Specialist Connection Spring 2015

Specialist Connection

Information and news from Physicians’ Clinic of Iowa for healthcare professionals.

Together in health.

APRIL 2015

Breast Reconstruction Education EventClosing the Loop on Breast Cancer Tuesday, May 5, 5:30-7:00 PMThis FREE event will focus on education, awareness and access regarding post-mastectomy breast reconstruction. Presented by: Helen G. Nassif Community Cancer Center, Physicians’ Clinic of Iowa, and UnityPoint Health St. Luke’s Hospital.

Health ClassesArthritis 101 Wednesday, May 27, 5:30-6:30 PMPresented by: Michael Brooks, MD, FACP, FACR PCI Rheumatology

Men’s HealthWednesday, June 10, 1:00-2:00 PMPresented by: Thomas Richardson, MD PCI Urology

Healthy HandsThursday, July 16, 1:00-2:00 PMPresented by: Timothy Loth, MD, FAAOS, FACS, FASSH PCI Orthopaedics–Hand Surgery

Register at pcofiowa.com/Events or call (319) 247-3010.

General Health ScreeningsThese walk-in screenings do not require registration. Screenings include: blood pressure, height and weight, Body Mass Index (BMI), cholesterol, and glucose testing.

• Wednesday, July 8, 7:00-8:00 AM• Wednesday, October 7, 7:00-8:00 AM

Lab results are sent post-screening and can also be faxed to patient’s primary care provider.

PATIENT EventsOffice Based Angiography at PCI Medical PavilionPhysicians’ Clinic of Iowa Medical Pavilion angio suite provides minimally invasive vascular/endovascular procedures performed by PCI vascular surgeon, David Lawrence, MD, FACS.

With the ability to perform angiography pre-op, surgery, and recovery all at PCI Medical Pavilion, PCI Vascular Surgery is reducing wait times and providing patients with the added comfort of a non-intimidating setting. In addition, the out-of-pocket cost to patients for in-office procedures is typically much less than the same procedure performed in a hospital setting.

Angiography is a minimally invasive procedure that is completed using balloons, stents, or plaque removal. Angioplasty is a procedure that uses a balloon to open narrowed or blocked blood vessels that supply blood to the legs. Fatty deposits can build up inside the arteries and block blood flow. The stent is a small, metal mesh tube that keeps the artery open. Angioplasty and stent placement are two ways to open blocked peripheral arteries. Atherectomy refers to plaque removal.

Symptoms of a blocked peripheral artery are pain, achiness, or heaviness in the leg that starts or gets worse when walking. Primary care physicians may try medicines and other treatments first. Reasons for having angiography surgery are:

David Lawrence, MD, FACS and Carrie Campbell, AGACNP

• Symptoms preventing daily tasks.• Symptoms that do not get better

with other medical treatment.• Skin ulcers or wounds on the leg

that do not get better.• Infection or gangrene on the leg.• Pain in the leg caused by

narrowed arteries even when resting.

David Lawrence, MD, FACS Physicians’ Clinic of Iowa–Vascular SurgeryPhone: (319) 362-5118

David Lawrence, MD, FACSPCI Vascular & Endovascular Surgery

Years at PCI: 10

Contact:Physicians’ Clinic of Iowa–Vascular Surgery 202 10th Street SE, Suite 290Cedar Rapids, IA 52403Phone: (319) 362-5118 or (800) 728-5118 Fax: (319) 364-0574Hours: Mon-Fri , 9:00 am to 5:00 pm

Special Interests:• Abdominal Aortic Aneurysm• Endovascular Aneurism Repair• Peripheral Angiography• Carotid Artery Surgery and Stenting• Varicose Veins and Treatment of Venous

Insufficiency

Training:MD - University of Iowa, Carver College of Medicine, Iowa City, IA

Residency in General Surgery, Lehigh Valley Hospital, Allentown, PA

Fellowship in Vascular Surgery, Geisinger Medical Center, Danville, PA

Certification:American Board of Surgery - Vascular Surgery

Hospital Privilege:• Mercy Iowa City• Mercy Medical Center• Surgery Center Cedar Rapids• UnityPoint Health - St. Luke’s Hospital

