Meet Your Candidates Running in the Next Governor Election
The Governor serves as the official representative of the College for the chapter, providing a link between members at the local level and leadership at the national level.
Drs. Bande and Ottenbacher both provided background information as part of the application process. Their responses are below. They’ve been very, very lightly edited for flow.
Who or what has inspired you to run for Governor?
- Dr. Bande: My 17 years with ACP North Dakota have inspired me to run for governor. Since my residency, I've engaged with ACP by inspiring medical students, leading early career chapters, and reviewing national competitions and capstone projects. I achieved FACP in 2016, served on multiple committees including the Governor's Council, and collaborated with organizations like the Society of Hospital Medicine and NDMA. Working with past Governors such as Dr. Blehm, Dr. Alberto, Dr. Nammour, and Dr. Ranum has been inspiring. Their leadership transformation of ACP's ND chapter motivates me to lead it to the next level.
- Dr. Ottenbacher: I want to make a difference in the lives and practices of my fellow internists. This is something my father inspired in me by taking care of an entire community for over 25 years. I believe that I am at a point in my leadership career (both military and civilian) with the experience and ability to do so. In a similar manner, I have developed integrative medicine (for internists) as a curriculum and training/rotation for residents. Some of the practices and ideas I developed are currently being recognized as best practices and models for education at a national VA level. They are also topics for which I have 3 scheduled presentations at national conferences. The goal for developing these education programs and spreading them is the same as my goal for governorship: to help other physicians be the best possible internist they can be (truly helping patients) and enjoy/get satisfaction from the work they do. Isn’t that exactly why we all went into medicine in the first place?!
These are difficult times with high-levels of burnout and dissatisfaction. This is particularly true for the outpatient primary care setting, which is my passion (although I also work in the hospital). My goal is to be able to influence and help fellow internists in any way possible and with as wide of an audience as possible. This goes hand-in-hand with the work and training I did as an ACP well-being champion for the last 3 years.
I feel that being a governor for the ACP is a path to making a difference as a leader and in areas that I am truly passionate about. This mirrors my VA leadership path discussed below and my military path (being considered to be the next South Dakota National Guard state surgeon and a battalion commander).
Describe prior leadership experiences that demonstrate how you would be effective as Governor.
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Dr. Bande: Throughout my career, I have held various leadership positions. I was the chief resident for an internal medicine residency program, clerkship director for internal medicine, and currently serve as the chair of the department of internal medicine at a medical school, and chair elect of the faculty academic council for the university. From a healthcare administration standpoint, I hold leadership roles related to value-based care and high reliability organizational transformation. In professional organizations, I served as the inaugural vice president of the Society of Hospital Medicine, commissioner on medical education for the North Dakota Medical Association, and participated in multiple committees related to the national alliance in academic internal medicine. I completed a healthcare MBA to develop my leadership skills further. I consider myself both a change leader and a servant leader. As a leader, my aim is to apply my knowledge, skills, and attitudes to motivate people and organizations to pursue ambitious goals and embrace failure as part of the process. I am humbled and honored to have been recognized for my leadership at ACP North Dakota chapter with the "Laureate award" and at the Society of hospital medicine North Dakota chapter with the "visionary hospitalist" award.
- Dr. Ottenbacher: I have held significant and diverse leadership roles over the last decade. I was hired as the chief of Primary Care for the Fargo VA HCS (Assistant COS for PC) and held the position for over 6 years. The role included direct supervisor of all Fargo VA PCPs including our main facility and 10 clinics in ND and MN. Then I transitioned to acting ACOS (Associate COS for PC) at the beginning of the COVID pandemic and held the role for 9 months until I deployed overseas. I supervised PC, specialty care, Occ Health, comp and pen, the ED and hospitalists/inpatient medicine. This was a significant leadership role covering more than half of the Fargo VA inpatient and outpatient services/providers. The fact that I held the position during the start and one of the most challenging times of the pandemic was an added bonus!
