Page 1

SUNDAY, MAY 27, 2018

Northeast Iowa Family Practice Center 40 years of excellence in patient care and physician education

2 | Sunday, May 27, 2018


NE Iowa Family Practice Center in forefront of care, education NANCY JUSTIS ‌

‌The Northeast Iowa Family Practice Center and its Medical Residency Program have been in the forefront of innovative care of its patients and of teaching future family practitioners since its founding. It is celebrating its 40th anniversary this year. “Our mission is to train family practice physicians by providing extra special care for our patients,” said Dr. Adam Roise, clinical medical director. “We provide the Cedar Valley with well-trained physicians to take care of our population, starting in our clinic, taking care of our patients.” Sponsored by Covenant Medical Center and Unity Point-Allen, FPC doctors see their patients if admitted at either hospital. They also see other providers’ patients in the hospitals if those doctors don’t. FPC also is affiliated with The University of Iowa Hospitals & Clinics. Under the agreement, the Roy J. and Lucille A. Carver College of Medicine provides grants, faculty appointments, visiting professors, technical assistance and various kinds of educational support. The staff is proud of the numbers of patients who have stayed with FPC through the years, from helping children from newborn through school years before transitioning to adulthood. Doctors and the care team assist with healthy living, address acute illnesses and diagnose chronic diseases as they develop. As people age and retire, staff prioritize screening tests, health goals and preferences dependent upon patient and family values and wishes. Patients build a level of comfort and trust with their doctor. The staff includes about 24 physicians, including 18 resident physicians who want to specialize in family practice, 11 nurses, three pharmacists, three behavioral health counselors, one licensed medical social worker; one health coach and one physician assistant,


The management team consists of Dr. Adam Roise; Dr. Anthony Day; Heather Stech, nurse manager; Dr. Chris Haymaker, psychologist/ behavioral science coordinator; Bonnie Hough, administrator; Diane Ravn, patient service manager; Julie Smith, IT/Lab/Imaging manager; and Wendy Hudson, education coordinator. Robert Welshons. The nurses work in either research, triage or on the floor with the doctors. Where many other doctors’ offices employ nurse practitioners, the FPC hires licensed practical nurses and registered nurses. FPC is a teaching clinic and the nurses help train residents before they go out and form their own practices. The facility at 2055 Kimball Ave., in Waterloo has on-site labs, X-ray capability, DEXA scans and obstetric ultrasounds, along with colonoscopy availability and many other services, including an on-call physician 24 hours a day. “As health care has changed, the skills and what is expected of family practice has changed,” Dr. Roise said. “The demands of primary care have definitely changed. As a program, we have tried to stay out in front of those changes and to train our residents to be prepared to enter the workforce.” Because family practice usually is the entry point for health care, FPC provides a long list of patient services all under one roof. Residents in training for a family practice need to be knowledgeable in a myriad of conditions. The list includes

ADHD management, adult and pediatric health maintenance, asthmatic management, chronic disease management, colon cancer screening, contraception, diabetic management, fracture care, geriatric specialty care, GYN services, home visits (yes, home visits) for home-bound patients, stress management, and much more. Patients expect quality care when visiting a doctor’s office. In this case, quality is tied in with technology. In 2006, FPC became part of a national quality improvement research group and began to work on quality initiatives. Dr. Roise explains that these initiatives refer to population management. “Knowing what percentage of your patients got the flu shot last year. Knowing how many of your people have high blood pressure. Reaching out to them, working with our pharmacists, our health coach to try to figure out how to wrap care around that patient. This is much more collaborative in nature and also much more proactive,” he said. Julie Smith, IT Quality Improvement director, says FPC has been “early adopters of technology. We got our first EMR

