It’s a misty Wednesday in Sioux Falls, South Dakota, which is not uncommon for the season and, for most residents, is not particularly noteworthy. But on Wednesdays, Dr. Michael McNamara doesn’t drive to work—he flies. So today, the fog is an issue. McNamara is a maternal-fetal medicine physician at Sanford Health, the largest rural health system in the United States, spanning the Upper Midwest. He manages high-risk pregnancies requiring frequent physical exams and ultrasounds to ensure the