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In This Issue:• A Fond Farewell • Meet PCM’s Board and Executive Committee• Honoring Choices Minnesota• Teens and Alcohol

Ahead of the CurveWhen you’re faced with a particularly difficult respiratory patient who needs specialized

ventilation care, consider a national leader. Consider Bethesda Hospital and our Respiratory Care program, established nearly 30 years ago and one of the first of its kind in our region. Since the founding of our program, we’ve been ahead of the curve in treating ventilation patients, thanks

in part to a dedication to high acute care nursing ratios and therapy staffing. As a result our ventilator weaning rates are among the best in the nation, with 70 percent of the vent patients we

see fully weaned, according to a study by the National Association of Long Term Hospitals.

When you need to move a patient on to the next step, it’s good to know you can turn to a leader in managing complex cases. Turn to Bethesda.

For more information, visit www.bethesdahospital.org.

A national leader in wean rates

MetroDoctors The Journal of the Twin Cities Medical Society January/February 2010 1

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

Contents

eAst MetRo

23 President’sMessage

24 UpdatefromtheEMMSFoundationBoardofDirectors

25 SeniorPhysicians/CaringHeartsforHomelessPeople

26 EMMSRepresentedatAMAInterimMeeting

West MetRo

26 WMMSAwardsHobanScholarships

27 CharlesL.Murray,M.D.ReceivesCharlesBollesBolles- RogersAward/HealthCareDinnerParty,Naples,FL

28 WMMSBoardofDirectorsCelebratetheEndofanEra

29 FrankS.Rhame,M.D.ReceivesFirstaPhysicianAward

30 WMMSAlliance100thCelebration

On the cover: New TCMS logo and officers. Logo description on page 2; TCMS leadership on pages 6-7.

Page 12

Page 9

Page 11

2 Index to Advertisers

TCMS Logo Description

3 PResident’s MessAge The Time is Right By Edward P. Ehlinger, M.D., MSPH

5 Welcome to the Twin Cities Medical Society By Sue Schettle, CEO

6 TCMS Officers and Board Members

8 A Letter to the Members By Jack G. Davis

9 ColleAgue inteRvieW RobyC.Thompson,M.D.

11 Honoring Choices Minnesota: A Community Approach to Advance Care Planning

12 A Fond Farewell By William E. Jacott, M.D.

13 YouR voiCe Teens & Alcohol—Not a Faceless Statistic By Carl E. Burkland, M.D.

15 Research Brief: Behavioral Impact of Graduated Driver Licensing on Teenage Driving Risk and Exposure By Pinar Karaca-Mandic, Ph.D., and Greg Ridgeway, Ph.D.

17 New Health Care CEO: Neeraj Chepuri, M.D., CEO, Consulting Radiologists, Ltd.

20 Healthy Menus Minneapolis Update

21 New Members

22 In Memoriam

30 Career Opportunities

2 January/February 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-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.

January/FebruaryIndex to Advertisers

TCMS Officers

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 Officer (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.

TCMS LogoDescription

SchaeferDesignCo.wasretainedtocreatealogofortheTwinCitiesMedicalSocietythatreferencedtwoseparatelong-standinghistoriesandwouldcommunicateelementsofunifi-cation,community,dedicationtoadvancinghealthandprofessionalism. Circlesareusedasadynamicsymboliza-tionofthesevencountiescomprisingtheTwinCitiesMedicalSociety.Astylizedrepresenta-tionthatnotonlyvisualizesariver,butalsoexpressesgrowthandvitalityflowsthroughthecircles.Thecolorgreenwasselectedasitisoftenusedacademicallyasthecolorforthedisciplineofmedicine(AcademicCostumeCode&CeremonyGuide).

Join Us At One of Our Upcoming“Violence in the Workplace” Seminars

FOR MORE INFO CALL:SafeAssure @ 1-800-920-7233

OREast Metro Medical Society @ 612-362-3799

www.safeassuremedical.com

ON-LINEON-LINEOSHA COMPLIANCEOSHA COMPLIANCE

Employee TrainingEmployee Training

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InsideBackCoverNeurosurgicalAssociates,Ltd.......................... 4OpenCitiesHealthCenter,Inc...................32PediatricHomeService........................................

InsideBackCoverSafeAssureConsultants,Inc............................. 2SouthsideCommunityHealthServices.....32UniversityofMinnesotaCME..........................

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MetroDoctorsT H E J O U R N A L O F T H E T W I N C I T I E S M E D I C A L S O C I E T Y

Doctors


President’s Message

The Time is Right

EdwARd p. EhLiNgER, M.d., MSph

AFTER TWO DAyS OF DISCUSSING THE MyRIADofpossibleimplicationsforcollegestudentsofthependingnationalhealthcarereformlegislation,IwasinneedofsomethingclearerandmoreconcretetocalmmyanxietiesandeasemyfrustrationsbeforeboardingtheplanebacktoMinneapolisfromWashingtonD.C.Ithought,“WhatcouldbemoreconcretethantheexhibitsintheNationalBuildingMuseum?”So,inthemidstofrushhour,ItooktheMetrofromFoggy

BottomtoJudiciarySquareandenteredthemuseumonehourbeforeitsscheduledclosingtime. Givenmytimeconstraintsandthatthiswasmyfirstvisit,IthoughtI’ddoawhirlwindtourofthemuseum’sexhibitstogetadispassionate“CliffNotes”overviewofitscontentsbeforeheadingtotheairport.Thefirstgallerymetmyexpectations.Itwasfilledwitharchitecturalbric-a-bracfrombuildingsalloverthecountry.Uniqueandbeautifulcornices,balusters,festoons,modillions,volutes,andotherbuildingcuriositiesfilledtheroom.Iwasinandoutin10minutes.Myworldwasbecomingrationalandobjectiveagain. Iexpectedasimilarexperienceinthesecondgallery,whichwasacomprehensivelookatparkingstructuresintheUnitedStates.Whilethereweremultiple“bricksandmortar”displaysofparkinggaragesandramps,theunderlyingmessageoftheexhibitwasthatwedevotealotofmoneyandspacetohousevehiclesthat,onaverage,spendover90percentoftheirexistenceparked.Thehistoricaldisplaysalsopointedoutthattherapidacceptanceoftheautomobilebytheearly20thcenturysocietydramaticallychangedthephysicalandculturalcharacterofourcitiesinalaissez-faireway.Urbanplanningandinfrastructuredevelopmenttoaccommodatetheautomobileonlyoccurredafteragreatdealofhaphazardanddamagingchangehadalreadyoccurred. AsIleftthe“HouseofCars”exhibit,Icouldsensethereturnofsomenervousnessabouttheeffectsthatpublicpolicies(orlackthereof )haveontheeverydaylivesofpeople.WhenIenteredthelastexhibit,mydreamofhavingasimpleandmanageableexperienceatthemuseumwascompletelyshattered.Thisexhibit,“ThePlacesWeLive,”waspurposelysetuptoagitatethoseofuswhohavetheresourcesandabilitytotravelandvisitmuseums—andwhohavetheabilitytopromulgatechangeinoursociety. Theexhibitbeganbyconfrontingallvisitorswiththisstatement:“In 2008, for the first time in human history, more people lived in cities than in rural areas. One-third of these urban dwellers — more than one billion people — resided in slums…The United Nations forecasts that the number of slum dwellers will double to two billion people within the next 25 years. Poverty is urbanizing at breakneck speed, and there are few overarching plans to address how cities can accommodate this rapid influx of humans.” Theexhibitthengraphicallyandobjectivelyallowedvisitorstoconsiderwhatitmeanstoliveinacityinthe21stcentury.Viaamultimediainstallation,peoplewereadmittedintothehomesof20familiesinfourslumsaroundtheworld:KiberainNairobi,Kenya;DharaviinMumbai,India;the“barrios”ofCaracas,Venezuela;andthe“kampongs”ofJakarta,Indonesia.Thepicturesandthevoicestoldachillingstoryofhowpeopleliveinthefastest-growinghumanhabitat—urbanslums.Evenforsomeonewhohasworkedinurbanpublichealthfornearly30years,Iwasstaggeredandstunned.Fortunately,themuseumclosedbeforeIbecametoooverwhelmed. SittingintheairplaneonthewaybacktoMSPandmycar(motionlessfor48hoursinaparkingramp),Iwasgratefulthatnoonewasseatednexttome.IneededtimetoabsorbwhatIhadheardinthe

(Continued on page 4)


healthcarereformdiscussionsandobservedintheNationalBuildingMuseum.IneededtofigureoutwhatIwassupposedtodowithallofthisjumbledandchaoticinformation. KnowingthatIwastobeitsfirstpresi-dent,IwasnotsurprisedthatmythoughtsquicklyturnedtothenewlyformedTwinCit-iesMedicalSociety(TCMS),anorganizationestablishedtoaddressthehealthandmedical

careissuesofalargemetropolitanarea.Itwasalsonotlostonmethatmyexperiencesoftheprevioustwodayswereprobablyprovidedasanatypicalin-serviceontheroleofthepresidentoftheTCMS.

Atatimewhenourmedicalcaresystemiscostingtoomuchandexcludingtoomany,whenourpublichealthinfrastructureiscrum-blingbecauseoflackofsustainedinvestment,andwhenurbanizationisaffectingthelivesofeveryoneinoursociety,therearisesacritical

needforleadership—notjustindividuallead-ershipbutorganizationalleadership.Itseemedobvious,whatbettertimefortheTCMStoassumethat leadership?NotonlyisthereachallengeandopportunityfortheTCMStoassumethisleadership,thereisalsoaprofoundresponsibilitytodoso.Whoelsebutthephysi-ciansintheTwinCitiesareahastheexperience,knowledge,skills,position,connections,andpowertobringhealthcarereform,medicalcare,andpublichealthtogetherforthebenefitoftheindividualswetreatandtheurbancommunityinwhichwelive? Iwasthinkingofthatquestionwhentheflightattendantbroughtmebacktoconscious-nesswithwhatIthoughtwasgoingtobetheusualwordsspokenuponlanding.InsteadIheard,“WelcometotheTwinCitiesMedicalSociety.Thecurrenttimeisrighttomakeadifferenceinyourcommunity.Pleasechecktobesurethatyou’veincludedallyourhealthcarereform,medicalcare,andpublichealthissuesasyoudepart.Andmayhealthypeopleinahealthycommunitybeyourfinaldestina-tion.”

President’s Message

(Continued from page 3)

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Welcome to the Twin Cities Medical Society

SUE A. SChETTLE, CEO

TheTwinCitiesMedicalSocietyispoisedtohitthegroundrunninginJanuary2010withsomenewandsomereturning

leadershipfromtheformerEMMSandWMMS.Thisgroupofphysicianleadersisreadytotakeonthechallengesandopportunitiesthatfacemetroareaphysicians.Inadditiontotheboardofdirec-tors,therearefivestaffpeopleworkingbehindthescenesatthemedicalsociety.Theyinclude:SueSchettleservingasthechiefexecutiveofficer;NancyBauer,managingeditorofMetroDoctorsandassistantdirector;JenniferAnderson,whoistheprojectcoordinatorspearheadingtheHealthyMenulabelinginitiative;KatieSnow,theadmin-istrativecoordinatorforthesocietyandEMMSFoundationandistakingthecoordinatingroleintheHonoringChoicesMinnesotaadvancecareplanningproject;andKathyDittmer,whokeepsusallonourtoes,gettinguswhereweneedtobeandontime,servingastheexecutiveassistant.JackDaviswillcontinuetoservein2010asatransi-tionconsultant.AllofusarededicatedtothephysiciansoftheTwinCitiesMedicalSocietyandtosupportingandhelpingtocarryoutitsmission. TheTwinCitiesMedicalSocietyBoardofDirectorswaselectedbythemembershipoftheformerEastMetroMedicalSocietyandWestMetroMedicalSocietyaspartofthePlanofMergerdocuments.Theboardisrepresentationalofthegeographicmembershipofbothsociet-iesandthiswasdonepurposelysoastoensurethatbothorganizationswereproportionatelyrepresented. TherearefiveelectedofficersoftheTCMSBoardofDirectors.EdwardEhlinger,M.D.willserveasthefirstpresidentofTCMS;RonnellHansen,M.D.willserveaspast-president;Thom-asSiefferman,M.D.willserveaspresident-elect;MelodyMendiola,M.D.willserveastreasurer;andAnthonyOrecchia,M.D.willserveasthesecretary.AllofficersserveontheTCMSexecutivecommittee.

