General Internal Medicine, some specifics

The below is a post from Richard Hoffman, MD, MPH, Director of the Division of General Internal Medicine.

FiordellisiWendy
Dr. Fiordellisi

The general internists at Iowa River Landing (IRL) are thriving. Led by interim clinic director and clinical assistant professor Dr. Wendy Fiordellisi, the 17 faculty physicians and 2 APPs follow more than 14,000 patients. Productivity is projected to increase substantially in the coming academic year, slot utilization exceeds 100%, and each week the Press Ganey reports are replete with effusive praise for our clinicians. Patient satisfaction with our care, as highlighted by responses to questions about being included in decision-making and being willing to refer others to the practice, is outstanding. Top-box scores for those two areas exceed 96%, the highest among all ambulatory practices in the Department of Internal Medicine.

KaliszewskiRochafellowHowever, these accomplishments have stressed the practice. Current clinicians have very limited clinic access, particularly for accepting new patients. As University of Iowa Health Care focuses on increasing access for our own employees and those of other groups within the state who want to have their care at UIHC, this limited access could have been problematic for new patients seeking care in general medicine. Fortunately, this has been a banner year for recruiting providers to IRL. In the past year, we welcomed two outstanding APPs, Susan Kaliszewski, PA, and Emily Rockafellow, ARNP. Two new full-time clinicians have just started this winter and 3 more full-time clinicians will start this spring and summer. Their arrival will increase our full-time employment capacity from 9 to 14, markedly expanding our ability to accommodate new patients and to see existing patients back for timely routine follow-up or acute care visits. With the planned expansion, though, we realized that we will need additional clinic space. We are working closely with departmental and IRL leadership to find additional rooms (and hire additional support staff) to keep up with our burgeoning clinical capacity.

KleinHoffmanWe are particularly pleased to have recruited two of our graduating resident clinicians, Drs. Michael Klein and Amanda Hoffman (née Brase). IRL faculty attend in the resident’s continuity of care clinic (COC), which now follows more than 2,000 patients, providing clinical and didactive teaching to our residents. We have worked closely with them on quality improvement projects addressing the clinical and teaching aspects of the COC. Being able to recruit residents attests to our success in creating a supportive working environment. We hope to continue our success in recruiting UI residents for IRL, and we are reaching out to them early in their residencies to nurture interests in primary care.

Medical Student with Simulated PatientOur faculty are also renowned for clinical care and teaching excellence. Dr. Becky Davis won the University of Iowa Physicians (UIP) Clinician of the Year Award in 2013. Dr. Gwen Beck, associate director of the department’s residency program, won the UIP Patient Satisfaction and Service Excellence Award in 2016. A number of faculty have held important institutional educational leadership roles. Dr. Krista Johnson supervises the VA quality chief resident and has led both a very successful quality improvement program for the residents in addition to an annual quality and safety symposium for six years. Dr. Johnson’s work has resulted in improved clinic processes and clinical outcomes as well as publications and presentations at professional society conferences. Dr. Katie White directs the Outpatient Medicine clerkship for third-year medical students. For many years, Dr. Shawna Westermann directed the Ambulatory Practice Module and the Community-Based Primary Care clerkship for medical students. These efforts introduce medical students to general internal medicine, which can spark career interests in an era when fewer students and residents are entering primary care fields.

Doctor with Medical Science Icon Modern InterfaceOur faculty members are also involved in innovative work that directly supports our clinical efforts. Dr. Helena Laroche is the principal investigator for an NIH R01 looking at obesity and directs the IRL Weight Management Clinic. Dr. David Katz has funding from the National Cancer Institute to implement smoking cessation programs for cancer survivors. We hope to leverage his efforts to support the work of the new IRL lung cancer screening program, which satisfies our institutional federal mandate to address smoking cessation and abstinence. Dr. Margo Schilling, the John McMaster Ristine MD Professor in Geriatrics Education, directs our geriatrics clinic, an area that will only become more important to our aging population. Dr. Nicole Nisly, Associate Chair for Diversity, and her colleagues run the LGBTQ clinic, nationally recognized for its health equity mission that spans clinical care delivery, legal support, and legislative initiatives. Dr. Nisly has also been funded by the Iowa Department of Public Health to launch an anal-dysplasia clinic with clinical services provided by gastroenterologist Dr. Yehudith Assouline-Dayan. The project builds upon Dr. Nisly’s successful effort to introduce a pre-exposure prophylaxis (PReP) clinic into the LGBTQ clinic. Another service offered through primary care is a weekly travel clinic, run by Dr. Todd Wiblin, a trained infectious disease specialist.

Overall, the ambulatory care clinicians at IRL are strongly supporting the clinical, educational, and scholarly missions of the University of Iowa Carver College of Medicine.

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