South Dakota Governor's Newsletter August 2019

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Governor's Greetings

– Robert L. Allison, MD MACP

Greetings to the 432 members of the South Dakota Chapter of the ACP!

2019 has already been a busy year for your Governor and the Executive Committee. In March the Executive Committee met in Sioux Falls to develop a strategic plan for the chapter. Two days of hard work gave us great guidance in what our amazing chapter sees as a vision of the future. Advocacy, membership, chapter finances, and a focus on Early Career Physicians, Residents and Students rose to the top of our brainstorming sessions. These topics will shape my first year as Governor as we move to grow our chapter and make it even more ‘valuable’ to our members. We mobilized our membership committee to reach out to past members and were the best chapter in the country to retain our members through our campaign and were recognized nationally for our efforts.

April brought the Board of Governors meeting in Philadelphia, PA just a day prior to ACP IM 2019. If you haven't been to a national meeting in a while it's time to re-energize yourself. It's the perfect prescription for work-life balance problems and 20 years into my career I look back and wonder why I haven't attended more. Thanks to Matt and Darcie Bien for being there for me when a winter storm prevented my wife from flying in to see my Masters' ceremony, it truly was an amazing honor.

May brought Leadership Day, and we descended on Washington DC in full force. Led by Drs. Kelly Evans-Hullinger (HPPC Chair), Rob Allison (Governor), Nazia Qazi (Hepatologist), Prince Sethi (Resident), and Mr. John Fanta (Medical Student), we were able to get the message of the ACP to our national leadership. Every year we build stronger relationships and advocate for our patients and our physicians in practice and training. Please consider joining us next year in DC.

In June we turned back to our Executive Committee to finish the fiscal year-end work of the chapter. We changed our long-standing financial relationships with our bank to meet our new strategic goals and redefined our investment policy. Our Executive Director Kris Rahm was given the heroic challenge of coordinating our members to meet the ‘GOLD’ criteria for Chapter Excellence, a goal that has never been accomplished by a small chapter. With luck we will be reporting success in the near future.

As we prepare for the next 6 months and our annual state meeting in Deadwood October 2-4, 2019 with the Nebraska Chapter, I want to thank all the members who have helped so far. Realize that as a small chapter we can do great things with the help of each other.

Please reach out to me or Kris ( to give us your thoughts on how we are doing.

Also, please consider following us on social media (see below) to share with the other internists across the state what is important to you about “your” South Dakota ACP. We are proud to have you as members and I am proud to be your Governor.



Keep Your Finger on ACP's Pulse….




“The Best Meeting of the Year”

– Josh Henderson, DO FACP, Program Chair

The dog days of Summer can only mean one thing….Fall is just around the corner. After last winter, we are not trying to look past some of the much-anticipated warmer weather of the year, but the thought of Fall for internists in SD conjures up excitement for “the best meeting of the year” being just around the corner.

We take a lot of pride in our SD Chapter ACP meeting and for good reason. It consistently features outstanding speakers and presentations, not to mention collegiality that is second to none.

This year looks to continue the streak of great meetings in great locations. Our meeting has yet another special offering, a chance to join forces with our colleagues to the south as Nebraska's ACP chapter will be joining us at The Lodge in Deadwood in the beautiful Black Hills of SD.

This year's meeting includes the opportunity to hear presentations from National Regent Dr. George Abraham, on Fostering Excellence in Internal Medicine. Lectures that are sure to offer valuable insights on a variety of subjects including antibiotic stewardship, insomnia management, opioids in primary care, adult immunizations, and an endocrinologist's update on the latest in the ever-increasing options of diabetes medications.

The meeting will feature our very own Multiple Small Feedings of the Mind, which is always popular at national meetings. Finally, the chance to see your old friends and colleagues and the opportunity to see new faces and form new relationships is a fine way to top the many reasons to attend this year's meeting, Oct 2-4 at The Lodge in Deadwood, SD.

