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Alan Kenien (BMF'90) helps create capacity in a rural state

September 1, 2006—

Kenien had always had an interest in children with metabolic disorders, fitting them into his schedule as needed, but the fellowship—and, later, the help of a proposal writer at his Fargo practice—allowed him to create a multidisciplinary clinic serving children in North Dakota and neighboring states.

“The multidisciplinary approach is important to a rural area,” Kenien said. “Many of the patients travel long distances for treatment and having a multidisciplinary clinic where they can see several providers in one day makes it much easier for them.”

Initial state funding for the Fargo clinic has created access to medical care for patients from three states and diverse backgrounds. Kenien said, “I work closely with other specialists and to keep the clinic viable to all who need it. I am not a specialist in all inborn metabolic disorders,” but now many can be treated close to home. Before the clinic was established, many families had to drive to the Mayo Clinic or to the Twin Cities for care.

Kenien’s work has also affected North Dakota state policy regarding reimbursement for a special formula for infants with PKU (a metabolic disorder that can cause mental retardation if not treated early). He led an effort to make legislators aware of the costs of not treating the affected infants. “We spread the word that if these children didn’t get their formula, they were going to be huge tax burden to the State of North Dakota. Although the formula is very expensive, it prevents the need to institutionalize these children as they get older and allows them to mature into healthy and tax-paying adults.” (As a result of Kenien’s campaign, the legislature rescinded its rejection of payment for the formula.

The 1990 Bush Medical Fellowship was a turning point for Kenien. Without it, he observed, “I would not have had the confidence or training or the experience” to create the clinic.

A physician specialist familiar with his work noted that education—of both physicians and patients—is a key strategy Kenien employs: “He provides education about the metabolic disorders and what they mean, and how they should be managed and what treatment is.” The specialist also spoke of Kenien’s impact on physicians in North Dakota through the clinic by serving as the state’s consultant for the newborn screening program. “He took over more responsibility for metabolic disease in the state. There isn’t anyone specifically trained for that here. It’s providing improved care and management for children with metabolic disorders. It means that kids . . . will be diagnosed earlier and appropriate treatment will be provided earlier.”