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Call Earthlink Today 1-855-679-7096 (MCN) 1850 Utility – Livestock Trailer If You Read This... You Know Advertising Pays! Call the Broadcaster at 605-624-4429 or stop by to place your ad today! Agriculture 201 West Cherry St Vermillion, SD 2001 Ford F250 extended cab 4x4 also a 2000 Ford F250 regular cab 4x4. Also a 2001 Chevy pickup ¾ ton 4x4 regular cab. 402-640-8387. Quality Rural Health Care with Less Burnout Trailer Sale: Santas new UTV, Side by Side, ATV utility trailers; 3 HORSE Aluminum Slant $12,500.00; Tow dollies $999.00; 18 Models of DUMP Trailers; H&H 7X16' $5,199.00; For more info & prices: www.FortDodgeTrailerWorld.com 515- 972- 4554 (MCN) 624-4429 By Richard P. Holm, MD The elderly patient came back to our rural hospital from a hospital in a nearby larger city after having had major surgery and feeding-tube placement. The care from the bigger hospital was superb except that the patient was getting too much nutrient and fluids and was a bit “overloaded.” Also, the family was concerned that perhaps they had been too aggressive in getting stressful surgery for their elderly mom, whose memory had begun to slip. As her physician, I cut back on the feeding-tube supplements, stopped the intravenous fluids, provided a little diuretic and did labs and X-ray for dementia. I took plenty of time with family and patient learning about their wishes should our patient again deteriorate. All agreed to emphasize comfort from here on out, and if she started to fail, we would do our best in her home hospital and not transfer her care again. I had been that patient’s primary care doc for years. Practicing outpatient and inpatient care in a smaller town gave me the experience to see what was happening. The patient and family knew me, trusted me and appreciated the time I spent listening to her. Quality care reviewers, government oversight people and insurance companies also know the value of a well-trained rural primary care provider who not only understands how to care for complex patients, but also, knows when and ed, EPD's available, Reed, 402-649-3615. Keith Unfortunately, there are not enough rural primary care docs. Many speculate as to why this is; however, I believe the need has resulted from misinformed med students and residents who think the lifestyle in rural America is not satisfying enough. In the July 2019 issue of South Dakota Medicine, a survey of family physicians practicing in this state found much lower burnout rates in family docs practicing in rural areas (25 percent) compared with those practicing in larger metropolitan areas (51 percent). Evidently, some social aspects of rural practice seem to confer a protective effect against burnout. This new data should be helpful when young physicians are looking for the most satisfying places to practice. My elderly patient went home in about a week, happy with our community hospital and the care she received. Her doctor was also pleased, as he had the reward of successful care, the honor of satisfied family and the joy of truly helping someone while practicing in a rural setting. Richard P. Holm, MD is author of “Life’s Final Season, A Guide for Aging and Dying with Grace” available on Amazon. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPTV most Thursdays at 7 p.m. central. ACA Health Insurance Enrollment For 2020 Coverage Now Open PIERRE, S.D. – The South Dakota Division of Insurance reminds consumers the Affordable Care Act (ACA) open enrollment for 2020 coverage runs from Nov. 1 to Dec. 15, 2019, for consumers Steel corncrib, corncrib pan- with individual policies. els, portable fuel tank with Open enrollment offers South electric pump 4'x12' trailer. Dakotans the opportunity to 402-640-8387. review and/or purchase health Wanted a 12'x14' wide by insurance coverage from options 16'-24' building. Call 402-640- available in the general market, 8387. as well as the federally facilitated 1875 Livestock - Poultry exchange, known as the Marketplace. “Your local health insurance 2 Year old virgin Angus bulls, agent can provide assistance in grandsons of OCC Paxton, good dispositions, semen test- identifying any changes in health Gehl 4625 Skidloader with trailer runs great, good tires, 6'x16' long trailer with ramps, 5'x11' skidloader trailer, 10'x21' steel flatbed on Westendorf gear. 402-640-8387. where to refer when specialized care is needed. In fact, experts believe an ideal system would define a primary care provider for every person. insurance needs, as well as discuss plan benefit options available for 2020,” said state Insurance Director Larry Deiter. “Consumers can search for Marketplace-certified producers and brokers in their area through the ‘Find local help’ link at healthcare.gov.” Consumers should: Check dlr.sd.gov/insurance for additional information, including carriers selling insurance in South Dakota. Be aware healthcare.gov is the official website for the federal Marketplace. The site has information on the ACA, qualified health plans and comparisons of Marketplace plans available in 2020. Remember no one offering comprehensive health care coverage will ask about pre-existing conditions. Ask for written information about the policy, including premiums. Get the facts up front, before buying, in order to understand what the policy will and will not do. If you currently have coverage through the Marketplace, your insurance carrier should have provided notice of the auto re-enrollment option in your same plan or a similar plan if you do not actively choose a plan for 2020. Two health insurance carriers, Avera Health Plans and Sanford Health Plan, were approved by the Division to sell individual comprehensive health policies during the 2020 open enrollment. Any other company offering health coverage is not approved to sell comprehensive coverage in South Dakota. Questions or concerns can be directed to the South Dakota Division of Insurance at 605-773-3563 or by email at insurance@state. sd.us. With a HealthPartners Sanford (Cost) plan, you’re always in good shape. The Medicare experts at HealthPartners have teamed up with trusted local partners Sanford Health and others to offer North Dakota and South Dakota Medicare plans that keep you in good shape – physical shape, mental shape and financial shape. Visit healthpartners.com/sanford to get in good Medicare shape today. Get more out of your Medicare plan without paying more! HealthPartners is a Cost plan with a Medicare contract. Enrollment in HealthPartners depends on contract renewal. Other Providers are available in our network. 19-584660-611617 (8/19) ©2019 HealthPartners H2462_118621_C IR 9/2019