Yankton Medical Clinic, PC | Examiner | Fall-Winter 2024

Free medical card Now it’s easier to stay in touch with your health care team Worried about your weight? Simple, everyday steps you can take Avoid asthma aggravation Get tips from our lung experts EXAMINER Fall/Winter 2024 So Much Care, So Close to Home at Yankton Medical Clinic

2 yanktonmedicalclinic.com Yankton Medical Clinic (YMC) staff p resented topics related to summer safety at a Lunch and Learn held at Yankton Thrive. Scott Kindle, MD, dermatologist at YMC, shared valuable information about sun damage to skin, skin cancer, sunscreen and preventive measures to stay healthy. Taylor Lofink, PA-C, and Sarah Arens, PA-C, spoke about common illnesses and injuries they see in ConvenientCare during the summer. They explained how to treat such conditions before coming to ConvenientCare to prevent further injury. Kristal Vogt, RN, coordinator of occupational medicine at YMC, described basic necessities to have in your first aid kit and how to properly use those items. We take our commitment to keeping our community healthy and well seriously. Be on the watch for more health education opportunities to come! New cardiologist now providing care It is our pleasure to introduce Venkata Pajjuru, MD, the newest cardiologist at Yankton Medical Clinic (YMC). As a preventive cardiologist, Dr. Pajjuru is focused on providing patient education on heart health. Working alongside Tim Irwin, MD, FACC, in YMC’s cardiology department, Dr. Pajjuru will be helping to support the needs of our community by providing services often only available in larger cities. Dr. Pajjuru will be working with other YMC primary and specialist physicians to ensure that our patients receive the highest quality and continuity of care, for which YMC is known. Dr. Pajjuru will offer specialized procedures in Yankton, such as pacemaker management and cardiac care for cancer patients undergoing specific chemotherapy. Dr. Pajjuru does not require a referral. At YMC, our cardiology team, including Dr. Irwin and Dr. Pajjuru, really does provide So Much Care, So Close to Home. OUR MISSION To provide timely, compassionate, quality care to all who seek that care, with respect for and trust in those we serve. OUR VISION To be an independent regional center of medical excellence committed to quality care and medical education. Models may be used in photos and illustrations. 2024 © Coffey Communications, Inc. All rights reserved EXAMINER is published as a community service for the residents of the service area of Yankton Medical Clinic, P.C., 1104 West 8th St., Yankton, SD 57078 yanktonmedicalclinic.com | 605-665-7841 Lunch and Learn gives summer safety tips that work all year-round Find out more about our services at www.yanktonmedicalclinic.com/ health-services/cardiology. Now open extended hours! Monday–Friday: 5–8 p.m. Saturday–Sunday: 12–4 p.m. Scott Kindle, MD, dermatologist, and Sarah Arens, PA-C

Fall/Winter 2024 3 In celebration of National Water Safety Month this past May, Yankton County Search and Rescue (YCSAR) teamed up with Yankton Medical Clinic (YMC) to provide youth life jackets to local families, free of charge. “The physicians at Yankton Medical Clinic care deeply about the health and safety of our community,” says Martha Holstein, MD, FACP, FAAP, an internal medicine–pediatrics physician at YMC. “We want to watch your families thrive and enjoy the beautiful waters around Yankton. There is an average of 11 fatal drownings per day and 22 nonfatal drownings per day nationwide. As local physicians, we understand the importance of teaching children water safety at an early age.” Becky McManus, CEO of YMC, agrees, Children’s life jackets giveaway promotes water safety adding, “When we learned of the Yankton County Search and Rescue event, our physicians immediately asked, ‘What can we do to help?’ as this is their community as well.” “We provided ‘water watcher’ cards and whistles to adults as a physical reminder of the responsibility to keep our families safe near the water,” Dr. Holstein says. In addition to picking up one of the 300 new life jackets, local families enjoyed a hot dog, chips and refreshments with Search and Rescue team members and staff from YMC. There were also educational activities, giving families an opportunity to learn more about water safety with YCSAR members; YMC staff; Missouri River National Park Service staff; South Dakota Game, Fish and Parks Department staff; and Gavins Point Dam staff. For your convenience, we’ve designed a new medical treatment card. This card can be completed for you and picked up at your Yankton Medical Clinic (YMC) primary care physician’s office. This is simply a card for you to carry that has your physician’s name and phone number for scheduling appointments and will soon include space to write in a current medications list. You can show this to any other medical personnel you may encounter if you’re traveling and need medical attention. It’s also important to present this card to medical personnel if you are in the hospital so they can contact your physician for NEW! Medical treatment card available any follow-up appointments. It’s always good practice to make sure your physician is notified if you are hospitalized. The physicians at YMC hope this card will help ensure that you continue to receive the highest continuity of care, to which you are accustomed at YMC. So much care, so close to home.® IMPORTANT MEDICAL TREATMENT CARD 1104 WEST EIGHTH YANKTON, SOUTH DAKOTA 57078 My doctor is: ALL MEDICAL RECORDS SHOULD BE SENT TO, AND ANY FOLLOW-UP APPOINTMENT SHOULD BE MADE WITH DR. BY CALLING It’s important this protocol is followed for the continuity of my care. Martha Holstein, MD, FACP, FAAP, and Scott Kindle, MD, and his family were on hand to represent YMC physicians and distribute water watcher cards and whistles. Martha Holstein, MD, FACP, FAAP, internal medicine/ pediatrics, distributes information to a long line of community members.

