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ASPECTS Southern Illinois University School of Medicine | Spring 2020 | 43-1

50 Years of Rural Community Care

As we go to press: A global pandemic alters every course

The American public is sheltering in place while its health care system sails into uncharted waters. Our national economy hangs in the balance, undermined by a threat so small it can’t be seen by the naked eye.

Initially detected in December on the other side of the world, the coronavirus has now entered medical annals as the most disruptive global pandemic of modern times. The interconnectedness of life on Earth and the virus’ highly communicable design brought it to our doors with sobering swiftness.

On March 19, the first day of spring, Sangamon County had its first COVID-19-related death.

One day later, SIU School of Medicine fourth-year students learned the results of the National Residency Matching Program at their homes in Springfield – a manner they never could have anticipated when starting their postgraduate education in Carbondale four years earlier. The next generation of physicians is experiencing problem-based learning on a sociological scale.

While the scope and seriousness of this outbreak is staggering, it is not unprecedented. And it was not unexpected. Public health experts have been warning of the potential for a globe-spanning pandemic for years. In an Aspects cover story in Winter 2018, we touched upon the topic – and the critical understaffing of the nation’s public health laboratory workforce:

Winter 2018 Aspects Cover

Since 1980, the number of dangerous disease outbreaks per year has more than tripled. The American health care system may be the envy of the world, but it has yet to face a global pandemic. If an infectious disease spreads around the globe, could a medicine be designed and mass-produced in time to keep history from repeating? It’s a problem that requires a massive investment of scientific resources and people, and one which a program at SIU School of Medicine hopes to help resolve.

The article highlighted the School of Medicine’s collaboration with the Illinois Department of Public Health to establish a master’s program in Public Health Laboratory Science. Since 2005, it’s been 1 of only 3 in the country training men and women in this vital field.

Like our young physicians and health care teams, these trainees are using their expertise, versatility and courage to focus on the tasks before them, doing their jobs to the best of their abilities, taking one day at a time.

We wish them — and you — the very best in the days ahead.

Read the full story

Family Medicine integrated care clinic opens in Taylorville

A ribbon cutting and holiday open house were held for Christian County residents and neighbors on December 11, 2019, at Taylorville SIU Center for Family Medicine. The integrated clinic at 303 East Bidwell Street began serving patients in November. It is shared by SIU Center for Family Medicine-Taylorville and Memorial Behavioral Health. Guests met health providers, toured the clinic, enjoyed holiday treats and picked up small gifts for the kids.

$5 million grant boosts effort to curb disease spread in Delta region

A new federal grant could help decrease the spread of disease among drug users in southern Illinois, one of the rural regions most affected by the opioid epidemic. SIU School of Medicine’s Department of Population Science and Policy (PSP) and the University of Chicago will partner on the $5.1 million project.

“People living in rural areas are more vulnerable to the opioid crisis, and this project will help us learn why rural opioid use takes such a disproportionate toll,” said Wiley Jenkins, PhD, epidemiology and biostatistics division chief at PSP who will direct the research.
Wiley Jenkins, PhD

The state’s 16 southernmost counties, referred to as the Illinois Delta Region, share many of the characteristics of rural areas that have experienced recent HIV epidemics. The federal grant from the National Institute on Drug Abuse of the National Institutes of Health (NIH) will support studies to explore how factors such as place of residence and local culture affect infectious disease spread and treatment among people who inject drugs.

“Based upon PSP’s preliminary work in 2017-19, the project can substantially expand the volume and accessibility of harm reduction services, and improve coordination for a continuum of care,” Jenkins said. “We can get those in need infectious disease screening, referrals to care and better treatment. We’re extremely grateful to NIH for supporting this research.”

Ringing in the School of Medicine’s 50th Year

Celebrating the medical school’s 50th anniversary, Jerry Kruse, MD, Dean and Provost, kicked off the year of planned events with an anniversary reception Jan.6. Guests included former and current faculty and staff, state representatives, municipal government officials, hospital partners, administrators and founders.

A red wine blend created specifically for SIU by a local winemaker and a new sign at the corner of Carpenter and Rutledge streets were unveiled during the celebration.

SIU School of Medicine intended to host events throughout 2020 to commemorate its golden anniversary but the COVID-19 pandemic has made scheduling difficult. Plans for a 50th Anniversary celebration at the Crowne Plaza in Springfield and a Student Welcome Celebration in the courtyard are on hold.

View photos from the evening

Kenniebrew speaker encourages equity, leading with character

Dr. B. Cameron Webb | Pictured, from left to right: Eric Linson, David Steward, MD, Patrice Jones, John Flack, MD, Sacharitha Bowers, MD, Vidhya Prakash, MD, and Susan Hingle, MD

Physician and lawyer Dr. B. Cameron Webb discussed “Healing Racial Trauma through Authentic and Critical Conversations” at the Alonzo Homer Kenniebrew, MD Lecture on February 11 at the Memorial Center for Learning and Innovation. He drew upon his personal experiences as a young African American, a health policy adviser in both the Obama and Trump administrations, and as an academic at the University of Virginia School of Medicine in Charlottesville, a flashpoint for racial violence in the summer of 2017.

Internal Medicine Chair John Flack, MD, accepted the 2020 Equity Award in recognition of the department’s multitude of academic endeavors and community events that promote diversity, respect and inclusiveness.

Day of Giving exceeds last year’s totals

SIU School of Medicine alumni and friends, your generous support on Day of Giving 2020 allowed the school to surpass its numbers from last year. Gifts totaling more than $200,000 will help support student scholarships, research and programs at SIU School of Medicine.

“I’m so thankful for and grateful to our donors. Your ongoing support of SIU School of Medicine will help us continue to fulfill our mission of serving the health care needs of the people of central and southern Illinois long into the future,” says Hal Smith, executive director of development at the SIU Foundation.

The School of Medicine is once again claiming the honor of the academic unit with the most individual gifts. A trophy for this accomplishment will again be awarded in Carbondale to Dr. Jerry Kruse at a later date.

Calling the classes of 1977, 1980 and 1998:

IT'S A $50K FOR 50 YEARS MATCHING CHALLENGE

Drs. Jerrold Jerrold Willis, ’77; Prashanth Shekar, ’80 and Ryan Willis,’98, have issued a challenge to their classmates in honor of the 50th anniversary. Each will match the gifts from his respective class, up to a combined total of $50,000. If all three classes meet the challenge, that’s a minimum of $100,000 for SIU School of Medicine scholarships and programs.

Members of the classes of 1977, 1980 and 1998 can donate to any fund as a part of this challenge. The school will run this match challenge through the end of the fiscal year, June 30, 2020. Help us leverage this very generous gift to create the maximum impact on scholarships that every medical student truly needs.

COMPASSIONATE CARE

A Message from the Dean

In the last 50 years, SIU School of Medicine’s physician practice has grown from a small medical school providing patient care with the help of community clinicians to a nationally recognized institution, partnering with hospitals, clinics and associations across Illinois. Today, SIU School of Medicine is a key player in the continued advancement of medical care in Springfield, Decatur, Quincy, Carbondale and dozens of towns in between.

SIU Medicine, the health care arm of SIU School of Medicine, is the largest multi-specialty physician group in the region, with nearly 300 full-time physicians and other medical professionals who provide patient care to more than 125,000 individuals each year.

Some have interpreted the school’s mission as filling the region with primary care physicians. Certainly, the numbers represent that: about half of the school’s nearly 3,000 graduates chose primary care. According to the Association for American Medical Colleges, SIU School of Medicine has the highest percentage of graduates in the nation practicing in rural areas, serving citizens who have few medical resources.

SIU Medicine now includes the largest university-owned and administered Federally Qualified Health Center (FQHC) system in the U.S., which serves the region with 13 clinics in eight cities.

SIU’s FQHC facilities offer a gamut of services: comprehensive primary medical, dental and mental health care, the largest network of medically assisted treatment options for opioid use disorder, neighborhood assessments with community health workers and hot-spotting for comprehensive care of the most vulnerable and underserved populations.

