Montana Governor's Newsletter June 2019

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Pam Hiebert, MD, FACP, ACP Governor

Pam Hiebert, MD, FACP, ACP Governor


Recent Events

Our Speed Dating Internists event was successful in spite of a raging cold blizzard. We had 18 doctors attend, representing most IM specialties along with 23 first year medical students. It is a great way to introduce the students to IM and for us to connect with our colleagues.


At the Osler Club Movie night for WWAMI students and physicians, we watched the movie Wit. Wit is a 2001 film with Emma Thompson playing an English professor diagnosed with Stage IV ovarian cancer. The film depicts her aggressive toxic chemotherapy and feeling more like a guinea pig than a human. The only person who seems to care for her as a person is one of the nurses. The rest of the staff show “terrible bedside manner” A good movie for all medical professional to watch to remind us of empathy.




HOSA Montana

I was asked to judge at the 2019 Montana HOSA State leadership conference. This is a high school interest group of future health professionals. The organization allows students an opportunity to explore health care careers while building relevant leadership and teamwork skills. They sponsor competitions, job shadows, leadership training and youth instruction. They are creating the next generation of Montana's healthcare workforce. The meeting was held at the GranTree Inn with hundreds of our best and brightest students competing. This is a great pipeline to get students interested in the medical field. Please check out your local HOSA chapter to see if you can volunteer.

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Big Sky Hospital Medicine Meeting

The Big Sky Hospitalist meeting was excellent, thanks to Jessica Hoge, MD, FACP and Michael Vlasses, MD, FACP, the program directors. The theme was Medical Complications, and the faculty gave outstanding presentations. Please consider going next year no matter what your specialty. I guarantee an excellent learning opportunity and fun.

Here are a few clinical pearls:

  • probiotics can cause lactic acidosis and “brain fogginess”
  • SIBO is the new fad, without good testing or treatment. Beware. 
  • patients in the hospital with OSA should have an identifying wrist band due to high morbidity and mortality from OSA.
  • STOPBANG is a great tool to identify patients
  • more post organ transplant patients in the state will need special precautions
  • watch for “quiet” or hypoactive delirium that occurs in about 75% of cases of delirium
  • resource for patients with chronic pain or chronic disease: Live Life Well Health care and benefits division. > benefits > Live Life Well. This is a free program sponsored by the state and available in every county.
  • Black Box finally removed on CCS/LABA inhalers for asthma

Skiing and Snowshoeing was fantastic!

Hope to see you in Great Falls Sept 12 to 14. You must check out the Lewis and Clark Center and the Charlie Russell Museum.



2019 Internal Medicine Meeting

IM 2019 in Philadelphia was a great opportunity for learning and socializing with colleagues. Four new fellows marched at convocation. We had a great representation of members from Montana. If you were not able to attend the conference, the Curbsiders podcast has a great summary highlighting updates and clinical pearls.


Congratulations to the new Fellows that participated in convocation in Philadelphia!

Jessica Hoge, MD, FACP, Sarah Donahue, MBChB, FACP, Pam Hiebert, MD, FACP (MT Chapter Governor), Kimberly Borke, MD, FACP, Tory Katz Kelly, MD, FACP


Adam Rodman with his beautiful wife and 11 month baby. Adam hosts the Podcast “Bedside Rounds”. Please listen to his excellent podcast about history and medicine.


The Waxman skills center is a great way to brush up or learn new procedures. Please consider training for POCUS next year in Los Angeles.

Congratulations to Kim Ng, MBBCH, for representing the Montana Chapter at the IM Abstract Competition!




Leadership Day 2019

Annie Bukacek, MD, FACP, Kelsie Delanie and I went to Washington DC to advocate for ACP priorities to members of congress. Here is a summary of issues discussed.

  1. The high cost of prescription drugs. Approval of more generic drugs, pricing transparency and more competition.
  2. The Epidemic of Firearms-Related Injury and Death. Funding research act, protection for violence against women act, and bipartisan background check act.
  3. Fund Federal Workforce, Medical and Health Services Research, Public Health Initiatives. Primary Care Training Enhancement, National Health Service Corps, CDC, NIH and VHA.
  4. Physician Payment under Medicare. Reduce burdens on Physicians
  5. Expand Coverage and Stabilize the Insurance Market.
  6. Reduce Unnecessary Administrative Tasks on Physicians and Patients
  7. Healthy Women and families.
  8. Medical Education and Debt. Increase residency slots, Support funding for GME, defer interest on student loans during residency training.

Click here for more information.




Please mark your calendar!