4 yanktonmedicalclinic.com Dr. Sedlacek named Early Career Physician of the Year Yankton Medical Clinic’s (YMC) Amanda Sedlacek, DO, has been selected as the 2023 South Dakota American College of Physicians Early Career Physician of the Year. She is a board-certified internal medicine and palliative care physician. Dr. Sedlacek received her award during the American College of Physicians national meeting, held in Boston. Becky McManus, CEO of YMC, says: “Dr. Sedlacek is an internal medicine/ palliative care physician respected by not only her peers, but also her patients. Her approach to internal medicine exemplifies a high standard of care by treating the whole person, not just the symptoms, and by establishing longterm care. We congratulate Dr. Sedlacek on her well-earned award.” Dr. Sedlacek is currently accepting new adult patients in her internal medicine practice at YMC and is also accepting patients in need of palliative care. To make an appointment, call 605-665-1152. Amanda Sedlacek, DO, receives her award from Eric Larson, MD, FACP, governor of the South Dakota Chapter of the American College of Physicians. Jordan Schild, MD, a family medicine physician at Yankton Medical Clinic (YMC), presents scholarships to Yankton High School students. YMC has offered a scholarship program for students in our surrounding area, including both South Dakota and Nebraska, for many years. Scholarship applications and deadline information can be found on our website, www.yanktonmedicalclinic.com. Dr. Eichfeld receives award for ‘most inspiring’ The Sanford School of Medicine presented Amy Eichfeld, MD, FACOG, a physician at Yankton Medical Clinic (YMC), with the prestigious Anton Hyden Award for this year during the inaugural University of South Dakota Sanford School of Medicine Awards Banquet, in Sioux Falls. The Sanford School of Medicine Class of 2024 gave the Anton Hyden Award to the faculty member who helped and inspired them most during their clinical years. Dr. Eichfeld is an OB-GYN at YMC. She also sees patients at the Vermillion Medical Clinic. Rated as a 5-star physician by her patients, Dr. Eichfeld provides women’s health services to women of all ages in the southeast South Dakota and northeast Nebraska area. Becky McManus, CEO of YMC, says, “What an honor for Dr. Eichfeld! To be nominated by the students makes this award even more special. She’s made a lasting impact on the students, just as she has on our YMC patients, who consistently rave about her care.” To schedule an appointment with Dr. Eichfeld, call 605-665-5538 or schedule online at www.yanktonmedicalclinic.com/scheduling.

Fall/Winter 2024 5 Emma Bye, MD, provided a little extra for her OB patients at Wagner, South Dakota, Indian Health Service (IHS). Dr. Bye, along with a University of South Dakota medical student and several public health nurses, worked to distribute donated diapers; wipes; sleeper outfits; and other items, like travel-size lotions, body wash and detergent. They went around door-to-door delivering items to Dr. Bye’s expecting moms from Wagner IHS. April Willman, MD, FAAP, has been appointed as the Dr. Charley F. and Elizabeth Gutch Chair in Medicine, effective July 2024 through June 2027, for the University of South Dakota Sanford School of Medicine (SSOM). Dr. Willman has been serving as associate dean of the Yankton campus and associate professor in the department of pediatrics. A 2007 SSOM graduate, Dr. Willman practices pediatrics at Yankton Medical Clinic, and she served as the SSOM pediatrics longitudinal integrated clerkship coordinator from 2017 through 2022. “Dr. Willman embodies many of the qualities Dr. Gutch stood for,” says Tim Ridgway, MD, Dean of the SSOM. “She is an accomplished physician and academic leader of the Yankton campus and is truly dedicated to the success of the school of medicine. Dr. Willman, like Dr. Gutch, is committed to excellence in all she does. She is most deserving of this honor.” Dr. Gutch was chief of medical services at the Royal C. Johnson Veterans’ Memorial Hospital, in Sioux Falls, South Dakota, and an associate dean at the school of medicine until his 1988 retirement, when he was named Professor Emeritus. He was recognized as an expert in kidney function and kidney dialysis and was a prolific writer and academic visionary. He passed away in 2009. It is through the generosity of Dr. Gutch and his wife, Betty, that this chair in medicine was endowed. Dr. Willman appointed Chair in Medicine University of South Dakota’s Tim Ridgway, MD, Dean of the Sanford School of Medicine; April Willman, MD, FAAP; and Lori Hansen, MD, FACP, FCCP, University of South Dakota’s Sanford School of Medicine Dean of Medical Student Affairs. Dr. Bye ‘delivers’ extra to Wagner patients

