Episode Transcript
Dr. Elizabeth Brown (guest):
Well, I think it helps them be able to realize that I come from a similar situation to them that I know kind of what they’re going through, kind of their sacrifices that they make to get here. As well as just kind of them knowing the personal aspect that I’m a person, too, and that they can open up to me and feel that they can get good care from me. I know yesterday I even had a patient that was a ranch lady from Beach who we were able to kind of talk to her about why some of her problems may be related to her lifting hundred-pound feed bags when she’s almost 80 years old.
Cassie Alvine (announcer):
“Reimagining Rural Health,” a podcast series by Sanford Health. Our host is Alan Helgeson with Sanford Health News.
Alan Helgeson (host):
Dickinson, North Dakota. It’s right along I-94 in western North Dakota. When you’re in town, a stop at local eatery Blue 42 might be for you if you want a bacon flight. Or how about knocking down some pins and a little bowling talk like the recent Dick Mueller memorial tournament? Well, you can find that at Paragon Bowl. And it’s pretty cool that dinosaurs still roam the area too – that’s at the Badlands Dinosaur Museum where they’ve got 14 full-scale dinosaurs on display.
Dickinson is a community of almost 25,000, and they’ve got a lot going on. And when they need medical care at Sanford Health, patients have access to care for many areas of health, including family medicine, orthopedics, cancer care, plastic surgery, and women’s services.
Now if it’s women’s services and you’re a patient, there’s a good chance you’ll hear her voice right after that knock on the exam room door.
Dr. Elizabeth Brown:
I am Dr. Elizabeth Brown, and I am a OB/GYN at Sanford Health in Dickinson.
Alan Helgeson:
Dr. Brown is one of only three OB/GYN physicians at Sanford Dickinson. More about that though in a little bit. First, let’s hear a different story and one that begins about a hundred miles west of Dickinson and not far from the Yellowstone River.
Dr. Elizabeth Brown:
I am Elizabeth Brown, and I live on a farm in Glendive, Montana.
Alan Helgeson:
To Elizabeth Brown, her husband Todd, and three kids, home is 650 acres, a working hay farm with roaring John Deere tractors, miniature donkeys and highland cows.
Wait a minute, highland cows?
On the farm, having to know and do lots of things is important. Elizabeth Brown’s husband, Todd, knows it means a lot, not only in the wide-open spaces, but also when she’s with her patients.
Todd Tibbets (guest):
She’s down to earth. I mean, she gets out here, she’ll drive a cement truck, she’ll drive skid steer. I mean we work cows. If you wanted us to put a cow in the chute and she could give it a shot.
Dr. Elizabeth Brown:
I apologize in advance. It’s kind of bumpy.
Alan Helgeson:
Elizabeth Brown’s busy home life means trading in her stethoscope for a pair of pliers and some leather gloves. She climbs into the cab of something that might be a Transformer, but this one is hiding out on a ranch and today it’s picking up bales of hay.
Dr. Elizabeth Brown:
I think I have a lot of work cut out for me this weekend, so. (Reporter: Why is that?) Oh, because my husband actually, he made – not that he “actually” – he made quite a few hay bales off of this field this year and a very good yield.
Alan Helgeson:
OK, before we go any further, remember when you were in school and you would call your teacher mister, Mrs. or Miss, then you grew up and you met them in the store, you still call them Mr. or whatever? Well, for the rest of this podcast, to avoid any confusion, let’s stick with Dr. Elizabeth Brown in the clinic or on the farm. Sound good? Great.
Now where were we? Oh yes. Well, when you live in eastern Montana and your clinic and your patients are in western North Dakota, days can start pretty early.
Dr. Elizabeth Brown:
So usually I leave around 5:30, sometimes 6. It depends on what time I need to be there, so if I’m on call, I need to leave for sure by 5:30 so that I get there by 7. I think it’s about 92 miles, but with the interstate, we’re able to, I usually get there about hour 20 to hour 30 minutes depending on what the construction is.
Alan Helgeson:
It’s not really a big deal for Dr. Brown. She knows that her patients are doing it every day, too, and they’re coming from a good distance to see her.