Outreach Clinic:Mercy Iowa City500 East Market Street, Iowa City, IABy appointment.Call to Schedule: (319) 339-0300

View a full profile at:pcofiowa.com/Lawrence

PHYSICIANProfile

Rikka M. Burroughs, ARNP, NP-CPhysicians’ Clinic of Iowa–UrologyPhone: (319) 363-8171Fax: (319) 363-3172Hours: Mon-Fri, 8:00 am to 5:00 pm pcofiowa.com/Urology

Rodney Dempewolf, DPMPhysicians’ Clinic of Iowa–Orthopaedics & PodiatryPhone: (319) 398-1545Fax: (319) 399-2069Hours: Mon-Fri, 8:00 am to 5:00 pm pcofiowa.com/Podiatry

Gregory M. Janda, MDPhysicians’ Clinic of Iowa–UrologyPhone: (319) 363-8171Fax: (319) 363-3172Hours: Mon-Fri, 8:00 am to 5:00 pm pcofiowa.com/Urology

Melissa A. Janssen, ARNP, FNP-BCPhysicians’ Clinic of Iowa–Ear, Nose & ThroatPhone: (319) 399-2022Fax: (319) 399-2014Hours: Mon-Fri, 8:00 am to 5:00 pm pcofiowa.com/Janssen

Thomas M. Rogers, DOPhysicians’ Clinic of Iowa–Neurology & Sleep MedicinePhone: (319) 398-1721Fax: (319) 399-2016Hours: Mon-Fri, 8:00 am to 5:00 pm pcofiowa.com/Neurology

A Warm Welcome to Our New PCI Providers

Beginning July 2015: Beginning August 2015:

Specialty Physician Openings

Physicians' Clinic of Iowa is currently seeking qualified candidates for the following physician opportunities:

• Colon & Rectal Surgeon• Dermatology/MOHS Surgeon• Hand Surgeon• Medical Oncologist• Orthopaedic Surgeon (Total Joints)• Orthopaedic Surgeon (Pediatric)• Physiatrist (Physical Medicine and Rehabilitation)• Vascular Surgeon

Candidate QualificationsIn addition to Medical Doctors, Allopathic and Osteopathic physicians will be considered. Board certification is preferred, although new graduates will be expected to seek board certification at the earliest opportunity in their respective subspecialty. The desire to be a team player and ability to work with other physicians of different generations and skill sets within a multi-specialty group practice is a must. Full partnerships can be offered between year one and year two of employment. Candidates must also be proficient in English and either be a United States citizen or have a permanent visa. Pre-employment drug testing and background check are required.

For more information, visit pcofiowa.com/Recruitment or call (319) 247-3010.

Thomas D. Richardson MD Physicians’ Clinic of Iowa–Urology

Specialty Care in Waterloofrom Physicians’ Clinic of Iowa.

We’ve opened a specialty care clinic in Waterloo. This location currently offers urology and ENT care, but plans to offer more specialties in the future.

Physicians’ Clinic of Iowa—Specialty Care315 East San Marnan Drive, Waterloo, IA 50702

Now accepting new patients and referrals.

Call to schedule: (319) 234-2055

Board certified specialists at PCI Specialty Care in Waterloo:

Ear, Nose & Throat (afternoons only) K. Carpenter, MD—2nd Wed/Month M. Pruzinsky, MD—4th Wed/Month

Urology Rotating physician—Every Thursday

Learn more at pcofiowa.com/Locations.

Together in health.Call to schedule: (319) 399-2022

pcofiowa.com/Outreach

ENT specialist, Ryan Dempewolf, MD, FACS and audiologist, Cheryl Koester, MA, CCC-A are pleased to now offer care at:

UnityPoint Clinic - Family Medicine - Belle Plaine 105 9th Avenue, Belle Plaine, IA 52208

Care for individuals suffering from:

Now accepting NEW patients.Appointments available the second Thursday of every month from 1–4 pm. To schedule, call (319) 399-2022.