(Electronic Medical Record) system in 2001. We’ve always tried to adopt technology sooner than later, ahead of everyone else, because we’re teaching residents. We want them to leave here with the latest, greatest knowledge. “We’re also in the quality arena, which is using the EMR meaningfully and proving it (through our record-keeping). Proving that we are using it to better patient care. We’ve always scored really high on that. In 2012, we earned a Patient Centered Medical Home Level 3 designation. When we were recertified in 2014, we were in the top one percent of the country.” Another initiative the FPC participates in is “Million Hearts.” According to that website, heart disease, stroke and other cardiovascular diseases kill over 800,000 Americans each year, accounting for one in every three deaths. To help combat this, the U.S. Department of Health and Human Services established “Million Hearts,” a five-year initiative launched in 2012 alongside 120 official partners and 20 federal agencies

aligned to promote cardiovascular disease prevention efforts around a set of evidence-based public health and clinical goals and strategies. Another priority is including patients as much as possible in their own care. “I think the responsibility of the patient has changed,” Dr. Roise said. “We (health providers) don’t want to tell patients what to do. More and more we want them to know what their options are in making smart choices and to have their priorities included. “Physicians are required to know what the science is, or what the medicine or research says. We’ve long been good at that. The thing we need to get better at is making sure we physicians and residents mesh the treatment with patient’s circumstances and goals. We need to continue to work on models that promote prevention and collaboration between providers and patients so they are working together.” Please see FPC, Page 3

3 | Sunday, May 27, 2018



FPC benefit gala June 2 to celebrate 40 years

From Page 2

“We make sure we respect the patients’ values and what they want,” said Dr. Christopher Haymaker, behavioral science coordinator. “We have to be compassionate about the choices they make at that moment. We don’t make judgements. We are medical experts, but not experts in their lives. The key component is to be able to have physicians here that understand the patient and what their priorities are and then help guide them to their medical decisions that makes sense.” FPC sponsors a medical ethics conference every other year. It also hosts the annual Jauch Symposium, a memorial to the center’s former director, Dr. Karl Jauch. It is provided to physicians, community health-care providers and pharmacists to enhance comprehension, knowledge and skills in practicing in the evolving world of family medicine. Students interested in the


Current faculty members are: Dr. Suzanne Munns; Dr. Adam Roise; Dr. Jim Hoehns; pharmacist; Bonnie Hough, administrator; Dr. James Poock; Dr. Anthony Day; Dr. Chris Haymaker, psychologist/behavioral science coordinator; and Wendy Hudson, education coordinator; and Dr. Robert Friedman, not pictured. health sciences can shadow FPC staff. FPC supports a summer internship for college-level students interested in clinical research. The University of Northern Iowa athletic training

students participate in shadowing experiences through the FPC, which also provides Panther home event physicians and residents on site.

‌ veryone loves a party! E The Northeast Iowa Family Practice Center is celebrating the 40th anniversary of its Medical Education Foundation with an invitation-only benefit gala on June 2nd at the Waterloo Convention Center at the Five Sullivan Brothers Plaza. The celebration runs from 5:30 to 8 p.m. and includes a dinner buffet and silent auction. Featured speakers include Dr. Robert Friedman, the Center’s Undergraduate Medical Education Director; Jim Waterbury, son of Dr. Charles Waterbury, the Foundation’s first program director in 1976 and a longtime Waterloo family phy

sician; Matt Hobson, stepson Dr. Karl Jauch, former director and for whom the annual Jauch Symposium is named; Dr. John Sutherland, who initiated the first clinical research program in 1992; and Dr. Anthony Day, Foundation Executive and Program Director. The staff celebrated the entire month of May with in-house games and other activities, and T-shirts commemorating the anniversary. An Open House for center patients will be scheduled at the end of June. All proceeds from the gala will go to help enhance the educational program of the Northeast Iowa Family Residency Program.

4 | Sunday, May 27, 2018


Residents well-trained to be primary care physicians NANCY JUSTIS‌

‌In the early 1970s, the Cedar Valley was experiencing a shortage of family physicians. In fact, that shortage continues nationwide even today. There are many reasons for this shortage, including doctors wishing to practice other specialties and the fact that many medical schools do not prioritize the training of future family practitioners. Whatever the case, Dr. Charles Waterbury, a longtime Waterloo family physician, came up with the idea of starting a residency program to bring more doctors to the community. Through his efforts and other local physicians and community leaders, the Northeast Iowa Medical Education Foundation was founded in 1975 to help develop a family medicine training program. The Family Medicine Residency Program is the branch of the foundation which provides physicians with three years of additional training in family medicine. During their training, resident physicians at the Northeast Iowa Family Practice Center provide comprehensive health care to nearly 7,700 patients under the supervision of the Center’s board-certified family medicine physicians. These faculty members have more than 130 years of combined clinical experience and clinical appointments with the University of Iowa Carver College of Medicine. At last count, an estimated 53 of the more than 200 graduates of the residency program are practicing in the Cedar Valley. More than 30 are practicing elsewhere in the state. The rest are practicing in at least 29 states and three foreign countries. Dr. Adam Roise, FPC clinical medical director, says over 1,000 doctors apply to the residency program each year. “When we recruit residents, we try to recruit those who have some ties to the area or want to practice locally,” he said. “Na-