Montana Chapter Scientific Meeting
September 12-14
Benefis East Campus, Great Falls

This year's meeting “Emergencies in Internal Medicine” is being planned by Brad Bergman, MD, FACP, Emma Sargsyan, MD, FACP and Gulara Hajiyeva, MD, FACP.

Below are just a few of the highlights:

  • Dermatologic Emergencies
  • Opioid Abuse Panel
  • Medical Jeopardy
  • Rheumatologic Emergencies
  • Medical Emergency Updates
  • Utilization of Radiation Therapy

Meeting registration will be available soon! Watch for our meeting brochure in your mail, via e-mail and on our Chapter website!



Chapter Awards

Do you have a mentor, colleague, or peer deserving recognition?

The Montana Chapter Awards Committee would appreciate your assistance in recognizing our chapter members that have made outstanding contributions in the practice of medicine, teaching, research, public service, leadership, and medical volunteerism.

The recipients will be honored during the Montana Chapter Scientific Meeting, which will be held September 12-14, 2019 at Benefis East Campus.

Please review the list of Montana Chapter awards and submit your nomination to Carrie at



Montana Chapter Wins 2019 John Tooker Evergreen Award


The John Tooker Evergreen Awards Program provides recognition and visibility to chapters that have successfully implemented programs to increase membership, improve communication, increase member involvement, enhance diversity, foster careers in internal medicine and improve management of the chapter. The Montana Chapter received a 2019 John Tooker Evergreen Award for their initiative, Medical Student Outreach Programs.



Montana Chapter Receives 2018 Chapter Excellence Award

The award recognizes chapters which successfully meet the standards for managing a chapter. In order to achieve the Chapter Excellence Award, chapters must meet all basic criteria and ten optional criteria. Criteria include such activities as formulating an effective Governor's Council and committees, communicating frequently with membership, providing educational opportunities, recruiting and advancing members and celebrating membership through local awards.



Meet Your New Governor-elect

Congratulations to the Montana Chapter Governor-elect, Steven J. Gerstner, MD, FACP. Our new Governor-elect (GE) will complete a year of training as a Governor-elect and then will start his four-year term as Governor in the spring of 2020. As Governor, Dr. Gerstner will serve as the official representative of the College for the Montana Chapter, providing a link between members at the local level and leadership at the national level. In the meantime, Dr. Gerstner will be working closely with Dr. Hiebert (the current governor) and College staff to learn about the College and his duties as Governor. To learn more about the new GE, read his bio below.


Our governor Pam Hiebert asked me to write a note of introduction and here it is! I am a Wyoming native growing up on a small ranch in the rural Ten Sleep area. My wife and I will have been married 36 years this July and have a son, Colin who is an attorney in Billings and a daughter Elizabeth who is a hospitalist PA at Billings Clinic. They both are married and Colin and his wife have four children. My wife Doris is very involved in volunteer work, is a treasurer for two churches, and looks after grandkids when needed. How awesome to have all our kids and grandkids close to us! I enjoy fly-fishing, am building a second drift boat, and of course hanging out with family.

I obtained my BS degree at the University of Wyoming, attended medical school at UCLA and completed my residency at the University of Washington in 1989. I have been a general internists at Billings Clinic ever since and have (rapidly!) become an old guy in our department. I have been involved in teaching WWAMI 3rd clerk clerks from the beginning and have coordinated or co-coordinated the Billings rotation ever since Ron Smith, who started the clerkship in Billings, retired in 2002. I have served on the WWAMI Admissions Committee for the past five years.

In 2013 Billings Clinic launched our internal medicine residency with our first group and I have served as an associate program director from the beginning. I spend approximately half my time precepting in both the outpatient and inpatient settings and it has been exciting to see how our program has developed. We now have 24 categorical residents plus 4 residents doing preliminary years as interns before going on to their specialty residencies. Our mission is to supply internists for the region and as of this fall will have graduates with in Lewistown, Sheridan Wyoming, and six with us at Billings Clinic. Between residents, WWAMI students, and fantastic colleagues I am completely immersed in a learning environment and in addition to my own practice truly have the best job ever!

I am now embarking on a new challenge as your governor-elect, especially in trying to fill Pam Hiebert's shoes. I saw at the Board of Governor's meeting in Philadelphia this spring just how active she has been on our behalf and how respected she is. I also witnessed how strong an administrator we have in Carrie Reisig. The two of them have been most welcoming and helpful to me already and I look forward to learning from them over this year how I can best serve as your governor.

So, wish me luck in my educational process this year! I am very proud to be a member of our Montana ACP chapter and to be a colleague of all of you!

Steve Gerstner MD FACP




MMA Update

James Loeffelholz, MD, CPE, FACP, FAAPL represents the Montana Chapter on the MMA board and provided the attached MMA 2019 legislative summary.