Cedar Valley Medical Specialists

Putting the patient first is what Cedar Valley Medical Specialists (CVMS) is all about.

“What we do with all our decisions is to make our mission ‘patient first,’ ‘corporation second’ and 'the individual providers third,’ ” says Gil Irey, CEO of Cedar Valley Medical Specialists.

Operating since Jan. 1, 1995, CVMS is 100 percent locally owned and 100 percent locally governed. All board members are physician shareholders. There is no outside influence. CVMS had six specialties and 80 employees when it first began service. Now it has over 20 specialties, over 50 specialized physicians, over 35 advanced practice and mid-level practitioners and over 400 total employees.

“Our role is to make the physicians’ lives as easy as possible with the non-medical aspects of operating their practices,” Irey says. “Practicing medicine today is burdened with tremendous efforts to comply with government regulations and federal, state and local insurances. We try to figure out everyday how we can make the providers' lives easier and keep them practicing medicine.”

CVMS considers Black Hawk County and the seven surrounding counties its primary coverage area with clinics in Grundy Center, Waverly, Sumner, West Union, Oelwein and Independence.

There are different operating models, but CVMS is unique across Northeast Iowa, particularly in how each specialty makes the decision concerning how to operate, staff, and where to locate its offices.

“We have a strong central board that manages the overall business affairs of the organization, but each department operates in its own clinic within CVMS’ structure,” Irey says. “They are departments of the corporation, but they operate in the best interest of their patients and the primary care physicians they serve. There is not a central authority from the corporation on where a physician must locate.” Thus, all of CVMS’ departments are not located under one roof.

Because CVMS currently does not include primary care, “people are coming to us for very specific reasons,” Irey explains.

“If someone needs breast care, they can be in a waiting room for just breast care issues. We really want to respect the privacy of the people who have more severe problems than general medical conditions.

“The other thing we want is easy patient access. Our patients can park close to an entrance, not in a parking ramp. They don’t have to find a parking spot, or go up elevators or flights of stairs. We want to be in the community where people can find us,” Irey says.

Though many of the offices are located at United Medical Park on West Ridgeway Avenue in Waterloo, other offices are off of that site. Cedar Valley Eye Care, Cedar Valley Cardiovascular Center and Advanced Diagnostic Imaging all are located in different parts of the community, for example.

“Most of our clinics have drive-up canopies, which makes access easier in case of inclement weather,” Irey says. “Having different locations makes business more expensive for us because we don’t have one phone number, and we don’t have one reception desk. But it’s part of our philosophy to put the patient first.”

CVMS attracts well-trained, world-class physicians to the community. Many have been trained at The Mayo Clinic, the University of Iowa, The Johns Hopkins Hospital, or Cleveland Clinic and many of the other top training programs in the country.

“We’re bringing the latest and the greatest from these teaching programs to the community. That’s a huge benefit for our patients,” Irey says.

An additional benefit for patients being treated under CVMS’ umbrella is the cost savings. “Our cost structure within our clinic is significantly lower than that of hospital-based physicians,” Irey says. “On average it’s less expensive to see a non-hospital-based physician. Hospitals get paid more money than private physicians because of their past Medicare and insurance trends and cost structure for comparable services.”

CVMS also is performing more procedures in-office because of technological advances. “Ten years ago a physician never would have performed outpatient procedures in any place other than an outpatient surgery center or a hospital. We can routinely do outpatient procedures in the physician’s office. This also is a cost savings — a valuable alternative,” Irey says.

With other technological advances, CVMS’ outreach doctors can now travel to their out-of-town clinics, perhaps perform a surgery in that hospital rather than necessitating that the patient travel to the Cedar Valley, and then follow up from their home office with the aid of telemedicine.

“We may have an orthopedic surgeon do a total joint replacement in Grundy Center,” Irey says. “That might mean a two-to-three-day stay in the hospital. Working with a local nurse or practitioner and primary care physician, the surgeon can follow up with the patient via telemedicine rather than physically having to drive back to the out-of-town site.

“It’s a video and voice hookup, much like Skype but higher quality, which can be rolled into the patient’s room. The camera will zoom in on the surgical site, the doctor will talk with the patient, the vitals will be shared, all things done as if the physician were there in person,” he says.

CVMS also has affiliations with other health systems that bring more advanced procedures and care to the Cedar Valley.

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