Current physician and pharmacy residents, graduating in 2018, 2019 and 2020.


on your 40 Year Anniversary & 40 years of helping the Community! Thank you for your continued Partnership with Fresh Start Cleaning.


Evelyn Rohrssen, RN, and Dr. Robert Friedman have worked together serving patients at the Family Practice Center since 1978. tionally, many residents stay in the communities where they received their training. They are familiar with the hospitals. Having the program here has gone a long way in supplying primary care physicians for the community.”

Resident physicians receive training in multiple specialties, including internal medicine, obstetrics/gynecology, surgery, pediatrics, Please see RESIDENTS, Page 5

Candace Wagner (319) 245-0174

Tony Wagner (319) 215-0178

Sunday, May 27, 2018 | 5


FPC is one-stop shop for mental, physical well-being NANCY JUSTIS ‌

‌The Northeast Iowa Family Practice Center and its dual purpose of training future family medicine physicians could be described as a one-stop shop for medical care. “The idea is to take care of the whole patient and to connect up well-being and physical health and mental health,” said Dr. Christopher Haymaker, FPC’s Behavioral Science Coordinator. “Family practice is the only discipline that has a behavioral science specialist to work alongside the faculty.” Multiple disciplines working under FPC’s umbrella include a clinical pharmacist, a social worker, mental health providers, a health coach and a research department. “It’s all integrated into primary care so that if you show up one day and your doctor sees a need and you are willing, we can meet that need right now rather than making you wait a few weeks to see a specialist. Hopefully, you can be seen the same day. Often, we can schedule appointments within a week.” This system of integrated care is unusual, especially outside of an academic facility. An important component of family medicine training is behavorial science, said Dr.

Residents From Page 4

emergency medicine, family medicine, community medicine, psychiatry and behavioral science, orthopedics, cardiology, urology, ophthalmology and dermatology. In addition, they may use elective time to concentrate on specialties and sub-specialties of their choice. “We certify our graduates are competent to practice in all the areas of family practice primary


Staff, faculty and employees at Northeast Iowa Family Practice Center. Haymaker. “The family doctor in his/ her office needs to know what theirfirst, second and third choices are in treating depression, for example. If we treat depression well, then many other chronic diseases are going to be less serious. We already have such a critical shortage in psychiatry and in rural health care there is an even more serious shortage. Our family medicine doctors going into rural medicine have to be prepared to treat those

psychiatric conditions. Counseling skills and lots of medical knowledge.” Clinical Pharmacist Emily O’Brien focuses on medical management and being the care manager for the patients. “Being a teaching facility, I get a lot of questions about what medications are and what works best. It’s preparing our residents for when they go out to practice themselves. I also work directly with the patients and then follow up with them over the phone between their

appointments and work with them on a follow-up plan.” The pharmacy resident program is separate from the family medicine program to the extent that Waverly Medical Center is the partner. It began in 1998, starting with one resident per year. The 19th resident is currently training. They complete their residency in the Waterloo/Cedar Falls area, practicing at Unity Point-Allen, Covenant and Greenwood Pharmacy over a five-week period. Debra Flammang-Roper is

the licensed medical social worker and has been with the practice since 1994. “If there is someone in crisis, Deb can meet with them and help them find services in the community. She does therapy,” Dr. Haymaker said. Griffin Hickey’s responsibilities as health coach overlaps many times with other staff members’ responsibilities. “Part of Griffin’s job is patient navigating. She works with