Theremaining15directorsarephysicianswhohaveservedasboardmembersonthefor-merEastMetroMedicalSocietyandWestMetroMedicalSocietyboardsofdirectors.Therearetwodirectorswhoarealsoservinginanat-largeposi-tionontheTCMSexecutivecommittee.ThoseindividualsincludePeterDehnel,M.D.andEd-winBogonko,M.D.Theremainingdirectorsinclude:ArthurBeisang,M.D.,PeterBoosalis,M.D.,PeterBornstein,M.D.,CarlBurkland,M.D.,EricChristianson,M.D.,LauraDean,M.D.,KenKephart,M.D.,PaulKettler,M.D.,StephenMacLeod,BDS,MBChB,NickMeyer,M.D.,FrankRhame,M.D.,PhilStoltenberg,M.D.andPeterWilton,M.D.,MB,BCh.Inadditiontothe15directors,therearetwoslotsforYoungPhysicians,definedasphysiciansundertheageof40.ThosetworepresentativesareMarieWitte,M.D.andStephanieStanton,M.D.Dr.ChadRolineandDr.ClintHawthornewillserveastheresidentrepresentatives,andJessicaVoightandMelanieFearingwillserveasthemedicalstudentrepresentatives.Thefiveofficersand15directorshavevotingprivileges. TheTCMSBoardofDirectorsalsohasaspotatthetableforthosephysicianswhoareservingasTrusteesfromtheEastMetroandtheWestMetroDistrictsoftheMinnesotaMedicalAssociation.CurrentlytherearethreerepresentingtheEastMetroDistrict,CharlesTerzian,M.D.,StuartCox,M.D.andDaveThorson,M.D.;andsixrepresentingtheWestMetroDistrictincludingMichaelAinslie,M.D.,BethBaker,M.D.,BenChaska,M.D.,DonJacobs,M.D.,RogerKathol,M.D.,andJimYoung,M.D.Inaddition,anyphysicianwhoisservingasanof-ficeroftheMMAandwhoisamemberoftheTCMSisalsoincludedontheboard.Currentlytherearethreewhoareservinginthatrole—LyleSwenson,M.D.asspeakeroftheHouse,KarenDickson,M.D.,vice-speakeroftheHouse,andBenWhitten,M.D.,MMApresident.Wealso

havetwospotsfilledbyCandaceSimersonandShariOhlandrepresentingtheMinnesotaMedicalGroupManagersAssociation. Lastly,theboardofdirectorsiscomprisedofTCMSphysicianswhoareservingasaDelegateorAlternateDelegatetotheAmericanMedicalAssociation.ThosephysiciansincludeBlantonBessinger,M.D.,KennethCrabb,M.D.,DavidEstrin,M.D.,andBenWhitten,M.D.(whoalsoservesasanMMAofficer). IfyouhaveanyquestionsabouttheTCMSBoardofDirectorsoritsactivities,pleasecontactSueSchettleat(612)362-3799.

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Michael B. Ainslie, M.D.West Metro Trustee

Beth A. Baker M.D., MPHWest Metro Trustee

Arthur A. Beisang, III, M.D.Director

Blanton Bessinger, M.D., MBAAMA Alternate Delegate

Edwin N. Bogonko M.D.At-Large

Peter J. Boosalis, M.D.Director

Peter F. Bornstein, M.D.Director

Carl E. Burkland, M.D.Director

Benjamin W. Chaska, M.D.West Metro Trustee

Eric G. Christianson, M.D.Director

V. Stuart Cox, III, M.D.East Metro Trustee

Kenneth W. Crabb, M.D.AMA Delegate

Laura A. Dean, M.D.Director

Peter J. Dehnel, M.D.At-Large

Karen K. Dickson, M.D.MMA Officer

Board Members

TCMS Officers

Edward P. Ehlinger, M.D., MSPHPresident

Thomas D. Siefferman, M.D.President-Elect

Anthony C. Orecchia, M.D.Secretary

Melody A. Mendiola, M.D.Treasurer

Ronnell A. Hansen M.D.Past President

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David L. Estrin, M.D.AMA Alternate Delegate

Melanie G. Fearing Medical Student Representative

Clint R. Hawthorne, M.D. Resident Representative

Donald M. Jacobs, M.D., FACSWest Metro Trustee

Roger G. Kathol, M.D.West Metro Trustee

Kenneth N. Kephart, M.D., CMDDirector

Paul A. Kettler, M.D.Director

Stephen MacLeod, BDS, MB ChBDirector

Nicholas J. Meyer, M.D.Director

Shari M. Ohland, CMPE, MHA MMGMA Representative

Frank S. Rhame, M.D.Director

Chad E. Roline, M.D.Resident Representative

Candace S. Simerson, COE, ACMPEMMGMA Representative

Stephanie D. Stanton, M.D.Young Physician

Phillip H. Stoltenberg, M.D. Director

Lyle J. Swenson, M.D.MMA Officer

Charles G. Terzian, M.D.East Metro Trustee

David C. Thorson, M.D.East Metro Trustee

Jessica M. VoightMedical Student Representative

Benjamin H. Whitten, M.D.AMA Alternate Delegate

Peter B. Wilton, M.D., MB, BChDirector

Marie L. Witte, M.D.Young Physician

James A. Young, II, M.D.West Metro Trustee

Sue SchettleTCMS Chief Executive Officer

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Dear Twin Cities Medical Society (TCMS) Members;

[FormerlyHennepinCountyMedicalSociety(HCMS),RamseyCountyMedicalSociety(RCMS),HennepinMedicalSociety(HMS),RamseyMedicalSociety(RMS),WestMetroMedicalSociety(WMMS)andEastMetroMedicalSociety(EMMS)]

It’sbeenmypleasuretohaveservedastheCEOofthemedicalsocietyofwestmetrophysicians.NotlongaftertheyearofmybirthTomCookbeganhiscareerastheEx-ecutiveDirectorofHCMSandstayedfor25years.HewasfollowedbyTomHoban,whoalsostayedfor25years,andI’veheldthepositionfor15years.Formyentirelifeandforthoseofyouwhoarearound65,therehaveonlybeenthreeexecutivesforyourSociety.ThatfactsaysvolumesfortheprivilegethatallthreeofushavefeltforworkingcloselywiththephysiciancommunityinandaroundMinneapolis. IbeganmymedicalcareerjourneyasanorderlyatMethodistHospitalintheearly’60s.ThereImetandquickly(beforeshecouldcometohersenses)marriedMarilynandshehasbeenmyever-supportivepartnerforthelast44years.DuringmycareerIwasajunioradministratorataruralhospital,Irepresentedapharmaceuticalcompany,Iwasaclinicadministrator,Iwasamedicalstaffadministratoratamajormetropolitanhospital,IdevelopedandranaphysicianownedHMOinthemodelofPhysiciansHealthPlan,andIwaspresidentofSelectCareforHealthSpanbeforebecom-ingtheCEOofyourmedicalsociety.Eachofthosepositionshadvaryingrelationshipswithphysicians.However,withvirtuallynoexception,thephysicianinteractionsduringmy15yearswithWMMShaveallbeenpositive. Yourmedicalsocietyhasbeenblessedwithvolunteerphysicianleaderswhohaveworkedtirelesslyinsupportofthepracticeofmedicineandforthepatientsyouserve.TheBoardChairswhoIhavebeenprivilegedtoworkwithinclude:DianeDahl,M.D.;JamesMeyer,M.D.;BurtonSchwartz,M.D.;EugeneOllila,M.D.;WilliamSchoenwetter,M.D.;EdwardSpenny,M.D.;DavidEstrin,M.D.;VirginiaLupo,M.D.;DavidSwanson,M.D.;T.MichaelTedford,M.D.;MichaelAinslie,M.D.;MichaelBelzer,M.D.;JamesRohde,M.D.;PaulKettler,M.D.;AnneMurray,M.D.;RichardSchmidt,M.D.;EdwardEhlinger,M.D.(Pres.);PeterDehnel,M.D.(Pres.Elect). Tospecialpeoplewho,withouttheirableassistance,theSociety’saccomplishmentswouldhaveindeedbeenslim—thankyou.Theyinclude,NancyBauerwhoseeffortswithMetroDoctorshavebeenoutstanding,KathyDittmerwhohasmanagedtoherdcatsandgetustomeetingsontime,attherightlocationandwiththerightmaterials,andJenniferAndersonwhoisarisingstaronthetrailforsoundpublichealthpolicy.Weareallindebtedtoothersforourabilitytosucceed. WithSueSchettle’sappointmentasCEOandoutstandingincomingleadership,thefuturelooksbrightfortheTwinCitiesMedicalSociety.There’ssomeimportantworkthatneedstobeattendedto.Theseincludecontinuedvigi-lanceforthepublichealthofthecommunityyouseektoserve,yourpatientsunobstructedaccesstoyou,yourabilitytomaintainunrestrainedclinicalautonomy,continuedconnectiontomedicaleducationandresearch,financialviabilityforyourpractice,andaseatatthetableforthehealthreformsthatareundoubtedlyonthehorizon.Now,morethanever,youractiveparticipationandmembershiparecritical.Thosewhochoosetositonthesidelineswillhavenovoiceincomplainingabouttheoutcome. Andlastly,toeachofyou,thankyouforyourcontributionandparticipationinthissatisfyingjourney.

A Letter to the Members


A Conversation With

Roby C. Thompson, M.D.

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


You have had a diverse career, one that includes clinical medicine, academic medicine and administrative medi-cine. What advice would you give to a young physician who is contemplating their future career direction? What was your favorite area?

Mycareerhasinvolvedclinicalpractice,academicmedicineandadmin-istrationandtheyhaveallhadacommonthemeforme.Ihavealwaysbeencommittedtothechallengeandrewardsofthepracticeofmedicine.Thecomplexitiesofarrivingatacorrectdiagnosisandapplyingthemostappropriatetherapyhavebeenaconstantinmyprofessionallife.ThatconstantpromptedmetoseekanacademiccareerwhereIcouldteachanddoresearchaspartoftheexcitementinthechallengeofmedicine.MyadministrativeroleswereinsomewaystheresultofmyprideintheUniversityofMinnesotaandmydesiretohelpkeeptheinstitutioninapositionofprominenceinthemedicalworld.

Myadvicetoayoungphysicianincareerselectionwouldbetoseekoutthemotivatingdriverintheirattractiontomedicineasaprofession,andfocustheirtalentsaroundthatmotivation.

Getting new graduates to become involved in the leader-ship of professional societies is a challenge. As somebody who has had numerous leadership positions, what are some of the benefits of involvement that may not be obvious?

Someoftheunexpectedbenefitsofassumingleadershippositionsinprofessionalsocieties,formehaveincluded:

• AnetworkofcolleaguesthatIhavelearnedtoadmireandrespect.• Excitingnewknowledgeaboutbusiness,organizationalmethods,

andexposuretonon-medicalprofessionalsinfinance,marketing,publishing,etc.

In your distinguished career in both clinical medicine and medical leadership, you have dealt with increasing pres-sure for academic faculty to generate revenues from their patient care activities. What are the key problems and challenges this poses, and what are your recommendations for addressing this important issue?

Theneedforacademicphysicianstogenerateclinicalrevenuesforsup-portoftheacademicmissionhasalwaysbeenpresentinsomedisciplinesmorethanothers(e.g.,thesurgicaldisciplineshavebeendependenttoalargedegreeforacademicsupportontheirclinicalrevenuethroughoutmycareer).Recently,alldisciplineshavecomeundermorepressuretoproduceclinicalrevenueforsupportoftheacademicmission,asoutsidesupportforresearchdollarshasbecomemoreconstrained,andasthesizeofourmedicalschoolclasseshasbeenexpanding,thereisaneedformorefacultyandmorepatientexposureforeducation.Allofthesearecontinuingtodrivetheneedforfacultytopracticeastheyteachanddoresearch.Myownassumptionhasbeenthatasacademiccliniciansweshouldbecompensatedforourclinicalactivitiesatacommunitycompetitiverateforwhatwedo,andthebenefitswereceiveasacademiccliniciansmustthenoffsettheuseofsomeofthatrevenuefortheedu-cationalandresearchmissionweelecttopursue.

Roby Calvin Thompson, Jr., M.D., is professor of orthopaedic surgery and vice dean for clinical affairs at the University of Minnesota School of Medicine. He obtained his medical

degree from the University of Virginia School of Medicine; served as an intern and assistant resident in surgery at Columbia-Presbyterian Medical Center, New york; and completed his residency and Anne C. Kane Fellowship at New york Orthopaedic Hospital, Columbia-Pres-byterian Medical Center. Dr. Thompson is board certified in surgery and orthopaedic surgery. Questions were provided by: Drs. Lee Beecher, Benjamin Chaska, Thomas Dunkel, Wil-liam Jacott, and Stephen MacLeod.

A Letter to the Members


Colleague Interview


Academiccareersaresuccessfulforthosewhovaluecontactwithstudents,intellectualchallengesandcollegialityintheirprofessionallife.Theserewardsareworthyofinvestingintheacademicmission.

Thatsaid,thereisapressingneedforthefutureinmedicaleducationtodefineourneedsandthesocietalvalueofourgraduates.Thereneedstobeacommunity-basedsupportforthemedicaleducationmission,andthatneedstobecoordinatedwiththeotherresourcesavailableforfunding,includingphilanthropy,tuitionandfacultycontributions.

What role should adjunct community clinical faculty play in medical student and residency education, and (how) should they be paid? Comments?

Adjunctfacultyplaysaninvaluableroleinmedicalstudentandresidenteducation.Therehastobevaluetothemedicalschoolandtheadjunctfacultyforthistobesuccessful.Thecompensationfortheparticipationintheteachingprogramwillvarybasedonthevalueprovidedtotheschoolorthecommunityfacultymember.Insomecasestheaddedvalueofhavingaresidenttoworkwithmayprovidecompensationinandofitself,whileinothersitmightrequiresomeformofcompensationfortimeandeffortbythecommunityfaculty.Wehaverecentlybeentryingtoaddressthisinourschool,andfindthatitvariesfromdisciplinetodisciplineandhaveleftthedecisionsoncommunityfacultyappointmentsandcompensationuptotheindividualdepartmentsandtheirneeds.

The U of M has undertaken a review of its ethical and administrative guidelines regarding “conflicts of inter-est” for faculty who receive money from pharmaceutical companies and device manufacturers. Give us an update on this work.