•Allergies•Cancers of the Head and Neck• Ear, Nose and Throat Disorders•Dizziness•Hearing Loss

• Sinus Problems• Snoring• Thyroid Disorders• Voice Disorders

Ear, Nose & Throat (ENT) care from Physicians’ Clinic of Iowa in Belle Plaine.

Ryan Dempewolf, MD, FACS

Cheryl Koester, MA, CCC-A

retirementAfter 18 years with Physicians’ Clinic of Iowa and over 31 years serving patients in Cedar Rapids, William Wilkinson, MD, general surgeon with PCI Surgical Specialists will retire from active practice on June 30, 2015.

Charity Walk Events

Physicians' Clinic of Iowa is proud to support walk teams for the JDRF One Walk on May 9 and Relay for Life on June 5 and 6. We hope to see you there!

Research Brief

Average hospital outpatient department prices for common imaging, colonoscopy and laboratory services can be double the price for identical services provided in a physi-cian’s office or other community-based setting, according to a study by researchers at the former Center for Studying Health System Change (HSC). Using private insur-ance claims data for about 590,000 active and retired nonelderly autoworkers and their dependents, researchers found, for example, that the average price for magnetic resonance imaging (MRI) of a knee was about $900 in hospital outpatient depart-ments compared to about $600 in physician offices or freestanding imaging centers. Likewise, the average hospital outpatient department price for a basic colonoscopy was $1,383 compared to $625 in community settings. For a common blood test—a comprehensive metabolic panel—the average price in hospital outpatient departments was triple the price—about $37 compared to $13 in community settings.

Moreover, across and within 18 metropolitan areas with substantial numbers of autoworkers, prices varied considerably between the two sites of care for a variety of services. For some simple laboratory tests, average hospital outpatient department prices were as much as eight to 14 times higher than average community-based lab prices in some metropolitan areas but less than 50 percent higher in other areas. In addition, the study found considerable variation in hospital outpatient department and community prices within metropolitan areas, with hospital outpatient prices typically varying more. The large price gaps offer an opportunity for purchasers and health plans to reduce spending by steering patients to lower-price, community-based providers through changes in network and benefit design.

Location, Location, Location: Hospital Outpatient Prices Much Higher than Community Settings for Identical ServicesBY JAMES D. RESCHOVSKY AND CHAPIN WHITE

A D V A N C I N G H E A L T H P O L I C Y R E S E A R C H

NUMBER 16 • JUNE 2014

About the Institute. The National Institute for Health Care Reform (NIHCR) contracted with the Center for Studying Health System Change (HSC) between 2009 and 2013 to conduct health pol-icy research and analyses to improve the orga-nization, financing and delivery of health care in the United States. HSC ceased operations on Dec. 31, 2013, after merging with Mathematica Policy Research, which assumed the HSC contract to complete NIHCR projects.

NIHCR Research Director: Paul B. Ginsburg c/o Mathematica Policy Research 1100 1st Street, NE, 12th Floor Washington, DC 20002-4221

Identical Services, Different Settings, Higher PricesMany medical services—for example, an MRI scan—are provided both in hospital outpatient departments (HOPDs) and community settings, such as physician offices and freestanding imaging or ambu-latory surgical centers (ASCs). Services commonly provided in both settings include laboratory tests, physical therapy, outpatient surgery, standard and advanced imaging, physician visits, and noninvasive and invasive procedures, such as endos-copy or cardiac catheterization.

Private insurers and Medicare generally pay more for services provided in hospital outpatient departments. Hospitals justify the higher payments by citing higher over-head costs related to stand-ready capacity for emergencies and additional regula-tory requirements, such as the obligation to screen and stabilize all patients with a medical emergency regardless of their abil-ity to pay.1 A key question for purchasers is whether the higher cost for routine, non-emergency services in HOPDs is justified when the same services are widely available at lower prices in community settings.