Many of our downstate citizens also rely on our physiciansfor specialty care. SIU’s clinical efforts have grown to include sub-specialties and innovative therapies: neonatology and other pediatric specialties, advanced cancer care, robotic surgeries, new psychiatric and neurological treatments, gastroenterology therapeutics and more. This maturation into highly specialized care means offering more educational opportunities to students and residents. They are equipped with the additional knowledge, skills and attitudes to excel when they venture into their own careers.

SIU School of Medicine coordinates the largest network of mental health and psychiatry services in downstate Illinois through combined efforts with its FQHCs, Department of Psychiatry and telehealth network. The teams also provide psychiatry services to some of our most underrepresented population downstate through a telemedicine partnership with the Illinois Department of Corrections and county jails.

SIU Medicine has the top infertility treatment rates in the country. The South-Central Illinois Perinatal Center, led by SIU Medicine providers, is the largest group in downstate Illinois and provides tertiary care services to 30 hospitals and 36 counties. SIU Medicine’s telemedicine network provides maternal-fetal medicine services to rural hospitals and clinics in central and southern Illinois.

SIU is providing accomplished team-based, multidisciplinary care through the following state-designated centers:

  • Neuroscience Institute at SIU Medicine
  • Simmons Cancer Institute at SIU Medicine
  • SIU Medicine Center for Alzheimer’s Disease and Related Disorders
  • SIU Medicine Parkinson’s Disease Center
  • SIU Center for Rural Health and Social Service Development (based in Carbondale)

Amid all this growth, SIU Medicine physicians continue to provide compassionate care to communities with the help of hospital partners and more than 700 volunteer faculty. Working together, physicians, nurses, staff and administrators not only bring the knowledge and skills to keep pace with the ever-evolving practice of medicine, but they also have the empathetic attitudes to function with care and conscience. We never lose sight of patients as people.

Our doctors have a commitment to lifelong self-directed learning, to expressing cultural humility and ethical practices toward patients. No matter what direction health care takes in the future, these humanistic qualities will always be vital to caring for neighbors and loved ones.

Jerry Kruse, MD, MSPH

Dean and Provost, SIU School of Medicine

CEO, SIU Medicine

Strategic Plan 2020 to 2025

For 50 years, the SIU School of Medicine has fulfilled its legislative mandate to assist the people of central and southern Illinois in meeting their health care needs. We have emphasized high quality programs in medical education, research, clinical care and regional outreach while training more than 9,000 physicians, physician assistants, scientists and scholars. Our philosophy and programs are also characterized by enduring partnerships with others who share our vision.

Health care and health care education are now in a time of rapid and accelerating change. New alliances and advances in technology are emerging at a pace that we have not before experienced. Opportunities and challenges abound for every health care organization. Throughout 2019, in the context of this rapid change, we engaged in a process to more precisely define our mission, vision and values, and to develop strategies that best allow us to seize the opportunities and surmount the challenges. In short, we gazed into the future to develop a plan to, in effect, create our future and to move the organization forward.

Our gaze has focused on the forces that influence the needs and desires of those around us – the people, communities and populations we serve.

  • Our Region. Our plan addresses a major initiative of the SIU System Board of Trustees. This initiative focuses on the unique nature of the geographic area in which we sit – an area with more than 2,500,000 people in a 40,000 square mile expanse, a distinctly rural area made up of the people in small urban areas, towns, and farms and the environment in which they exist. The vision of the Board is that the SIU System will develop a coordinated effort to unify the health services in this region, and that SIU will be known as the nation’s leader in rural health care assessment, education and delivery. We at the School of Medicine will be leaders in this effort.
  • Global and National Forces. Our plan has considered systemic elements that threaten the health of those we serve. Our nation’s health care system is fragmented and uncoordinated. Inequities in access to care, in the delivery of care, in education and in the work environment are overflowing. The current global pandemic and climate change pose the greatest potential long-term threat to health. To address these elements, we envision a future with partnerships that are deeper and more effective. We believe that multilateral alliances of academic, private and government organizations will provide the best solutions.
  • Fundamental Advances. Our plan has considered the rapid advances in the understanding of the continuum of lifelong learning, in new research methodologies, in new models of clinical care, and in human-machine collaboration, artificial intelligence and other technological advances. We must embrace the advances of this new world, as we continue to emphasize personal and healing relationships

Thus, our fundamental responsibility is two-fold. The first is based on our mission of social accountability to the people of central and southern Illinois, and is defined by our programs and partnerships. The second is based on the medical school’s new vision, “Better Health for All,” and is defined by our desire to advance the discipline of medicine to fulfill this vision.

Our new strategic plan will guide SIU School of Medicine for the next five years. We will develop a work plan with tactics to fulfill these strategies. Yet even when these tasks are accomplished, our work will not be done. Given the rapidity of change, we will commit to the foresight and adaptability that is needed to best serve the people of our region, to improve the public health, and to advance the discipline of medicine.

VALUES

Better Care Behind Bars

Corrections, SIU Medicine partner to improve health care delivery in state facilities

More than 76,000 Illinoisans live behind bars, and nearly 41,000 of those individuals call state prisons home. Like the more than 2.2 million justice-involved individuals in the United States, many suffer from a complex combination of anxiety, post-traumatic stress and a range of chronic health conditions, including hypertension and arthritis.

In an effort to improve health care delivery in correctional facilities and meet its mission, SIU School of Medicine is partnering with the Illinois Department of Corrections (IDOC) to offer a “new approach to care” for justice-involved individuals.

SIU School of Medicine’s mission, to assist the people of central and southern Illinois in meeting their health care needs through education, patient care, research and service to the community, will be met in two ways, says Dr. Jerry Kruse, dean and provost of SIU School of Medicine. “Our history always has been one of social accountability, so we’ll do what’s best for the people of Illinois. We will care for this new patient population and provide services to help reintegrate them into their communities.”

Slated to officially begin in summer 2020, the three-year pilot project will initially provide health care in four correctional facilities: state correctional centers in Pinckneyville, Shawnee and Vienna, and the Logan Correctional Center in Lincoln.

During the first phase of the partnership in 2020, an SIU primary care physician and psychiatrist will work jointly with the IDOC chief medical officer to provide services to the correctional facilities in Pinckneyville. The school will also establish obstetrics and gynecology care at Logan Correctional Center in Lincoln.

Also within Phase 1, SIU Medicine will connect individuals with a medical home as well as provide peer support and reentry services to parolees. “After incarceration, they often face poorer health outcomes and reduced life expectancy, so we want to try to assure that the care we provide to our patients during incarceration continues during that time of particular vulnerability,” says Dawn DeFraties, Executive Director of the newly created Office of Correctional Medicine at SIU.

SIU School of Medicine’s and IDOC’s partnership reflects a national trend in which correctional facilities collaborate with academic medical centers to provide health care.

Similar agreements in Texas and Connecticut have resulted in:

  • more structured delivery of health care services using evidence-based medicine
  • greater access to subspecialists
  • improved clinical outcomes for chronic illnesses
  • cost savings for the state.

“As a medical school, we are better able to address social determinants of health through our current research, education and clinical care – things we already do quite well,” says DeFraties.

The partnership is also expected to yield unique benefits to SIU’s budding health care professionals.

“Correctional medicine is a rich environment for learning. By providing the opportunity for expanding learning and clinical opportunities, SIU School of Medicine will drive not only quality health care to our justice-involved population but will serve as a pipeline to producing qualified, board-certified correctional medicine physicians.”

IDOC recognizes the benefits for justice-involved individuals as well. “We are eager to offer a new approach to care for our corrections population,” says Rob Jeffreys, acting director of IDOC. “SIU School of Medicine has a reputation for quality medical care and innovation. This new partnership gives us the opportunity to explore a different health care model, one that’s more patient-centered and outcome-based.”

No Restrictions

Novel surgery offers relief for kidney stone injuries

Drs. Bradley Schwartz (left) and Adam Jenks work to remove a kidney stone.

SIU Medicine urologist Bradley Schwartz, DO, FACS, performs nearly 400 surgeries each year to remove kidney stones from patients. The hard deposits are made from minerals such as calcium, infection or other constituents such as uric acid that collect in the kidneys. They are sometimes small enough to pass naturally, but when they aren’t, they can cause obstruction, discomfort and often, intense pain.