The“conflictsofinterest”policieswillbeadoptedinthenexttwoweeksandwillbepublicbythetimethisarticleispublished.

What was the biggest challenge in merging the medical school department silos into a single multi-specialty group called UMP?

Thebiggestchallengeinmergingthe18clinicalpracticegroupsintoonegroupwasfinancial.Howdidwecapitalizethenewventureandcouldweaccepttransparencyinourfinances?Wehadthreebasicformsofpracticesinour18departments,LLCs,PartnershipsandNot-for-profits.WewereformingaNot-for-profitcorporationsothepriorNot-for-profitscouldsimplyrollover.However,thepartnershipsandLLCshadownershipandinthecaseoftheLLCsvestedinterests.Wehadnoresourcestobuyoutthosestructures,andtheywereaskedto“contribute”theiraccountsandownershiptotheneworganization.Fortunately,wehadveryfewfacultywhooptedoutbecauseoftheprocesswewentthroughindefiningthestructureanditsbenefitstotheorganizationasawhole.Thewillingnesstoaccepttransparencyoffinancialdatawaslesscontentious,butittookalotoftimetogeteveryoneonboardand,fortunately,itwasanon-issueoncewegotitsetup.

What motivated you to stay on so long as chairman of UMP?

IwasaskedtobecomechairmanoftheboardofUMPin2000,whenDr.ScottGiebinksteppeddownasthefirstchairoftheboard.Iwasthenaskedtobecomethechiefexecutiveofficeroftheorganizationin2001andremainedasCEOandchairoftheboarduntil2004whenIsteppeddownandtheboardelectedDr.LeoFurchtasthenewchair.Iwasstilldoingsurgeryuntil2004andthenrestrictedmypracticetoanoffice-basedpractice.MytenureatUMPhysicianswasbasedonmygoodhealth,myenjoymentinseeingtheorganizationgrowandflourishandmydesiretoremaininaleadershippositionuntilFairviewhadselecteditsnewCEO,MarkEustis.

Orthopaedic surgeons are paid four to five times as much as primary care physicians. This is a problem for recruit-ment of medical graduates into lesser paid specialties. Should specialty pay differences be addressed and how?

Thedifferentialinphysiciancompensationhasgrownaswehavebecomemoreandmorespecialized.Thisdifferentialisessentiallymarketbasedandunlesswehavemoregovernmentalcontrolofhealthcareexpendi-tures,Idon’tseethatchanging.Themarketwillchangecompensationaswehaveseenincardiovascularmedicineandsurgery,dermatology,etc.

Can you explain how small animal science interacts with rehabilitation and orthopaedic surgery? What are the advances in orthopaedic surgery for war injured folks? What role will the foundation play in future medical development?

WehavehadanactivecollaborationbetweentheSchoolofVeterinaryMedicineandOrthopaedicsfor30years.Atpresent,Dr.Clohisyasde-partmentchairofOrthopaedicshasatraininggrantandhasVetSchoolfacultyonthegrant,whoarestudyingsarcomasinanimals. TheuseofBoneMorphogeneticProteinstospeedfracturehealinghashadwideuseinthewarinjuredofthelast10years(notwithoutcontroversy).Butthemostimportantcontributionshavebeeninrapidaccesstoatieredmedicalsystemfortriage,stabilization,andeventualdefinitivecare.Thecurrentwarinjurieswithhighnumberofamputeeshavepromptedgiantstepsforwardinprostheticdesignanddevelopment.

As you look back on your medical career, what are the most pleasing and satisfying achievements?

ThetwomostsatisfyingaspectsofmycareerarethesuccessesIenjoyedinpatientcareandthegoodoutcomesIwasfortunatetoenjoy,andthesuccessoftheresidentsthatIhadapartinrecruitingandtraining.Thelatterisprobablymysourceofgreatestsatisfaction.

What are your plans for the future?

IplantohavemoretimeformyselfandmyfamilywhileIstillenjoygoodhealth,andIhopetobeinvolvedparttimeasaconsultantorinbusinessinawaythatallowsmetobeincontrolofmytime.


Honoring Choices Minnesota: A Community Approach to Advance Care Planning

ONE OF THE PROJECTSthattheTwinCitiesMedicalSocietyiscontinuingtofocusonin2010isHonoringChoicesMinnesota(HCM).Thisinitiativehasexperiencedgreatgrowthandsuccessinthepastsixmonths.HonoringChoicesMinnesotaisacomprehensive,col-laborativeapproachtoadvancecareplanningthatisbeginningintheTwinCitiesmetroarea,usingtheinternationally-recognizedRespect-ingChoices®programasamodelandguide.

Themajorityoflocalhospitalsandhealthplansareinvolved,alongwithseveralhomecare/hospiceandhealthcareorganizations.

ICSIisengagedandisstartingworkonapal-liativecareinitiativeincludingstandardsforqualityandcostmeasurement.Allofthesegroupsarerepresentedontheadvisorycom-mittee,andcommitteemembershavecreatedasharedadvancedirectiveformforallsystemsacrossthestatetouse.SevenlocationswillpilottheHCMprogramandmaterialsfromJanuarythroughJune,2010.

AtatrainingcourseheldinearlyNovem-ber,2009,45peoplewerecertifiedbyRespect-ingChoices®facultytobefacilitators.ThoseindividualscanuseRespectingChoices®tools

andmethodstohelppa-tients understand their

optionsforfuturemedicalcareasitrelatestotheirmedicalcondition;aswellashavediscus-sionswiththepatient’sfamilyandlovedonestoreflectupontheirdecisionsinlightofpersonalvalues,religiousbeliefs,orculturalperspec-tives.Tenpeoplewerecertifiedasinstructors,enablingthemtoteachfuturetrainingcoursesforhealthcareprofessionalstobecomefacilita-tors.Inthisway,HCMcangrowandbecomeself-sustaining.

For additional information on thiscommunity initiative, please contactTwinCitiesMedicalSocietyat (612)362-3704,[email protected],orvisitwww.metrodoctors.com/choices.cfm.

HCM Pilot Sites

• FairviewEagan&RosemountClinics• FairviewOxboroClinic• FairviewRedWingMedicalCenter• FairviewRidgesHospital&Homecare• HennepinCountyMedicalCenterMedicineClinic• HealthEast–St.Joseph’sHospitalUnit4000(cardiac)

&MidwayClinic• HealthPartners–RiversideClinic,BrooklynCenter

Clinic&CHFClinicatRegionsCourse attendees break into small groups to discuss details of the HCM pilots.


By william E. Jacott, M.d.

A Fond Farewell

AFTER 18 yEARS OF SERVICEtoTheJointCommission(10ontheBoardofCommission-ersandeightasSpecialAdvisorforProfessionalRelations)myrelationshipwillbediscontinuedattheendof2009.Thusthiswillbethelastar-ticleIwillwriteforMetroDoctors.AsdirectedbyTheJointCommissionBoard,Ihavefocusedmyactivityinthepasteightyearsonengag-ingphysiciansandphysicianorganizationsintheaccreditationprocess,patientsafetyandqualityactivities.Duringthese18years,IhaveseenTheJointCommissionchangefromaregulatory,process-focusedorganizationtoonethatismorefocusedonclinicalcare.AgoodexampleofthisistheTracerMethodology.Thisisatechniqueusedbysurveyorstofollowthepathofapatientthroughanorganizationandalongtheway,notecompliancewithstandards. Inthelast issueofMetroDoctors,Idis-cussedthenewJointCommissionstatementsonvisionandmission.Theenterprisevisionis:allpeoplealwaysexperiencethesafest,highestquality,best-valuehealthcareacrossallsettings.Inordertoimplementtheenterprisevision,theBoardandstaffhaveundergoneasignificantstrategicplanningprocess.Fourstrategicim-perativeshavebeenidentifiedtohelpachievethatgoal:1.Improvethequalityandsafetyofhealthcare.2.Exceedcustomerexpectations.3.Committostaffandexceloperationally.4.Maintainstrongfinancialperformance.Allverychallengingandaccompaniedbyanumberofgoalsandtactics. MarkChassin,M.D.,presidentofTheJointCommission,putsitthisway.“Myvi-sionforTheJointCommissionincludesanevenstrongerfocusonhelpingtoprovidethebestpossiblecareforpatients.Centraltothis

newvisionisanefforttofacilitatemorerapidandwidespreaddevelopmentandadoptionofprovensolutions.Wewillbeworkingwithhospitalstoidentifyanddevelop,throughtheapplicationofrobustprocess improvementmethods,effectiveinterventionsthatwillpro-ducegreatlyimprovedlevelsofsafetyandqual-ity.Andwewillrapidlyputtheseinterventionsinthehandsofouraccreditedhospitals.” AsTheJointCommissioncontinuestoprovidethis improvedaccreditationprocessandservicetohospitals,questionsariseaboutcompetition.TherearetwootherorganizationsthathavebeengranteddeemedstatusbyCMS.DetNorskeVeritasHealthcare(DNVHC)Inc.isasubsidiaryofDetNorskeVeritas,aNorwe-gianorganizationwhoseprimarybusinesshasbeenofferingclassificationandtestingservicestothemaritimeandmanufacturingindustries.DNVHChasbeenconductingaccreditationofhospitalssincetheyhavereceiveddeem-ingauthorityfromCMSinSept.2008.Theiraccreditationrequirementsarebasedonthe1986CMSConditionsofParticipationandtheISO9001standards.TheotherorganizationistheAmericanOsteopathicAssociation(AOA)whosemissionistoadvancethephilosophyandpracticeofosteopathicmedicine.Theprogrambeganasawaytoensurethatosteopathicstu-dentsreceivedtheirtraininginfacilitiesthatprovidedhighqualitypatientcare.Sofar,thenumberofhospitalsaccreditedbythesetwo

organizationsissmall,butTheJointCom-missionmustcontinuealongtheenterprisevisionpathwaytomaintainitsdominationinthefield. Lookingahead,ourprofessionandthehealthcareorganizationswebelongtofaceseveralchallengeswithrespecttoaccreditation.First,weneedtomaketheaccreditationprocessrelevantwhiledeliveringvaluetoinstitutions.Thatis,wemustdemonstratethattheprocessesofpre-surveypreparation,selfassessment,andon-siteevaluationforstandardscompliancecanresultinmorepositivehealthcareoutcomes.Thequestionremains:wheninstitutionsand/orhealthcareprofessionalsareevaluatedthroughtheaccreditationprocess,doesitmakeadiffer-enceinhowcareisdelivered?Ibelieveitdoes.Wearemovingfromanecdotalresponsestomoreevidence-basedresponses.Withourin-creasingabilitytocollectandanalyzedatafromperformancemeasurement,wearegeneratinganddemonstratingmoredocumentedpositiveoutcomes. It’sbeenagreattrip.Icontinuetobeim-pressedwithTheJointCommissionleadershipandstaff.Ithasalsobeenapleasuretomeetandinteractwithsomanytalentedanddedicatedleaders inthefield—chiefmedicalofficers,medicalsocietyleaders,medicalstaffleaders,CEO’sandpracticingphysicians.TheJointCommissionBoard,whichIhadtheprivilegetoChairin1999and2000,isauniqueandexperiencedbodywithabroadbackgroundoftalent.IthasalsobeenapleasuretoserveontheMetropolitanHospitalPhysicianLeadershipCommitteesponsoredbyEMMSandWMMS.Thisisauniqueorganizationwithopportuni-tiestodiscussandagreeuponcommonissuesandpolicies. Mythanksandadmirationtoallthegoodpeopleinhealthcare.—WmJ


Y O U R V O I C E

AttheMMAannualmeetingheldinRochesterthislastSeptember,theHouseofDelegatesadoptedtheresolutiontoopposeeffortstolowertheminimumlegaldrinkingagefrom