Several trends heighten the importance of investigating the gap between HOPD prices and community-based prices for routine, nonemergency services. Increased spending on HOPD services is playing a major role in overall spending growth for both publicly and privately insured people because of increases in both prices

Research Brief











Research Brief











Data Source

This Research Brief uses detailed 2011 facility and professional claims data for current and retired autoworkers and their dependents under age 65. General Motors, Chrysler, Ford and the UAW Retiree Medical Benefits Trust provided access to the claims data. The data include detailed information on the service provided, the type of provider, the allowed amount—the total amount paid to the provider, including amounts paid by the insurer and the patient. Price comparisons were generated in 18 metropolitan areas with 10,000 or more enrollees in the autoworker plans, and each community had at least 75 HOPD and 75 community-based observations to make reliable comparisons for the services investigated (see the Technical Appendix for more about the study’s methodology). The 18 metropolitan markets are Akron, Ohio; Buffalo, N.Y.; Cleveland; Detroit; Flint, Mich.; Grand Rapids, Mich.; Indianapolis; Kokomo, Ind.; Lansing, Mich.; Monroe, Mich.; Rockford, Ill., Saginaw, Mich.; St. Louis; Syracuse, N.Y.; Toledo, Ohio; Warren, Mich.; Wilmington, Del.; and Youngstown, Ohio.

National Institute for Health Care Reform Research Brief No. 16 • June 2014

2

About the Authors

James D. Reschovsky, Ph.D., is a former Center for Studying Health System Change (HSC) senior fellow now at Mathematica Policy Research (MPR); and Chapin White, Ph.D., is a former HSC senior researcher now at RAND. The authors thank Amanda Kudis and Menolly Hart, both MPR senior programming analysts, for their excellent programming work.

and quantities.2 The Medicare Payment Advisory Commission (MedPAC) has ques-tioned whether these site-of-service pay-ment differences are warranted and has rec-ommended that Medicare pay for routine physician evaluation and management visits provided in hospital outpatient depart-ments at the same rate as services provided in community-based physician offices. Such a move would reduce the cost of an average Medicare HOPD physician visit by 56 per-cent and would save an estimated $1 billion to $5 billion over five years.3 More recently, MedPAC recommended reducing or elimi-nating the differences in Medicare payment rates between outpatient departments and physician offices for 66 specific categories of ambulatory services—a move estimated to reduce patient cost sharing alone by $200 million per year.4

Recent increases in the employment of physicians and acquisition of community-based physician practices by hospitals, along with hospitals purchasing ambulatory surgical centers and other community-based facilities, are resulting in more and more services being paid at higher hospital

outpatient rates.5 The payment differentials likely have accelerated the trend of hospital acquisition of physician practices, which is contributing to growing provider market power.6

This analysis examines the prices paid by private insurers for routine services—knee MRIs, colonoscopies, several laboratory blood tests and physical therapy—that account for significant spending. The analy-sis uses 2011 claims data for about 590,000 privately insured active and retired non-elderly autoworkers and their dependents to identify price variation for these services based on whether they are provided in hos-pital outpatient departments or community-based settings (see Data Source).

Price Variation for Common Procedures MRIs of the knee. Knee MRIs with contrast (Current Procedural Terminology (CPT) 73721) accounted for $6.5 million of the $48 million spent for nonemergency ambula-tory MRIs in 2011 by the autoworker health plans. Based on prices for nearly 7,000 knee MRI scans roughly split between hospital

outpatient departments and community-based settings, the average price was 52 percent higher in hospital outpatient depart-ments—$919 vs $606 (see Figure 1).

While median prices for knee MRIs in outpatient departments and community settings were closer, the price distribution differed, with HOPD prices markedly skew-ing up and community-based prices skewing down from the median. Moreover, price variation for knee MRIs was much greater among HOPDs than community settings. For example, the 90th- to 10th-percentile range was $1,518 to $513 in HOPDs compared to $719 to $390 in community settings.

Colonoscopies. Colonoscopies are con-sidered the most effective colon cancer screening tool and involve insertion of a flexible tube containing a camera for visual inspection of the colon to detect polyps that might be cancerous. If polyps are found, they are typically either sampled to assess whether they are cancerous or removed and tested for cancer.