6 yanktonmedicalclinic.com Yankton Medical Clinic, P.C. 1104 W. 8th St., Yankton, SD 57078 Primary Care Specialty Care FAMILY MEDICINE AUDIOLOGY CARDIOLOGY EAR, NOSE AND THROAT NEPHROLOGY ORTHOPEDIC SURGERY PALLIATIVE MEDICINE McKenzie Hanson, MD* 605-665-8910 Elizabeth Nicholas, MD* 605-665-8910 Carrissa Pietz, MD* 605-665-8910 Abigail Reynolds, MD* 605-665-8910 Jordan Schild, MD* 605-665-8910 Scott Weber, DO, FAAFP* 605-665-8910 Jennifer McGinnis, CNP 605-665-8910 Beth Beeman, AuD, CCC-A, FAAA 605-665-0062 Jason R. Howe, MS, FAAA, CCC-A 605-665-0062 Tim Irwin, MD, FACC* 605-664-2741 DERMATOLOGY Scott Kindle, MD* 605-664-2741 David Abbott, MD* 605-665-0062 Byron S. Nielsen, MD* 605-665-1082 Jeremy Kudera, MD, ABOS* 605-665-1722 Dawn Lauer, MPAS, PA-C 605-665-1722 PHYSICAL MEDICINE Judith R. Peterson, MD* 605-665-1152 RADIOLOGY Ben LaCrosse, MD* 402-379-2349 Will R. Eidsness, MD* 605-665-7841 UROLOGY Christopher Hathaway, MD, PhD* 605-664-2742 Haley Schroeder, MPAS, PA-C 605-664-2742 Brent Adams, MD, ABOS* General Orthopedics and Spine Specialist 605-665-1722 Tom Viereck, CNP 605-665-1722 Amanda Sedlacek, DO* 605-665-1722 Becky Sawatzke, PA-C 605-665-1152 Leann Bassing, MD* 605-665-1722 RHEUMATOLOGY OBSTETRICS AND GYNECOLOGY Kevin Bray, MD, FACOG* 605-665-5538 Emma Bye, MD+ 605-665-5538 Amy M. Eichfeld, MD, FACOG* 605-665-5538 Robert T. Ferrell, MD, FACOG* 605-665-5538 Spencer Ferrell, MD+ 605-665-5538 Jill F. Sternquist, MD, FACOG* 605-665-5538 Visit www.yanktonmedicalclinic.com/scheduling and follow the prompts. INTERNAL MEDICINE Venkata Pajjuru, MD, FACC* 605-664-2741 PULMONOLOGY Linda Reese, MPAS, PA-C 605-665-1152 Michael P. Pietila, MD, FCCP, FACP* Critical Care 605-665-1152 Liz Wortmann, CNP 605-664-2741 Self-schedule your appointment online!