For Dr. Schwartz it’s also personal; he has had three stones himself and knows the big problems these little irritants can generate.

In the past year, Schwartz has added a novel procedure to his repertoire of laparoscopy and minimally invasive surgery. From literature reviews, he estimates the new procedure has been performed only 15 or 20 times in the world, and he has done three of them – two in Springfield and one in Washington. Its technical name is a mouthful: the robotic-assisted buccal graft ureteroplasty.

Dr. Schwartz takes tissue from the inside of a patient’s mouth, in the cheek – the buccal mucosa – and grafts it to repair damage to the ureter. The ureter is the tube that drains the kidney into the bladder. “People who have kidney stone disease can get strictures when stones lodge in the ureter,” he says. “Think of a golf ball in a garden hose.” Pressure builds up behind the partial obstruction and the friction creates a ring of scar tissue within the ureter.

The urologist can remove the stone, but the ischemic damage has already been done. The scarring in the ureter can be managed with stents, but patients’ responses vary. “They work for a while,” Dr. Schwartz says, “but then they don’t like it or can’t tolerate it and are ready to try something else.”

That was the case with his first patient, Lamar Johnson, 72, a state employee with a history of kidney stones. While on vacation in St. Thomas in summer 2019, Johnson was struck by incredible pain that he assumed was appendicitis. In the ER he learned he had a stricture.

“I’d never heard of that before,” Johnson says. Back in Springfield, Dr. Schwartz examined him and reached the same conclusion. “He explained what it was and told me about this procedure. He said ‘it’s never been done here but if you don’t mind I’d like to try it.’

Usually no one wants to be the first, but Johnson was “more than willing,” he says, chuckling.

Schwartz had confidence knowing there was a 40-year history of buccal tissue being used to repair the urethra – the tube that carries urine out of the body. He was applying the same principle and utilizing Intuitive Surgical’s da Vinci® Surgical System for robotic assistance to enhance precision and control in placing the graft. Patients who undergo robotic surgery tend to recover quicker.

Dr. Schwartz cautioned Johnson that while patients are rarely bothered by abdominal pain afterward, there would be considerable cheek pain due to the density of nerves and vascular tissue in the graft donor site.

“He was right about that,” Johnson says, “but it was temporary.” He considers the 3-hour surgery well worth it.

“I can’t tell you what a difference it has made in my life. It was like night and day. The very next day was just unbelievable relief. I could pee again without pain.”

Johnson says while he still has kidney stones, he passes them. “They don’t get hung up. I don’t have to have somebody go in and retrieve them or blast them. That’s what I’d put up with for years.”

Dr. Schwartz’s other two patients, a man and a woman, experienced similar successful outcomes.

Schwartz’s team will be presenting its work on the novel surgery at an international meeting in Germany in August.

YOUNG PATIENT MAKES HISTORY: In 1978 SIU plastic surgeon Allen Van Beek, MD, performed one of the world’s first bilateral surgeries, reattaching the arms of 2-year-old Devin Vannoy after a farming accident in rural Atlanta. Today Vannoy works in Lincoln and visits his friend, Dr. Van Beek, whenever travel takes him north to Minneapolis.

First-year Resident in Family Medicine

aspects of a LEARNER

Navpreet Badesha, MD

Tell me about your childhood, what’s your family like? Both of my parents are immigrants and hustlers. My parents grew up in India and immigrated to California and started their own business. I grew up watching them live out the American dream. They were always telling me as a kid that I could grow up to live out any dream I imagined.

What made you decide to go into medicine? It’s funny because one of my friends recently told me that in sixth grade, our teacher asked us to write on the board what we wanted to be when we grow up. He said I wrote “doctor” on the board and he congratulated me by saying “you became exactly what you said you would.” I didn’t even remember that! It meant the world to me. As I progressed through school, I was drawn to science and sports. I had a dream of being a professional athlete or a sportscaster when I was young, when that didn’t work out, I was into studying sports and sciences. The more I learned about the human body, the more obsessed I became with how awesome our bodies are! Remember, no matter who you are, someone is always loving and fighting for you – your white blood cells!

Why did you choose family medicine for residency? I love the idea of treating what we call from the “cradle to the grave” or “womb to the tomb.” In med school I learned how much I love babies, I love caring for moms and their babies. When I was exposed to caring for women during childbirth, I knew I wanted to take care of families as a whole. Plus it really encompasses my philosophy around caring for your mind, body and spirit at the same time.

You have a side project outside of residency too. How did that come to fruition? In my first year of med school, I was really focused on a mind-body-spirit connection. One day, while I was meditating by a beautiful ocean, the name MEDspiration came to me. It started as a blog about functionality of the human body. The blog grew to be extremely popular, to the point where we got featured on ABC news, Business Insider and The Doctor’s TV show. After all of this success sent more people to the blog, I decided that I wanted MEDspiration to be a non-profit organization, something that could be much larger than just one person. Today, we offer free open access medical education to over 5 million people each month! We have a podcast, an awesome YouTube channel and a team that is truly dedicated to promoting healthy living across the globe.

How do you handle the intersection of social media and medicine? I take this opportunity to educate patients on a different platform. Instead of educating one patient at a time in a clinic setting, I’m sharing the latest research in medicine in a new, engaging way that our patients can share with their friends too. I think of it as counseling millions of patients without actually doing that in a one-on-one setting. My intention is always to inspire others. I’ve had multiple occasions where patients come into clinic to tell me they saw a post on Instagram and they were inspired to run more, to work out, to eat right, you name it. Because I know patients are following me, I keep it really professional and inspirational.

How did you choose SIU Medicine? I met my wife and better half, Malika, in med school – and we ended up training together in Chicago. As we spent time together over the years, I knew this was the woman I wanted to spend the rest of my life with. So, we applied to couples match – where you do residency at the same program or at least in the same geographic area. We both fell in love with Springfield and the Family Medicine program here! My biggest inspiration was Careyana Brenham, MD, our program director. She is one of the strongest and most energetic human beings I’ve ever met. Now, looking back on it, I am so grateful to be here. I love everything SIU stands for and I am lucky to be training toward my dreams, with my wife doing the same by my side!

As you know, SIU Medicine has a focus on improving the health care offered in rural settings. What are your thoughts on providing care in a rural area? I think you have more opportunities to truly add value to patients’ lives in a rural and even small urban setting. Because resources aren’t as abundant, providing quality care to those individuals can be truly life-changing for them, and I personally love seeing that impact.

What are your plans for the future? Aside from finishing residency, I am drawn to sports medicine and hospital medicine. I also love outpatient clinic. My goal is to be the best version of myself each and every day, whatever comes as a result of that, I trust will be greater than anything I can imagine. My dream is to continue building MEDspiration’s platforms to the point where we have a Netflix series or something similar. A man can dream!

Dr. Nav’s MEDspiration page on Instagram has 238,000 followers.

A MATCH DAY LIKE NO OTHER

For the first time in the history of the school, SIU senior medical students received results from the National Resident Matching Program at home on their phones or computers on March 20, at the same time other U.S. medical students learned their matches to postgraduate training programs. The 61 members of the Class of 2020 who secured residency positions were notified via email in adherence to pandemic guidelines limiting large gatherings.

“I’m so proud of our medical students as they enter the next phase of their career,” said Jerry Kruse, MD, MSPH, SIU School of Medicine dean and provost. “The COVID-19 precautions made the Class of 2020’s Match Day unique, and it underscores the crucial roles our learners will be filling as they matched into many excellent training programs.”

Match results also were announced for SIU’s residency programs in Springfield, based at the school’s two affiliated hospitals – Memorial Medical Center and HSHS St. John’s Hospital. Seventy-seven starting positions in Springfield were filled. The first-year residents will join more than 225 senior residents and fellows already in training at SIU programs in Springfield.

The Class of 2020 at SIU School of Medicine will graduate in May, and diplomas will be mailed to the new physicians. They will begin their residency training in July.

