ExaminerSpring 2024 Dedication receives recognition Our providers are health care leaders Got gout? Don’t underestimate it: Get the right diagnosis and treatment Caring for older adults The benefits of geriatric expertise
2 yanktonmedicalclinic.com 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 The Yankton Medical Clinic Diagnostic Imaging department has been awarded a three-year term of accreditation in computed tomography (CT) as the result of a recent review by the American College of Radiology (ACR). CT scanning—sometimes called CAT scanning—is a noninvasive medical test that helps physicians diagnose and tailor treatments for various medical conditions. The ACR gold seal of accreditation represents the highest level of image quality and patient safety. It is awarded only to facilities meeting ACR Practice Parameters and Technical Standards after a peer-review evaluation by board-certified physicians and medical physicists who are experts in the field. Image quality, personnel qualifications, adequacy of facility equipment, quality control procedures and quality assurance programs are assessed. The findings are reported to the ACR Committee on Accreditation, which subsequently provides the practice with a comprehensive report that can be used for continuous practice improvement. YANKTON MEDICAL CLINIC earns ACR gold seal What does the gold seal mean for patients? ● The facility has met the high standards of the ACR for quality and safety in medical imaging and radiation oncology treatment. (The ACR’s standards in imaging and quality control are set by radiologists and radiation oncologists across the country.) ● The facility has systems in place to help ensure appropriate dose levels are used for adult and pediatric imaging, where appropriate. ● The facility has undergone a rigorous review process, which includes this criteria: ● Equipment must be assessed annually by a medical imaging and radiation oncology expert who verifies that it functions properly, takes optimal images and uses the appropriate radiation dose. ● Personnel meet ACR qualification standards to perform procedures and interpret medical images. ● Physicians review each other’s work to ensure diagnostic accuracy. ● ACR accreditation programs are recognized by the Food and Drug Administration (mammography) and Centers for Medicare & Medicaid Services (diagnostic MRI, CT and nuclear medicine imaging procedures). ● The ACR performs site surveys to validate compliance with regulations and safety standards.
Spring 2024 3 Dr. Pietila is Top Physician among 1,800 Michael Pietila, MD, FCCP, FACP, board-certified pulmonologist and critical care physician at Yankton Medical Clinic, P.C., was recently presented the Top Physician award from Avera Home Medical Equipment’s Jeff Hart, Sales Representative/Business Development, and Mark Bauer, RRT, Director of Avera Home Medical Equipment. Dr. Pietila ranked first among all 1,800 independent and Avera physicians in the area. “We congratulate Dr. Pietila on being number one out of 1,800 physicians! What a well-deserved honor for him,” says Becky McManus, CEO of Yankton Medical Clinic. “Dr. Pietila provides high-quality care to our patients, as evidenced by his consistent fivestar rating. We are fortunate to have an expert like Dr. Pietila in our clinic and outreach locations.” Dr. Pietila is part of the pulmonology team at Yankton Medical Clinic, which provides full pulmonary function testing, imaging and sleep medicine services, eliminating the need for patients to travel to receive the same services. Our pulmonologists are able to see new referrals within two to five days, eliminating a long wait time. To schedule a visit with Dr. Pietila, call 605-665-1152. Yankton Medical Clinic–Norfolk physicians donate to Liberty Centre Yankton Medical Clinic–Norfolk physicians Alan Spanel, MD, and Ben LaCrosse, MD, both Norfolk natives, and Charles Harper, MD, recently donated $1,000 to the Liberty Centre in Norfolk’s medication support program