I have held intermittent VA leadership assignments on multiple occasions as the Acting ACOS for Education. Some were for durations of over 6 months. Currently I have transitioned into a CHIO (chief health informatics) role with the specific task of finding/hiring the team for our EMR transition, leading them and spearheading the transition process. This includes setup, optimization, and customization of the EMR and all related systems plus hands on training for all providers in our facility. I developed a process of daily “informatics rounds” walking around and helping providers or offering improvements and optimizations. This process was felt to be useful enough that I was asked to present at a national VA informatics monthly update meeting along with my process for training/setting up new providers.
These VA leadership roles demonstrate that I can effectively run leadership processes at a high level with effective, demonstrable results even during the most difficult of times. My goal and starting point for all staff conversations and processes was always – “how can I help you better do your job and better help patients?” It is constantly striving for servant leadership and helping others reach their potential.
For UND involvement and resident education, I am the Internal Medicine VA residency site director. I coordinate our core PC rotation and have intentionally expanded our training and UND relationship with a focus on Integrative Medicine/Whole Health. This includes creating several lengthy curricula from scratch plus rotations for 3 electives in integrative medicine (for Internal Medicine, mental health and family medicine –they are intentionally focused on shifting our clinic/hospital practices). Along with being the site director, I serve as the rotation coordinator, attending for the residents, and core faculty.
For military leadership, I have served over 15 years as an Army officer currently serving as a Lieutenant Colonel. I am one of the 3 most senior physicians for the SD Army National Guard assisting our State Surgeon and also supporting both medical units in the state (the admin unit and the field medical unit). For deployments and overseas medical missions, my leadership roles have included deploying as our brigade surgeon initially (for the Maneuver Enhancement Brigade) and then continuing to Africa as the deputy CJTF-HOA Surgeon (Joint Task Force Surgeon). This was a leadership role overseeing all medical operations for northeastern Africa. I coordinated on a weekly basis with the 1-start commander for CJTF-HOA and infrequently coordinated with the 4-star Africom Commander. In addition to this deployment, I have served as the OIC (officer in charge) for multiple overseas medical missions (MEDRETEs) to Suriname, South America. This involved coordinating the missions, providing medical care, plus teaching/training US medics and foreign medics/providers. These missions typically provided care for over 1000 patients at multiple locations including both medical and dental services plus supplying and organizing our own pharmacy and transportation.
I believe my VA, UND and military leadership demonstrate a range and diversity of leadership roles along with the senior nature and significant responsibility of the roles. Simply serving in a role does not make one effective nor do all leaders learn and grow from their experiences. However, I take it as a personal challenge and strive for continuous improvements in my careers as both a physician and leader. I truly believe I will continue to grow and learn, but in very intentional and focused ways, as long as I serve.
What are the top three challenges or opportunities facing internists in your chapter, and how will you use your position to address them?
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Dr. Bande:
1) Primary care internist workforce - North Dakota faces challenges in accessing primary care due to its predominantly rural nature. Although family practice physicians play a significant role, the number of internists choosing primary care as a career is decreasing in both urban and rural areas. Addressing this issue requires a multidisciplinary working group composed of medical students, residents, academic leaders, healthcare system leaders, and ACP. Incentives need to be properly aligned among various stakeholders to tackle this problem effectively.
2) Driving value-based care - Internists have a strong potential to contribute to achieving value in healthcare for patients and communities. For a rural state like North Dakota, implementing value-based care from a rural perspective is vital. This goal can be achieved through local and regional efforts alongside national organizations. Establishing a center for rural value-based care has begun, and leveraging leadership roles within ACP can help bring additional resources. Collaboration with National ACP and rural ACP chapter governors will be crucial in advancing value-based care in North Dakota.