Graduates pictured from left to right, top to bottom: Shelby Markel, Lauren Grant, Brendan Finnell, Brea Sturm, Susan Oo, Peter Wade, Kelly Schmidt, McKenna Murphy , Abigail Levy
MATCH DAY through the years
SIGN OF THE TIMES: Photographer Ed Warner chronicled the early years of the School of Medicine, including this hand-painted appeal mounted in a field outside Divernon (pop. 1,100), 15 miles south of Springfield.

2020 Vision

Rural Health in Focus in Electoral Politics

Health advocates across the country experienced an apex of information and agenda-setting on the issue of rural health in early February. When New Hampshire voters made their way to the polls, they did so with more information on candidate stances on rural health than in any other recent election. As Democratic candidates packed to leave the first primary state, President Donald Trump was releasing an FY2021 budget that included new investments for rural America. In the very same week, health policy leaders gathered in Washington, DC, for the National Rural Health Association’s Rural Health Policy Institute. While there, they leaned into conversations about the role of health care policy in the 2020 election.

“Rural health care conversations are louder than they have been in the past,” said Heather Whetsell, administrative director of the SIU Medicine Department of Population Science and Policy. Whetsell also represents SIU on the NRHA Rural Health Congress’ hospital and community health systems constituency group. “We cannot afford to stay silent, as rural hospitals are closing, with even more at-risk for closure. There is a growing awareness that we need to advocate, educate and communicate on the importance of rural health.”

Rural health is a bipartisan issue that has been elevated to a position of prominence in the platforms for candidates seeking the highest office. Polls show that Americans are interested in the issues of rural health as part of a broader conversation about rising health care costs and decreased access for all.

A 2019 Bipartisan Policy Center (BPC) and American Heart Association poll reveals that 92 percent of Democrats and 93 percent of Republicans consider rural health to be an important issue. The survey further concludes that three in five voters say they are more likely to endorse a candidate who prioritizes rural health.

“We are pleased to see that our poll shows rural health is an issue of concern for rural, urban, and suburban Americans, and transcends political parties,” said former Senate Majority Leader Tom Daschle (D-S.D.), who is co-chairing a new BPC Rural Health Task Force with former Senator Olympia Snow (R-Maine). “Rural health has never been a top tier issue on the campaign trail. However, these findings show that it could be a powerful topic in the 2020 election. It should prompt every candidate and policymaker to address the challenges of rural health and take action,” he continued.

Beyond the campaign trail it’s clear that rural health isn’t just a positioning opportunity for candidates in pursuit of voters. It has also become a budget priority for the White House. President Trump had rural America in mind as he delivered a budget address that included spending on business loans, intranet access and infrastructure to rebuild rural America.

When it comes to health care, the administration has outlined four priorities: prevention, sustainable financing, technology and health care workforce solutions. Funding for rural health care programs include investments and payment updates for rural health clinics, emergency hospitals, telemedicine and telehealth services.

Autumn Bohac of Effingham was diagnosed with Type 1 diabetes when she was 16 years old. Now a 29-year-old mother of four, her health care journey reveals the everyday anxiety and pain that rural patients feel.

Autumn lives just a few blocks away from her town’s hospital. However, specialty care teams she has needed to manage her diabetes and four high-risk pregnancies have always been almost two hours away.

With her first two pregnancies, seeing a specialist required 1.5 hours of travel. However, during her third and fourth pregnancies, she was able to use telehealth for appointments with SIU Medicine’s Department of Maternal-Fetal Medicine in Springfield.

“I just can’t stress how nice it was to be able to have specialty appointments that didn’t require that I take an entire day off of work and search for childcare.”

Still, one stressor for Autumn and millions of mothers like her is there were no options to deliver her children at her hometown hospital. With her health history and the lack of a NICU, delivering her babies required that she travel nearly 2 hours away.

Patients living in rural communities with hospital closures, mergers and doctor shortages don’t need anyone to preach to them about the importance of building a better rural health infrastructure. Their long trips to rural emergency rooms, trouble accessing specialists and maternity wards speak louder than any elected official or candidate can.

Rural populations often face very distinct health challenges and disparities. Multiple factors for these disparities include poverty, social determinants, higher rates of obesity, smoking and decreased access to insurance in rural areas.

As a result, the health of rural patients tends to be worse than those in urban areas. According to a recent Pew Research Center survey, mortality rates for the five leading causes of death – heart disease, cancer, unintentional injury, low respiratory disease, and stroke – are all higher in rural areas.

In addition to measuring health disparities, rural health policy advocates are also paying attention to a disappearing health care infrastructure in rural America. According to the National Rural Health Association, more than three-fourths of rural counties are primary health professional shortage areas. More than 120 rural hospitals have closed since 2010 and hundreds more are vulnerable. And in an emergency, rural patients travel twice as far as urban residents to get to the closest hospital.

One of the root causes of rural health disparities is the nationwide shortage of primary care physicians that has a disproportionate impact on rural communities. The high cost of medical education remains a factor. Taking on medical school debt to work in a rural area with a modest salary continues to be a detriment to students who would otherwise choose to work in underserved areas. In addition to these personal factors, rural practitioners and hospitals receive lower reimbursement for the care provided to patients on Medicare and Medicaid.

“SIU School of Medicine was founded on the need to provide better care to the community in central and southern Illinois more than 50 years ago,” said Jerry Kruse, MD, dean and provost. “While the need was critical back in the 1960s, it remains a high priority for the medical school today. Creating the next generation of doctors to provide care to our communities – regardless of where they call home – is still a mission for us.”

Rural voters may not be paying attention to the political priming of candidates, but ample evidence shows candidates are paying attention to rural voters. Every presidential candidate had a rural agenda that includes ways to address doctor shortages, funding and reimbursement rate changes and telehealth expansions to improve access.

  • Former Vice President Joe Biden has pledged additional funding for residency programs in rural areas.
  • Former New York Mayor Mike Bloomberg wanted to change rural hospital payment models to fixed, capitated budgets.
  • Senator Amy Klobuchar (D-MN) wanted to create a new Rural Emergency Hospital classification under Medicare so that more rural hospitals can maintain an emergency room and outpatient services.
  • Senator Bernie Sanders (D-VT), like all Democratic candidates, wants to increase funding for the Community Health Center Fund and the National Health Services Corps to increase providers.
  • Senator Elizabeth Warren, (D-MA) wanted to target residency placements in rural and medically underserved areas and higher reimbursement rates.

Polling data may show wide bipartisan support for rural health issues, but that doesn’t necessarily translate into voting behavior. Campaign promises don’t mean much to patients. Rural communities and patients are ready for real action and investments in the country’s rural health infrastructure.

Autumn wants every state and national policymaker talking about rural health to stop long enough to listen to the real-life struggles of people without transportation and access to health care that includes specialists and telehealth services. She believes that if they listen to stories like hers, they will quickly realize that this isn’t about election politics at all.

“It’s about access. It’s about the everyday struggle to get the care you need. These are the stories that politicians need to listen to.”

Population Science and Policy to offer Rx for State Rural Health

The Department of Population Science and Policy (PSP), in collaboration with University of Illinois at Chicago School of Public Health, SIU Paul Simon Public Policy Institute, SIU Medicine Center for Rural Health and Social Service Development and the Illinois Department of Public Health, convened a summit of 50 influential stakeholders across various sectors such as government, health care, public health, philanthropy and academia to share perspectives on the state of rural health in Illinois. The summit’s activities were designed to spark conversation on major challenges and successful initiatives happening in the state’s rural regions to allow PSP to begin building a blueprint to improve the health of rural Illinois through sustainable, innovative programs and policies.

From the summit came a report titled “The State of Rural Health in Illinois: Great Challenges and a Path Forward,” which found that rural Illinois residents face significant challenges and health disparities compared to residents in the state’s metropolitan areas. The report identifies rural issues such as physician shortages, opioid use, childhood disparities, an aging population, obesity, housing and the rural economy as major issues contributing to suboptimal rural health outcomes. That report drew national attention and has paved the way for sweeping policy recommendations to sustainably improve rural health in Illinois. The SIU PSP team spent hundreds of hours on research and discussions with experts and rural residents to develop 24 specific recommendations in eight categories to improve health in rural Illinois.