Fall/Winter 2024 7 Vermillion Medical Clinic Primary Care INTERNAL MEDICINE Susan E. Fanta, MD* 605-665-1082 Jennifer Fillaus, DO* 605-665-1082 Tyler Hanson, MD* 605-665-1082 Martha Holstein, MD, FACP, FAAP* 605-665-1152 Daniel J. Megard, MD, FACP* 605-665-1152 Amanda Sedlacek, DO* 605-665-1722 Sarah Arens, MPAS, PA-C 605-665-1152 Robert Nicholas, MD* 605-665-0062 GERIATRICS Jennifer Fillaus, DO* 605-665-1082 Todd Espicha, MPAS, PA-C 605-624-8643 Amy Fluit, MPAS, PA-C 605-624-8643 *Board-certified +Board-eligible GENERAL SURGERY Jesse L. Kampshoff, MD* 605-664-2742 Luke C. Serck, MD* General and Vascular Surgery Specialist 605-664-2742 Ryan J. Garry, MD, FACS* General and Breast Surgery Specialist 605-664-2742 PEDIATRICS Martha Holstein, MD, FACP, FAAP* 605-665-1152 Dawn M. Larson, MD+ 605-665-5538 Sara Pepper, MD, FAAP* 605-665-5538 April K. Willman, MD, FAAP* 605-665-5538 101 S. Plum St., Vermillion, SD 57069 David W. Withrow, MD, FAAP+ 605-665-5538 Matthew D. Krell, MD, FAAP,* Pediatrics 605-624-8643 Michelle Chaussee, MPAS, PA-C 605-624-8643 Ashley Johnson, MPAS, PA-C 605-624-8643 Pharmacy hours have been extended! Monday through Friday: 8:30 a.m. to 8 p.m. Saturday: 8:30 a.m. to 4 p.m. Sunday: Noon to 4 p.m. Yankton Medical Clinic, P.C., Norfolk Alan Spanel, MD* Internal Medicine 402-316-4606 Kelly Jueden, CNP Family Medicine 402-316-4606 Erin Wolf, AuD, CCC-A, FAAA, Audiologist 402-844-8110 Charles Harper, MD* Internal Medicine 402-316-4606 Brian Kim, AuD, CCC-A, FAAA, Audiologist 402-844-8110 3901 W. Norfolk Ave., Norfolk, NE 68701 Ben LaCrosse, MD* Radiologist 402-379-2349 TAKE NOTE!

By Linda Reese, MPAS, PA-C Asthma is a chronic disease of the lungs that makes it difficult to get air out. It is characterized by inflammation and increased mucus in the airways along with constriction of the muscles surrounding the breathing tubes. When the airways become inflamed, narrowed and filled with mucus, this causes wheezing, coughing, a feeling of chest tightness and shortness of breath. The cause of asthma is not known, but both genetic and environmental factors contribute. Intermittent obstruction can often be reversed. However, if asthma is left untreated, the airways undergo structural changes, and the obstruction can become permanent. An unpredictable but common condition Asthma is classified as mild, moderate or severe. Symptoms can be triggered by a wide variety of factors, including viruses, allergens, pet dander, dust mites, stress, and certain foods and medications. Each person has different triggers, and these can change over a person’s lifetime. Asthma is with the expansion of pulmonary care By Michael Pietila, MD, FCCP, FACP, pulmonary, critical care, sleep and internal medicine physician at Yankton Medical Clinic and clinical professor of internal medicine at the University of South Dakota Sanford School of Medicine I would like to take this opportunity to introduce Linda Reese, a physician assistant (PA) who has joined the pulmonary, critical care and sleep medicine team at the Yankton Medical Clinic (YMC). Linda has a vast amount of experience as a respiratory therapist and now as a PA caring for patients across the spectrum of respiratory illness. She has extensive knowledge in managing conditions like asthma, COPD, sleep apnea and other diseases affecting the lungs and causing breathing difficulty. Linda has been a member of the health care community in Yankton for 25 years, working at the YMC and Avera Sacred Heart Hospital. She is now providing clinical care for patients with any respiratory complaint as an extension of our pulmonary care practice under my direct supervision. With her assistance, we are establishing an outpatient respiratory clinic to make sure patients receive timely and appropriate post-hospital care for respiratory complaints and to assist local care providers with immediate post-hospital specialty care. We are also establishing a specialty clinic for the use of monoclonal antibody therapy for the management of difficult-to-treat asthma and COPD as well as for environmental and seasonal allergies. Linda will tell you more in the article that follows. Breathe easy All about 8 yanktonmedicalclinic.com