Josh Henderson, DO (





Health & Public Policy Update

– Kelly Evans-Hullinger, MD FACP, Chair of HPPC

Greetings Physicians!

I am glad to report we had another great trip to Washington DC with the South Dakota delegation. We had an excellent showing on Leadership Day in May, as I was joined by Governor Rob Allison, MACP, hepatologist Nazia Qazi, FACP, resident member Prince Sethi, and medical student John Fanta. We learned about the ACP's national advocacy efforts, met with staffs of our congressional delegation, and enjoyed fellowship with each other and physicians and trainees from around the country.

I was particularly inspired by ACP Senior VP in Governmental Affairs Bob Doherty's talk titled “Being in the Room Where it Happens.” Bob reminded us that advocacy is not something that happens in a single day on Capitol Hill but results from years of forming relationships and insisting on giving our input when the big decisions are being made. We have a unique opportunity in our state to be advocates, as our national, state, and local lawmakers are our also neighbors and patients.

As always, the ACP had a wide array of legislative topics for us to address in Washington which included:

  • The high cost of prescription drugs, a topic with large momentum and bipartisan support, and several active bills this year
  • Reducing unnecessary administrative tasks on physicians and patients, including some bills specifically targeting the prior authorization process with insurers
  • Medical education training and debt, including bills targeting the lifting of GME caps for primary care, deferring interest on student loans for residents, and GME funding reform
  • The epidemic of firearm-related injuries and deaths
  • Funding federal workforce, medical and health services research, public health initiatives
  • Physician payment under Medicare
  • Expanding coverage and stabilizing the insurance market
  • Healthy women and families

You can locate the ACP's many position papers here

I encourage you all to stay updated on the ACP's advocacy efforts and policy updates by joining the Advocates in Internal Medicine Network (AIMn). You can join the network and get periodic email updates here

I hope to see many of you at our Annual Scientific Meeting in October, where we will be joined and updated on advocacy by Bob Doherty. Take care until then!

Kelly Evans, MD, FACP (


Caption:  Drs. Robert Allison (Governor), Kelly Evans-Hullinger (Chair-HPPC), Nazia Qazi (Hepatologist), Prince Sethi (Resident) and John Fanta (USD SSOM Medical Student)




A Student's Perspective of Leadership Day

– John Fanta, MS

Earlier this month I was given the opportunity to attend Leadership Day May 14-15, a conference dedicated to advocating for Internal Medicine physicians and sub-specialists. I am a third-year medical student attending the Sanford School of Medicine, originally from Yankton and now back in Yankton for the start of my Pillar 2 Clerkship.

Entering the conference, I was intimidated by the thought of advocating for the expansive group that the ACP represents. During the first two years of medical school we learned an immense amount of medical knowledge, but healthcare policy was left out of these discussions. Thus, before this trip my only exposure to healthcare policy was limited to the bits and pieces I heard from the news. This trip dramatically changed my perspective on the importance of the ACP's representation in Washington, D.C. During this week, I was able to witness the hard work and commitment of ACP members who advocate for the issues in healthcare delivery that physician's face each day. It was incredible to see the hundreds of students, residents and physicians from every state joining forces with the unified message of improving healthcare quality and delivery.

Our SD delegation met with staffers from the offices of Senators Mike Rounds and John Thune, as well as Representative Dusty Johnson. The issues that we focused on addressing included increased funding for Graduate Medical Education, the high costs of prescription drugs, as well as decreasing administrative burden imposed on physicians.

As a medical student my input focused primarily on increasing funding for GME, an issue especially pertinent to our state due to physician shortages in rural areas. I was able to help advocate for two bills, the first focused on adding 15,000 new residency spots over the next five years and the other providing interest free loans for residents.

It was truly a privilege to be able to represent the students in our healthcare system and advocate for legislation that could make such a big impact. Thank you to the SDACP for making this trip possible and I look forward to continuing to be involved in the organization in the years to come.