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Photo by: Sanford Health
Dr. Elizabeth Brown:
So it’s really probably like east, like eastern Montana and western North Dakota. So we have some people, you know, from south, you know, have some people from like Hettinger. I think we’ve had some people from Bowman coming up eastern Montana, had some from Baker, some from Glendive where I’m from as well. And then north, like Watford City I would say, you know, the longest would probably be like an hour and a half, maybe two hours that they would have to drive to get to us. And that would just be, probably like if they came from Baker, that’s probably the longer drive.
Alan Helgeson:
With all of the time behind the wheel each week for Dr. Brown, she sees all of the weather extremes in rural North Dakota and Montana, and it’s a topic that is never far away at home.
Dr. Elizabeth Brown:
So yeah, so I actually, I don’t know, I watch the weather quite a lot and if, to be honest, if I feel like there’s going to be a storm coming in or the weather’s going to be really bad or it’s icy or anything like that, I try to either go up the night before.
Alan Helgeson:
Or in the clinic.
Dr. Elizabeth Brown:
My patients and I oftentimes bond about the weather. It seems like ranchers and farmers, their lives revolve around kind of what the weather is and when you say all they do at the coffee shop is kind of talk about the weather and you know what’s going on, but it really determines a lot of what we do.
And so for me, I talked about earlier about how I look at the weather reports and make sure, like with driving and I’m understanding to a lot of the patients when they’re like, you know, 15, 20 minutes late and I’m like, well, yeah, the roads were horrible. So let’s go ahead and just see them. Because I know how far they’ve come from and we want to make sure that they don’t have to come back.
Alan Helgeson:
After her morning drive to Dickinson, it’s game on and a full day with patients.
Dr. Elizabeth Brown:
A typical day actually starts with me usually rounding on patients in the hospital if I’ve done any deliveries or any postoperative patients. And then I come over to the clinic and start seeing patients around 8 a.m. Before 8 a.m. if I get over here to the clinic, I’ll go through the chart, see if there’s any results to review, see if there’s any patient messages, nurse messages, other staff messages from other physicians.
Alan Helgeson:
When providing care in a rural community, it means that medical professionals like Dr. Brown are relied upon for their depth of expertise.
Dr. Elizabeth Brown:
Actually, it’s very rewarding to see a lot of different things. We kind of take care of women from menarche all the way to postmenopausal. So a typical day will include, you know, some OB patients, some new OB’s, some routine OB’s. It may include people with bleeding issues, contraception management. We manage abnormal Pap smears, so sometimes I’ll have a colposcopy or a LEEP procedure. And so that’s kind of the typical day is just a variety of things. And so you never know what you’re going to get on any given day.
Alan Helgeson:
For Dr. Brown with a busy professional life and home life. There have to be similarities in there somewhere, right?
Dr. Elizabeth Brown:
I guess one of them is just that you’re almost, you know, you’re going, going, going (laugh). So you know, at the farm there’s not much downtime. Here in the clinic, there’s not much downtime. You also, preparing for your day, just like at the farm, if we need to grease your equipment, you need to make sure you’re fueled up. Make sure that the windshield is clean or kind of come up with that plan of the day.
The same thing over here in the clinic. Make sure the rooms are stocked for me for appointments. It’s making sure that I know exactly what the nurses are going to be, what they need, what I need in the rooms, kind of prepping my nurse before we go into those appointments.
Alan Helgeson:
Having this perspective and seeing these similarities makes a difference with the people she sees every day. Not only in the clinic exam rooms or in the hospital rooms, but likely on the sidewalk, the grocery store or in the stands at the high school game this week.
Dr. Elizabeth Brown:
I think in the rural communities, the patients know you and your family and so you kind of have that connection outside of the medicine, you know, physician-patient relationship. Also, they may know you outside of the clinic and so you kind of have that special bond with them as well.
In the rural setting, when people come from longer distances, I want to make sure that they feel like they get as much out of that visit as possible, as well as trying to coordinate their care before they leave. So if we can, they need an ultrasound, trying to get that ultrasound before they leave, trying to get the lab work done that day, knowing that they’re not going to be able to come back in two to three days very easily.
Alan Helgeson:
It’s knowing how these miles can impact your patients’ lives in rural communities and how it can make such a difference when driving so many miles each day herself. It puts things in perspective for the patients that travel great distances to see her.
Dr. Elizabeth Brown:
I know yesterday I even had a patient that was a ranch lady from Beach who we were able to kind of talk to her about why some of her problems may be related to her lifting hundred-pound feed bags when she’s almost 80 years old.