21years.ThispolicysendstherightmessageaboutMMA’sconcernsrelatingtothedangersandconsequencesofalcoholusebyyoungadultsunderage21. Congress,in1984,passedtheNationalPurchaseActtoencour-ageeachstatetoenactaminimumlegalpurchaseageof21by1986becauseofthenumberofunderagealcohol-impaireddriverswhowereinvolvedinfatalcrashes.Statesthatfailedtoraisethelegalageforthepurchaseandpublicpossessionofalcoholfaceda10percentdecreaseintheirannualamountoffederalmoneytheyreceivedforhighwayconstructionandmaintenance.Withinfouryears,all50stateshadestablished21astheminimumlegaldrinkingage(MLDA). UnderabannercalledtheAmethystInitiative,about130collegeanduniversitypresidentscalledonlawmakerstoconsiderloweringthedrinkingagefrom21to18,sayingthatthe“twenty-one(MLDA)wasnotworking”andthata“cultureofdangerous,clandestine‘bingedrinking’….haddeveloped”atU.S.collegesanduniversities. Theyclaimedthatthedevelopmentofthis“bingedrinkingculture”amongcollegestudentsoccurredsubsequentlytochangesinthedrinking-agelaw.TheyurgedtheAmethystInitiativetoprovideanationaldebateaboutthedrinkingage.TheiralternativeapproachtocontrollingtheconsumptionofadultbeveragesbyyoungerAmericanswastoteachresponsibledrinkinginhighschool. Thisplanwassimilartotheapproachusedbymanystatestoeducateandlicenseyoungdrivers.Acertifiedalcoholeducatorwouldteachhighschoolgraduates,whochosetoconsumealcohol,aboutthelegal,ethical,healthandsafetyissuesrelatedtoalcoholconsumption.Passingthiscoursewouldresultinalicensetodrink.Ifyouviolatedit,thelicensetodrinkwouldbetakenawayrightaway. InsuranceInstituteforHighwaySafetypresidentAdrienLund,thoughtthatitwasirresponsibletoassertthatthisuntestededucationprogramwouldbringdownhighwaysafetycrashesthatwentdown30percentwhenthedrinkingagewasraised. Ibelievethereareatleastthreemajorfactsthatsupportnotloweringthedrinkingageto18: First,maintainingtheMLDAatage21isaboutprotecting

thepublichealthandthepublicsafety.Livesaresavedandinjuriesareprevented.TheMinnesotaDepartmentofPublicSafetyofficialsopposeloweringthedrinkingagebecauseofthehighratesofyoung,inexperienceddriversincaraccidents. Second,thisnextpointisveryimportanttomeandIwantmyfellowcolleaguestothinkaboutit.Statisticsthatdocumentcarcrashesandcarfatalitiesthatinvolvepreventablecarnagewroughtbyalcoholmisusearenotfaceless.To me, to you, to emergency personnel, to police officers, and to firemen, alcohol statistics have a face with a history.Asanurseoncesaid,“youcantalkaboutpolicybutwhenyoustareatahumanface,it’sawholedifferentstory.” Society’sopinionaboutalcoholisambivalent.Ithinkwefartoooftenidentifywiththerightsofthealcoholabuserandnotwiththerightsofthevictim.Weneedashifttooccurinsocietyandidentifyfirst,morewiththevictim’splightthanwiththealcoholabuser’splight.Afterallwe,oroneofyourfamilymembers,couldbeanin-nocentvictimofsomeonewhoisillegallymisusingalcohol.WouldyouhaveaTeflonattitudetowardsomeonewhowasmisusingalcoholifoneofyourfamilymemberswasoneoftheirinnocentvictims? Third,thesciencehereisclear.Thepresentlawbestservesthecommongoodtofirstdonoharm.Ina2009Hazeldennewslettersupportingkeepingthecurrentlegaldrinkingageat21,itstatedthattherewasnoevidencethatloweringthedrinkingagewouldsolvealcohol-relatedtrafficaccidentsandotherunintentionalinjuries.Instead,itwouldsimplygiveyoungpeopleeasieraccesstoalcohol. Anationalsurveyof16-21yearoldsfoundthatteensfromstateswithahigherMLDAdranklessfrequently.Ifapersonwaiteduntilage21beforetakingtheirfirstdrink,theirriskofbecomingalcoholdependentandabusingalcoholdecreasedbyover60percent. In2000,NewZealandlowereditsMLDAto18.Sincethen,alcoholrelatedcrasheshaverisen12percentamong18to19yearoldsand14percentamong15-17yearolds. AMarch2009articleintheAmerican Journal of Preventive MedicinenotedthatresearchconductedbytheUniversityofMinne-sotaandtheCDConbingedrinkingofactive-dutymilitaryperson-nelfoundthatbingedrinkingrateswerehighestamongpersonnelbetweentheagesof17and25,withaboutfivemillionepisodesofbingedrinkingamongpersonnelunderthelegaldrinkingageof21.MandyStahre,MPH,whohelpedauthorthestudystatedthat“ourstudyclearlyshowsthatbingedrinkingisasignificantpublichealth

Teens & Alcohol—Not a Faceless Statistic

By Carl E. Burkland, M.d. (Continued on page 14)


probleminthemilitary,whichisdangeroustoboththedrinkersandthosearoundthem.Italsounderscorestheimportanceofimplement-ingeffectivestrategiestopreventunderageandbingedrinking,suchasmaintainingandenforcingtheage21minimumlegaldrinkingageandincreasingalcoholexcisetaxes.” AJuly2009articleintheJournal of the American Academy of Child and Adolescent Psychiatrycomparedbinge-drinkingprevalenceratesamongyouthsandyoungadultsintheU.S.between1979and2006.Theyfoundthat:• Bingedrinkingamonghighschoolseniorswasatahistoriclow,

morethanone-thirdlowerthanitspeakin1979-1983.• Thereweresignificantreductionsinrelativeriskforbingedrink-

ingamong12to20yearoldmalesbutnosignificantchangesintherelativeriskforbinge-drinkingwereobservedamong12to20yearoldfemales.

• Therewasnoreductioninbinge-drinkingin18-20yearoldcollegemen,whereastheirnon-studentcounterpartsintheagerangeof18to20yearsoldhadareductionintheirrelativeriskforbinge-drinking.

• Thehighestratesofbingedrinkingwereamongmales21to23yearsold.Thistrenddidnotdifferbystudentstatus.

• And21to23yearoldcollegewomenexperiencedlargerincreas-esinbinge-drinkingratesthantheirnon-studentcounterparts,ages21to28yearsold.

Thisstudyconcludedthatthereductioninbinge-drinkingamongyouths12-20yearsoldislikelytobeatleastpartlyattributedtotheadoptionoftheuniformdrinkingageof21years.Andfur-thermore,theseresultssuggestthatbinge-drinkingproblemsamongcollegestudentswouldbestbeaddressedbyinterventionsspecifictothecampusenvironmentandbyinterventionstargetedtowardwomenandnotbypresumingthattheMLDAorotherlawshadbeenineffective. Insummary,thereisnosilverbulletoreasilyutteredsound-bitethatwillproclaimthesolutiontodeterringunder-agedrinking.Theanti-smokingmodel—education,highertaxesandenforcedagerestrictions—wassuccessfulandshouldbeusedtocurbunder-agedrinking.MaintainingtheMLDAat21isyetanotherimportantpartofthesolution,especiallysinceitfurtherdiscouragesdrinkingbegin-ningatevenyoungerages. Physiciansshouldasktheiryoungpatientsspecificquestionsregardingtheamountofalcoholtheyconsumeperdayand/orontheweekendswhiletheyareperformingroutinephysicalexaminationsorwhenseeingthemformedicalortroubledbehaviorproblems.IamsurprisedbythehonestanswersIget. Frankandfreecommunicationisvitalinaddressingthesolutiontothispossiblelife-changingunder-agedrinkingproblem.

Teens and Alcohol


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MOTOR VEHICLE CRASHES aretheleadingcauseofdeathamongteenagers.In2005,atotalof5,300teenagers,ages13to19,diedinamotorvehiclecrash,representing33percentofalldeathsamongthisagegroup.Variousstudieshaveattributedthisincreasedriskleveltofactorssuchasalackofdrivingexperience,tendencytodriveatriskiertimes (nighttime),andfellowteenagepassengersthat leadtoadistractingenvironmentforthedriver. Overthelast12years,almostallU.S.stateshaveadoptedgraduateddriverlicensing(GDL)policies,whichhavebeenpreviouslyimplementedinAustralia,NewZealand,andseveralCanadianprovincesastoolstoreducetraffichazardsforteenagers.Thesepoliciesin-troducethreedistinctlicensingstages:learner’spermit,intermediatelicense,andfulllicensure.Thefirsttwostagestypicallyinvolverequire-mentsontheminimumnumberofhoursofsuperviseddriving,aswellasdrivingrestrictionsespeciallyinhigh-risksituations(night-timeandwithteenpassengers).Theserestrictionsaregraduallyliftedasteendriversmatureandadvancetothenextstage.Thefinalstage,“fulllicensure,”removesalltherestrictions.Thepurposesofthesepoliciesincludeexpandingthelearningprocess,reducingriskexposure,improvingdrivingproficiencyandencouragingsafedriving. PreviousliteratureevaluatingtheimpactofGDLpoliciesof the1990shasdemon-stratedthepolicies’effectivenessonreducingteenage-involvedfatalcrashes.However,themechanismsthroughwhichthesereductionsareachievedareunexplored.Inparticular,doesGDLhelpimproveteendriving,ordoesit

simplylimitthenumberofteensontheroadespeciallyinhigh-risksituations?Thedifficultyininvestigatingthisissueisduetotheunavail-abilityofgoodestimatesofhowmanyteen-agedriversareontheroadsatanygiventime,andhowthatvarieswiththeGDLpolicies.(Inasportsanalogy,itisliketryingtoguessabaseballplayer’sbattingaverageusingonlythenumberofhits.)Moreover,itisunknownwhetherGDLpolicieshavelong-termeffectsonteenagedriving.Forexample,doGDLex-posedteensbecomebetterdriversinthefuture?Alternatively,doGDLregulationsshiftriskydrivingtoolderteensbydisallowingthemtomaturethroughriskybehaviorwhiletheyareyounger?Ourgoalistoinvestigatesuchbehav-ioralimplicationsoftheGDLpolicies.

Study DesignWeestimateastructuralmodelthatseparatelyidentifiesGDL’seffectontherelativeteenageprevalenceandrelativeteenageriskiness.WealsodistinguishbetweenstatesthatimplementstricterGDLpolicies.Ourabilitytoidentifytherelativecrashrisksandrelativeexposurereliesondatafromtwo-carcrashesandtheinformationcontainedinthecountsofteen/teen,teen/adult,andadult/adultcrashes.Thereareonlycertainrelativerisksandexposuresthatwouldmakeaparticularcollectionofcrash

countsplausible.Ifmanyoftheaccidentsin-volveteen/teencollisionstheneithertheteen-relativeriskishighortherearemany[more]teensontheroadrelativetoadults.Thecountsofteen/adultandadult/adultcrashescanbeusedtoidentifyhowmuchthenumberofteen/teencrashesdependsonriskandhowmuchdependsonexposure. Wemodelthesecrashfrequenciesasafunctionoftheteenagedrivingexposureanddrivingrisk,bothrelativetothoseofadults.NexttherelativeamountofteenagedrivingandteenagedrivingriskarerelatedtotheGDLpoliciesaswellasotherstate-yearleveldrivingrelatedlawsanddemographicinformation.Themodelisestimatedjointlyinatwo-levelhierarchicalmodelingframework. WeusearelativelynewdatasetcalledtheStateDataSystem(SDS)whichhasdatafrom1990to2005.ThisdataisverysimilartotheFatalAnalysisReportingSystem(FARS)datausedextensivelybypreviousresearchontrafficsafety.WhileFARSreportsonlyfatalaccidents,SDSincludesallpolicereportedcrashesandprovidesinformationonallpersonsinvolvedinthecrash(age,gender,drinking,status,etc.)aswellasdetailedinformationonthecrash(loca-tion,time,roadtype,roadconditions,numberofvehiclesinvolved,etc.)andonallthevehiclesinvolved(make,model,year).Unfortunately,notallstatesreporttoSDS.Weobtaineddatafrom12states.

FindingsWefindthattheGDLpolicieshavereducedthenumberofaccidentsby15to17year-oldsbylimitingtheamountofteenagedrivingratherthanbyimprovingteenagedriving.Morespe-cifically,GDLreducesrelativeteenprevalenceby5percentduringthedayand15percent

By pinar Karaca-Mandic, ph.d., and greg Ridgeway, ph.d.

Research Brief: Behavioral Impact of Graduated Driver Licensing on Teenage Driving Risk and Exposure

pinar Karaca-Mandic, ph.d.


duringthenight.StricterGDLpolicies,espe-ciallythosewithnight-timerestrictionshavebeensignificantlymoreeffectiveinlimitingteenagedrivingatnight.Forinstance,aGDLpolicyrated“good”(i.e.moststrict)bytheInsuranceInstituteofHighwaySafetyreducesteenprevalenceatnighttimeby43percentwhileaGDLpolicyrated“fair”reducesitby12percent.Wedonotfindstatisticallysignificanteffectofthepoliciesrated“marginal”(i.e.leaststrict)onrelativeteenprevalence.

We investigatewhetherdrivingunderGDLrestrictionsresultsinacohortofdriversthathavereducedrisksinthefuture,althoughtheeffectsduringtheearlyteenyearsmightbeinsignificant.AlthoughwedonotfindevidencethatGDLpoliciesmaketeenagersbecomebet-terdriversinlateryears,futureresearchshouldrevisitthisissueasmore teensgraduatefromtheGDLpolicies.

Fromapublichealthperspective,ourfind-ingssuggestthatmorerestrictiveGDLpoliciesfor15to17year-olddriversreduceteenac-cidentsandfatalities.StrongerGDLpoliciesdeferunrestricteddriving,thusreducingteens’exposuretohighriskdrivingsituations.Recentneurologicalstudiesmayhelpexplainourfind-ings.Inparticular,NationalInstituteofMentalHealthresearchersfoundthatregionsofthebraingoverningimpulsecontrol,prioritiza-tion,andstrategy(thedorsallateralprefrontalcortex)arestill“underconstruction”duringteenyearsanddonotdevelopfullyuntilearly20s(Giedd,2004).Ultimately,biologicalorbehavioralmaturation,ratherthanexperience,maybethemechanismthroughwhichGDLreducesteens’drivingaccidentrisk.Naturally,furtherresearchmayprovideinsightintoop-timalGDLpolicystructure,aswellashowalternativepoliciesmightinfluencelearningbyteendrivers.

Reprinted with permission, University of Min-nesota School of Public Health, Research Brief, October 2009.

Pinar Karaca-Mandic, Ph.D., assistant profes-sor, Division of Health Policy and Management, School of Public Health, University of Minnesota.

