Health Care at the Top of its Game

By Robert J. Summerer, DO
SDSMA President

On a recent radio interview, I was asked the question, “What is going well in the world of medicine in South Dakota?” It gave me an opportunity to reflect on the many ways that the physicians in our state continue to find effective ways to maintain and expand quality health care for a diverse population spread out over miles of farmland, ranchland, and Native American reservations. Despite being a rural state, South Dakota is fortunate to have an outstanding medical school with a mission to supply talented doctors to communities in the state. Additionally, our physicians have embraced the many facets of technology and its ability to enhance patient care, and finally, our state medical association continues to push forward with providing member services, advocacy, and leadership training.

I have the pleasure of working in an independent health care facility that has made its mark in delivering medical care to a small community. The Madison Regional Health System is a critical access hospital (CAH) that is fully staffed with eight physicians and four advanced practice providers. Our physicians and providers include both seasoned and freshly trained professionals who work well with each other and interact effectively with the health care community. We are involved in medical education and have maneuvered successfully into the digital world. Madison could be a model for rural health care done well and is reflective of the good things happening in South Dakota medical care.

In addition to a handful of other independent health facilities, South Dakota has three large health care systems. These systems and a physician owned hospital have given our largest city, Sioux Falls, a reputation for state-of-the-art health care. All three systems have developed networks of community hospitals that extend into the more remote parts of our state and others. By doing so, they provide stability to the local facilities and offer an economic safety net for the physicians they employ. The systems’ networks allow patients and their physicians to more easily connected to specialty care. Mobile mammography is one example of health systems filling a need to bring services to remote locations in the state.

Educating physicians in South Dakota is perhaps the most effective way to keep our facilities staffed with qualified doctors. The University of South Dakota Sanford School of Medicine intentionally recruits applicants from South Dakota communities and reservations. The Frontier And Rural Medicine (FARM) program developed in 2012 places medical students in rural communities for a significant portion of their third year. Sixty percent of the residency programs in our state focus on primary care, but even the general surgery program is designed to prepare surgeons to practice in rural communities by teaching endoscopy and surgical obstetric care. Physicians around the state continue to be clinical educators for residents, PA students, medical students, and even nurse practitioner students.

Technology has proven to be an invaluable means of providing medical care to the patients in our state. Cities such as Brookings have embraced robotic surgery. Small communities such as Wagner have access to eCare, which provides immediate oversight from specialty physicians bringing their expertise to emergency departaments, ICUs, and even standard inpatient care. Telemedicine continues to expand allowing patients access to specialists without the hardship of travel. Radiological images can be shared easily for appropriate interpretations and review. Slowly, EHRs are learning to communicate with each other in order to safely share patient information. Physicians have increased their access to the PDMP to prevent opioid overprescribing.

Exceptionalism is the new buzzword for the concept that a particular region is doing well.  At the SDSMA annual meeting in June, one of the speakers shared rankings germane to South Dakota physicians. South Dakota is designated as the sixth best state to practice medicine. It is second in lowest malpractice awards per capita, and when adjusted for cost of living, South Dakota ranks the highest in average physician salaries. I believe that part of the reason for these positive rankings is because of the efforts of the SDSMA. It is a robust organization dedicated to the needs of South Dakota physicians and patients. Advocacy efforts have been directed for better patient safety and care. The organization continues to work with legislators and state officials to help our membership. They also provide leadership and direction as physicians navigate an ever-changing landscape of health care delivery. South Dakota physicians are exceptional women and men doing great things in their professions to provide cutting edge, and often novel, health care to a rural and frontier state. I’m proud to be a part of the team.