Theresa (Sanford clinic):
Thank you for calling Sanford. This is Theresa.
Alan Helgeson:
In the Sanford Dickinson clinic. Dr. Brown is ready for a full day and there is a lot to do.
Dr. Elizabeth Brown:
We do a lot of messaging like the MyChart, kind of doing that in the computer. Not everyone is OK with that. And so usually when patients leave I’ll ask them, you know, are you signed up for the portal? Are you comfortable with getting messages that way or would you prefer to be called? Abnormal results or results that I feel like there needs to be a management based on it, I’ll directly call or I’ll have my nurse call.
So there’s abnormal Pap smear. We need to set up different things. I usually have prepped the patient in their visit and so when my nurse calls, she’s able to just kind of explain the procedure, get the patient forwarded to our scheduler and that they’re kind of aware if they have additional questions, she’ll send me a message and then I can reach out to them as well.
Alan Helgeson:
Sanford Health is the largest rural health care system in the U.S. And technology is key in helping connect expertise to patients in rural areas. Being able to see patients via technology is a plus.
Dr. Elizabeth Brown:
And we definitely offer virtual visits. It seems like a lot of people like that face to face (laugh) if they can, but we do offer that ability. And then also if the patients, you know, if they have one or two questions, we’ll answer those. But if not, and we feel like we need to dedicate more time to them, we can convert on a telephone call over to a virtual visit just so that they have that time that’s dedicated to them.
Sometimes in these rural settings, especially when they know I’m a Montana person, they may also know some of my friends, some of my relatives. You know that they definitely do their research before they come in and if they have any common people that they know, a lot of them will actually know who I am and kind of be aware of me before I come in. And so, and they’ve had other people who’ve either friends or family who have recommended coming to see because they know, with me giving care and they know that I’m a pretty down to earth person.
Alan Helgeson:
When working in a community the size of Dickinson, knowing and seeing your patients is important, but when you’re doing things like spending 90 minutes on the road to get to work or loading a flatbed full of hay, personal life balance is always a good thing.
Dr. Elizabeth Brown:
In Dickinson, we try to deliver all of our own patients that are established patients. That being said, we also realize that we need to have our personal lives as well. So our weekends are Friday, Saturday, Sundays, and oftentimes it’s whoever’s on call will manage those deliveries, but if we’re here in town, we’re going to be doing our own deliveries.
Alan Helgeson:
As we’ve heard from Dr. Brown, it’s easy to get a sense that she’s definitely in the right place and with the people that need her most, but how does someone choose where they practice medicine? Does the community seem to call them? Deciding to be a physician isn’t a choice that comes easily in certain parts of the country. Access to medical schooling can be limited. As was the case for Dr. Brown.
Dr. Elizabeth Brown:
There’s a certain number from Wyoming that every year we would get selected and then we would do some of our training at our home state and then we would go out to Seattle and did like an underserved pathway when I was there. And then also did a lot of rotations in rural Wyoming and Washington and then also in Montana.
And I grew up in, you know, my town was like 3,200 people and as far as Dickinson with its size, it’s a lot larger than what I grew up with, but it’s still, as far as OB/GYN world, it’s still a rural setting and providing care for a lot of women in the rural area around Dickinson.
Alan Helgeson:
For Dr. Elizabeth Brown, while she’s seeing patients today, it did take a little while to find the place where she belonged: Sanford Health.
Dr. Elizabeth Brown:
The support that Sanford gives to physicians and kind of supportive of the practice as well as the doctors that I work with at Sanford, the OB/GYN doctors are very in line with how I practice. And so all of those things and for like my mental health and ability, I feel like I’m actually a better mom even though I’m working more and might be gone more.
I probably wasn’t the best mom when I was here because it was not, you know, when you’re not in a job that you enjoy working at you tend to be a little more short, not probably your best person that you could be.
Alan Helgeson:
When you provide medical care in a clinic that serves a diverse patient population in a rural community, you’re afforded great opportunities, and it takes a certain openness and flexibility in doing things. So what kind of person thrives in this environment?
Dr. Joshua Crabtree (guest):
The kind of provider that enjoys a challenge, the kind of provider that is comfortable with not necessarily knowing what’s going to walk through their door on any given day or time.