Greg Ridgeway, Ph.D., senior statistician, RAND Corporation.

Graduated Driver Licensing


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New Health Care CEO:Neeraj Chepuri, M.D., CEO, Consulting Radiologists, Ltd.

Editor’s note: MetroDoctors is continuing to highlight newly named health care executives. Each CEO has been asked to outline his/her vi-sion and challenges for their organization as well as offer some personal insights.

What or who inspired you to pursue a health care career?

Myfatherhasbeenoneofthegreatestinfluencesonmylifeincludingmycareerchoices.HegrewupinIndia,anddidnothavetheeducationalopportunitiesIhadtobecomeamedicaldoctor.AsfarbackasIcanrememberhewantedmetofollowacareerthatallowedmetobeinvolvedinpatients’healthcare—acriticaltimeineveryone’slife.Ivaluealloftheadviceandmentoringhehasgivenmeovertheyears.

What is the best career advice you received?

IreceivedadvicefromoneofmymentorswhenIwasinmedicalschool.Atthetimetherewasagreatdealofuncertaintyaboutafutureinspecial-ists.Therewasastrongmovetowardprimarycareandaconcernthattherewouldbenojobsinradiologyorspecialistmedicine.However,thiswastheareathatIwasinterestedin,andanareawhereIfeltIcouldmakeadifference. Mymentortoldmethatgoodpeoplewouldalwaysbeneededinmedicinewhocouldprovidevaluetopatients.Headvisedmetofol-lowmydreamsandtodowhatIthoughtwouldbesthelptakecareofpatients.Itookthatadviceandranwithit.SevenyearslaterasIcameoutofmyfellowshipprogram,jobsinspecializedareas,particularlyinradiology,wereavailableandInowfeelveryfortunatetobethepresidentofalargeradiologygroup,centeredinMinneapolis.

What motivated you to leave clinical practice to become an administra-tor? What new skills are needed for this career?

Ihavenotreallyleftmyclinicalpracticetobecomeanadministrator—50percentofmytimeremainsdevotedtomyclinicalpracticeasaneu-roradiologist.Itismybelief,andConsultingRadiologists,Ltd.(CRL)asanorganizationhasagreed,thatthebestadministratorforahealthcarepracticeisanindividualwhounderstandstheprocessofdeliveringcaretopatients.Assuch,acombinedphysician/leaderisviewedbymyorganizationastheidealpositionfromwhichtoleadalargehealthcareorganization.Infact,wearedevelopingacorpsofphysicianleaderswithinourorganization.ThesephysicianleadersrangefromFinance

Committee Chair, PracticeOperationCommitteeChair,Chief Technology Officer,ChiefQualityOfficer,ChiefofMedicalStaffAffairs,andChiefofStrategyandDevelopment. Thesearenewrolesforourphysicians.Theydorequirenewskills,andIhaveperson-allybeeninvolvedwithaphy-sicianleadershipcourseattheUniversityofSt.Thomas.Inaddition,Ihavereceivedpersonalcoaching,andhavereadnumerousarticlesandbooksonthetopicofleadership,physicianleadership,andphysicianleadershipwithinhealthcare.Thishasbeenalearningjourneyformeaswellasformyorganization.

What aspect of modern clinical care, in your opinion, has made the greatest difference in the lives of the most people?

Asaradiologist,Iseealotofcontributionsthatimaginghasmadetopatientcare.Itistrulyamazingthatwecandissecttheinternalstructureofapatientwithouttheuseofknivesorsharpinstrumentation.Wenowhaveagreatdegreeofcertaintyaboutthesizeofabnormalities,thestructureofabnormalities,thephysicalandbiochemicalcompositionoftheseabnormalitiesand,tosomeextent,eventhepathologicalnatureoftheseabnormalities.Thishelpsagreatdealinbeingabletotreattheabnormalityandtoreturnthepatientbacktoanormalstateofhealth.Thishasmadeatremendousimpactonourabilitytodeliverhealthcaretoourpatients.

A great deal of research has been done through the American College of Radiology regarding the appropriate use of imaging studies. For example, when a patient presents to a primary care physician with a complaint such as back pain, there are rigorous research appropriate-ness criteria for determining who should have an MRI, who should have an x-ray, and who should be treated medically without any type of imaging. Unfortunately this information is often not available to our primary care physicians at the time a patient presents to them. Also, imaging referrals are influenced by factors such as patient request (after


New Health Care CEO


reading something on the internet, perhaps), and fear of litigation. This “defensive” style of medicine clearly drives a subset of imaging referrals and is one cause of imaging over-utilization.

Inresponse,CRLaswellasotherradiologygroupsisgoingonanedu-cationoffense—tryingtomakeiteasierforourreferringphysicianstoaccessappropriatenesscriteriaatthetimeofimagingreferral.Wearealsoengagedinalargeeducationalprogramtryingtogettoourreferralcommunityandletthemknowaboutthebesttimetoorderwhichtest.

How do radiologists (in general) deal with the excess use of scans in this new environment?

ThecentralbusinessnotionofCRListhatwhenmedicalimagingisusedappropriately,theoverallqualityofpatient’shealthcareisincreasedandtheoverallcosttothehealthcaresystemisreduced.Webelievethatalotoftheover-utilizationofimaginginhealthcaretodayisrelatedtoimproperlyalignedincentives,andincompleteeducationabouttheusefulareasofmedicalimaging.WehavebeenworkingforquiteawhilewiththeAmericanCollegeofRadiology(ACR)inpromotingtheACRap-propriatenesscriteriaformedicalimaging.Westronglyfeelthatmedicalimaginghasaroleinhealthcare,andtherehavebeenquitedramaticandsignificantgainsduetomedicalimaging.Unfortunately,thereissomemisuseandoveruseofmedicalimaging,whichwearequiteinterestedinstompingout.

Do your radiologists also recommend other studies, and since there is a conflict of interest, who monitors this?

WhenCRLradiologistsareinterpretingimagingstudies,occasionallythereisaneedforfurtherfollow-upscanstoeithermonitortheprogres-sionofadiseaseortoansweraquestionthatwasbroughtaboutbyacertaintypeofimagingstudy.Atthispoint,followingACRappropriate-nesscriteria,thenextimagingstudywouldberecommended,andthisisaservicethatweprovidetothereferringdoctorssincethereferringdoctorsoftendonotknowwhichstudywouldbemostappropriatenext.Thereisnotreallyaconflictofinterest,asmostoftherevenuefromtheseadditionalstudiesactuallygoestoourhospitalandpartnerfacilities,andnottous.Thereisnonationalmonitoringboardforwhorecommendsfurtherscans.However,thereisagreatdealofinternalmoni-toringbetweenphysicians,aswedoneedtorecommendtheadditionalstudiestoourreferringphysiciansaswellastoourpatients.Overall,averysmallpercentageofimagingstudiesperformedarerecommendedbyradiologists.Thevastmajorityofover-utilizationofimagingisnotfromrecommendationsofradiologists,butreferredbynon-radiologists.

How much does competition from other imaging sites, hospitals and clinics increase the cost? And, why is the cost of a CT in Japan or Germany so much less than here in the U.S.?

ThereareseveralreasonswhyadvancedmedicalimagingsuchasCTandMRIcostmorehereintheU.S.thaninJapanorEurope.Idon’tbelievethatthereasoniscompetition—infactIbelievethatcompetitionreduces

thecost.IntheTwinCities,thereisquiteabitofcompetitionforoutpatientimaging,andthathasledtoasignificantlylowercostandhigherqual-itythanwhatisseenelsewhereinthecountry. TounderstandthedifferencesinimagingcostsbetweentheUnitedStatesandEuropeorJapan,wehavetolookatthepayerside.IntheUnitedStates,thereisalargeconsumerdemandformedicalservices,particularlyhigh-technologyservicessuchasimaging.Alargepercentageofthepopulationalsohashealthinsurance,whichbasicallyinsulatestheconsumersofhealthcareresourcesfromtheirtruecosts.So,fromtheperspectiveoftheconsumer,wehavea largedemand,andahiddencostthatisbornebytheindustryandnation,butnotbytheindividualatthetimeofthehealthcareepisode. Othersocietiesdonothaveashighacon-sumer-culturedriveforhigh-techhealthcare.Ibelievethatisthekeyfactor.Theothercountriesalsouseothertypesofpaymentstructuressuchassingle-payersystemsthatplacelimitsontheamountofhigh-techhealthcaredelivered(ra-tions).WhatisrightforJapanorEuropeisnotnecessarilyrightfortheU.S.Wemustlookforahealthcaresystemthatfitswiththeconsumer

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mentalityintheU.S.,butalsodoesnotrationhealthcare.Idon’tthinktheU.S.consumerwilltoleraterationedcare.

In general, do you think patients today are better informed about health topics than in earlier times and why or why not?

Absolutely,Ibelievethatpatientsarebetterinformedabouthealthcaretoday.Thereareseveralreasonsforthis.Thewidespreaduseofhealthinformationontheinternethasmadehealthcarereadilyaccessibletoeverybody.Everyoneisnowlookingontheinternetforadviceaboutpersonalhealthissues,aswellasissuesofhealththateffectfamilymembersandfriends.Theinternetisatremendousresource,andisoneofthetrulyrevolutionaryfeaturesofourtime. Inaddition,thereisagreatdealofdiscussionamongpeopleabouthealthcarerelatedissues,muchgreaterthanIrememberseeingasachild.Healthcarehastakenaprominentroleinpopularculturewithnews,TVshows,andmovies.Americansarefascinatedwithhealthcare.

What will the impact of the pay reductions be on your organization?

Itisunclearwhattypeofpayreductionswillbetakingplaceaspartoftheoverallhealthcarereformwhichwilloccursometimewithinthenextfewyears.Ourhopeisthatthehealthcarereformwillbefocusedonqualityandoverallcostreduction.Webelieve,thatasanorganiza-tion,CRLprovidesagreatdealofquality,andagainwebelievethatwhenmedicalimagingisusedappropriatelyitactuallyreducestheoverallcostofhealthcare.Assuch,wefeelthatwecanminimizetheimpacttoourorganization.However,weareconcernedthatsomeoftheproposalsinfrontofCongressarereallynotrelatedtoincreasedqualityandoverallhealthcaresystemcostreduction,butaresimplyouttoreducereimbursementforcertaintypesofprocedures.Thiswouldactuallyhavetheoppositeoftheintendedimpactasitwouldreducethequalityofcareforpatientsandincreasetheoverallcostforthehealthcaresystem.Weareworkingwithvariousgovernmentalbodiestotryandmakesureoverallqualityofhealthcareistheoverridingconcerninanyhealthcarereformthatoccurs.

How do you deal with multiple EMRs in sending out the reports and images to the refer-ring doctors?

Wehavehadourinternalinformationsystemforthepastfouryearsandourinternalimagedistributionsystemforthreeyears.WearenowintheprocessoflinkingourinformationsystemsandourimagedistributionssystemstoothersystemsandEMRsthroughoutourimagingnetworkinordertoprovideeasyaccesstoreportsandimagestoreferringdoctorsandpatients. Duringthisprocess,wehaverealizedthatradiologyisthefieldofmedicalinformation.Itisafastchangingfield,andithasbecomeclearertousthatwemustbeexpertsindealingwithinformationbeingsenttomultipleelectronicmedicalrecordsaswellasmultipleimag-ingsystems.Assuch,wedohaveaninformationtechnologystaffofeight,ledbyaChiefTechnologyOfficerwhoisalsoaphysician.Wealsohaveanon-physicianChiefOperationsOfficer.Wefeelthatthesestructuralmoveswillhelpusgettheinformationtoourpatientsandcustomersefficientlyinashortperiodoftime.

What message about health and wellness do you most wish to communicate to your patients?

Asphysicians,wearepartnersinourpatient’shealthcare.Intheend,thepatientistheonewhohasthemostcontrolovertheirhealthandwellness.Thelifestylechoiceswemakesuchaswhatweeat,howweexercise,whetherornotwesmoke,dramaticallyaffectourabilitytostayhealthy.IwishIcouldcommunicatethisbettertopatients.

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Muchhashappenedinthepastfewmonthsrelatedtomenulabeling,locallyandonthena-tionalstage.HealthyMenusMinneapolishadaverysuccessfulsummerrecruitingsupportersalloverMinneapoliswhowantalocalordinancerequiringMinneapolisfastfoodestablishmentstolistcaloriesontheirmenus,menuboardsanddrive-thruareas.JenniferAnderson,withthehelpofacoregroupofvolunteers,attend-edseveraldifferentcommunityhealtheventseducatingpeopleontheimportanceofmenulabelinginMinneapolisandhowtheycanhelpbringanordinancetoMinneapolis. Nationally,thereisamenulabelingbillinboththeHouseandSenateaspartofhealthcarereformlegislation.TheSenatehaspassedtheirbillandnowtheHousewilltakeupdelibera-tions.HealthyMenusMinneapolissupportsacomprehensivenationalmenulabelingbillthatwillhelpconsumersmakehealthyinformedchoicesatthepointofpurchase. For more information about HealthyMenusMinneapolis,pleasecontactJenniferAnderson,projectcoordinator,at(612)[email protected].

