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South Dakota Governor's Newsletter August 2018

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From Your Governor

Matt Bien, MD, FACP, FAAP, ACP Governor

– Matt N. Bien, MD FACP FAAP

Dear ACP Colleagues:

Greetings to each of you! I hope that this newsletter finds you enjoying your medical practice as well as time with family and friends this summer. As you will read, your chapter has been busy – throughout the state and across the nation – promoting internal medicine and its subspecialties and advancing the mission of the ACP. I will share a few highlights but please take time to read all of the sections below.

In April, the Board of Governors met in New Orleans to debate a record number of resolutions. It's refreshing to see that grassroots efforts started at the local chapter level can truly influence national policy through this process. Know that South Dakota's voice is heard at the BOG.

The membership committee has a new Chair, Fatima Kidwai, from Aberdeen. This committee has embarked on a drive to contact potential members from across the state. Through such efforts, our membership remains strong, even leading the nation in many categories. Thanks to each of you who reach out to colleagues and share with them all that membership has to offer. To our new members, welcome! Please be in touch if you have an interest in serving on one of the many committees or otherwise getting involved in the chapter.

I would also like to welcome our new Chair of the Health and Public Policy Committee, Kelly Evans, from Brookings. She led our South Dakota contingent at Leadership Day in Washington, DC, this May. Please review her HPPC report for all of the advocacy details from that week.

At last spring's council meeting, Ashok Kumar of Rapid City completed his term as Vice-President. I would like to extend a very special thank you to Ashok for his years of service and for his ongoing support of chapter activities.

In closing, I invite each of you to attend the annual SD ACP scientific meeting in Deadwood this September. Great speakers, interesting topics, and the beauty of the Black Hills should make for wonderful event. As always, please contact me with any suggestions, questions, concerns, or simply good news to share about our chapter and profession.



“The Best Meeting of the Year”

– Kris Rahm, Executive Director

Now that we are only about 30 days out from our annual scientific meeting, I want to share with you why I believe our members tell me time and time again, that our chapter meeting is “the Best Meeting of the Year”.

After hosting many out-of-state guest speakers, I often hear comments from them like….”Our chapter meeting doesn't seem to have the same collegiality as the SD meeting”. One Regent specifically told me he felt there was a “sense of family” that he didn't feel at his own chapter meeting. Truly, SD members seem to have a connection that is missing in other chapters. Where else can you get excellent CME/MOC, while interacting with people who are truly in the same situation as you….a general internist, hospitalist, or sub-specialist practicing in a “rural” state?

That is why I hope that you will take a few days away from the trenches to refresh and renew yourself by attending our 2018 annual scientific meeting September 12-14 in Deadwood, SD. We will have 21 presenters sharing THE absolute latest up-to-date information on Hot Topics and ample chances to interact and socialize with your colleagues. Register NOW before late fees go into effect!

As always, I look forward to seeing my ACP “family” at this annual reunion. Questions? Contact Kris Rahm

Here are some photos from the 2017 meeting in Brookings



My ACP, Your ACP

- Rob Allison, MD, FACP Governor-Elect


Matt Bien, Governor and Rob Allison, Governor-Elect

2019 will bring lots of changes to “My ACP”. I call it “My ACP” for a few reasons. Each of us has a journey through the practice of Internal Medicine. Mine has gone from Residency in Nebraska, to 10 years in private practice in South Dakota, to now being part of a large health system for the last 10 years. During that time the ACP has changed and become a more complete organization for me. I have been to 20 state meetings and have hosted 3 in Pierre, all for the camaraderie of the practice of our specialty. I have gone to Washington DC to give our message and felt the power of our organizations advocacy, and I have seen the influence of our organization in the National AMA. We help move medicine and advocate for patients!

My professional career has not been defined by the number of patient visits I have done. It has been built on the relationships created over time, with physicians and patients. I take huge pride knowing that when I make that phone call to anther physician they are probably an ACP member. I never want to lose that closeness we have in our small state and it never gets old to have the other states just a little bit jealous over what we have.

There is nothing in my professional career that I have more pride in than enjoying those I have worked with, and those with whom I have shared my passions. The men and women physicians of our great state have given me the honor to now be that voice on a national level. It is an honor I don't take lightly, following in the steps of those great Governors ahead of me: Sandvik, Elson, Braithwaite, Holm, and Bien. I look forward to being the voice of Internists across South Dakota and view it as a new and exciting challenge.

But Internal Medicine is in a transition. We are being split into clinical and hospital-based providers. We need to embrace our roots and support the evolution of internal medicine but never forget that we are stronger as a group, especially in a small state. The leadership in both organizations has always seen the value of each other and I have strong faith in our ability to maintain that relationship.

So, your challenge will be to tell me how to make “Your ACP” better. I will be asking for your help on membership, advocacy, and maintaining our chapter meetings as the best in the country. I'm happy to take on the tough questions and work through the hard times with our chapter.

Thank you again for your faith and confidence. I won't let you down.