Alan Helgeson:
Now that sounds a lot like what Dr. Brown has been describing in her day-to-day clinic, but how do you replicate that passion for care and carry those special virtues into other communities when you have hospitals and clinics across a 300,000-square-mile area? Who does that?
Dr. Joshua Crabtree:
My name is Dr. Joshua Crabtree, and I am Sanford Health’s chief physician.
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Photo by: Sanford Health
Alan Helgeson:
Dr. Crabtree, in his role, leads a team of nearly 3,000 physicians and advanced practice providers across Sanford Health’s footprint. And like Dr. Brown, Dr. Crabtree experienced rural health as a physician because he was a family medicine physician at Sanford Health in a rural community for over two decades. With that experience, Dr. Crabtree knows firsthand what else you need to be successful in rural health care.
Dr. Joshua Crabtree:
One who’s comfortable with a more general or broad scope of practice, one who likes to develop a little more of a broad or robust relationship with their patients.
Their patients are not just going to be their patients in the exam room. They are going to also be their patients and connections that they have in communities, in the church, in the grocery store, probably at a sporting event or a choir concert. They’re going to see and engage with their patients on multiple levels.
The provider that will thrive in that environment is one who’s comfortable and actually enjoys that. You have to be comfortable with maybe not knowing all the specific answers right now, but you know how to find those answers.
You know where your resources are, you know that you have specialty colleagues, maybe subspecialty colleagues that are either a phone call away or a virtual visit away or an in-basket message through our electronic medical record away to help find those answers, to help provide those patients that come to us in all areas of our footprint with that top-notch world-class care that they should come to expect from Sanford.
Alan Helgeson:
Dr. Crabtree talked about the many different people involved in providing care at Sanford Health and those various ways he talked about in staying connected.
Dr. Joshua Crabtree:
We have made it our mission. In fact, it’s the statement that we put out there that we are going to provide world-class care no matter your geography, no matter your ZIP code. As an organization, we are committed to making sure that whether it’s through our virtual care platform or through outreaching to these communities, we send physicians or clinicians to over 430 different locations throughout our footprint on any given year to make sure that we’re putting specialty care and high quality generalist care in the communities where our patients are from. That’s our commitment.
Alan Helgeson:
That world-class care, while Dr. Crabtree really looks to make sure, this also means how Sanford takes care of their team, too. Dr. Brown is fairly new to Sanford and knows firsthand that new employee feeling.
Dr. Elizabeth Brown:
So Sanford Health, there’s the professional support. So as far as you know, they make sure I have nursing staff available. They make sure that we’re working to get patients on my schedule, working with the call schedule, coordinating things to make my life as stress-free as possible here. And so Sanford Health, with their physician support structure has been very helpful for that.
Also, Dr. (Amy) Oksa is our clinical director. She’s constantly checking in on me, making sure that things are still going well and how things can improve. And I even know when I was interviewed or even initially hired, even the higher ups in Bismarck, were checking to be like, OK, is there anything else? How can we modify your practice so that we can keep you? They know how hard it is to recruit to this area. And so they definitely make sure that things are going that way.
I think prior practice, kind of the frustrations I’d have, I have not ran into that. If I’m having an issue, people quickly address it, but also I feel like Sanford Health seems like a well-oiled machine that I’m able to seamlessly kind of integrated myself into the clinic. And really to me it seems like it’s been a very smooth startup and been able to establish pretty quickly.
Alan Helgeson:
A transition that allows Dr. Brown and her colleagues to care for patients in the way that is important to them and the people that trust them for that care.
Dr. Elizabeth Brown:
And just know that they know that I’m not just someone who’s some city slicker who’s never, doesn’t have any idea what’s going on. So I know my husband reminded me of a time when I had to explain to one of his friends’ wives that she can no longer throw in the net wrap because the net wrap is very heavy. And they’re usually having to put it in odd angles and I’m like, you can’t do that after a hysterectomy. Like your husband’s going to have to come to the field.
And so just trying to relate to them of like, OK. And most of the time, you know, when they’re coming here, like I said, that respect that North Dakotans or the Montanans have for physicians is very great.
Alan Helgeson:
Rural health care. Dr. Brown drives it, lives it, provides it every week to dozens of patients in and around Dickinson, North Dakota. She’s fairly new to Sanford Health and talks about why she does what she does. But let’s hear it from someone that has been in Dickinson and at Sanford Health for longer.