Fall/Winter 2024 9 highly unpredictable, and even those with mild or infrequent symptoms can have severe, lifethreatening episodes. Data published by the Centers for Disease Control and Prevention in 2021 indicate that 7.7% of the U.S. population—about 25 million people—have asthma. Diagnosis of asthma consists of a thorough history and physical exam, breathing tests, and lab work. How it’s treated Treatment of asthma often includes inhaled medications that target airway constriction and inflammation. Asthma flare-ups sometimes require oral corticosteroids to tame the inflammation and reduce symptoms quickly. Oral steroids are associated with negative side effects, such as diabetes, cataracts, osteoporosis and pneumonia. Research has shown that using oral steroids for even four to five courses over a lifetime can have a cumulative effect that puts people at higher risk for these side effects. Inhaled corticosteroids cause far fewer side effects and are the preferred approach in asthma management. Treatment guidelines for asthma have changed significantly over the past decade, including shifts in the use of inhaled medications as well as the emergence of several treatments targeted at severe and difficult-to-treat asthma. Roughly 5% to 10% of asthma is considered severe. In these cases, patients continue to have asthma flare-ups despite treatment with high-dose inhaled steroids combined with long-acting medications to reduce constriction, and they often require oral steroids. For these patients, monoclonal antibody therapy, sometimes called biologic therapy, can be highly effective. The inflammatory changes associated with asthma are often termed a cascade, and monoclonal antibody therapy works to block or bind with specific molecules along that path to stop progression. Careful assessment of a patient’s symptoms, history, lab work, response to previous therapy and other medical conditions guides our decision in choosing the biologic therapy that will be most effective for each patient. The goal of this personalized approach is fewer symptoms for the patient and a reduction in steroid use and associated side effects. Our team is here for you Working with your primary care provider is the first step, and as lung specialists we can offer the latest in diagnostic and therapeutic options. We are dedicated to providing evidence-based treatment to help our patients breathe easier. Sources: Allergy. 2007 Jun; 62(6):591-604. doi: 10.1111/j.1398-9995.2007.01349.x; David B. Price et al. J Asthma Allergy. 2018. We are dedicated to providing evidencebased treatment options to help our patients reach their goals and breathe easier. asthma Find relief from asthma To make an appointment with one of our lung experts, call 605-665-1152.

10 yanktonmedicalclinic.com Learn how to eat well Nutrition is the most important component of weight management. We should try to eat food in its most natural form and minimize processed foods. For fruits and vegetables, frozen can be a good alternative to fresh food if you are concerned about food not lasting. Just be sure to read labels and avoid foods with added sugars or other processed ingredients. Year after year, the Mediterraneanstyle diet has been shown to be beneficial for many health conditions. During your office visit, we may discuss a nutritionist. I often focus on a few key things: protein, fiber, added sugars and water. Make sure to move With all the advances in technology, many of us work in sedentary jobs rather than doing physical labor. Because of this, getting additional exercise is important. In general, it is recommended to get 150 minutes of moderateintensity exercise weekly. Aerobic activity is important, but strength training is also key. It helps maintain bone density, which is especially important for women. It also can help increase muscle mass, which boosts metabolism. The goal is not to build huge muscles, but to improve strength, balance and flexibility so we can function well even in our older years. By Carrissa Pietz, MD One of the most common concerns I hear in the clinic on a daily basis is “No matter what I do, I cannot seem to lose weight.” Managing weight is a struggle for many and is even harder in a society filled with processed foods, sedentary lifestyles and quick fixes that are not longterm solutions. It is important to understand that whatever approach a person takes to weight management, it needs to be a lifestyle change that can be maintained over the long term to be successful. There are many components to living a healthy lifestyle. Eating healthy and exercising are important, but it is also essential to get adequate sleep and minimize stress. Many of us are constantly pulled in many directions, but we need to remember to take care of ourselves as well. The trend for the quick fix Managing your weight: A physician just for you If you need a primary care provider, check our physician finder at www.yanktonmedicalclinic.com/find-a-provider.

Fall/Winter 2024 11 Make water your friend According to the National Academies of Sciences, Engineering, and Medicine, on average, men should drink 3.7 liters and women 2.7 liters of water daily. People with certain medical conditions should not drink this much water, so you should always consult your physician prior to making any major changes in your diet. How much protein and fiber do you need? Protein is essential for our muscles. A sedentary person’s daily protein intake should be 0.8 grams per kilogram of body weight. This amount increases for those that exercise regularly (1.1 to 1.7 grams per kilogram) and for those over age 40 (1 to 1.2 grams per kilogram). Again, certain medical conditions could affect what is recommended for your protein intake, so make sure to discuss with your doctor if you have underlying medical conditions. Daily fiber intake should be in the range of 25 to 30 grams per day. Stay sweet without the sugar Added sugars should be limited. This does not include sugars found naturally in fruits. These are sugars that are added to foods and are listed on food labels as “added sugars.” The goal is to limit these to less than 25 grams for women and less than 36 grams for men per day. What about medications or surgery? If lifestyle changes alone aren’t enough, there are medications that can be used for weight loss, and there are surgical options. Many times, insurance coverage limits the use of medications, but ask your doctor about options. One medication for weight loss, semaglutide, received a new indication from the U.S. Food and Drug Administration in February 2024 for reduced risk of cardiovascular death, heart attack and stroke in adults who are overweight or obese, which has expanded coverage for certain patients. To qualify for weight loss medication, a person needs to have a body mass index (BMI) of 30-plus or a BMI of 27-plus with an underlying medical condition; however, meeting these criteria does not guarantee insurance coverage. Surgery could be considered if you have a BMI of 35-plus or a BMI of 30-plus with underlying metabolic disease. If you think you qualify, make an appointment to talk with your doctor. Care for yourself It is very important to be proactive in taking care of your health rather than reactive once conditions arise. Scheduling an appointment with a primary care provider for a general physical can be a great way to discuss some of the items mentioned here along with other things you can do to help yourself live a healthy life.