after learning the program no longer receives government funding. “Our intensive medication support program offers assistance for patients with all range of needs— from patients just starting on meds who need help with scheduling, checking for drug interactions and other management tasks to those patients who must be visited three times a day and given their medication,” explains Patty Skokan, Executive Director of Liberty Centre. If you would like to donate to the medication support program at Liberty Centre, please call Skokan at 402-370-3503. To schedule an appointment with Dr. Spanel or Dr. Harper, call 402-316-4606. Go paperless! E-statements are now available Yankton Medical Clinic is unveiling an updated look to patient statements. In addition to the new look, you now have the option to receive a statement by email! The process is simple and will offer patients the ability to receive their statement and pay online, eliminating paper statements by mail. To sign up for e-statements, simply follow the instructions provided on your statement or call 605-665-7841 for assistance. Robin Claussen, Clinical Director, Liberty Centre; Patty Skokan, Executive Director, Liberty Centre; Alan Spanel, MD, Yankton Medical Clinic–Norfolk; and Tammy Planer, Medication Support Program Staff, Liberty Centre Dr. Pietila (at center) with Mark Bauer and Jeff Hart, of Avera Home Medical Equipment
4 yanktonmedicalclinic.com Help is here For an appointment with Dr. Fillaus, call 605-665-1082. The benefits of geriatric expertise By Jennifer A. Fillaus, DO, board-certified internal medicine, nephrology and geriatric medicine; Yankton Medical Clinic, P.C. Improvements in health and health care have led to a worldwide increase in longevity. In the United States alone, there are more than 46 million adults age 65 and older, and that number is expected to continue to rise.1 Population aging is creating a greater need for specialized care. This is where geriatricians and geriatric medicine are important to the health care system. Geriatricians are physicians who completed a residency in internal medicine or family medicine and then completed training specializing in treating older adults. Geriatrics is the health care specialty dedicated exclusively to providing high-quality, person-centered care for older adults. Personcentered care places the values and preferences of the patient at the heart and center of their plan of care and medical decisions. References: 1Mate, K.; Fulmer, T.; Pelton, L.; Berman, A.; Bonner, A.; Huang, W.; Zhang, J. Evidence for the 4Ms: Interactions and Outcomes across the Care Continuum. J Aging Health. 2021 Aug-Sep;33(7-8):469-481. doi: 10.1177/0898264321991658. Epub 2021 Feb 8. PMID: 33555233; PMCID: PMC8236661. 2American Geriatrics Society (Americangeriatrics.org). 3Fulmer, T.; Patel, P.; Levy, N.; Mate, K.; Berman, A.; Pelton, L.; Auerbach, J. (2020). Moving toward a global age‐friendly ecosystem. Journal of the American Geriatrics Society, 68(9), 1936-1940. 4Lundy, J.; Hayden, D.; Pyland, S.; Berg‐Weger, M.; Malmstrom, T. K.; Morley, J.E. (2021). An age‐friendly health system. Journal of the American Geriatrics Society, 69(3), 806-812. 5Tinetti, M.E.; Esterson, J.; Ferris, R.; Posner, P.; Blaum, C.S. (2016). Patient priority–directed decision making and care for older adults with multiple chronic conditions. Clinics in geriatric medicine, 32(2), 261-275. 