Patients Deserve Care Led by Physicians

By Benjamin C. Aaker, MD
SDSMA President

As you read this we are in the swing of another SDSMA presidential year. This year will of course, be unprecedented. I had the opportunity to address your representatives on the SDSMA Policy Council recently. I explained my plans for this year and the work that I hope we can get done together. We now have our Ad-hoc Committee on Scope of Practice up and running. This committee aims to determine how the lives of South Dakotans have changed after allied healthcare practitioners have expanded their scope of practice. I certainly hope it has been for the better, but we won’t know until we ask the questions.

These groups usually argue that South Dakota is a rural state; they say physicians don’t want to move to small communities, which leads to a lack of care. Further, they assert that their practitioners are clamoring to give primary care in those underserved areas. Other groups would like to expand their scope of procedures, stating that patients would rather have an operation done by a less skilled provider than travel. A person with less training is better, they say, than no one at all. One thing they have failed to mention, however, is telemedicine. How many of these practitioners have actually moved to these communities in the last few years? How many patients decided to stay home rather than travel to visit their physician? How many practitioners purport to be ‘specialists’ in certain areas? Are these practice changes bettering our state’s health or making it worse?

Sometimes it seems the knowledge and training physicians have aren’t valued. We won’t despair. Who do people look to for advice and help in times of difficulty? The physician. Despite those who seek to devalue the role of the physician, it is physicians who are consulted when people have a serious illness, physicians who are turned to when a pandemic hits, physicians who step up to volunteer, physicians whose patients choose to perform an operation, and physicians who give a voice of reason in news and media.

When I addressed the Policy Council, I mentioned how some cruise ship workers are still stranded on their ships waiting for a friendly port to disembark. Hopefully by the time this is published they have been able to do so. I can’t imagine what it must be like to be trapped in that tiny cabin. The physicians on those ships have a unique role. They need to continually monitor the passengers and crew for signs of illness and make recommendations to respond. They spent many years training, and more time learning the intricacies of cruise ship medicine. They know how to look for signs of outbreaks (whether norovirus, novel coronavirus, or any number of other maladies), and how best to respond. They can give the knowledgeable recommendations to make the passage better and to perhaps save lives. These are only recommendations, however. The ship’s physician is not the captain. The physician doesn’t know how to steer the ship. It’s not part of the training. In the end, the captain makes the decision to continue the voyage or end it. The captain and the rest of the staff work as a team to accomplish the goal.

In this pandemic, the world is our cruise ship and we are the ship’s physicians. Our elected government is the captain, we are not. If we wanted to be the captain, we should have run for office. Our role is to be as knowledgeable as possible and to advise our leaders. It is critically important that we avoid getting stuck in the politics of the situation while still advocating for our patients. We need to rely on the science, do the research, and treat the population.

Now, we are in the midst of a pandemic that continues. As of writing this article, things in our corner of the planet seem to be improving. You deserve credit! Many people have been taking your advice to protect themselves and others and we are having an effect. But it’s not over. We will continue to have a need to be ready should an outbreak occur.
Now is the time for us to step up and make a difference. Volunteer with SD SERV. Contact your newspaper or other news outlet and offer to give health advice. People respect your opinion and are desperately in need of guidance. We also need to continue to give guidance to our leaders. We need to help them make the best decisions for the population. If we give up, our planet will be like a cruise ship without a physician. That would be a terrible world to die in.

I want to hear from you. Please take the time to contact me and give me your thoughts on how we can help get the word out. We have set up an email at This is a public email address and you can feel free to give it to anyone. Let’s stick together and accomplish our only goal: bettering the health of our population.