“The fact that our work received such significant attention shows the national narrative shifting to focus on rural health,” said Sameer Vohra, MD, JD, Department of Population Science and Policy Chair. “Healthier rural areas can contribute to a stronger country – and we’re proud to help make Illinois the case study for rural health improvements.”

The Department of Population Science and Policy and its Rural Health Summit partners are currently finalizing recommendations and preparing to publicly release the recommendations throughout Illinois in 2020.

“The public rollout of these recommendations is the culmination of years of work,” said Vohra. “But it also represents the start of a new phase, where we work with Illinois legislators and communities to support policy changes that will give rural residents a bright, healthy future.”

Learn more about these recommendations to improve rural health in Illinois

THE CYBER-COUNTRY DOC: Debra Phillips, MD, was known as a first adopter of technology during her 34+ years at SIU Center for Family Medicine – Quincy, and she liked to test their merits in rural settings. In 1991, Dr. Phillips was instrumental in creating the East Adams County Clinic, a national model for training family medicine residents in rural medicine.

BETTER DAYS AHEAD

Community health worker programs are improving lives in Illinois neighborhoods

On a gray February afternoon, Tami Langford is interviewing a new client in a busy office space at the Third Presbyterian Church in Springfield. Verlon Melton had been released from prison the previous spring and is now working in retail and raising his 3-year-old daughter as a single parent. He’d hoped to move into an apartment in the Enos Park neighborhood, where Langford serves as one of SIU Medicine’s community health workers.

The man politely answers questions on a range of subjects. Eventually, Langford asks, “How’s your health?”

Melton’s eyes drop. He mentions a nagging knee problem that sent him to the emergency department in December. The physician had prescribed a hinged knee brace, physical therapy and a pain reliever. Unfortunately, the low-dosage pain reliever proved ineffective and Melton was unclear on how to schedule time with a therapist. When the local medical supply shop offered a less supportive brace, he left disappointed. A former semi-pro athlete, Melton suspects he has knee dysplasia. For the past two months he has been walking to and from work or calling Uber.

“We can help you,” Langford says.

She picks up her phone and contacts the SIU Center for Family Medicine. Within minutes an appointment has been scheduled to establish care through a primary care physician. The center’s receptionist discusses insurance and Langford explains the Medicaid-funded transport system that Melton can use for his visit the following Tuesday. She offers to accompany Melton to this first clinic appointment to ensure things go smoothly and insists on doing the driving. Melton is grateful to have the new options. The promise of a health care worker at his side during the visit is a stress reliever. “Thank you, ma’am,” he says softly.

Langford ends the call, makes a few notes and turns her focus again to Melton.

“So, besides the knee, how are you feeling?” she asks.

Melton straightens up in his chair. “I’ll tell you, even though things are transitional right now, I’m happy,” he says. “To get up in the morning and see the smile on my daughter’s face, to just sit and have a cup of coffee across from her when she’s having her cereal. It’s the small things that make you appreciate life. I know if I keep pushing, there’s going to be better days.”

Langford is now the one smiling. “Just to hear you say that inspires me,” she says.

“Thank you for sharing that.”

Enos Park

The Enos Park Access to Care Collaborative was designed to spark these moments of inspiration and connection. Launched in October 2015, it targeted an underserved population who had difficulty navigating the complicated routes of the health care system. HSHS St. John’s Hospital and Memorial Medical Center agreed to fund the Enos Park neighborhood outreach program for three years, in collaboration with SIU’s Center for Family Medicine.

The program grew out of the Sangamon County Health Needs Assessment, in which area residents shared input at public forums and through online surveys to identify the region’s top health priorities. The two Springfield hospitals allocated $500,000 to support the project. Tracey Smith, DNP, director of population health integration and community health with SIU Center for Family Medicine, hired a pair of community health workers (CHWs), Shelly Weatherholt and Shirley Thompson, to focus on the most vulnerable members of the community. The goal was to improve conditions for those who were becoming marginalized within their own neighborhoods and offer a model for improving the health of impoverished communities.

SIU administrators measured more than 50 areas to gauge the program’s success. The key metrics included connection to primary care providers, enrollment in insurance programs, an ability to schedule and cancel one’s own appointments and achievement of basic needs (food, housing and income). The CHWs focused on the residents’ social determinants of health – the factors outside the doctor’s office that affect well-being – and tried to remove any barriers to accessing care.

In the initial interviews, residents are asked about the goals they’d like to achieve. These can include employment, housing, some connection to the community, improved care access, “really anything they feel they need,” Smith says. “It might be life or parenting skills. And since they set the criteria, it gives them ownership of the process.”

As it hit the 3-year mark, the program was exceeding expectations. Employment, health outcomes, safety measures and government relations were all improved. Visits to an emergency department had been reduced and replaced by regular appointments with a primary care provider. More than 520 of Enos Parks’ approximately 2,300 residents had been enrolled in the program. Of those, 372 attained their goals of self-sufficiency and “graduated” from the program.

Others noticed too. In July 2018, members of the Enos Park Collaborative were invited to San Diego to receive one of the American Hospital Association’s NOVA Awards, which recognized hospitals and health systems across the U.S. for their efforts toward improving community health.

The uniformly positive results and the strengthened social service networking within the Mid-Illinois (Springfield) Medical District inspired the hospital partners to renew the collaborative’s support for another three years. In addition, they encouraged SIU to expand the program in scope and range.

An adjacent neighborhood was already on their radar.

Pillsbury Mills

Its proximity to Enos Park, the Pillsbury Mills neighborhood in northern Springfield had a different demographic and a variety of challenges. Nearly 80 percent of its housing is rental properties, which makes for a more transient population. Railroad tracks and main streets used as commuting arteries crisscross the district. It is anchored by an 18-acre industrial site, a former Pillsbury processing facility that closed in 2001. Though surrounded by a fence, the property is a nagging safety concern. There was less neighborhood organization and limited connections with city and health officials.

In 2019 SIU Medicine created the Office of Community Initiatives and Complex Care (OCICC) to administer the work of the newly labeled Access to Health program that would include Pillsbury Mills. Bobby McKinney was hired as a CHW to build relationships within the neighborhood. Originally from Chicago, he had been a group facilitator and drug counselor at Helping Hands, and a former clergyman. McKinney began by walking around the region, introducing himself and literally reaching out, sharing business cards and offering a hand.

Initially, he was met with reticence and sometimes, resistance. “It was odd,” he says. “We knew residents had unmet needs and were interested in the community, but finding them wasn’t easy.”

Two months into the job, inspiration struck when a colleague suggested McKinney lower his expectations. “So I started parking my big Lincoln in different spots. I’d get out and just sit on the trunk. Folks would come by and make small talk, and I’d learn about them, asking about their families,” he says.

Now a fixed presence in the neighborhood, his phone soon rang with his first call. He went into action. Word of mouth spread, and McKinney’s days got much busier – and longer.

Now he considers it a compliment when clients call after hours and on the weekend, another sign of trust. “I tell people I don’t sleep, so they know they can call me if it’s an emergency.” And often it is. “There’s trauma, drug addiction, concern over their next meal and worry about the necessities.”

During ECHO training (Extension for Community Healthcare Outcomes; sidebar), McKinney tells new community health workers to expect these odd calls. “This is not structured. It’s their lives, and it’s especially unpredictable when someone’s health is going downhill.”

However, with the teams now engaged in the Access to Health model, an uphill trajectory is more common.

Case in point: Rosie Jackson. A senior Enos Park resident, Jackson suffered from knee, hip and back trouble that had her in “a lot of pain.” Following heart surgery in 2019, she met regularly with a primary care team at SIU Center for Family Medicine that included a dietitian and CHWs. McKinney started taking her to therapy appointments and to get groceries in her wheelchair. Over the course of several visits, he encouraged Jackson to forgo the wheelchair and begin using her walker. As her mobility increased, McKinney suggested she lose the walker and try getting around with a cane. Jackson’s pace eventually improved to the point where she lost 30 pounds. She credits McKinney and the family medicine team. “They keep me cheerful too,” she says.