6Motter, F.R.; Fritzen, J.S.; Hilmer, S.N.; Paniz, É.V.; Paniz, V.M.V. (2018). Potentially inappropriate medication in the elderly: a systematic review of validated explicit criteria. European journal of clinical pharmacology, 74, 679-700. Your time to thrive Who benefits from geriatric expertise? According to the American Geriatrics Society, it’s best to start working with a geriatrics professional when: ● An older person’s condition causes considerable impairment or frailty (this tends to happen after age 75 or when someone starts managing a number of health conditions).2 ● An older person’s family, friends or other caregivers start feeling considerable stress related to care.2 ● Older adults or their caregivers start having trouble following complex treatments or working with many different health care professionals for multiple health needs.2 At the core of geriatric medicine practice are the 4Ms—what matters, medication, mentation and mobility.1, 3, 4 This means: ● Prioritizing the older adult patient’s values and preferences to create their unique plan of care.1, 3, 4, 5, 6 ● Prescribing age-friendly medications and avoiding high-risk medications that may interfere with mental activity and function.1, 3, 4, 5, 6 ● Addressing the prevention, identification, treatment and management of dementia, depression and delirium. 1, 3, 4, 5, 6 ● Ensuring older adults are able to move safely every day to maintain functional ability and enjoy life.1, 3, 4, 5, 6 “Beautiful young people are accidents of nature, but beautiful old people are works of art.” —Eleanor Roosevelt
Spring 2024 5 GOUT: Don’t underestimate it! Living with gout People who have chronic kidney disease, high blood pressure or heart disease are at higher risk for gout and should not ignore symptoms of localized joint pain or joint swelling. These patients also should avoid oral nonsteroidal anti-inflammatory drugs to treat joint pain because of the negative effect these drugs can have on their kidney function or blood pressure. If you think you may have gouty arthritis, it is important to pursue an accurate diagnosis and be sure you are receiving the appropriate long-term treatment to prevent irreversible joint damage over time. How is it treated? There are two important parts to treating gout. The first is aimed at quickly and completely resolving the acute attack when it occurs. Treating an acute flare typically involves receiving a small dose of medication injected into the joint or taking a course of oral medication to help calm the inflammation down. The second part is initiating a once-daily medication to lower the amount of uric acid in the body, thus limiting or ideally stopping future gout flares altogether. In addition to prescribing medication, I address lifestyle changes and dietary recommendations that can help manage gout. Diagnosing gout As a rheumatologist, I have special training in diagnosing and treating arthritis and other diseases that affect the joints, muscles and bones, including certain inflammatory and autoimmune diseases. Diagnosing gout ideally includes aspirating the affected joint with a small needle, then viewing the fluid under a microscope. If urate crystals are observed, then the diagnosis is confirmed and an accurate treatment plan can ensue. While a blood test to measure the amount of uric acid in the body is helpful information, it is not enough on its own to confirm or rule out a gout diagnosis. By Leann Bassing, MD, board-certified in rheumatology and internal medicine; Yankton Medical Clinic, P.C. Gout is a type of inflammatory arthritis that affects over 9 million people in the U.S. It is something I see often in my rheumatology practice. When treated correctly, gout can be extremely well-controlled and permanent joint damage can be avoided. However, when ignored or treated inadequately, patients with gout can develop permanent, and sometimes very severe, joint damage over time. What are the signs and symptoms of gout? The most common presentation of gouty arthritis is that of sudden and intense pain and swelling in one or two joints. Small joints, like toes and fingers, are a typical location, but larger joints, such as knees and elbows, can be involved too. Severe attacks of joint pain are often followed by periods of time with no symptoms. When gouty arthritis lingers, the urate crystals that develop from excess uric acid in the body can also form lumps or swollen growths under the skin. These are called tophi. Avoid painful attacks If you are experiencing recurrent gout flares, please reach out for an appointment: 605-665-1722.