3) Leveraging artificial intelligence, informatics, and digital health - Adapting artificial intelligence, informatics, technological solutions, and digital health can address many issues faced by internists in North Dakota. Networking with organizations at state, regional, and national levels to advocate for solutions that enhance the fulfillment of healthcare providers, particularly internists, will be prioritized -
Dr. Ottenbacher:
1) Burnout including finding the joy in medicine/physician well-being
As a governor I would lead the charge to help physicians in hunting the good in our current practices and having an intentional, focused approach to developing the areas or niches we love and have a passion for. These are the bright spots in our career (teaching, outreach, integrative medicine, lifestyle medicine, geriatrics, ect) that we can leverage to love our medical practice and enjoy helping patients. It gets us through dreaded pajama time, paperwork and all the other aspects of our practice that drag us down.As the chief of primary care for the Fargo VA for over 6 years, this was a focus of my leadership. To be a leader is to help others succeed and pave the way for it. I would frequently develop practical modifications to their practices or projects or championship duties for my providers while keeping a focus on realistic approaches and timeframes. I would collaborate with my providers to find what they most loved or had unique skills in, then build it into a part of their practice. One example of this was building a nurse practitioner residency program for the Fargo VA. I had a provider with had a strong background in teaching and who was struggling with PC burnout being 100% clinical. We leveraged her experience, changed her clinical duties, and dedicated significant time for teaching and running the new program.
2) Work life balance
Along with my work as an ACP well-being champion, I helped build the Fargo VA Whole Health department (integrative medicine) from the ground up as one of its founding members. I later assisted as a clinical champion, primary care integration champion, and Whole Health clinical director (as collaterals). These have taught me numerous lessons and given concrete, actionable plans for helping physicians work towards a work-life balance. There is no perfect answer for work life balance. It means quite different things to different physicians, but we all benefit when we collaboratively discuss it and work towards the balance that makes sense to each of us. We do not move closer to our goal of balance unless we intentionally do so, including leveraging best practices from fellow internists.3) Connecting to other physicians
During the pandemic and since, we have severed many connections to our peers and maybe worse, now feel like that is normal. We have lost connectiveness. In order for the internists in our state to succeed, we need to lean on each other during hard times and help out colleagues when things are going well. I believe Dr. Ranum and I both have experienced this and are still struggling trying to get physicians to connect and/or participate. We are keeping it as a focus and a critical priority. It is easy to forget how many resources, and even confidants, we have in the other physicians around us!
How would you encourage your membership to increase participation in its activities at both the national and chapter level?
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Dr. Bande: The ACP North Dakota chapter has faced challenges in achieving participation at both the Chapter and national levels. Our state covers a large geographic area but has a relatively small number of members. To enhance our engagement, we have previously combined activities with various professional organizations such as the North Dakota Medical Association, the Society of Hospital Medicine-North Dakota Chapter. Additionally, several innovative methods exist to further increase involvement. Incorporating the ACP North Dakota chapter into educational activities at medical schools, residency training sites, and faculty development opportunities within the Department of Internal Medicine is an effective strategy for member engagement. Furthermore, collaborating with health system leaders on initiatives related to policy, advocacy, value-based care, leadership development, wellbeing, and workforce recruitment and retention can significantly engage ACP North Dakota chapter members in their professional practice environment.
To enhance national-level engagement, we should create pathways for professional and leadership development. Encourage state chapter members to join national committees such as health and public policy, medical informatics, education, compensation, clinical guidelines, and clinical skills etc. Additionally, involvement in councils like early career physicians, resident and fellow members, student members, and subspecialty societies can provide valuable service and leadership opportunities.
- Dr. Ottenbacher: Increasing participation (beyond the small group of people who help with everything!) is an age-old problem for organizations. I believe that focusing on innovative approaches and combining trainings or activities to provide optimal benefit that fit into busy schedules is one way forward. I am working on combining trainings for internists so that they can learn an acupuncture skill plus develop self-care/physician well-being skills all within a 1-hour training – then present it while they are at work. Again, we can try to combine a tangible skill that can be used tomorrow in a practice along with soft skills (which are hard to get physicians to spend time on) like well-being. What matters the most to physicians and what is worth their time participating in? Having a sense of our group helps us guide participation activities and chapter goals.
Additionally, I would encourage peer to peer, mentor to mentee relationships, and specialized groups with a common interest all within the ND chapter. This can be intentionally increased to regional or national levels with poster or live presentations or grand rounds. These allow smaller groups to focus on what matters most to them and allows organized approaches to leadership, education, or practice development. We can build positions and allow for physician champions and more informal leaders: Sanford Fargo or Essentia champions, a resident education/curriculum development group, physicians passionate about integrative medicine or lifestyle medicine, ect. Finally, creating a group or project with the intent that it will be presented at regional or national levels can be personally fulfilling and help professional advancement. Being mindful of this helps us gain more participation.