Multiple procedure codes are used for colonoscopies depending on whether polyps are found and sampled or removed. This analysis focused on the three most common procedure codes that arise from screening colonoscopies: no polyps found, polyps found and sampled for pathology tests, and polyps found, sampled and removed—CPT codes 45378, 45380 and 45385, respec-tively. Nearly 45,000 of these three types of colonoscopies were conducted in 2011 for the study population, accounting for about $23 million in spending, excluding the cost of related services like drugs, anesthesia and pathology tests. Price comparisons are based on claims data for 16,566 colonosco-pies with complete and clear information about the site of service—9,782 conducted in HOPDs and 6,784 in community set-tings. Prices are reported based on a bundle of colonoscopy-related services because some health plans pay a flat amount for the procedure plus ancillary services, rather than on an item-by-item basis.

Data Source

This Research Brief uses detailed 2011 facility and professional claims data for current and retired autoworkers and their dependents under age 65. General Motors, Chrysler, Ford and the UAW Retiree Medical Benefits Trust provided access to the claims data. The data include detailed information on the service provided, the type of provider, the allowed amount—the total amount paid to the provider, including amounts paid by the insurer and the patient. Price comparisons were generated in 18 metropolitan areas with 10,000 or more enrollees in the autoworker plans, and each community had at least 75 HOPD and 75 community-based observations to make reliable comparisons for the services investigated (see the Technical Appendix for more about the study’s methodology). The 18 metropolitan markets are Akron, Ohio; Buffalo, N.Y.; Cleveland; Detroit; Flint, Mich.; Grand Rapids, Mich.; Indianapolis; Kokomo, Ind.; Lansing, Mich.; Monroe, Mich.; Rockford, Ill., Saginaw, Mich.; St. Louis; Syracuse, N.Y.; Toledo, Ohio; Warren, Mich.; Wilmington, Del.; and Youngstown, Ohio.

National Institute for Health Care Reform Research Brief No. 16 • June 2014

2

About the Authors

James D. Reschovsky, Ph.D., is a former Center for Studying Health System Change (HSC) senior fellow now at Mathematica Policy Research (MPR); and Chapin White, Ph.D., is a former HSC senior researcher now at RAND. The authors thank Amanda Kudis and Menolly Hart, both MPR senior programming analysts, for their excellent programming work.

and quantities.2 The Medicare Payment Advisory Commission (MedPAC) has ques-tioned whether these site-of-service pay-ment differences are warranted and has rec-ommended that Medicare pay for routine physician evaluation and management visits provided in hospital outpatient depart-ments at the same rate as services provided in community-based physician offices. Such a move would reduce the cost of an average Medicare HOPD physician visit by 56 per-cent and would save an estimated $1 billion to $5 billion over five years.3 More recently, MedPAC recommended reducing or elimi-nating the differences in Medicare payment rates between outpatient departments and physician offices for 66 specific categories of ambulatory services—a move estimated to reduce patient cost sharing alone by $200 million per year.4

Recent increases in the employment of physicians and acquisition of community-based physician practices by hospitals, along with hospitals purchasing ambulatory surgical centers and other community-based facilities, are resulting in more and more services being paid at higher hospital

outpatient rates.5 The payment differentials likely have accelerated the trend of hospital acquisition of physician practices, which is contributing to growing provider market power.6

This analysis examines the prices paid by private insurers for routine services—knee MRIs, colonoscopies, several laboratory blood tests and physical therapy—that account for significant spending. The analy-sis uses 2011 claims data for about 590,000 privately insured active and retired non-elderly autoworkers and their dependents to identify price variation for these services based on whether they are provided in hos-pital outpatient departments or community-based settings (see Data Source).

Price Variation for Common Procedures MRIs of the knee. Knee MRIs with contrast (Current Procedural Terminology (CPT) 73721) accounted for $6.5 million of the $48 million spent for nonemergency ambula-tory MRIs in 2011 by the autoworker health plans. Based on prices for nearly 7,000 knee MRI scans roughly split between hospital

outpatient departments and community-based settings, the average price was 52 percent higher in hospital outpatient depart-ments—$919 vs $606 (see Figure 1).

While median prices for knee MRIs in outpatient departments and community settings were closer, the price distribution differed, with HOPD prices markedly skew-ing up and community-based prices skewing down from the median. Moreover, price variation for knee MRIs was much greater among HOPDs than community settings. For example, the 90th- to 10th-percentile range was $1,518 to $513 in HOPDs compared to $719 to $390 in community settings.