6 yanktonmedicalclinic.com Yankton Medical Clinic, P.C. 1104 W. 8th St., Yankton, SD 57078 Yankton Medical Clinic, P.C., Norfolk 3901 W. Norfolk Ave., Norfolk, NE 68701 Primary Care Specialty Care FAMILY MEDICINE AUDIOLOGY CARDIOLOGY DERMATOLOGY EAR, NOSE AND THROAT NEPHROLOGY ORTHOPEDIC SURGERY PALLIATIVE MEDICINE UROLOGY 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* 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 Liz Wortmann, CNP 605-664-2741 Scott Kindle, MD* 605-664-2741 David Abbott, MD* 605-665-0062 Robert Nicholas, 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 Christopher Hathaway, MD, PhD* 605-664-2742 Haley Schroeder, MPAS, PA-C 605-664-2742 Brian Kim, AuD, CCC-A, FAAA, Audiologist 402-844-8110 Erin Wolf, AuD, CCC-A, FAAA, Audiologist 402-844-8110 Charles Harper, MD* Internal Medicine 402-316-4606 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 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 INTERNAL MEDICINE
Spring 2024 7 Vermillion Medical Clinic Primary Care INTERNAL MEDICINE GASTROENTEROLOGY GENERAL SURGERY GERIATRICS PULMONOLOGY RADIOLOGY Susan E. Fanta, MD* 605-665-1082 Jennifer Fillaus, DO* 605-665-1082 Tyler Hanson, MD* 605-665-1082 Martha Holstein, MD* 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 Steven H. Gutnik, MD, FACP, Associate 605-665-1722 Jesse L. Kampshoff, MD* 605-664-2742 Luke C. Serck, MD* General and Vascular Surgery Specialist 605-664-2742 Jennifer Fillaus, DO* 605-665-1082 Lori A. Hansen, MD, FACP, FCCP* 605-665-1082 Michael P. Pietila, MD, FCCP, FACP* Critical Care 605-665-1152 Leann Bassing, MD* 605-665-1722 Ben LaCrosse, MD* 402-379-2349 Will R. Eidsness, MD* 605-665-7841 Todd Espicha, MPAS, PA-C 605-624-8643 Amy Fluit, MPAS, PA-C 605-624-8643 Alan Spanel, MD* Internal Medicine 402-316-4606 Kelly Jueden, CNP Family Medicine 402-316-4606 Ben LaCrosse, MD* Radiologist 402-379-2349 *Board-certified +Board-eligible Ryan J. Garry, MD, FACS* General and Breast Surgery Specialist 605-664-2742 RHEUMATOLOGY PEDIATRICS Martha Holstein, MD* 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 Self-schedule your appointment online! Now you can schedule online anytime! Visit www.yanktonmedicalclinic.com/ scheduling and follow the prompts. 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
8 yanktonmedicalclinic.com Spirit of Volunteerism award honors community physician Reprinted with permission from United Way of Greater Yankton (edited for space) At United Way and Volunteer Services of Greater Yankton, we believe that volunteers are essential in making our community a better place. Extraordinary community leaders are honored through our Pam Kettering Spirit of Volunteerism award. During United Way’s recent Community Campaign Kickoff and Appreciation Event, the annual award was presented to Tim Irwin, MD, FACC, a community member who demonstrates a strong, dedicated and healing spirit. Dr. Irwin serves in many roles: board member, volunteer physician, medical student supervising physician, team leader for various committees and more at Servant Hearts Clinic—a free, faithbased clinic to assist people who are uninsured or underinsured in our community. “Dr. Tim Irwin goes above and beyond,” says Frani Kieffer, Executive Director of Servant Hearts Clinic. “He is a respected cardiologist with a young family. Even with his busy schedule, Servant Hearts Clinic is his passion. He is dedicated to the mission of Servant Hearts Clinic and ensuring it continues and thrives. Whether he is assisting with IT issues, recruiting physicians or taking care of patients who have no other access to health care, Dr. Irwin is making his community a better place for everyone.” We at Yankton Medical Clinic thank Dr. Irwin for his inspiring dedication to the greater Yankton community and commitment to serving others. Congratulations! For more information on volunteer opportunities or to nominate a volunteer for an award, please visit yanktonunitedway.org/volunteer. To learn more about Yankton Medical Clinic, visit yanktonmedicalclinic.com. 2023 Pam Kettering Spirit of Volunteerism award winner Tim Irwin, MD, FACC What does the award mean to you? “I view the Pam Kettering Spirit of Volunteerism award as a great honor that recognizes those altruistic greats among us. I am humbled, as I don’t consider myself in that group, and honored that others would. I am blessed to be part of an incredible team and could not do this work without them.” How has volunteerism changed or affected your life? “It provides focus for my ‘why.’ I started volunteering at free medical clinics prior to medical school; continued through every stage of training and thereafter. It was a deeply moving experience that solidified my decision to go into medicine and helped to guide my choices, leading me to my current specialization.” What advice would you give to others interested in volunteering? “Stop thinking and just give it a try. In the grand scheme, it is very little time but to others can make such a powerful impact. If we each gave just a scrap of our time, imagine the good we could bring to this world.” We asked Dr. Irwin to share more about his volunteer service here in the greater Yankton community:
Spring 2024 9 Yankton Medical Clinic, P.C., was recognized as Business Partner of the Year by the Department of Health and Human Services, Indian Health Services, Wagner IHS Healthcare Center. Obstetrician-gynecologist Emma Bye, MD, and staff Pam Cokeley, Lizzie Huber and Janine Van Osdel were named on the award presented to Dr. Bye at the Wagner, South Dakota, IHS Healthcare Center. The award was given “In grateful recognition of your service in health care for Native Americans and Alaskan Natives.” Dr. Bye provides women’s health care outreach to the Wagner IHS in addition to her OB-GYN practice in Yankton at the Yankton Medical Clinic. “I’m speaking for Pam, Lizzie, Janine and myself when I say we are humbled at being chosen Business Partner of the Year for Wagner IHS,” says Dr. Bye. “Personally, participating in outreach health care at Wagner IHS is an opportunity to be proactive in promoting healthy guidelines for women and to assist them with their health care needs. Anytime I can help women learn how to stay healthy, it’s a positive experience.” Becky McManus, CEO of Yankton Medical Clinic, agrees with Dr. Bye: “We are grateful our physicians have a true calling to their patients, and Dr. Emma Bye is no exception. Dr. Bye is passionate about providing women’s health care, and her patients appreciate her expertise, as they consistently rank Dr. Bye five stars. “Thank you to Dr. Bye, Pam, Lizzie and Janine for representing Yankton Medical Clinic in the most positive way, by sharing their compassionate care to others. Because of Dr. Bye and many of our physicians, Yankton Medical Clinic provides outreach in 13 locations outside of Yankton, including Wagner IHS.” YANKTON MEDICAL CLINIC named Business Partner of the Year Yankton Medical Clinic staff Pam Cokeley; Lizzie Huber; Emma Bye, MD; and Janine Van Osdel
10 yanktonmedicalclinic.com Vermillion Medical Clinic donates to community organization Vermillion Medical Clinic recently donated $1,000 to the Vermillion Public Schools Foundation Playground fundraiser. The foundation is helping to provide an accessible playground, inclusive of children with limited mobility, at the new elementary school in Vermillion. Amanda Sedlacek, DO, boardcertified in internal medicine and palliative care at Yankton Medical Clinic, P.C., was recently notified that her article, “Palliative Care Knowledge Following an Interdisciplinary Palliative Care Seminar,” has been selected to be featured in an upcoming edition of the American Journal of Hospice and Palliative Medicine. Dr. Sedlacek, one of the few board-certified palliative medicine physicians in South Dakota, wrote the article about her work with the Sanford School of Medicine Director of Interdisciplinary Palliative Care (IPC) seminar. “This seminar provides foundational palliative and hospice concepts, introductions into palliative care disciplines, integration of teamwork, and interdisciplinary studentled patient encounters,” says Dr. Sedlacek. “Traditionally, this experience had been in person; however, during the COVID-19 pandemic, health care restrictions transitioned our educational delivery to a virtual platform.” To monitor how outcomes may have been affected going from an Pictured are Anna Nelson, RN, Clinic Manager; Matthew Krell, MD, pediatrics; Todd Espicha, PA, family medicine; and Amy Fluit, PA, family medicine, as well as members of the Vermillion Public Schools Foundation. Published doctor will speak at national conference in March Congratulations, Dr. Sedlacek!