care. They have experience and can see patients in a clinic or hospital, nursing home, in home visits and in hospice,” Dr. Roise said. “One of the challenges of being a good primary care doctor is you have to know when you don’t know the answer. You have to know when you are out of your league, when to refer your patient to a specialist; but also know when it’s okay to keep your patient under your care. I can take care of most things for most of my patients most of the time and I can explain to them

why they don’t need to go see a specialist. They trust me. “I think I reduce the burden on the system.” Currently, there are 18 residents training at one time, six per class. Training takes place in the hospital setting, in private physician offices and in the center, which serves as the base of training. FPC’s environment is modeled after a private medical office, akin to what resident graduates will practice in. Residents are required to see 1,650 outpatients over their

three years in the program. They may start out seeing a patient for up to an hour. By the time they are in their third year of residency, the appointment is reduced to perhaps 15 minutes. “Students learn how to be more focused, how to set an agenda,” Dr. Roise said. “They learn how to refer, how to collaborate with the pharmacist or social worker. You don’t graduate from medical school taught how to manage schedules and stay on time, how to deal with crises.” Residents also participate in two scholarly research projects,

sit on clinic committees and spend one to two months on an off-site rotation, which can include international practice. The residency program would not be possible without the participation of area physicians who volunteer to teach skills and procedures required for those doctors in private practice. The program is accredited by the Accreditation Council of Graduate Medical Education, which is composed of representatives of five national associations interested in medical education.

Please see ONE-STOP, Page 7

6 | Sunday, May 27, 2018


Foundation formed to support mission NANCY JUSTIS ‌

‌The Northeast Iowa Medical Education Foundation was founded in 1975. The mission is to prepare qualified physicians in the specialty of family practice, to provide undergraduate, graduate and continuing medical education, to provide quality, compassionate, comprehensive and continuing care to patients, and to enhance health care services and education through the promotion of interdependent relationships in the community and with other medical and surgical specialties. The Family Medicine Residency Program is the branch of the foundation which provides physicians with three years of additional training in the specialty of family medicine. The foundation was the bridge to get the program up and running 40 years ago. Dr. Charles Waterbury became the foundation’s first director in 1976. Today, the Foundation is sponsored by Unity Point Health-Allen Hospital and Covenant Medical Center. It has


been affliated with the University of Iowa since 1977. The foundation coordinates the university’s Roy J. and Lucille A. Carver College of Medicine’s medical education activities in Northeast Iowa, participates in faculty development programs and teaches university students on site. Foundation faculty physicians have been appointed as members of the UI College of Medicine faculty. “The bottom line why more organi-

zations aren’t doing this is money,” said Dr. Christopher Haymaker, FPC’s behavioral science coordinator. “It’s difficult to do with a fee for service system. It’s hard to do if you have to look at the immediate concern of costs for a clinic.” In addition to the residency program, undergraduate medical education, continuing medical education and medical research also are included in the educational activities. The Charles A. Waterbury Funds

were established to enhance these educational activities. Donations help achieve the standard of excellence that the foundation strives to achieve. The Waterbury Endowment Fund is a permanent endowment with income being utilized each year. These gifts are eligible for a 25-percent state tax credit in addition to normal federal charitable deductions. More information is available at contribute/68. The Waterbury Fund allows an entire gift to be used for current priority items. Gifts can be designated for specific categories, including new program development, enhancing resident recruitment, scholarships, faculty development, visiting faculty such as the Karl Jauch Symposium, and educational resources. Dr. Anthony Day is executive and program director. For more details, contact Northeast Iowa Medical Education Foundation, 2055 Kimball Ave., Suite 101, Waterloo, IA 50702, (319) 272-2525 or

C O N G R AT U L AT I O N S Northeast Iowa Medical al Educ Education ion Foundation Thank You For

of Helping to Keep






1501 Technology Parkway, Suite 200, Cedar Falls, IA 50613

Sunday, May 27, 2018 | 7


’70s doctor shortage lead to organizing residency program is it corporate owned, which most practices are today. It is sponsored by Unity Point-Allen and Covenant, however. In the 40 years since opening, FPC has had just three head nurses. Current Nurse Manager Heather Stech has been on board for 15 years.