John Fanta (



Yet Another ACP Benefit: Group Disability Insurance

– Cathy Leadabrand, MD FACP

I want to point out a little-known and probably under-utilized benefit of belonging to ACP–the opportunity to obtain group disability insurance.

Like many busy physicians, I was naïve and undereducated regarding financial issues. After a recent job switch, I realized to my horror that I had been without disability insurance for the last 3 years. I immediately sought a new policy (avoiding ladders and extreme sports while I did so)!

I had an excellent plan at a former job 20 years earlier, but now with age and some accompanying unpreventable (and, I'll admit it, preventable) health issues the best option my trusted financial advisor could find cost four times my old plan! Nonetheless, not wanting to play Russian Roulette, I signed up.

One day, dejected after writing yet another exorbitant premium check, I was sorting through my mail. Mindlessly, I started to toss the familiar ACP mailer on group disability that I'd received and discarded regularly for the last 20 years. This time, I caught myself and checked out the plan online. Long story short, after a few months I have now switched to the ACP Group Disability Plan, with almost identical coverage at a savings of $500/month ($6000/year!).

While surveying my colleagues, I was surprised at how many (especially the younger ones) don't carry a disability plan. I believe this is a mistake, for according to White Coat Investor: “Studies have shown that 10-20% of people will have a period of disability of some kind between the ages of 25 and 65. Those odds are simply too high not to insure against that type of financial catastrophe. If you do not currently have disability insurance, it is time to get serious about it and cover that risk.”

There are many excellent plans out there but for me, the ACP Group Disability Insurance Plan gave me the best bang for my buck with the following benefits:

  • “Own occupation” disability definition means you receive benefits when you cannot work in your specialty. You will not be forced to work in another occupation.
  • Monthly benefit levels up to $12,500.
  • Rates do not increase after age 60, a unique benefit!
  • Benefits do not reduce throughout life of the plan.
  • Qualify for coverage when working just 20 hours per week.
  • Coverage is not tied to your job; it can follow you through your career.
  • Benefits are typically tax free.

There is also an option to pursue disability insurance for one's spouse or children. One caveat is that the plan lapses should the insured not maintain continuous ACP membership. This requirement isn't an issue for me, as the savings on my premium and many other benefits of belonging to ACP more than cover my dues.

A few morals of this story:

  1. Don't forget disability insurance (and it may be wise to secure it earlier rather than waiting till you're a road-worn middle ager requiring higher premiums).
  2. Be your own financial advocate. While my financial advisor is amazing, it also pays to do one's own research. I found the White Coat Investor to provide especially valuable resources for education and assistance on disability insurance and other topics.
  3. Explore the ACP site for this and other benefit pearls: ACP Membership Benefits

Cathy Leadabrand (



USD Residency Program Tops National Scores


-Submitted by Russ Wilke, MD FACP

-Written by Peter Carrels

There are approximately 500 internal medicine residency programs in the United States, and residents at USD Sanford School of Medicine's internal medicine residency program earned the nation's top performance scores. Residency leaders credit a curriculum redesign for this impressive achievement.

In 2014, leadership of USD Sanford School of Medicine's internal medicine residency program embarked on an ambitious redesign of curriculum and all other aspects of the three-year program. “We completely overhauled the program,” said Dr. Joseph Fanciullo, director of the residency.

Fanciullo and others at the medical school wanted to create a residency that was more responsive to the needs of residents and would better serve patients, too. “We prioritized resident well-being, including having our residents work more reasonable hours, and we also greatly reduced the number of overnights they worked,” explained Fanciullo. “We wanted the residents to be more engaged with their patients during their clinical rotations by minimizing conflicts in their clinical schedules.” This new model, he added, also provided the opportunity to integrate or weave together the various components of internal medicine, and that strengthened resident preparation for practice.

The results of this curriculum restructuring, said Fanciullo, began to reveal themselves very quickly. “Within one year, our in-training examination scores began to climb,” he reported.