Community Health Workers lead other programs in the Community Initiatives and Complex Care office, in addition to the Access to Health program. Three of the most active are the Nurse Family Partnership (which pairs a first-time, low-income expectant mother with a home-visiting nurse), ECHO training and the Community Mental Health Team. Abigail Ivancicts works in the latter. She completed an internship at SIU Center for Family Medicine and is now pursuing a master’s degree in social work at the University of Illinois-Springfield. Because 40 percent of her clients are homeless, she often collaborates with Chris Jones, the Springfield Police Department’s homeless outreach team officer and with the Memorial Behavioral Health staff and psychiatrists at Family Medicine to coordinate care. Therapists Meghan Golden and Kathy Martin are licensed clinical social workers on the OCICC staff available to counsel clients.

“It’s called ‘complex care’ for a reason,” Ivancicts says. “We work with the people who have struggled to succeed in other community health programs. But we’ve got great support. The SIU physicians understand what we do: They’ll make an appointment or a walk-through if someone just needs a prescription, get the patient signed up for whatever they need. There’s a lot of collaboration, and it makes our job easier.”

Education & expansion

The OCICC also focuses on educating the next generation of heath care providers within the complex care model. “Very few U.S. medical schools allow students to learn about providing care for individuals struggling with complexity,” Smith says, “but SIU has a multitude of ways for students to get involved throughout their four years.” These include working in teams with a CHW or working with other students to organize care for a high-risk, high-need patient, also known as “hot-spotting.” In fact, the National Center for Complex Health and Social Needs chose SIU School of Medicine as one of its four national hub sites for student hot-spotting training, a 6-month curriculum program that students can take at any stage of their education.

Social workers and undergraduate students in business, engineering and nursing are also learning the intricacies of complex care in the OCICC. Residents may rotate in as well, to gain community-focused training outside the office.

As the group’s innovative work has caught on, many external and state organizations have contracted with SIU to expand their community health programming with CHWs. More than 20 new contracts and grants have been received during the past two years, prompting planning for a more cohesive structure. In July 2019, SIU School of Medicine established the OCICC within the Office of External Relations. In January 2020, its staff moved into a new building at 401 N. Walnut Street in Springfield and began renovations to accommodate new staff and workspace needs. In February the group received a $400,000 Illinois state grant to establish a trauma recovery center at the facility. It will be modeled on a system established in California to help address adverse childhood experiences.

What does the future hold? SIU has been working with state officials at IDPH, DHS and CMS to pursue a sustainable billing model for its services. The fiscal component is tied to personnel needs. “We want to continue to expand the number of community health workers in all of our service areas,” Smith says. “We currently have CHWs in our four residency training sites and want to work with our other service sites to assist the rollout of a CHW program. We’ve listened to our community and learned what services are needed.”

“Our motto is ‘listen, look and love.’ Then we’ll be able to identify individual and community needs and help make connections to services, whether it’s to the neighborhood police officer, to a health care provider, a social service agency, landlord, or whoever or whatever is identified. We believe that our mission is to take the ‘complex’ out of complex care and just care for people and communities.”

ECHO training extends outreach

ECHO training for community health workers (CHWs) is one of the most in-demand modules offered at SIU School of Medicine. Project ECHO® (Extension for Community Healthcare Outcomes) is a hub and spoke educational model that connects specialists in academic medical centers (“hubs”) to community health workers in rural and underserved communities (“spokes”) via workshops and videoconferencing. The ECHO sessions involve a case-based learning approach that contains 15-minute didactic lessons and patient case presentations by CHWs at participating spoke sites.

SIU School of Medicine and the Illinois Health and Hospital Association coordinate the three-day training workshops to transform the way rural, underserved communities learn and share knowledge. The CHW module includes sessions on diabetes, asthma, oral health and hypertension, as well as immersive, boots-on-the-ground trips into the neighborhoods. Experts can mentor and discuss their medical experiences with participants who acquire new skills and competencies to better manage patients with complex health conditions.

Since October 2019, 56 individuals have undergone the CHW training. At a February CHW workshop at SIU Medicine, Michelle Sanders, director of development and marketing at Heartland Health Service in Peoria, came with her patient navigator to listen and learn from the community health workers. With eight locations in Tazewell County, Heartland’s clients face common challenges: transportation, food insecurity, chronic disease management. Sanders sees the importance of taking a holistic, nuanced approach to improve self-sufficiency. “We’re trying to reduce the cost on the health care system and improve the quality of life for our patients at the same time.”

“ECHO is a cost-effective way to grow your program and get over some hurdles,” she says. “Listening to these other organizations is giving us great ideas.”

In addition to community health worker training, SIU offers single-day ECHO modules for

  • Hypertension
  • Opioids
  • Memory and aging

Participants earn continuing medical education credits for each.

Roy’s Story

Roy Bellamy, 55, was in and out of the emergency department approximately 90 times in 2014, amassing upward of $330,000 in hospital charges to Springfield’s Memorial Health Systems. His costly pattern led him to Tracey Smith, DNP, and a team of “hotspotters,” a multidisciplinary group of care providers and medical students dedicated to identifying and helping hospital super-utilizers like Bellamy.

The Cairo, Ill., native was chronically homeless, in and out of jail and had mood swings that would get him banned from places frequently. Together, the team fashioned a plan to treat Bellamy’s range of chronic illnesses: diabetes, kidney disease, pancreatitis, seizures, depression, anxiety and alcoholism.

Today Roy is one of the success stories of the grant-funded program, and a frequent guest speaker at the ECHO training sessions for community health workers at SIU School of Medicine.

Read more about Roy’s turnaround

SIU WORK GROUP TO EXPLORE RURAL CARE NEEDS, COORDINATION

SIU School of Medicine has 23 clinics and health service facilities in a 40,000 square mile expanse. It’s a distinctly rural area with more than 2.5 million people living in small urban areas, towns and farms. The SIU System Board of Trustees wants to develop a coordinated plan to unify the health services within this region and provide better rural health care to its residents. Its long-term goal is to position SIU as the nation’s leader in rural health care assessment, education and delivery.

To aid the effort, a Rural Healthcare Work Group has been established to gather information and make recommendations to Dr. Dan Mahony, the new SIU System president. Dr. Jerry Kruse, dean and provost at SIU School of Medicine, is spearheading the group’s work as it gets underway.

The initial tasks include creating a detailed inventory of the current programs and activities related to rural health care within the SIU System. The school’s network of clinics, providers and programs is vast, and has expanded in the past decade to include studies on cancer disparities, opioid use, childhood development and other factors to improve the health of the region’s populations.

“The second goal is more challenging – but potentially more fun,” says Kruse. The group members are asked to be creative, and to consider what’s missing from the rural health care mix SIU provides. “What new cutting-edge activities could we offer if given the opportunity?” he asked. One example cited: A state lawmaker has suggested mental health care services be available within public schools, supported by Medicaid payments.

Group members may also consider organizational structures for the SIU System to facilitate the Board’s vision for rural health as the work proceeds. Meetings will take place throughout 2020 to build out these plans.

FAIR VALUE: Beginning in 1979, downstate Illinois health and community leaders met at the Doctors Fair to talk with SIU learners about establishing a practice in Illinois. For more than 25 years the fair attracted representatives from 40+ communities and 100+ students and residents.

In celebration of the School of Medicine’s 50th Anniversary, each issue of this year’s Aspects will feature a sampling of our physician graduates. Their careers, like so many of our alumni, represent SIU School of Medicine’s core values of education, patient care, research and community service.

Our graduates practice in a broad range of specialties, following diverse career paths after earning their medical degrees from SIU. They practice medicine in a variety of settings, from private practice offices and community clinics to sophisticated tertiary care centers.

Some have become university professors while others serve as volunteer faculty for health professions schools in their regions. Some have taken up careers in research while many others are applying clinical research findings to the everyday practice of medicine. Some serve their communities through military careers or government service. And many more serve their communities through mission work, volunteering and civic engagement.

SIU School of Medicine graduates have developed their talents in countless ways that enrich the lives of others at the local, national and international levels. We are proud of their service, their accomplishments and their commitment.