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ActiveCarl B. Burkland, M.D.NorthClinic,P.A.Internal Medicine/Pediatrics/Hospitalist

Diana G. Crintea-Stoian, M.D.FairviewRidgesClinicInternal Medicine

Stefan DeBoel, M.D.NorthMemorialHeartandVascularInstituteCardiology

Laura A. Diamandopoulos, M.D.MinnesotaHeartClinicInternal Medicine

Cory R. Ecklund, M.D.RiverwoodHealthcareCenterFamily Medicine

Nazih N. Farah, M.D.ConsultingRadiologists,Ltd.Diagnostic Radiology

Simon N. Fenton, M.D.AllinaMedicalClinicWestSt.PaulFamily Medicine

Ronald W. Glinski, M.D.MetroUrology,P.A.Urology

Kimberly J. Haycraft-Williams, M.D.Fairview–AndoverClinicFamily Medicine

Tara L. Kelly, M.D.FamilyHealthServicesMNFamily Medicine

Matthew K. Kissner, M.D.SpecialistsinGeneralSurgery,Ltd.General Surgery

Julie O. Laidig, M.D.NoaddressspecifiedPediatrics

Andrew J. Larson, D.O.TwinCitiesDermatopathologyDermatology

Denise H. Long, M.D.FamilyHealthServicesMNFamily Medicine

Sumner T. McAllister, M.D.AppleValleyMedicalClinic,Ltd.Family Medicine

Dana L. Metzger, D.O.FairviewHighlandParkClinicUrgent Care

Robert A. Mittra, M.D.VitreoRetinalSurgery,P.A.Ophthalmology

Kirana Narayana, MBBSHealthEastCancerCenterPulmonary Critical Care Medicine

William R. Phipps, M.D.ReproductiveMedicineInfertilityAssoc.Obstetrics/Gynecology

Lawrence G. Richmond, M.D.ParkNicolletClinic-PlymouthFamily Medicine

Kayvon S. Riggi, M.D.OrthopedicMedicine&Surgery,Ltd.Orthopaedic Surgery/Sports Medicine

Alison C. Rudy, M.D.Anesthesiology,P.A.Anesthesiology

Steven C. Skildum, M.D.FamilyHealthServicesMNFamily Medicine

Neil A. Stein, M.D.MetroUrology,P.A.Urology/Urological Surgery

Richard D. Taylor, M.D.NorthMemorialHeartandVascularInstituteInternal Medicine/Cardiology/Cardiac Electrophysiology (IM)

Alden R. Tetlie, M.D.FamilyHealthServicesMNFamily Medicine

Mary K. Tuohy, M.D.FamilyHealthServicesMNFamily Medicine

Brandy L. Utter, M.D.AllinaMedicalClinicShoreview

Ranji Varghese, M.D.RespiratoryConsultantsPulmonary

Sarah M. Vernon, M.D.ParkNicolletHeart&VascularCenterInternal Medicine/Cardiovascular Diseases

Hoo yin Wong, M.D.MetroUrology,P.A.Urology/Urological Surgery

Resident PhysiciansUniversityofMinnesotaMahsa Abdollahi, M.D.Kamaldeen T. Aderibigbe, M.D.Shaheen R. Alanee, M.D.Nino Alapishvili, D.O.Osamah T. Aldoss, MBBSTamas Alexy, MBBSOsama A. Alsaied, MBBSAlain Alvarez, M.D.Brandon J. Anderson, M.D.Bhavana C. Anand, MBBSGanesh Asaithambi, M.D.Ned A. Austin, M.D.Mohan P. Ayyaswamy, MBBSNathan C. Bahr, M.D.Brett Baloun, M.D.Maisha N. Barnes, M.D.Todd A. Barrett, M.D.Mark G. Bartlett, M.D.Mrunmayee Barve, MBBSMegan Baxter, M.D.Heather A. Bechtel, M.D.Julie M. Bennett, M.D.Sonja M. Bjerk, MBBSStephen J. Bloechi, M.D.Juan Jose Blondet-Teixeria, M.D.Thomas J. Bollinger, M.D.Kristina J. Braun, M.D.Adam C. Breunig, M.D.Philip A. Brooks, M.D.Lori D. Bryant, M.D.Michael Q. Bui, M.D.Marco A. Caccamo, M.D.Jori S. Carter, M.D.Kelly J. Casserly, D.O.Phillip L. Chaffin, M.D.Sara M. Champlin, M.D.Katherine Chang, M.D.yeilim Cho, MBBSEun Ju Choi, M.D.Melissa T. Choi, M.D.Toby Christie-Perkins, M.D.Peter K. Chweyah, MBBSJessica M. Cici, M.D.Efkan M. Colpan, M.D.Keith Craig, M.D.Laura E. Cudzilo, M.D.Donna L. D’Souza, MBBS

Jeffrey R. Dahlen, M.D.Peter K. Dahlstrom, M.D.Daniel A. Danczyk, M.D.Stephen F. Darrow, M.D.Anna M. DePompolo, M.D.Lindsey L. Deuster, M.D.Elizabeth L. Dickson, M.D.Li Ding, MBBSMankpondehou E. Djevi, MBBSPatrick T. Dornack, MBBSGeorge Dreszer, M.D.Byron Eddy, M.D.Zainab Elsarawy, M.D.Nicolai A. Esala, D.O.Anna G. Euser, M.D.Abeer B. Farrag, M.D.Gwenyth A. Fischer, M.D.Maren E. Flynn, M.D.Carolyn J. Foley, M.D.Nicholas R. Fossland, M.D.Claudia K. Fox, M.D.Mary L. Fredrickson, M.D.DeAnna J. Friedman, M.D.Daniel W. Giles, M.D.Noah I. Goldfarb, M.D.Sarah W. Grahn, M.D.Gurjeet S. Grover, MBBSJack D. Hagan, M.D.Kathy I. Hakanson, M.D.Kelly M. Halderman, M.D.Brian J. Hanson, M.D.Tasma Harindhanavudhi, MBBSAmeer E. Hassan, M.D.Luke T. Hawes, M.D.Clint R. Hawthorne, M.D.John P. Heimerl, M.D.Kathleen A. Hecksel, M.D.Elizabeth R. Hofbauer, M.D.Def-Chen T. Huang, M.D.Sarah L. Hutto, M.D.Kimberly A. Indovina, M.D.Jennifer L. Irani, M.D.Jennifer K. Ische, D.O.Jennifer F. Iverson, M.D.Katherine M. Jacobs, D.O.Mollie M. James, M.D.Christina J. Jarosch, M.D.Malinda M. Jorgensen, M.D.Ingrid B. Kaijage, MBBSHeidi J. Kamrath, M.D.Muneera R. Kapadia, M.D.Alesia Kaplan, M.D.Elissaios K. Karageorgiou, M.D.Nicole A. Karras, M.D.Kapilmeet Kaur, MBBSLouis J. Kazaglis, M.D.Ryan Kelly, M.D.Joseph R. Kelly, M.D.Christopher B. Komanapalli, M.D.yoel Korenfeld Kaplan, M.D.

New Members



Jennifer A. Krueger, M.D.yogesh Kumar, MBBSNghia H. La, M.D.Health L. Labere, MBBSChalton C. Lacema, MBBSAngela J. Lamb, M.D.Molly M. Lammie, D.O.Thai Lee, D.O.Robert B. Levy, M.D.Ming Li, MBBSMelanie R. Lind Ayres, M.D.Jennifer A. Longo, M.D.Jon W. Loo, M.D.Marc A. Lubin, M.D.Nathan E. Lueck, M.D.Jeffrey T. Luna, MBBSMary B. Mackenzie, M.D.Jennifer E. Maki, M.D.Bryana K. Malner, D.O.Catherine G. Manabat, M.D.John W. Mathewson, M.D.Kristine G. Matson, M.D.Kathleen G. May, D.O.Annie L. Meares, M.D.Abbey L. Mello, M.D.Michael D. Miedema, M.D.Christa Miller, M.D.Wes Miller, M.D.Tasadug H. Mir, MBBSMohi Mitiek, M.D.Amir A. Moheet, MBBSBrian P. Moran, M.D.Sabeen Munib, M.D.Preetika Muthukrishnan, MBBSWesley K. Nahm, M.D.Daisy C. Nieto, M.D.Oluwakemi T. Olowoyo, MBBSJames C. Olson, D.O.Andrew P. Olson, M.D.Elizabeth C. Olson, M.D.Megan T. Otis, D.O.Julie R. Overboe, D.O.James A. Owusu, M.D.Manju Pandey, M.D.James W. Pate, M.D.Sapna Patel, MBBSSwaroop Pawar, MBBSEdwin C. Pereira, M.D.Erik J. Peterson, M.D.Gregory D. Poduska, M.D.Pamela R. Portschy, M.D.Vitaliy y. Poylin, M.D.Alexa A. Pragman, M.D.Jonathan T. Pribila, M.D., Ph.D.Jerrod D. Quarles, M.D.Lipi M. Ramchandani, MBBSPablo A. Ramirez, MBBSMary Elizabeth T. Rashid, M.D.Jason T. Rasmussen, M.D.

Ronald Reiter, MBBSJason A. Ricco, M.D.Dominic Rossini, D.O.Javad A. Sajan, M.D.Tiare E. Salassa, M.D.Shaden Sarafzadeh, M.D.Basar Sarikaya, MBBSEmily M. Schaaf, MBChB, M.D.Amy B. Schminke, M.D.Ian W. Schwartz, M.D.John E. Selickman, M.D.Ellen M. Selkie, M.D.Miriam C. Shapiro, M.D.Amit K. Sharma, MBBSJason R. Sheffler, D.O.Matthew A. Sherrill, MBChB, M.D.Daniel Shibru, M.D.Prashant Shrestha, M.D.Jasvir Singh, M.D.Charanjeet Singh, MBBSMarek J. Siorek, M.D.Israel O. Sokeye, MBBSHarveen K. Soodan, MBBSDimitrios G. Stalikas, MBBSMark D. Stephany, D.O.Daniel J. Stephens, M.D.Thanasak Sueblinvong, MBBSRiaz Tadia, MBBSRuby W. Tam, D.O.Elisa M. Tanaka, D.O.Heather A. Taylor, M.D.Savita S. Thorat, MBBSDinesh Thawrani, M.D.Sarah A. Traxler, M.D.Katharine D. Tumilty, M.D.Anita Udayamurthy, M.D.Chinwe Umez, M.D.Anjali S. Vaidya, MBBSCiro A. Vasquez, M.D.Silvia M. Vilarinho, MBBSJeffrey M. Vinocur, M.D.Madhuri Vuppalanchi, M.D.Hengbing Wang, MBBSJohn F. Wechter, M.D.Laura M. Wellington, M.D.Karen L. Williams, M.D.Shelly M. Williams, MBBSJon D. Wilson, M.D.Alison C. Wing, M.D.Kosuke yasukawa, MBBSMegan M. Zaander, M.D.Rebecca J. Zadroga, MBBSZhuo-yi Zhang, M.D.

Medical Student(University of Minnesota)Christopher L. Thompson

In MemoriamHOWARD B. BURCHELL, M.D.,diedrecentlyattheageof101.HegraduatedfromtheUniversityofTorontoFacultyofMedicine.HewasaretiredMayoClinicandUniversityofMinnesotaphysicianandcardiologist.

WILLIAM R. GLENNy, M.D.,aretiredpathologistinSaintPaulforcloseto40years,diedonJanuary1,2009,attheageof82.Dr.GlennygraduatedinSequim,Washington,intheclassof1952.

GEORGE OTTO HILGERMANN, M.D.diedrecentlyattheageof84.HegraduatedfromtheMarquetteMedicalSchool,nowtheMedicalSchoolofWisconsinin1948.HeinternedattheCharlesMillerHospitalinSt.Paul,andcompletedhisresidencyinophthalmologyattheUniversityofMinnesotaandMinneapolisVAHospital.From1949-1951hewasinactivedutyintheUSNR.Dr.HilgermannwasanassociateprofessorofophthalmologyattheUniversityofMinnesota.

MILTON M. HURWITZ, M.D.diedinOctoberatage91.HegraduatedfromtheUniversityofMinnesotaMedicalSchoolin1940andworkedattheCharlesT.MillerHospitalinSt.Paul.HehadaprivatepracticeinSt.Paulfrom1945to1990,butremainedveryinvolvedwithMillerHospitalas itmergedwithSt.Luke’sHospitalandlaterbecameUnitedHospital.TheMiltonM.HurwitzExerCareFitnessCenteratUnitedHospital,wasnamedafterDr.Hurwitztohonorhisyearsofservice.

LOWELL D. LUTTER, M.D.,“Hap,”hadafouryearbattlewithcancerbeforehediedonOctober4at70years.HewasanorthopedicsurgeonwhograduatedfromthePritzkerSchoolofMedicine,UniversityofChicagoin1965.

HERSCHEL LEON PERLMAN, M.D.,95,diedonNovember19,2009.HegraduatedfromtheUniversityofMinnesotaMedicalSchoolin1941.HeservedintheArmyintheSouthPacificduringWWII.DischargedasaMajorhewentontodopostgraduatetraininginob-gynandinternalmedicinebeforesettlinginMinneapoliswhereheworkedformanyyearsasageneralpractitioner.InitiallyinsolopracticehewentontoworkatSt.LouisParkMedicalCenter.Dr.Perlmanbecameanassociateclinicalprofessorinfam-ilypracticeandservedaschiefofstaffatMethodistHospital.Heretiredin1979andmovedtoSunCity,AZ.