Spring 2024 11 in-person event to a virtual one, the Palliative Care Knowledge Test was administered to students before and after the IPC seminar. A one-year follow-up survey was also administered to evaluate how the IPC seminar was applicable to the students’ clinical experiences and practice. Dr. Sedlacek was very pleased with the results. Great news for patients “This is significant because it showed that virtual palliative education provided to undergraduate nursing, graduate nursing, medical students, clinical psychology, physician assistants and social work students through the Sanford School of Medicine IPC seminar has shown to improve knowledge, foster collaboration across disciplines, and promote the growth of palliative and hospice care understanding and access across the region,” explains Dr. Sedlacek. “Many of our students practice in rural areas, where access to palliative care services is limited or nonexistent. This experience exponentially impacts the growth of palliative and hospice care understanding and access to care across the region. Ultimately, this is great news for patients.” “Dr. Sedlacek’s very important work on creating and monitoring a virtual IPC seminar has already shown a profound effect,” adds Becky McManus, CEO of Yankton Medical Clinic. “We congratulate Dr. Sedlacek on being published in the American Journal of Hospice and Palliative Medicine.” Palliative care conference Dr. Sedlacek has been selected to present during the 2024 Annual Assembly of Hospice and Palliative Care, taking place March 20 to 23, in Phoenix. Dr. Sedlacek has been asked to give a podium presentation as well as a poster presentation during the national conference. The podium presentation, “Overcoming Geographical Barriers: A DistanceMediated Interdisciplinary Palliative Care Seminar,” and the poster presentation, “Know Thyself: Assessing and Improving One’s Comfort Around Spirituality and Patient Care,” were selected by the Annual Assembly Planning Committee from among many physician submissions. “I am honored to have been chosen by physician colleagues to present on such important health care topics during a national conference,” says Dr. Sedlacek. “I hope to convey the importance of these palliative medicine topics. In addition, I will be learning from other physicians chosen to present.” Dr. Sedlacek consistently receives five-star ratings from her patients, who frequently acknowledge her vast expertise, empathy and compassion in the care she provides. McManus notes that Dr. Sedlacek is respected not only by her patients but also her peers. “Her approach and expert knowledge of palliative medicine exemplifies a high standard of care by treating the whole person, not just the symptoms,” McManus says. Schedule your visit Dr. Sedlacek sees palliative care and internal medicine patients in her practice at Yankton Medical Clinic. For an appointment, call 605-665-1722. Amanda Sedlacek, DO
1104 West 8th Street Yankton, SD 57078 Standard U.S. Postage PAID Walla Walla, WA Permit No. 44 Don’t wait to be seen when you’re sick! Call 605-665-8910 or schedule online with the physician on call at yanktonmedicalclinic.com/scheduling. Same day acute care appointments Nebraska Creighton, NE Avera Creighton Hospital 402-358-5700 ● Jesse Kampshoff, MD* General Surgery Norfolk, NE Yankton Medical Clinic, P.C.–Norfolk at Fountain Point Medical Community 402-844-8110 ● David Abbott, MD* Ear, Nose and Throat ● Brent Adams, MD* Orthopedic Surgery ● Ryan J. Garry, MD, FACS* General and Breast Surgery ● Christopher Hathaway, MD, PhD* Urology ● Dawn Lauer, MPAS, PA-C Orthopedics ● Robert Nicholas, MD* Ear, Nose and Throat ● Michael Pietila, MD, FCCP, FACP* Pulmonology Care near youWe provide specialty care in 13 locations outside of Yankton. O’Neill, NE Avera St. Anthony’s Hospital Specialty Clinic 402-336-5122 ● Kevin Bray, MD, FACOG* Obstetrics-Gynecology ● Byron Nielsen, MD* Nephrology ● Michael Pietila, MD, FCCP, FACP* Pulmonology ● Amanda Sedlacek, DO* Internal and Palliative Medicine 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 Parkston, SD Avera St. Benedict Health Center 605-928-3311 ● Michael Pietila, MD, FCCP, FACP* Pulmonology 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 ● 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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