MARK CHRISTOFERSEN, MD

  • Class of 1978
  • Pediatric Orthopedic Surgeon,Tennessee Orthopedic Alliance, Nashville

I was born in a medical mission setting in Durban, South Africa. One of my older brothers was cognitively challenged and when I was 5, my parents placed him in a sheltered home setting during a trip to the United States. We came back to the United States when I was 12, entering 8th grade. I spent my high school years searching desperately for an elusive identity (like so many peers) and I found I could play dramatic parts with ease and so entered college as a drama major. I kindled a nascent interest and ability in science and switched to biology, receiving my degree from the University of Chicago (Where Fun Goes To Die). My dad told me one of his old Sunday School students, Richard Moy, had just started a medical school in Springfield and I should check it out. The rest is history.

The approach to medicine at SIU was just what the doctor ordered. The defined module, self-study model, the emphasis on the whole patient, and the application of new ideas and approaches to education placed many of us on a course to practice with a definable ‘care for the whole patient’ that I think set us apart from many peers. Maybe, influenced by my older brother’s life path, I was drawn to the challenging field of pediatric orthopedics.

I’ve had honors like ‘best resident paper’ and ‘best lecturer’ at board review courses, chief of medicine at a Nashville hospital, president of the Nashville Orthopedic Society, and vice president of my 60-surgeon orthopedic group, but none of that compares to the joy of coming in at night and piecing together a 5-year-old’s deformed elbow or figuring out all of the stressors leading to an adolescent girl’s psychogenic knee pain. I owe so much to my classmates whose humor and camaraderie carried me through school and to the faculty who followed through on their dreams and created such a fine experience for young men and women to grow into the practice of medicine.

JANET WILLIAMS, MD, FAAP

  • Class of 1979
  • Professor of Pediatrics (tenure), University of Texas System
  • Distinguished Teaching Professor, Vice Dean for Faculty, Long School of Medicine

I grew up amidst the corn fields and some very small towns in central Illinois before attending the University of Illinois and SIU SOM. SIU gave me the freedom and opportunity to explore my own learning style, appreciate human complexity; learn to listen, think and hone medical problem-solving, and develop a class full of lifelong friendships. We all worked hard and played hard, we laughed hard and medical school was fun! This was not too long ago, but before computers, the Internet, electronic health records, resident work hour restrictions, etc., a different century. At our recent 40 Year Reunion, we laughed hard together once again!

My intensive pediatrics residency in Springfield followed by a combination of private practice and faculty teaching led me to become one of only 12 Robert Wood Johnson academic pediatrics fellows in the U.S. Both residency and fellowship training ‘grew’ my interest in and experience with child development, eating disorders, and addiction. My faculty position at the University of Texas Long School of Medicine (LSOM) allowed me to develop recognized expertise in providing newborn to adolescent patient care and educating about it. My SIU training to listen, inspect and cogitate was foundational to my skill in solving diagnostic dilemmas, such as scurvy in a 4-year old, that stump the stars. I earned promotion to Professor of Pediatrics with tenure, and the honorific designation of University of Texas Distinguished Teaching Professor. I served 10 years as a member of the American Academy of Pediatrics Committee on Substance Use and Prevention, four years as chair, and authored many clinical and technical reports as well as national policy, most notably regarding fetal alcohol spectrum disorders, inhalant abuse, and substance use screening, brief Intervention and referral to treatment (SBIRT). I was the principal investigator on a large national grant to teach SBIRT across medical disciplines and continue to work nationally in SBIRT and related education.

Women comprised nearly one-third of the SIU SOM Class of 1979, certainly a unique force influencing all of us! I have led our institution’s Women’s Faculty Association and a UT System women’s leadership workshop series, represented our campus’ women faculty to the UT Chancellor and Board of Regents, provided national testimony about the recruitment, retention, re-entry and advancement of women in the biomedical sciences, and long served as our LSOM liaison to the Association of American Medical Colleges’ Group on Women In Medicine and Science. Undoubtedly, these endeavors helped my selection in mid-2011 as the inaugural LSOM associate dean for faculty and diversity and vice dean for faculty. I continue to be recognized for my leadership and innovations that improve faculty programs, processes and policies and promote a culture of excellence for all faculty across the career lifespan! This means that I have yet to retire!

GREGORY FORSTALL, MD, FACP

  • Class of 1987
  • Consultant, Infectious Diseases (ABIM certified in ID and IM)
  • Division Chair, Infectious Diseases, McLaren Flint, Flint, Michigan
  • Associate Professor, Michigan State University School of Human Medicine

I was raised in Springfield. I’ve practiced consultative infectious diseases since 1993 in Flint, Michigan, married to my amazing and supportive wife, Tami, for 29 years and helped raise three wonderful daughters, Stephanie, Gabrielle and Savannah. I served the medical staff of McLaren Flint as chair of the Department of Internal Medicine from 2000-06 and as chief of staff from 2007-09. I was honored as Teacher of the Year in 1994, Consultant of the Year by the Internal Medicine Residency Program in 2000, 2005 and 2009, and Consultant of the Year by the Family Medicine Residency Program in 2005, 2009 and 2011. I’ve been a community supporter of wellness HIV/AIDS services.

I’m most passionate about making sure that every patient understands that I truly care about them, and together we work towards improving their present state of health. I am most grateful for being able to share the rigors of private practice with my wife, who is my office manager, and for having the experience of being a loving caregiver to both of my parents.

BROOKE FRENCH, MD, FACS

  • Class of 2004
  • Associate Professor, Co-director, Cleft and Craniofacial Programs, Children’s Hospital Colorado
  • Director, Cosmetic Program, University of Colorado School of Medicine

After a decade of training at SIU from medical school through residency, I followed my newfound passion in pediatric craniomaxillofacial surgery to Toronto in order to gain specialized training. Serendipitously, a dedicated pediatric plastic surgery job opened at University of Colorado School of Medicine as I approached graduation. I currently practice at Children’s Hospital Colorado and University of Colorado Hospital as a full-time academic plastic surgeon. I joined as the residency program was being resurrected and the faculty had yet to expand. It was an exciting and terrifying time!

In the last eight years, I have ridden the bumpy road of navigating a very busy clinical practice in the context of tremendous growth of our academic medical center while trying to provide meaningful research and teaching impact. Usually I’m driving towards the success of shared missions and other times I feel that I’m being drug behind the car! But all the time, I feel the joy and satisfaction of being able to care for my patients, support my teams, foster the future for students and residents and push the envelope for our specialty.

The lessons and connections I gained from my time at SIU are immeasurable. Every single day I draw on the wisdom from the giants who trained me. I hear their instructions, humor, generosity and steady guidance; I am grateful for their dedication to shaping and sponsoring me. I am most proud of my ability to continue to pass the burning torch of passion for learning, excellence and education that was given to me by my mentors at SIU. Thank you for everything.

Dr. Zook: “Don’t say ‘oops’ when operating on an awake patient.” “Keep reading.” (Be the best.)

Dr. Neumeister: “Theeeeere you go!” (Obligatory celebratory conclusion to successful surgery. Also, support your teams.)

Dr. Bueno: “Stay humble, stay hungry.” “Stick with your principles and core values.” (Steadfast commitment to excellence.)

Dr. Sommer: “Do you not see that?” (#thebreastwhisperer whenever I failed to see the 3rd or 4th dimension in surgery. This keeps me on my toes both as a surgeon and educator.)

Dr. Berry: “Book it.” (Do the work. Do it well.)

BRENT JONES, MD

  • Class of 2011
  • Family physician at Southern Illinois Healthcare, Harrisburg

Growing up in Harrisburg, I always knew I wanted to return home to practice family medicine. My goal was to join Primary Care Group with fellow SIU alums including Drs. Larry Jones-‘76, Shannon Rider-’99, Matt and Laura Winkleman-‘02, Blaine Eubanks-‘08, and most recently Jason West-‘16. Working with the group before, during and after medical school at SIU solidified my dream, and I love serving my home community alongside well-trained doctors. It makes me proud to know we deliver excellent full spectrum care. I have been in Harrisburg five years since finishing residency at Deaconess Hospital in Evansville, Indiana, and am now enjoying working with Southern Illinois Healthcare.

I have a beautiful wife, Leslie, and four children: Noah, Grant, Becket, and Clara. We are involved in our church and community and have lots of fun with family and friends. In my spare time I woodwork, bike ride, read books, garden, play music and generally anything else that sounds fun. We just try to laugh a lot each day.