Dr. Erica Hofland (guest):
My name is Dr. Erica Hofland. I’m an OB/GYN out in Dickinson Sanford and I actually grew up in Dickinson.
Alan Helgeson:
Dr. Hofland knows the Dickinson community well. And as a physician with Sanford Dickinson understands that living in a rural community gives an awareness of important things that mean so much for the patients they see every day.
Dr. Erica Hofland:
It makes you a lot more aware of how much time patients put into their appointments and how much time and effort they make to come here. So you really want to do a great job caring for these people. Being cognizant of the fact that we try to do a lot when they do come in because it’s not as easy as like, oh, you know, again, follow up in two weeks. Sometimes we have to adjust schedules, adjust what we’re doing to maximize that time that they’re here in town with us.
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Photo by: Sanford Health
Alan Helgeson:
Sometimes that time might mean looking at their own schedules.
Dr. Erica Hofland:
And this is kind of life that not everyone who lives in more centralized hubs appreciates that how much effort even something as basic as going to work can sometimes be.
Alan Helgeson:
Remember earlier when we were talking about the weather, since it’s kind of a thing in the upper Midwest? It’s important here too. For Dr. Brown and her colleagues and clinic team in Dickinson and communities like this across Sanford Health’s vast footprint, Dr. Hoffman’s words could echo across the windy planes.
Dr. Erica Hofland:
There’s a lot of teamwork. I think there’s a lot of flexibility too, knowing that unexpected things come up. Like again, when she was driving into work, I don’t know if she told you the story, but she definitely hit a deer on her way in here. And so her day changed a little bit.
You know, again, part of living far away from the location you’re working out in rural western North Dakota, eastern Montana. So just, we all have to be supportive, flexible, and able again just to adjust again with what the day brings.
Alan Helgeson:
As the team in the Dickinson clinic stands together for each new day, they’re the front door to the people that are needing health care in western North Dakota.
Dr. Joshua Crabtree:
That those individuals are the way that our patients are going to engage with us as a health system, but also how they’re going to feel safe and how they’re going to trust us to provide that care.
So it’s really, really important that we listen to and we understand what those front-line workers – clinicians, nursing staff, patient access staff – we have to understand what they need and what challenges they’re having on a day-to-day basis. And then try to help and put the resources in place for them to do their job the best they can.
Alan Helgeson:
One of the things that Sanford Health and Dr. Crabtree pay attention to is balance. There’s work and there’s family. They do come together in a way.
Dr. Joshua Crabtree:
For most of us in health care, we spend as much time and sometimes more time with our work families than we do with our families at home. And so if we’re providing and/or able to work in an environment where we’re feeling supported and we’re feeling connected to our employer and our staff, I think what that’s going to do then is it’ll translate into feeling better about going home.
We can leave work at work, and we can go home and do what we need to do at home.
Also, understanding that the organization values that family connection. I mean, we use this terminology, I use this terminology on a regular basis. I call it part of being part of our Sanford family. When I’m talking to new recruits that are coming to the organization or contemplating coming to the organization, I talk about how we want them to be part of the Sanford family and that’s our work family.
But our work families get connected to our at-home families. And I would say that may be amplified in our small or smaller communities because of the connections that I mentioned earlier. It’s not just about going to work and leaving it at work. Your coworkers are probably your friends that you go to a football game on Friday night with, or maybe you’re on a bowling league or a card club or something.
Our teams are connected in many different ways. So I do think that ability to feel supported in the organization at work translate to feeling supported at home.
Dr. Elizabeth Brown:
Here at Sanford Health, I value giving patients good quality care, being able to provide a service where they would otherwise have to go to another community. I think that’s something that Sanford seeks to give care in rural areas. They’ve expanded into rural areas because they see a need: bringing health care to patients versus patients having to travel for health care.
Alan Helgeson:
Bringing health care to patients. It’s not by accident. People like Dr. Crabtree and other physicians and clinicians are leading the way.
Dr. Joshua Crabtree:
Our clinician governance structure, our clinician leadership structure, it’s all put in place very intentionally to make sure that we have physician and clinician input into decisions that are made about how we move our organization forward.
Alan Helgeson:
This matters and helps in growing the team, but also when it comes to recruiting new people to the organization too, like Dr. Elizabeth Brown, OB/GYN in Dickinson, North Dakota.