JULIEN VICTOR PETIT, M.D.,passedawayonNovember8,2009.Hewas93.HegraduatedfromtheUniversityofMinnesotaMedicalSchool.HewasanArmyCaptainduringWWII,servinginFrancefrom1942-1945.Dr.Petitwasaprivatepracticephysicianfor41years,servingFairviewHos-pitals.HewaschiefofstaffatFairviewRiverside.Hewasanavidtraveler,andastudentofCivilWarhistoryandMinnesotahistory,belongingtotheCivilWarRoundTable,theMinnesotaHistoricalSocietyGrantBoard&FriendsofGrandPortage.

VERNON L. SOMMERDORF, M.D.,age88,diedonOctober19.HegraduatedfromtheUniversityofMinnesotaMedicalSchoolin1952andpracticedinSt.Paulformorethan50yearsatPayneAvenueMedicalAs-sociates,MinnHealthClinicinAfton,andfinally,attheUofMGeriatricClinicattheSt.PaulWilderfacility.HewasaformerpresidentoftheRamseyCountyMedicalSociety,theRamseyCountyAcademyofGeneralPractice,theMinnesotaAcademyofMedicine,andaformerchiefofstaffatMoundsParkHospital.HereceivedtheRamseyMedicalSociety’s2005CommunityServiceAwardinrecognitionofhissignificantworkhostingfosterchildren,volunteerworkatSt.Mary’sHealthClinics,volunteerworkwiththeConway-BattleCreekLivingatHome/BlockNurseProgram,andserviceatFirstBaptistChurchinSt.Paul.Dr.SommerdorfalsoservedintheMinnesotaHouseofRepresentativesfrom1964to1972.

New Members



eMMs President’s Message

Final Thoughts

RONNELL A. hANSEN, M.d.

IN 2009, EVOLVING PUBLIC POLICyhasproposedpotentiallytumul-tuouschangestothepracticeofmedicine,perhapsdrivingastaketothecoreofindependentphysicianpracticeandtheautonomyofthepatient/physicianrelationship.WhileintegrationofEMMS/WMMSintoTCMSin2010willideallyservetobenefitourmetro-widemembersbyvirtueoffinancialstabilityandnumericforceofvoice,itisuptoeachofusnow

practicingtowellunderstandthethreatwhichpoliticallyexpedientandsociallypopularstateandnationallegislation,intheguiseof“healthreform,”posestobothourpracticesandourpatients. WhilelargeorganizationssuchastheAMAclaimtospeakonourcollectivebehalf(perhaps17percentofphysiciansbelongtotheAMA),itisuptousdeliveringthecaretodecideiftheclaimofrepresentationisaccurate,andthebargainingpositiontoutedintradeistrulyfeasible,realistic,orevendesirable.Wemustunderstand,currentproposalsostensiblyseektostructurepaymentstophysiciansbaseduponoutcomes,butfailtoappropriatelyrecognizethatindividualpatientoutcomesdonotequatetothemetricsofpopulationstatistics. NationallyproposedAccountableCareOrganizationswilleffectivelytransfertheunwantedroleofrationingpatientservicesontous,financiallyatriskphysicians.Legislatorsperpetuatepopularentitlement“free”or“lowcost”caretotheirconstituents,side-steppingtoughpolicytruecostdriversincludinguncheckedpatientdemandforserviceswhichappear“cheap”duetotaxsubsidies.Theresultisanapparentlowcosttopatientswithlittlemechanismaddressingpersonalresponsibilityinlifestylechoices,andunnecessary/duplicativecostsinmedicineassociatedwithlackoftortreforminmedicalliability.Suchcostdriverswillalmostcertainlybecomplicatedbynewcongressionalattemptsto“rationcaresupply,”whenaprimaryeconomicbasisoftheproblemis,inactuality,taxsubsidizedconsumerdemand. Idonotdenyorminimizethatthoseofusprovidingcaremustimproveouroverallqualityuniformityanduseexpensivehightechnologymethodsmoreappropriatelytomoderatecosts.Aftercountlesshoursinstudyofeconomics,however,itremainsuncleartome(aswellasmanyrespectedeconomists)howthecurrentreformpackagewilleithermeetcalculatedbudgetestimates(readas“fakeaccounting”)orwillactuallyaddressanytruecostdrivers.Whatitdoesappeartodoiswidentheentitlementpopulationandimposealmostassuredsignificantreductioninreimbursementforserviceswewillprovide(ifwesochoose)tothosecovered.Medicareisagoodhistorylesson—arewedoomedtorepeatit? Simplemathsuggeststhe30millionnewinsuredwillbeachievedatthecostofnearly$700Kperpersonifoneassumesa$2Toutlayover10years.Therearemanyoptionsmorefiscallyre-sponsible,andprofessionallyfair—whichalsoempower,self-moderate,andmotivatepatientsinuseoftheirownhealthcare.Timeisveryshort.Asindividualphysicians,wemustimmediatelytakeourwell-studiedconcernsdirectlytothearchitectsofpolicy,beforethegovernmentandcorporatepracticeofmedicinebecomesthenewAmericanstandardofcare.


Last MeetingTheEastMetroMedicalSociety (EMMS)FoundationmetonMonday,October19,2009, and reviewed the progress of thefoundation-ledadvancecareplanninginitia-tiveknownasHonoringChoicesMinnesota.Manylocalhospitals,healthplans,andclinicsaroundtheTwinCitiesareinvolved;formoreinformation,visithttp://www.metrodoctors.com/choices.cfm.

Board AppointmentsDr.KentWilson,retiredotolaryngologistfromMidwestEarNoseandThroat,wasre-electedaspresidentoftheEMMSFoundationBoardofDirectorsforasecondtwo-yearterm.Dr.MarkDestache,ofAssociatedAnesthesiolo-gists,wasalsore-electedforasecondtwo-yearterm.Dr.CharleneMcEvoy,apulmonologistatHealthPartners,waselectedasanat-largememberforatwo-yeartermendingin2011.

Update from the EMMS Foundation Board of Directors

TheFoundationBoardis lookingforcandi-datestoserveontheBoardofDirectorsasat-largedirectors.

EMMS Foundation Awards GiftsTheEMMSFoundationhasagiftingpolicythatwasadoptedin2006whichstatesthattheFoundationBoardmaygrantupto4percentofthethreeyearmarketaverageofitsfundtoorganizationsorprojectsthathaveaskedforfundingandwhomeetthecriteriaestablishedbytheBoard.Twoawardsweregrantedin2009,onewenttoHonoringChoicesMin-nesotaandtheothertoWestSideCommunityHealthServices.ThefundingtoHonoringChoicesMinnesotasupportedtheeducationalprogramsofferedinJulyandNovember.ThesecondawardwasgiventotheWestSideCom-munityHealthServicestohelpsupporttheiroperations.

Kent Wilson, M.D.

Charlene McEvoy, M.D.

Mark Destache, M.D.

Foundation Looking for Grant WriterTheHonoringChoicesMinnesotaprojecthasthedistinctpossibilityofbecomingaratherlargeinitiativewithfar-reachingimplications.Withthisinmind,theEMMSFoundationisbeginningtointerviewgrantwriterswhocanhelptoobtainfundingtosupportthisprojectforthelongterm.

Minnesota Epilepsy Group is the largest and most comprehensive epilepsy program in the Midwest. As a regional referral facility, we are the recognized leader in treating epilepsy and other seizure-related conditions in patients of all ages, from infants to the elderly. We also offer comprehensive neuropsychological assessment for a broad range of acquired or developmental neurological conditions in both adult and pediatric patients.

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

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

Functional Neuro-ImagingWenbo Zhang, MD, PhD

NeuropsychologistsElizabeth Adams, PhDRobert Doss, PsyDAnn Hempel, PhDDonna Minter, PhDGail Risse, PhD

Appointments(651) 241-5290225 Smith Avenue NSt. Paul, MN 55102

www.mnepilepsy.org


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EMMS Senior Physicians Association

TheEMMSSeniorPhysiciansAssociationmetinOctoberandheardRolandBirkebak,M.D.,aretiredorthopedicsurgeon,speakabouthisexperienceasavolunteermedicaldirectorinFiditi,Nigeria.Heservednotonlyasasurgeonandinternist,butalsoasanadministrator,en-gineer,architect,electrician,plumber,spiritualadvisorandmuchmore.Dr.BirkebakwenttoNigeriatoworkwiththeGoodSamaritanSo-cietyofAmerica(TGSSA),beginningin2002.Initially,amedicalclinicwasintendedfortheTGSSAbuilding,butwhentwoindividualsdiedafterbeingunabletopaybribesfortreat-mentatthegovernment-runhospital,plansweremadetobuildanewhospital. Dr.Birkebakalsoheldmedicalclinicsatvariousgovernmenthospitals intheareaandstartedapermanentmedicalclinicattheTGSSAvillagesitein2004.ANigeriandoc-torandpublichealthnursecurrentlystafftheclinicandvolunteerphysiciansfromtheU.S.andCanadahavebeeninvolvedonashort-termbasis.Oneofthegovernmenthealthof-ficialssaysthatthenewTGSSAhospitalwillbe“theMayoClinicofWestAfrica.”Tolearnmoreabouttheorganization,volunteeringordonating,pleasecontactDr.Birkebakat(651)429-3240orvisitwww.TGSSA.org.

Dr. Birkebak helped to ensure the hospital was built according to comprehensive, American standards.

Rollie Birkebak, M.D. recounts the chal-lenges of both medicine and construction in Nigeria.

The18thannualCaringHeartsforHomelessPeopledrivewillcollecthealthandhygienesuppliesandover-the-countermedicationsforhomelessadultsandchildrenintheeastmetroarea.Donateditemswillbesortedanddistributedtothehomelessthroughthefol-lowingprograms:HealthCarefortheHomeless,ListeningHouseofSt.Paul,andSafeZoneResourceCenter.Pleaseconsiderputtingoutacollectionboxatyourofficeandencourag-ingemployeestodonate.Manyclinicsandhospitalsareinvolvedinthisyearafteryear.

PleasecallKatieSnow,EastMetroMedicalSocietyFoundation,at(612)362-3704ore-mailheratKSnow@metrodoctors.comifyourorganizationwouldliketoparticipate.Youwillthenreceivepostersandlistsofsuggesteditemstodonate.ThedriverunsthroughthemonthofFebruaryandvolunteerswillpickuptheitemsatyourofficeinearlyMarch.

Sponsored by HealthEast Care System and East Metro Medical Society Foundation

Will Your Organization Share With Those Less Fortunate?

Supply Drive February 1-28, 2010


TheThomasW.andMaryKayHobanScholar-shipwasestablishedbytheWestMetroMedicalFoundationinhonorandrecognitionoftheextensiveandexemplarycareerofthe25-yearChiefExecutiveOfficerofthethenHennepinMedicalSociety,ThomasW.Hobanandhiswife,MaryKay,anutritionist.Sincethattime,over80scholarshipshavebeenawardedtostudentspursuinggraduateleveleducationinhealthcaremanagement/administrationaswellasnutrition.TheoriginalintentoftheHoban

WMMS Awards Hoban ScholarshipsScholarshipwastosunsetthisofferingafter10years.Now,15yearslater,thefinalcohortofscholarshasbeenselected:• Meredith (Meg) Bruening, Nutrition

(Ph.D.),UniversityofMinnesota• CarissaGlatt,PublicHealthNutrition,

SchoolofPublicHealth,UniversityofMinnesota

• PaulaHalverson,HealthCareMBA,Uni-versityofSt.Thomas

• LakminiH.Nanayakkara-Kidder,HealthCareMBA,UniversityofSt.Thomas

• DanaQuinn,MasterofHealthcareAd-ministration,MasterofBusinessAdmin-istration,UniversityofMinnesotaSchoolofPublicHealthandCarlsonSchoolofManagement

• ElizabethSauer,PublicHealthAdminis-tration&PolicyMastersProgram,Uni-versityofMinnesotaSchoolofPublicHealth

• CassandraSilveira,MastersinNutrition,UniversityofMinnesota

• JamieStolee,HealthCareMBA,Univer-sityofSt.Thomas

ThankyoutotheHobanScholarshipSelectionCommittee:PaulR.Hamann,M.D.,chair;PaulBowlin,M.D.;RichardFrey,M.D.;Bon-nieFrancisco,clinicadministrator;ThomasandMaryKayHoban;VirginiaLupo,M.D.;DarlaMorris-Preble,R.N,clinicadministratorandformerHobanScholar;WilliamR.Petersen,M.D.;RebeccaSanchez,formerHobanSchol-ar;MarvinSegal,M.D.;DougShaw,formerclinicadministrator;TimothySignorelli,clinicadministrator;andChristineTaddy-Bloom,formerHobanScholar.

2009 Hoban Scholars and representatives from the Selection Committee. Pictured from left, back row: Bonnie Francisco, Dana Quinn (scholar), Carissa Glatt (scholar), Tim Signorelli, Paula Halverson (scholar), William Petersen, M.D., Paul Hamann, M.D., chair. Front row: Richard Frey, M.D., Rebecca Sanchez, Cassandra Silveira (scholar), Lakmini Nanayakkara-Kidder (scholar), Elizabeth Sauer (scholar), Jamie Stolee (scholar). Scholar not pictured: Meredith Bruening.

