Pancreatic Surgery

aLSO OFFereDadvanced Pediatric Dermatology may 14, 2010Updates on enhancing skills in the recognition and management of common and selected dermatologic problems seen in pediatric patients

Topics and advances in Pediatrics 2010 June 10 – 11, 2010Practical approaches in Pediatrics, Clinical Pearls, Special Lectures, Clinical Roundtables

Workshops in clinical Hypnosis June 10 – 12, 2010Instruction in the theory and application of hypnosis in a clinical setting

Global Health course: clinical Tropical, migrant and Travel medicine July 6, 2010 – august 27, 2010 (in weekly modules)Prepare to work in this field with skills for providing health care in a global village

Free on-line courses available for cme credit are listed below. Visit cme website at www.cme.umn.edu.• Fetal Alcohol Spectrum Disorders (FASD) • Heart Failure in Children • Supraventricular Tachycardia in Children• Reducing Recurrent Preterm Birth • ECG of the Week• The Reality of Fibromyalgia: Pathways

to Diagnosis, Therapy, and Quality of Life

All courses are held in the Twin Cities unless noted

Upcoming CME Courseswww.cmecourses.umn.edu

Office of continuing medical education

612-626-7600 or 1-800-776-8636

www.cme.umn.eduemail: [email protected]

University of minnesota

continuing medical education

CME Metro Docs ad March 2010 1 3/22/10 1:00 PM

2010 may/june

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