‌Today’s Northeast Iowa Family Practice Center and its Medical Education Foundation was the brainchild of long-time Waterloo family physician Dr. Charles A. Waterbury. He, along with Dr. Karl Jauch of La Porte City, started the residency program to bring more family physicians to the Cedar Valley, which was experiencing a shortage of that medical specialty. The plan came together with the help of the University of Iowa School of Medicine. Dr. Waterbury also asked health-care educator Jane Hasek, who eventually became an administrator at Unity Point-Allen Hospital’s Allen College, to help formulate goals and objectives of the residency program. That planning took about a year before the first resident was selected. The program is celebrating its 40th anniversary this year. Dr. Robert Friedman, undergraduate medical education director, has been with the FPC almost from the very beginning. “Dr. Waterbury and Dr. Jauch advertised for a third faculty in the Illinois Medical Journal and my mother, who was a physician, sent me this little blurb about a faculty position in a new residency program in Iowa. At the time we were in Kentucky,” Dr. Friedman recalls. “I was with the National Health


The Extended Care Team: Debbie Flammang-Roper, MSW/social worker; Dr. Emily O’Brian, pharmacist/case management; Griffin Hickey, health coach/patient navigator; and Dr. Chris Haymaker, psychologist/ behavioral science coordinator. Service. We had two children, and my wife said we wanted to go somewhere that had good schools. “I came up and visited. We just clicked. This is the only place I looked. I always wanted to teach, and I started July 1, 1978.” The first office opened at 441 E. San Marnan Drive. The first class of five residents began study with the hiring of Dr. Friedman. In 1995, the clinic and program moved to its current location at 2055 Kimball Avenue. “We were expanding,” Dr. Friedman explained. “We ended

One-stop From Page 5

some of our high-risk patients if they have been in the hospital or ER, she follows up with them after they have been discharged to make sure they get in to see their doctor, getting their medications,” Dr. Haymaker said. The most unusual element of the Northeast Iowa Family Practice Center in this system is the research component under the direction of Clinical Pharmacist and Research Director Jim Hoehns.

“I still love my job because it’s exciting,” she said. “We help train the residents, helping them learn how to run a practice.” The Residency Program has graduated about 220 family practice doctors. Many of the family practice doctors in the community were trained at the FPC.


Lab technician Marcy Zimmerly The Medical Education Foundation started conducting clinical research in 1992 with then Program Medical

up with 12 residents for a few years. Now we have 18, six in each class of the three-year program. We had three faculty back then. We have many, many more now, including five physicians. We have many more teachers and more ancillary staff.” That ancillary staff includes a clinical pharmacist, a health coach, a social worker, a research team and others. The Northeast Iowa Family Medicine Residency Program and the Center is somewhat unique in that it is not hospital-based, nor

Director Dr. John Sutherland. The center has participated in over 120 clinical trials, enrolling over 1,350 center patients. “Our research program is unknown in the Cedar Valley in the grand scheme of things,” said Hoehns. “We currently have 10 clinical trials either closed but still following patients, and three that are open that we are recruiting patients for.” The NEIFPC became a certified patient-centered home in 2012, the first to earn this designation in the Cedar Valley, because of the focus on continuity and collaboration.


on your 40th Anniversary! Thank you for your continued service to the community and partnership with BankIowa.

8 | Sunday, May 27, 2018


P: 319.272.2112 F: 319.272.2107

2055 Kimball Ave, Suite 101 Waterloo, IA 50702


Providing 40 Years of Excellence in Education and Patient Care in the Cedar Valley!


Monday through Friday: 8:00 a.m. - 5:00 p.m. Saturday: 9:00 a.m. - 12:00 p.m. Monday through Friday: 8:30 a.m. - 4:30 p.m.

LAB & XRAY SERVICES Saturday (Lab only): 9:00 a.m. - 11:30 a.m.

Robert Friedman, MD

Anthony Day, MD

Suzanne Munns, MD

James Poock, MD

Adam Roise, MD

We pride ourselves on getting to know our patients and constantly striving to improve the care the we provide. We offer same day appointments and have a physician on call 24 hours a day.

Come see us today and let us provide you with, what we feel is, the best care in the Cedar Valley!

Profile for Waterloo-Cedar Falls Courier

Northeast Iowa Family Practice Center  

40 years of excellence

Northeast Iowa Family Practice Center  

40 years of excellence