I treasured my time at SIU, not only for the excellent training, but most of all for the friendships and memories made.

CLASS NOTES

John Benitez, MD, ’81, and wife Christina Benitez | Dr. Kyle Yasuda, president of the American Academy of Pediatrics, with Drs. Cheryl Kasel and Kevin Murphy, both ’83 | Dr. Roland Folse, Dr. Steve Goetter, ’76, and Dr. Elvin Zook at SIU School of Medicine’s 50th Anniversary kick-off reception, January 6, 2020

1980s

Gregory Poland, MD, ’80, is a vaccinologist; the Mary Lowell Leary professor of medicine at the Mayo Clinic in Rochester, MN, as well as the director of the Mayo Clinic’s Vaccine Research Group. He is also the editor-in-chief of the medical journal Vaccine and was interviewed about the race to produce a COVID-19 vaccine.

John Benitez, MD, ’81, married Christina Benitez on September 21, 2019.

Ronald Romanelli, MD, ’83, retired from the Orthopedic Center of Illinois after 32 years but continues in an administrative role.

Stephen Hazelrigg, MD, ’83, and Traves Crabtree, MD, ’95, and the thoracic surgery team at Memorial Medical Center in Springfield launched their Zephyr Valve program and treated their first two patients with the Zephyr Valves, a less-invasive treatment option for COPD/emphysema.

Cheryl Kasel, MD, ’83, and Kevin Murphy, MD, ’83, attended the Mayo Clinic Pediatric Days Conference in Chicago in September 2019 while Cheryl was visiting from Australia.

Mary Jo Gorman, MD, ’84, is chief executive officer of Healthy Bytes, a company that connects registered dietitians to providers and employers, and is on the board of directors for Curavi Health, Inc.

Wesley Robinson-McNeese, MD, ’86, was the keynote speaker for the 45th annual Dr. Martin Luther King Jr. Breakfast at the Wyndham City Centre in January.

Beth Bergman, MD, ’87, received the Dr. Eveloff Award of Clinical Excellence in December.

Alison Kirby, MD, ’88, received the University of Illinois College of Liberal Arts and Sciences 2019 LAS Alumni Humanitarian Award. She was also featured in an article detailing her work with school-based health clinics in Washington.

David Kristo, MD, ’88, was promoted to professor at the University of Pittsburgh School of Medicine and completed his second three-year term on the Board of Directors for the American Academy of Sleep Medicine.

Dr. Michael Ellerbusch and family

1990s

Pradip Patel, MD, ’92, has resigned from the University of Louisville SOM after three years of residency and 24 years of academic pediatrics. He was afforded many opportunities there, and now looks forward to his new role as medical director for Anthem Health.

Michael Ellerbusch, MD, ’96, has worked at Southlake Orthopaedics Sports Medicine and Spine Center in Birmingham for 15 years primarily in sports medicine, and has been sports medical director at the largest high school in the state — Hoover High School — since 2005.

Nicole Pelly, MD, ’98, covered end-of-life topics on Spokane Public Radio in November.

Peter Hofmann, MD, ’99, continues to serve on the State of Illinois’ Medical Disciplinary Board. Hofmann is a partner at Springfield Clinic as a practicing surgeon. In addition, he serves as assistant professor of surgery at SIU School of Medicine.

Dr. Matthew Winkleman and team | Dr. Melinda Lukens and family

2000s

Matthew Winkleman, MD, ’02, and his team received the Patient Excellence Award for patient care at SIH Primary Care Harrisburg.

Melinda Lukens, MD, ’05, practices obstetrics and gynecology at Northwestern Memorial Hospital in Chicago.

Margie Robinson, MD, ’05, Wendy Ledesma, MD, ’05, Aja Wiedeman, MD, ’05, Carla Shah, MD, ’05, Roxanna Lefort, MD, ’05, Nahid Marsden, MD, ’04, Cozumel Pruette, MD, ’05, Mindy Lukens, MD, ’05, reunited to celebrate Dr. Lefort’s birthday and we hope to see many from the Class of ’05 at reunion June 26.

Katherine Robbins, MD, ’05, has been appointed as interim chair of pathology at Saint Louis University School of Medicine. Katherine was a resident and fellow in pathology at Wake Forest University and came to Saint Louis University in 2012. She has been director of anatomic pathology since 2018 when she was also promoted to the rank of associate professor.

Ted Clark, MD, ’06, was named chief medical officer at Decatur Memorial Hospital.

Kelli Webb, MD, ’08, was featured in the Southern Illinoisan.

Drs. Matt Rutz and Ashley Satorius Rutz with daughter | Drs. Travis Healey and Jessica Healey with daughters, Adelaide and Elodie

2010s

Irene (Meder) Bozich, MD, ’11, and husband, Dan, welcomed a baby girl, Marlowe, in September 2019.

Sameer Vohra, MD, JD, ’11, will serve on the Illinois State Board of Health. Vohra is the founding chair of SIU School of Medicine’s Department of Population Science and Policy. He is one of 60 Scholars in the sixth annual Presidential Leadership Scholar program brought together to collaborate and make a difference in the world as they learn about leadership through the lens of the presidential experiences of George W. Bush, Bill Clinton, George H.W. Bush and Lyndon B. Johnson.

Michael Sinha, MD, ’12, presented at Medicine & Medical Humanities Grand rounds/Ted LeBlang Distinguished Lecturer to students and residents in Springfield in early March.

Matt Rutz, MD, ’12, and Ashley Satorius Rutz, MD ’16, are practicing emergency medicine in Indianapolis.

Terah Holland, MD, ’14, spoke about laws protecting pregnant women at work in an interview with WCIA in February.

Travis Healey, MD, ’16, and Jessica Healey, MD, ’16, are living in Indianapolis and completing their interventional radiology and OB-GYN residencies, respectively at IU — Jess in Ob/Gyn (2020), Travis in Interventional Radiology (2022). They plan to stay and work in Indianapolis. They have two little girls, Adelaide (4) and Elodie (2), as well as a baby boy due in July.

Peoria area alumni joined Dean & Provost Dr. Jerry Kruse and SOM representatives for an alumni reception at The Waterhouse in Peoria on November 14.
Student Alumni Dinners 2020 week of March 9 in Springfield.

Stepping up, giving back

As SIU School of Medicine turns half a century old, Mike Williamson, MD, ’76 fondly recalls his years as a medical student. “I’ve had a good career and even met my wife, Susan, while she was also in medical school. I’m grateful for the education and experiences SIU School of Medicine gave me.”

Dr. Williamson has shown his gratitude to the school in many ways. Since 2018, he has served on the SIU Foundation Board and also served on the SIU School of Medicine Alumni Society Board of Governors from 2014-19. Through both of these positions, he has been a champion of the School of Medicine, speaking to others about the importance of giving back during these challenging times. “The state of Illinois is concerning, and the school can’t survive all these years of cuts without financial support from other means,” he says. “It’s critical that our alumni step up and give back, even if it’s only $20.”

As a regular giver to the school since 1987, Dr. Williamson has donated to various scholarships and departments each year. Most recently, he has leveraged his Required Minimum Distributions (RMD) to benefit SIU. Those who neglect to withdraw their RMD from qualified retirement accounts face a hefty penalty of 50% of the required withdrawal amount. And, of course, withdrawals are taxed.

The workaround: an IRA charitable contribution to SIU School of Medicine.

Those who file a joint tax return can contribute up to $100,000 each tax-free from their IRAs to any of SIU School of Medicine’s accounts. The IRS requires withdrawals from qualified retirement accounts once a person reaches age 72. (For those who turned 70.5 prior to January 1, 2020, their required minimum distribution – RMD – is based on age 70.5, not 72.)

“My class members are largely retiring now, so donating from their retirement accounts would be very reasonable for most of them,” Dr. Williamson says.

For the more recent graduates, Dr. Williamson says, “It’s not about donating millions; it’s about showing support when you can give back.”

Contact the Foundation Office to learn how you can leave a legacy for future generations. 217.545.9402 | forwardfunder.siumed.edu

THEN & NOW

Aspects through the years