How would you plan to reach and engage nonmembers?
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Dr. Bande: In a small state like North Dakota, engaging physicians and promoting membership in professional organizations is challenging due to the limited number of physicians. A multimodal approach is needed, including visits to healthcare systems, networking activities, scientific meetings, surveys, and social media campaigns. Engagement “value” lies in the quality of services over membership costs. Improving quality involves clearly sharing goals and objectives, defining process and outcome metrics, developing shared strategies, and maintaining communication about achievements.
- Dr. Ottenbacher: I am passionate about resident education, but truly speaking, I have an equal interest in engaging with internists and all physicians. This passion has helped me shaped plans and ideas for engaging others. For example, I have been intentionally active this academic year for integrative medicine engagement and promotion. I set personal goals for increasing lecturing and presentations. I am tracking for this academic year (July 2024 - July 2025) to present at:
· 4-5 grand rounds or resident didactic series (local presentations)
· 2 state conferences: one combined civilian conference and one state military conference
· 2 national medical conferences:
--Selected as lead for our panel presentation at the International Congress on Integrative Medicine and Health (“Leveraging the Academic/VA Partnership: Bringing Whole Health to Medical Trainees”)
--Selected as co-presenter for our group presentation at the National Society of General Internal Medicine meeting (“Teaching Concrete and Efficient Skills for Patient Engagement and Whole Person Care: Using VHA’s Whole Health Approach to Care with Learners Everywhere”)
--Also selected for a poster presentation at SGIM specifically on my curricula and rotations/training for resident physicians in regards to integrative medicine
I would leverage the lessons learned from presenting by reaching out to fellow physicians. In a similar way as to how you need to be intentional and energic to engage a crowd, we need to intentionally engage non-members. This must be a multi-faceted approach in the current medical environment.
This is similar to the work I do to engage resident physicians where I was honored as the 2024 TY outstanding faculty of the year with comments from residents such as: “Dr. Ottenbacher does an absolutely outstanding job overseeing this rotation. I thoroughly enjoyed the time we spent together and learned more from him than from almost anyone I can remember. He is a great physician and a wonderful person. The way he approaches medicine should be the gold-standard in patient care.”
The intent of highlighting my speaking and resident work is to show that engagement is an intentional and active process. We must be intentional in how we structure engagement activities including meeting non-members where they are at plus overcoming barriers they have to joining.
For non-members, the ACP and its physicians provide countless benefits (many of which are highlighted in above discussions on burnout, well-being, and connectiveness). We can reach other internists not in the ACP to bring them into the fold with stories of what we are doing and allowing them to join activities like acupuncture/well-being trainings then subtlety, or more overtly, highlighting ACP benefits.
How would you expand chapter programs and leadership opportunities to include underrepresented groups within your chapter?
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Dr. Bande: There is an opportunity to develop new programs related to addressing primary care interests, education, and training in value-based care initiatives, exploring AI, informatics, technology solutions, and digital health. Many of these programs will require collaboration between the University, its medical school, health professions programs, healthcare systems, payers, vendors, tech companies, and digital health companies. For example, as part of driving rural value-based care for the state of North Dakota, we partnered with United Health Group including its payer, Optum as a provider, and Optum Insights as a solutions company. This collaboration has revealed issues with disparities and equity not only in patient care but also in opportunities for underrepresented groups to lead. Continuing to work on such collaborations will create opportunities for underrepresented groups within our chapter.
- Dr. Ottenbacher: One key group, especially within the North Dakota ACP chapter, is rural physicians. There is an additional concern that the internists who may benefit the most or need the most help are those least involved (especially internists physically separated from peers due to living in a rural community frequently as the sole physician). This includes involvement in chapter programs and leadership positions.
I was born and raised in the back of my parents’ clinic: my father is a family medicine doctor and my mother is a nurse. This was in a small town 80 miles south of Bismarck (Selby, SD – population 707 and I have picture from the town newspaper walking our pet raccoon as a child down Main street to prove it - I was barefoot in July and had our raccoon Bandit on a leash no less!).