So-called in-training exams are annually administered to residents in nearly every residency program across the country, not just internal medicine residencies. The exam and its results –known as a program performance tool- allow the many different residency programs in many different specialties to understand resident knowledge as well as their own successes and shortcomings. It also enables each program to evaluate their standing when contrasted with similar subject programs.

By 2018, when resident in-training exam scores are most recently available, it had become clear that USD's revamped internal medicine residency curriculum and program appeared at least partially responsible for an astonishing fact: Scores in the in-training exam by USD's internal medicine residents topped those scores recorded by residents at all other internal medicine residency programs in the country. USD Sanford School of Medicine's internal medicine residents in their second and third years posted exam scores that were rated at the 100th percentile of all internal medicine residency program in the United States. It's worth noting that across the nation there are approximately 500 internal medicine residency programs, and that more than 7,000 residents are training in each of the three years of a residency at these different programs.

Those outstanding 2018 test scores at USD's internal medicine residency continued a sharply rising trajectory. In 2017 scores had already elevated the program to nationally significant stature. This important metric –the results of in-training exams- has also portended impressive certification exam success by residents. One hundred percent of those residents who have completed the program within the past three years and have taken the American Board of Internal Medicine certification examination have passed the exam.

Although the program's leadership expects exam scores to remain exemplary, many factors –some unrelated to the program- can impact results. “Sustaining this level of excellence,” Fanciullo acknowledged, “is a big challenge, but a good one.”

Fanciullo reported that he is hearing lots of positive feedback about the program's residents. “Other physicians are telling me how impressed they are with the quality of our residents,” he said. “It's also gratifying to see that many of our residents are being hired by health care facilities in South Dakota.”

USD's categorical internal medicine three-year residency program contains 24 residents, with eight residents training during each year.

Typically, close to 1,600 recently graduated students from medical schools located around the world apply to enter USD's internal medical residency program. “Through this highly competitive situation, we've been able to determine that the graduates of certain medical schools and certain types of applicants best fit our program,” said Fanciullo. “That helps us determine which applicants to select.”

The program relies on the help of both Avera and Sanford in Sioux Falls. “Both institutions,” explained Fanciullo, “have been highly supportive of the residency.” According to Fanciullo, the program's redesign involved the support, input and energy from all levels of the medical school. “The dean, the program's leadership, its faculty and the residents themselves participated in this effort.”

Fanciullo noted that the curriculum redesign not only increased exam scores, but it has compelled a deeper level of devotion by residents. “Our residents are pursuing excellence like never before,” said Fanciullo. “They are challenging themselves to become better physicians, and we are witnessing this high level of ambition throughout the residency program.”

SD ACP Calendar of Events

August 20 12:00 pm noon First Year Student Introduction Meeting on Benefits of ACP Vermillion, SD
September 26-28 ACP Board of Governors Meeting Tucson, AZ
October 2-4 SD ACP Scientific Meeting Deadwood, SD
April 21-22 ACP Board of Governors Meeting Los Angeles, CA
April 23-25 ACP IM2020 Meeting Los Angeles, CA



New Members

Max Dehaan
Brett Rozeboom
Kristine Zimmerman
Joyce Achenjang, MD
Mohammad Ahmed, MBBS
Elliot M Lawrence, MD
Prince Sethi, MBBS
Muhammad Arshad
Katherine E Kondratuk
Evan Lange
Touba Naim
Mansi Oberoi
Hilal Olgun Kucuk
Sharoon Samuel
Muhammad Waleed



New Fellows

Marioara Gavozdea Barna, MD FACP
Jennifer Hasvold, MD FACP
Josh B Henderson, DO FACP
Ayodele O Ogunremi, MD FACP
Govarthanan Rajendiran, MD FACP
Maria A Stys, MD FACP
Hamza Tantoush, MD FACP
Ranjith Wijeratne, MD FACP



Treatment of Opioid Use Disorder Course

Friday, October 18, 2019 – 8:00 AM – 5:00 PM MST

Registration: Contact or

More Information, click here.