“It’s been good so far,” said Dr. Mark Smith, a 2008 graduate of Park Rapids Area High School and one of a father-son pair of surgeons practicing at Essentia Health-Park Rapids Clinic, with surgical privileges at CHI St. Joseph’s Health.
“Day to day, we’re not necessarily working directly with each other, but it’s certainly very helpful, starting out in a practice, having somebody that you trust to run things by and work with,” he said.
Dr. Daniel Smith has been doing general surgery with the clinic since 1989. The oldest of his five children, Mark was born a year later and now practices general surgery there as well.
“We’ve been working together now for just a few months,” said Mark. “It’s interesting how medical training takes you away for a while. I’ve been gone almost 20 years, doing that. So we’re kind of just getting started in terms of working together.”
“Mark’s practice is gradually picking up steam pretty well,” said Daniel. “I’m happy to see that.”
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He added that it’s fun to have his son to discuss cases with, not to mention having Mark’s two children (plus one on the way) living nearby.
Mark and his wife, Anna, a physician’s assistant, live near his parents on Mantrap Lake, as do one of his brothers, Scott, and his family.
Though Scott and another brother, Steve, didn’t follow their father into a medical career, their sisters did. Christina takes forensic nursing calls in the Twin Cities while working part-time in a neuro-ICU at Abbott Northwestern and studying in the nurse practitioner program at St. Catherine University.
Youngest sibling Julia is a cardiac device specialist with a company that does atrial fibrillation ablation (a heart procedure) with cardiologists and cardiac surgeons across Minnesota, Wisconsin and the Dakotas.
As a family tradition, you might say it goes back to Daniel’s father, who was a dentist in the small town of Dowagiac, Mich. From that, Daniel said, he got his first “inkling” into medicine.
“Then,” he said, “I worked as an orderly in the operating room in a rural hospital in Michigan as an undergraduate, and then got hooked into the whole rural general surgery thing.”
Daniel graduated from the University of Michigan, then went to medical school at Wayne State University in Detroit, where he also did his residency. “That included the Detroit Receiving hospital,” he said, “which is the main trauma hospital in Detroit. At that time, we’d average, like, six gunshot wounds a day. So, very busy, and you really learned how to operate.”
That was where Daniel met his wife and Mark’s mother, Norita.
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Mark’s path to surgical practice started with shadowing his father during his early teens. “You just see the pros and cons of being a doctor in a small town,” he said, “not having quite as many resources, so a little bit more of it falling on you, but also the rewards of helping your community. That really stuck with me throughout undergrad and training, in terms of leading me back this way.”
After graduating from the University of North Dakota, Mark went on to medical school at the University of Minnesota, Twin Cities, a residency at Hennepin County Medical Center and, most recently, a one-year fellowship in Texas, focusing on minimally invasive and bariatric surgery.
“I knew, going into college, I was interested in medicine, and probably something surgical,” he said. “It’s a nice blend of being a doctor and still having an opportunity to work with your hands. I appreciated that combination.”
Both father and son do what Mark described as “head-to-toe, general surgery,” including thyroid, parathyroid, lung, abdomen, skin, soft tissue, breast, colorectal, hernia and gallbladder surgery – pretty much everything except neuro-, vascular and orthopedic surgery.
Meanwhile, Daniel has been increasingly practicing bariatric surgery, seeing about 4,900 gastric bypass patients since 2000.
“We’re one of the handful of Centers for Excellence for bariatric surgery in the state,” he said. “Basically, the insurance companies will only let those be done in a few, select places, because of the high risk some patients have. We’ve had BMIs of, like, 99, in really extreme cases.”
A normal body mass index (BMI) is between about 18.5 and 25, with the risk of diabetes, hypertension, sleep apnea and death increasing the farther above that range it goes.
Daniel said a study shows that for an obese person with diabetes, bariatric surgery can add an average of nine-and-a-half years to their life expectancy.
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As possibly the only rural hospital with a Centers for Excellence designation in bariatric surgery, the Park Rapids practice has pulled in patients from throughout northern Minnesota and eastern North Dakota. “Only about 14% of the (patients) would be in what you would call our service area,” said Daniel. “Everyone else is outside of that.”
It’s been a boon, not only for Essentia’s practice and the local hospital, but also for their patients, he said.
Mark’s training also emphasized bariatrics, but it’s the minimally invasive part that’s bringing change to the area’s healthcare system.
He explained it as, “rather than making a big incision, making small incisions with a camera and instruments.”
Daniel said he thinks of it as “rather than a big incision, having three, four, or five half-inch to one-inch incisions that you can work through little ports, so you have a lot less incisional pain and less problems with hernia and organ infections, and much faster recovery.”
Basic laparoscopy has been around for a while, but the new wrinkle has to do with robotics. Daniel said laparoscopic robots provide “very good visualization and really precise manipulation, working corners that you otherwise would find difficult.”
He said he’s in the process of picking up these robotic procedures, in which Mark is already certified.
After more than 30 years of practice, Daniel still feels he chose right. “In a practice like this, you’re really a major component of patients’ healthcare,” he said.
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“It’s an exciting time to build on the surgery program that’s been here,” said Mark. “There are certainly challenges with providing excellent surgical care in a small community, where you don’t have as many resources, but that’s part of the fun. Figuring out how we can continue to provide care with more technological advances that tend to favor bigger cities, and being able to come back to where I’m from and continue to build on that, has been a lot of fun.”
The Trust Project