Dr. Joshua Crabtree:
For our clinicians to be able to see that we have a leadership structure, we have leadership development opportunities for those clinicians that want to progress. I mean, just by definition a clinician in the role that they play in our health care system, they are leaders of teams, the health care teams.
But if they want to expand that leadership, education or opportunities, we have resources. We have internal leadership development programs that will help our clinicians attain those goals. And we’re actively seeking those individuals to make sure that we’re providing that for them or they’re able to find it if they want it. I think that’s an important piece as to how we develop our own and grow our own.
I would also say that Sanford’s investment in graduate medical education and in our own training programs, that’s significant. We know that depending on who you read, 40(%) to 50% of trainees, so we’re talking residents and fellows will stay within a hundred miles of where they train. So by investing in those training programs, we know that we’re going to have a pipeline and a pool of excellent physicians for years to come.
I think that also speaks volumes to how the intentionality of the structure is to make sure that we will have those clinicians who can work in those rural areas.
Alan Helgeson:
This investment into people and growing physicians is important. Even for new people joining like Dr. Brown.
Dr. Elizabeth Brown:
I think having, you know, physicians in those leadership positions and not just administrators that have never practiced, I think it’s useful that they have been on the other end of things. No matter who I reach out to, they’re very supportive and they want me to succeed as a physician as well as a person.
Physician leadership is always checking in, making sure that if there’s any problems or issues, especially they know my living situation. They’re always just checking in and making sure that, asking about how are the kids, how’s the husband, how are things going? Like, that was just something that just never really experienced my last job. And that’s kind of why I chose Sanford.
Alan Helgeson:
Sanford Health is the largest rural health care system in the U.S. So how do you do that?
Dr. Brown has shared her story and why she does what she does. Dr. Hofland has lived in Dickinson for a long time and shared some of her thoughts, and Dr. Crabtree, well his part feels almost like watching over a closely guarded family recipe on just how Sanford Health is focusing on people. But really it’s not that much of a secret, and Dr. Crabtree and the family have just been doing it for quite a while.
Dr. Joshua Crabtree:
We’ve been very intentional about trying to, if distance is a barrier, if resources are a barrier, if finances are a barrier, if transportation’s a barrier, if weather’s a barrier, we’re trying to put the resources in place to make sure that our patients have access to the care they need. Because we know that if we don’t reduce those barriers, people will just not access health care.
We want people to live in the places they want to live. We want them to be able to access the care they need to have access to. And in order to do that, we have to put processes in place and strategies in place. And that is our virtual care. It is our ability to recruit and retain clinicians within those facilities. It’s to partner with communities that our health care facilities are in as to how can we make sure that there are good schools, day care providers, things that help a community be strong and vibrant.
We want to work with those communities too, as a health care provider within those communities, because we know if the community’s strong and the health care is strong, then the people are going to get the care that they need.
Dr. Elizabeth Brown:
It’s very rewarding to work with rural patients. They respect our opinions. They are excited that we’re here. They like the fact that they can get good quality care in rural areas. The other thing is just family wise, the communities of these smaller communities, you have a lot of opportunities for children. You know, it’s a safe, safer communities. You get to form those relationships inside and outside of the clinic and just be able to really care for people in a closer-knit type of situation.
And you get to – the continuity over years of being in the community – eventually, hopefully I’ll be delivering (babies of) some of the people I delivered.
Alan Helgeson:
Health care is about people – people helping people no matter where they live. Elizabeth Brown is a physician and a darn good one. Her Sanford story is a fairly new one. And next time when she walks into the clinic to see her patients, remember Dr. Brown has a story just like you.
Now, Dr. Brown’s story maybe includes a few hundred more bales of Montana hay than yours or mine. And when she’s not in the clinic, you’re likely to find her on that ranch where she’s busy doing all sorts of things, just like a lot of the people she’s going to see tomorrow. And oh, by the way, if you have any leads, Dr. Brown is still looking for that one thing.
Dr. Elizabeth Brown:
When I decided what I wanted in life, I always wanted to have at least a few animals. So I still have not got my horse, but that will come (laugh).
Additional reporting by Jason Anschutz.
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Posted In Bismarck, Company News, Dickinson, General, Here for all. Here for good., Leadership in Health Care, Menopause Care, People & Culture, Physicians and APPs, Rural Health, Sanford Stories, Virtual Care, Women's