1104 West 8th Street Yankton, SD 57078 Standard U.S. Postage PAID Walla Walla, WA Permit No. 44 Contact your pharmacy directly for prescription refills. Nebraska Creighton, NE Avera Creighton Hospital 402-358-5700 ● Jesse Kampshoff, MD* General Surgery Norfolk, NE Yankton Medical Clinic, P.C.–Norfolk 402-844-8110 ● David Abbott, MD* Ear, Nose and Throat ● Jennifer Fillaus, DO Nephrology ● Ryan J. Garry, MD, FACS* General and Breast Surgery ● Christopher Hathaway, MD, PhD* Urology ● Robert Nicholas, MD* Ear, Nose and Throat ● Michael Pietila, MD, FCCP, FACP* Pulmonology Care near youWe provide specialty care in 14 locations outside of Yankton. O’Neill, NE Avera St. Anthony’s Hospital Specialty Clinic 402-336-5122 ● Byron Nielsen, MD* Nephrology ● Michael Pietila, MD, FCCP, FACP* Pulmonology ● Amanda Sedlacek, MD* Palliative Medicine (telehealth visits) Osmond, NE Osmond General Hospital 402-748-3393 ● Jesse Kampshoff, MD* General Surgery Plainview, NE Plainview Area Health System 402-582-4245 ● Jesse Kampshoff, MD* General Surgery ● Byron Nielsen, MD* Nephrology Santee, NE Santee Outreach Clinic 402-857-2300 ● Spencer Ferrell, MD+ Obstetrics-Gynecology ● Byron Nielsen, MD* Nephrology ● Sara Pepper, MD* Pediatrics South Dakota Freeman, SD Freeman Regional Health Services 605-925-4219 ● Jill F. Sternquist, MD, FACOG* Obstetrics-Gynecology Gregory, SD Avera Gregory Hospital 605-835-8394 ● Kevin Bray, MD, FACOG* Obstetrics-Gynecology ● Amanda Sedlacek, MD* Palliative Medicine (telehealth visits) Parkston, SD Avera St. Benedict Health Center 605-928-3311 ● Michael Pietila, MD, FCCP, FACP* Pulmonology Sioux Falls, SD Royal C. Johnson Veterans' Memorial Hospital 605-336-3230 ● Leann Bassing, MD* Rheumatology Tyndall, SD Bon Homme Family Practice Clinic 605-589-3322 ● Ryan J. Garry, MD, FACS* General and Breast Surgery Vermillion, SD Vermillion Medical Clinic 605-624-8643 ● Amy M. Eichfeld, MD, FACOG* Obstetrics-Gynecology ● Jason Howe, MS, FAAA, CCC-A Audiology ● Jesse Kampshoff, MD* General Surgery ● Jeremy Kudera, MD, ABOS* Orthopedic Surgery ● Robert Nicholas, MD* Ear, Nose and Throat ● Byron Nielsen, MD* Nephrology ● Linda Reese, MPAS, PA-C Pulmonology ● Jill F. Sternquist, MD, FACOG* Obstetrics-Gynecology Wagner, SD Wagner Community Avera ● Brent Adams, MD, ABOS* Orthopedic Surgery 605-665-1722 ● Spencer Ferrell, MD+ Obstetrics-Gynecology 605-665-5538 ● Byron Nielsen, MD* Nephrology 605-665-1082 Wagner Indian Health Service Clinic ● Emma Bye, MD+ Obstetrics-Gynecology 605-384-3621 *Board-certified +Board-eligible

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