RonnellHansen,M.D.,presidentoftheEastMetroMedicalSocietyandSueSchettle,chief

executiveofficeroftheEastMetroMedicalSociety,attendedthe2009InterimMeeting

oftheAmericanMedicalAssociationinHouston,Texas,November7-10. ThismeetingoftheAmericanMedi-calAssociationwaswellattendedandmany of the delegates and alternatedelegatesspokeatreferencecommitteesabouttheAMA’srecentsupportoftheU.S.Househealthreformbill.ManyofthespeakersquestionedtheAMAontheirsupportofthereformbill,yetothertestifierscommendedtheAMAfortak-ingaleadershiproleinthehealthcarere-formdebate.Theresultsofthetestimonyconcludedwitha14-partresolutionon

healthsystemreformthatrestates,strengthensandexpandsexistingAMApolicy.

OtherEMMSphysicianswhoattendedincludeBlantonBessinger,M.D.,KenCrabb,M.D.,DaveThorson,M.D.andLauraDean,M.D.

Ken Crabb, M.D., Blanton Bessinger, M.D., Ron Hansen, M.D. and Dave Thorson, M.D. enjoy time together in Houston, Texas.

Ron Hansen, M.D. and Sue Schettle attend a breakfast meeting at the AMA meeting.

EMMS Represented at AMA Interim Meeting


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CharlesL.Murray,M.D.waspresentedwiththeCharlesBollesBolles-RogersAwardattheParkNicolletFoundationCelebrationofLifeeventonSaturday,October3,2009. TheCharlesBollesBolles-RogersAwardwasestablishedin1951.Mr.Bolles-RogersservedontheSt.BarnabasHospitalBoardofTrusteesandwaspresidentofthatBoardformanyyears.OriginallycalledtheSt.BarnabasBowl,anengravedsterlingsilverRevereBowlisgiventoaphysicianinrecognitionofhis/herprofessionalcontributiontomedicineonthebasisofmedicalresearch,achievementorleadership.TheWestMetroMedicalSocietyservesastheguarantoroftheaward. EdwardEhlinger,M.D.,president,WestMetroMedicalSociety,presentedtheawardtoCharlesL.Murray,M.D.highlightingthefollowingaccomplishments.

The nomination for Dr. Murray described him as an outstanding clinician and oncologist, epitomiz-ing what a physician stands for. Although now retired, he spent his medical career dedicated and

Charles L. Murray, M.D. ReceivesCharles Bolles Bolles-Rogers Award

devoted to his patients, often making arrangements for home visits. He had a strong passion for teaching as evidenced by always working with medical students and residents. This commitment to education and his infl uence on many young physicians was acknowledged as he received the Distinguished Teacher of the Year award. He is known as a tremendous in-novator of care – always looking for new, better ways of enhanc-ing patient care. He was in-strumental in developing the tumor registry used throughout the state and region (The Up-per Midwest Oncology Registry Systems or “TUMORS”), pro-viding a resource for research opportunities and benefi tting patient care. The clinical research programs (CCOP) for many of the west metro areas as well as the Cancer Program

at Methodist Hospital were es-tablished through his vision and leadership. He was one of the most insightful people regarding computerized medical records. He is a leader in medicine, in-volved in many boards and has received many awards.

TheWest Metro Medi-calSocietyBoardofDirectorshasthehonorofselectingtheawardrecipientfromthenom-inationssubmittedbymedicalstaffsofthewestmetroareahospitals.

On behalf of the West Metro Medical Society and Park Nicol-let Methodist Hospital Medical Staff, Steven Duane, M.D. presents Charles Murray, M.D. with the Charles Bolles Bolles-Rogers Award.

Edward Ehlinger, M.D. WMMS president, introduces the CBBR Award recipient.

Photos by: George Byron Griffi ths

ATTENTION all Minnesota Physicians Residing in

Naples, Florida

8th Annual Minnesota Health Care Dinner Party

Monday, March 15, 2010Pelican Marsh Golf Club, Naples, Florida

Cocktails:6:00p.m.Dinner:7:00p.m.

Cost:$55.00perperson(estimated)Spouse/guestinvited

If you are planning to be in Naples at that time, please contact Thomas W. Hoban with your Naples address at

(239) 948-4492 or [email protected]


WMMS Board of Directors Celebrate the End of an Era

OH WHAT A NIGHT!TheWMMSboardofdirectorshelditsfinalmeetingonThursday,October22,2009markingtheendoftheWestMetroMedicalSocietyandthebeginningoftheTwinCitiesMedicalSociety.EdwardEh-linger,M.D.,presidentofWMMS,presidedoverthecelebrationofthetermofRichardD.Schmidt,M.D.,out-goingchairandtheboardmembersastheycompletetheirservicetothemedicalsociety.JackDavis,CEO,wasalsorecognizedasheretiresfromthispositionattheendoftheyear. Frank Rhame, M.D. was selected asthethirdrecipientoftheFirstAPhysicianAward,recognizinghispassionateworkonHIV/AIDS(seerelatedarticle).TheeveningconcludedwithanoutstandingpresentationbyScottHillstrom,Esq.,founderandchairman,TheHealthStoreFoundation,ontheworkofhischaritableorganizationoperatingafran-chisenetworkof85medicalclinicsserving

approximately50,000oftheworld’spoorestpeopleeachmonthinEastAfrica. Dr.EhlingeraddressedtheboardnotingthatinadditiontothependingmergerwiththeEastMetroMedicalSociety,2009hasseenourpublichealtheffortsfocusonalocalcalorielabelingpolicyandtransfatphase-outinMin-neapolisfoodestablishments.WMMShasalsojoinedEMMSinanexcitingnewinitiative,anadvancecareplanningprojectcalled“Honor-ingChoicesMinnesota,”modeledafterasuccessfulprograminLaCrosse,WI.And,themedicalsocietycontinuestobeastrongadvocatefortheprofessionthroughactiveadvocacyattheCapitolalongwiththeEMMS,MMA,theMin-nesotaGroupmanagementAssociationandtheMin-

nesota ProviderCoalition,andforourpatientswithaggressiveworkinthepublichealtharena. Edward Eh-linger,M.D.hasbeen selected as the first presidentoftheTwinCitiesMedicalSociety,beginningJanuary2010.IncomingboardmembersofTCMSfromthewestmetroinclude:EdwinBogonko,M.D.; Carl Burkland, M.D.; EricChristianson,M.D.;MelanieFear-ing,medicalstudentrepresentative;KennethKephart,M.D.;PaulKettler,M.D.;StephenMacLeod,BDS,MBChB;andChadRoline,residentrep-resentative.SueSchettle,CEOoftheEastMetroMedicalSociety,willserveasthefirstCEOoftheTwinCitiesMedicalSociety.

Thank you to board members completing their service:J.PaulCarlson,M.D.LaurieDrill-Mellum,M.D.BrianHenjum,M.D.J.RileyMcCarten,M.D.GregoryPflaster,M.D.KarinTansek,M.D.,WestMetroTrusteeTrishVaurio,WMMArepresentativeDavidWalcher,M.D.

Benjamin Whitten, M.D., MMA president and TCMS member, addressed the WMMS Board and guests.

Scott Hillstrom, Esq., founder and chairman, The HealthStore Foundation, discussed the work of his charitable organization serving East Africa.

Edward Ehlinger, M.D. presents the WMMS Chair's Award to Richard Schmidt, M.D.


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FrankS.Rhame,M.D.waspresentedwiththeFirst A PhysicianAwardbytheWest

MetroMedicalSocietyattheirannualBoardofDirectorsmeetingonOctober22,2009.

The“First A Physician”awardrecognizesamemberoftheWestMetroMedicalSocietywhoexemplifiestheprofessionofmedicine.Theworkofthis“unsunghero”hasresultedinanoutstandingcontributiontocommunityand/orthegovernanceandsuccessoftheWestMetroMedicalSociety.Communityservice,workonpublicpolicyissues,orothernote-worthyvolunteerservicecontributingtoim-provingthehealthofthepopulationdefinestheleadershipandcommitmenttomedicinebythisindividual.

Inpresentingthisaward,JackDavisstatedthat“Dr.Rhametrulyembodiesthehumani-tarianspiritoftheaward.Aninfectiousdiseasespecialist,Dr.RhamehasfocusedhiscareeronresearchingandcaringforpatientswithHIV/AIDS.InadditiontoworkingonHIVintheUnitedStates,heisalsoawell-traveledhumani-tarian.Inthepastsevenyears,Dr.RhamehasparticipatedinactivitiesoninfectioncontrolandAIDScareinRussia,Ukraine,KenyaandIndia,workingforsuchorganizationsastheAmericanInternationalHealthAlliance,Chil-dren’sHeartLink,MedicalAdvocatesforSocialJustice,NairobiHospitalandUniversalAidforChildren,Inc.”

Dr.RhameisanadjunctprofessorintheinfectiousdiseasesectionoftheUniversityofMinnesotaSchoolofMedicineandanadjunctassociateprofessorintheepidemiologydivisionoftheUniversityofMinnesotaSchoolofPublicHealth.HeiscurrentlytheresearchdirectorofClinic42,aprivateHIVoutpatientclinicatAbbottNorthwesternHospital,andisaprac-ticinginfectiousdiseasesspecialistwithTheDoctors,abranchoftheAllinaMedicalClinicinMinneapolis.HeisalsoamemberofthecorecurriculumfacultyfortheAmericanAcademyofHIVMedicine,andamedicaladvisorfortheMidwestAIDSTrainingandEducationCenter,wherehehasorganizededucationalprogramsonHIVforhealthcareprofessionalssince1992.

Frank S. Rhame, M.D. Receives First A Physician Award

Frank Rhame, M.D. receives 2009 First a Physician Award presented by Edward Ehlinger, M.D. (left) and Jack Davis (right).

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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 32.

Introducing the“Career

Opportunities”section of

MetroDoctors!

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100TheWMMSA100thAnnualMeetingcommitteeisplanninganafternoonbrunch,annualmeetingandprogramtohonorWestMetroMedicalSocietyAlliance(formerlyHennepinCountyMedicalAuxiliary)pastandpresentmembersfortheir100yearsofenduringvol-unteerismtopromoteahealthycommunity.

Please mark your calendars now so you don’t miss this special celebration!

SAVE THE DATE

WMMS Alliance 100th Annual Meeting & Celebration

Sunday May 16th, 2010Interlachen Country Club 1:30 - 4:00 p.m.

MANKATO CLINIC

The Mankato Clinic is physician owned with a service area population of over300,000. We offer outstanding benefits including generous CME allowance,health/disability/life and medical malpractice insurance, 401(k) plan and more.

Mankato has exceptional recreational and cultural activities, excellentprivate and public school systems and Minnesota State University, Mankato.

If you would like to join our growing practice, submit a detailed CV or callMark S. Matthias, M.D., Chief Medical Officer at 507-389-8756 or DennisDavito, Director of Provider Placement at 507.389.8654, Fax: 507.625.4353,Email: [email protected].

An AAAHC-accredited Clinic • www.mankato-clinic.com

The Mankato Clinic, is recruiting for the following BC/BE primarycare physicians to join our well-established practice in theregion’s leading multi-specialty group:

• Family Practice• Hospitalist• Internal Medicine• Pediatrics


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.

• Family Practitioner/OB• Family Practitioner – Med/Peds

Open Cities Health Center (OCHC) has an opening for the positions above. We would like tohave these position filled by January 2010. OCHC provides cost-effective, quality health careto patients from a wide range of socioeconomic backgrounds and ethnic groups. We havebeen in existence since 1967 providing culturally competent primary and preventive healthcare and related services to all people throughout the Twin Cities Metropolitan Area.

Candidates must have demonstrated ability in the provision of primary medical care within thebounds of the specialty; strong personal and professional communication skills; knowledge ofand desire to work within a public health/community medicine model of service delivery and;respect and concern for patients regardless of economic status, race, gender, ethnicbackground or disability.

Minimum qualifications: current Minnesota licensure; graduate from an accredited school ofmedicine; board certified or eligible and a; strong community health/public health orientation.Salary is negotiable depending upon experience and qualifications. Cover letters and CV maybe submitted via fax, e-mail or mailed to:

Lashell Barnes, Human Resources ManagerOpen Cities Health Center, Inc.

409 North Dunlap Street, St. Paul, MN 55104651-290-9211 / 651-290-9210 (fax)

[email protected]

Family Practitioner

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

shared positions.

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

Join a team of caring individuals, providing

quality healthcare to a culturally diverse patient population.

Southside Community Health Services is seeking Full-time/Part-time Family Practice Physicians to work in our family practice/community clinic locations in St. Croix. We provide a full range of medical services, including OB care, to the underserved community. Practice is clinic based only, with weekends and holidays off. Great benefits and salary with paid malpractice. Applicants may qualify for student loan repayment programs.

Please fax or email resumes to:Human Resources

Telephone: 612-821-2798Fax: 612-821-2818

Email: [email protected]

Southside Community Health Services

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Primary carecardiac arrhythmias: an interactive Update for Primary care april 2, 2010Learn the recognition, evaluation and treatment of common heart rhythm problems from experts in Cardiology and Cardiac Electrophysiology

allergy and clinical immunology april 9, 2010New clinical strategies for diagnosis and management of allergic conditions

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 Day may 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 OFFereDWorld Symposium (Lysosomal Disease Network) February 10 – 12, 2010 (Miami, FL)Manage and understand diagnostic options for patients with lysosomal storage diseases, and identify the latest findings in the natural history of these diseases

advanced 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

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• Dyslipidemia in Children • Congenital Adrenal Hyperplasia • Reducing Recurrent Preterm Birth

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

2010 sept/oct

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