Robert L. Allison, MD FACP



Upcoming Election for At-Large Council Positions

Later this year, the SD ACP will open nominations for two At-Large council positions that were created as part of the revised chapter bylaws. In order to offset terms, one position will be a one-year term and the other a two-year term, both with the potential for renewal. Council members support the mission of the SD ACP, meet twice per year, and engage in committees and other work of the chapter. If you are interested in serving in this role, stay tuned for an email and formal invitation coming this November.



New SD ACP Council Members

The SD ACP welcomes the following new members (or members in new positions) to the Council. Thank you for your service!

Rob Allison: Governor-Elect
Eric Larson: Vice-President
Tim Ridgway: Secretary/Treasurer
Kelly Evans: Chair, Health and Public Policy
Fatima Kidwai: Chair, Membership
Randall Lamfers: IM Residency Representative



Health & Public Policy

– Kelly Evans-Hullinger, MD

Your ACP Chapter sent four members to meet with our national lawmakers in Washington DC at the annual ACP Leadership Day on May 22-23. I was excited to join Governor Matt Bien, Governor-Elect Rob Allison, and medical student Matthew Bell, in learning about the ACP's legislative agenda and meeting with our legislators. We were updated on the climate in Washington by ACP's Senior VP in Governmental Affairs and Public Policy Bob Doherty and learned from a panel of congressional staffers on the trajectory of legislative efforts to reduce administrative burdens and address the opioid epidemic.

The ACP had a broad legislative agenda this year, asking us to advocate for seven different issues when meeting with our lawmakers and staff. Given limited time with each team, we prioritized issues most pertinent to South Dakota. We approached each issue with focus on challenges we face in caring for patients in rural settings and the difficulties encountered in daily primary care practice that may deter students and residents from choosing that career path. We were happy to meet with Senators Thune and Rounds along with their wonderful staff members and Representative Noem's Legislative Director.

We advocated for legislative efforts to reduce unnecessary administrative tasks on physicians and patients, emphasizing the desire to return to spend more time with patients and less time on paperwork that does not add to quality of care. There had been several bills introduced with these goals in mind, one of which deems patients under observation as inpatients for the purpose of the infamous Medicare 3-day inpatient stay rule (S. 568/H.R. 1421). We found these efforts seemed to have bipartisan support. We encourage all our members, if presented the opportunity, to share your experiences in regards to unnecessary administrative burdens and how they affect your ability to care for patients with your lawmakers. View a summary of the ACP's “Patients Before Paperwork” initiative

We advocated for improvements in Graduate Medical Education (GME) funding with the desperate need to train our future physician workforce, especially in primary care. As we all know, there is a large projected shortage of physicians in coming decades, and while many medical schools around the country (including our own SSOM) have increased slots to produce more MD's and DO's, residency programs (GME) has not kept up. This largely has to do with the antiquated way residency programs are funded through Medicare; much of this Medicare funding currently remains capped at 1996 levels. The ACP advocated for the Resident Physician Shortage Reduction Act of 2017 (S. 1301/H.R. 2267), which aims to increase the number of GME slots by at least 3000 per year over five years for internal medicine and other specialties facing shortages.

We found that GME funding was an issue in which our SD lawmakers were particularly interested, and since Leadership Day our advocacy team has conferenced with others from the SD American Academy of Family Physicians, the Sanford School of Medicine, and advocacy experts from local healthcare institutions, to collaborate on common goals that we may advocate for as a multidisciplinary group. These efforts are ongoing.

Other issues addressed at Advocacy Day included the following:

- Promoting continued action to address the opioid epidemic, including support of the Comprehensive Addiction and Recovery Act of 2018 (CARA 2.0; S. 2456/H.R. 5311), which expands on funding previously approved by Congress.
- Reducing firearms related injury and death, an issue which currently has numerous proposed bills but, as always, an uncertain political fate.
- Reducing prescription drug costs, including several bills which aim to increase transparency in drug pricing.
- Funding for workforce, medical and health services research, and public health initiatives. It is a never ending effort to advocate for programs that fund research, public health, and patient care, via the National Institutes of Health, Center for Disease Control, National Health Service Corps, and others.
- Expanding coverage and stabilizing the insurance market, an issue that was still awaiting introduction of pertinent legislation at the time of our Leadership Day.

I encourage you all to stay up to date on the ACP's advocacy efforts by joining the Advocates for Internal Medicine Network . You can view the ACP's Policy Papers, read the monthly ACP Advocate Newsletter, and learn about other advocacy related topics .

I look forward to continuing to serve our chapter in public policy efforts, and I hope to see you all at the Annual Meeting in September!

Matt Bell, Robert Allison, Kelly Evans-Hullinger, Matt Bien



A Student's Perspective

– Matthew Bell, MS3

Leadership Day 2018 - In May I had the opportunity to travel to Washington DC with the South Dakota ACP delegation for National Leadership Day. The three days I spent in our nation's capital were an absolute whirlwind, but I left with a better understanding of medical advocacy and the ways in which the ACP strives to influence policy at the national level. It was amazing to see internists from nearly every state in the country converge on Washington, all with the same goals in mind— to advocate for their patients and to play their role in influencing health care policy.

During the event, we heard speeches from members of congress, staffers, and lobbyists on topics ranging from the opioid epidemic to stabilization of the health insurance market. We were briefed on the ACP's goals and key talking points for this year's event and then we were sent out to Capitol Hill to convene with our state's representatives and to share with them our perspectives on these complex issues.

To be honest, meeting with our senators and congresswoman was at first quite daunting. However, our members of congress were all very respectful and generous with their time. In fact, we had the opportunity to have face-to-face meetings with both Senators Thune and Rounds as well as a meeting with a staffer from the office of Representative Noem. I was specifically given the responsibility of presenting the topic of graduate medical education funding in each of our meetings, a topic that ended up being well received and hopefully will gather momentum and support over the next few years.

All in all, I am so grateful for this opportunity to have attended the Leadership Day in Washington DC. During my time at the event, my eyes were opened to the world of medical advocacy and health care policy—a complex arena that I hope to pursue further in the future. I cannot thank the South Dakota ACP enough for giving me this opportunity and am so grateful to the rest of the South Dakota delegation at the event for taking me under their wings. Through this event, I was able to learn valuable skills and lessons that I will take with me into my future career as a physician. Thank you, SD ACP, for this amazing opportunity that I will cherish for years to come.

IMIG event - Over the last few months, students from the USD medical school and the SD ACP have partnered in an effort to start a new Internal Medicine Interest Group (IMIG). The goal of the IMIG is to support and serve medical students interested in pursuing careers in internal medicine by providing educational and informative sessions throughout the year.

Those involved in founding this new interest group included Abby Wegehaupt (MS4), Ben Staum (MS4), Matthew Bell (MS3), John Fanta (MS2), Dr. Roxanna Lupu, Dr. Matthew Jahraus, Dr. Matt Bien, and Kris Rahm. The efforts of all those involved culminated in the first meeting of the newly formed IMIG on July 26th at the Health Science Center in Sioux Falls. A total of 34 medical students attended the EKG skills night hosted by the first-year Sanford cardiology fellows. The event was a complete success with informative presentations, meaningful fellowship, and delicious food that was generously paid for by the SD ACP. The IMIG event concluded with the elections of the first executive committee, the results are as follows:

President: Matthew Bell (MS3)
Vice President: Max DeHaan (MS2)
Secretary: McKenna Eisenbeisz (MS2)
Treasurer: John Fanta (MS2)

Dr. Matthew Jahraus, the new Internal Medicine Clerkship Director for the medical school, will be serving as the advisor to the group. Considering the excellent turnout at the first event, as well as the number of younger students interested in getting involved in leadership positions, the future of the IMIG appears bright. I would like to take this opportunity to thank all of those involved, especially the SD ACP, for their partnership in creating this new group and for helping us get it off the ground. Hopefully, the IMIG can flourish for years to come and serve as a way to get more students interested in Internal Medicine.



Cardiology event held by the newly formed IMIG



IM2018 – New Orleans

– Kris Rahm, Executive Director

Many of you may not be aware that I often have had the opportunity to attend the National ACP Board of Governors and IM meeting each Spring. 2018 was in New Orleans and trust me, we enjoyed the beignets! Looks like fun, right? Mark your calendar now for the IM2019 in Philadelphia April 8-10!

Sightseeing in New Orleans



Caitlin Hof, SD ACP Student Poster Winner


Maryam Sheikh, SD ACP Resident Poster Winner


New Orleans Convocation – New Fellow Nnamdi Nwafo with Governor Matt Bien


“Working” at New Orleans Reception


Enjoying the local culture!


SD ACP Calendar of Events

September 12 SD ACP Council Meeting Springhill SuitesDeadwood, SD
September 12-14 SD ACP Scientific Meeting - Online Registration! Springhill SuitesDeadwood, SD
September 27-29 ACP Board of Governors Meeting Seattle, WA
April 8-10 ACP Board of Governors Meeting Philadelphia, PA
April 11-13 IM2019 Meeting Philadelphia, PA
September 26-28 ACP Board of Governors Meeting Tucson, AZ
October 2-4 SD ACP Scientific Meeting Deadwood, SD



New Members

Kevin D Marquez, MD
Elizabeth P Haller, MD
Spencer D Schilling, MD
Jon Demuth
Nadia K Wesche, DO
Adham M Mohsen, MBCHB
Maria A. David, MD
Ananta Subedi, MD
Nitesh Kumar Jain, MBBS
Jared L Velgersdyk, MD
Matthew H Muller, DO
Guy Vin Chang, MD
Muhammad Shahjahan Khan, MBBS
Maryam R Sheikh, MD
Alex Chan, DO
Sudhir Finch, MD
Gerard David, MD
Brett Baloun, MD
Drew Jorgensen, MD