Colonoscopies. Colonoscopies are con-sidered the most effective colon cancer screening tool and involve insertion of a flexible tube containing a camera for visual inspection of the colon to detect polyps that might be cancerous. If polyps are found, they are typically either sampled to assess whether they are cancerous or removed and tested for cancer.

Multiple procedure codes are used for colonoscopies depending on whether polyps are found and sampled or removed. This analysis focused on the three most common procedure codes that arise from screening colonoscopies: no polyps found, polyps found and sampled for pathology tests, and polyps found, sampled and removed—CPT codes 45378, 45380 and 45385, respec-tively. Nearly 45,000 of these three types of colonoscopies were conducted in 2011 for the study population, accounting for about $23 million in spending, excluding the cost of related services like drugs, anesthesia and pathology tests. Price comparisons are based on claims data for 16,566 colonosco-pies with complete and clear information about the site of service—9,782 conducted in HOPDs and 6,784 in community set-tings. Prices are reported based on a bundle of colonoscopy-related services because some health plans pay a flat amount for the procedure plus ancillary services, rather than on an item-by-item basis.

Research Brief











Research Brief











PCI Medical Pavilion—a Community SettingPhysicians’ Clinic of Iowa Medical Pavilion offers imaging, laboratory services, chemotherapy, and in-office procedures (like angiography and breast biopsies) in a community-based setting where most patients typically pay less out-of-pocket than at a hospital.

While PCI surgeons offer surgery at both Cedar Rapids hospitals, they also allow patients to choose to have procedures (like colonoscopies and tonsillectomies) at Surgery Center Cedar Rapids—an excellent alternative to hospital-based outpatient surgery at a cost that can be significantly less.

Continue reading Research Brief No. 16 from the National Institute for Health Care Reform at: http://www.nihcr.org/news_Hospital-Outpatient-Prices.

Lab ServicesThe laboratory at Physicians’ Clinic

of Iowa Medical Pavilion accepts lab

orders from any physician (not just

PCI physicians.)

Phone: (319) 247-3900 Fax: (319) 399-2038Hours: Mon-Fri, 7:00 am to 5:30 pmpcofiowa.com/Lab

Imaging ServicesWe accept outside orders and appointments. Same-day and next-day appointments can be scheduled based on availability.

Phone: (319) 247-3750 Fax: (319) 247-3767Hours: Mon-Fri, 7:00 am to 5:30 pmpcofiowa.com/Imaging

Therapy ServicesComplete and professional physical

and occupational hand therapy rehabilitation services.

Phone: (319) 398-1506 Fax: (319) 558-4062Hours: Mon-Fri, 7:30 am to 5:30 pmpcofiowa.com/Therapy

propelOPENS.DELIVERS.MAINTAINS.

40% reduction in need for oral steroids

46% reduction in frank polyposis

75% reduction in middle turbinate lateralization

PROPEL’s meta-analysis provides Level 1-A evidence - a first in ENT - demonstrating the benefit of localized steroid delivery in the post-FESS period1

improves post-fess outcomes compared to spacing alone

Physicians’ Clinic of Iowa - Ear, Nose & Throat is pleased to offer the PROPEL® steroid -releasing implant. This dissolvable implant is the first in a new category of products offering localized, controlled delivery of steroid directly to the sinus tissue to maintain the openings created in surgery.

The spring-like PROPEL implant props open the ethmoid sinus to maintain the surgical opening, delivers an anti-inflammatory medication directly to the sinus lining, and then dissolves following endoscopic sinus surgery, avoiding the need for removal.

The result is improved surgical outcomes, reducing the need for additional surgical procedures and for systemic steroids, which can have serious side effects.

Patients with chronic sinusitis suffer from symptoms such as:

Medications often prescribed for chronic sinusitis patients:

If patients’ symptoms continue even with medications, sinus surgery using the PROPEL implant may be an option. During the surgery, PCI otolaryngologists enter the sinuses through the nostrils to open blocked sinus pathways and clean out infection. PROPEL is then placed at the time of surgery and clinically proven to reduce inflammation and scarring.

Advanced Treatment for Chronic Sinusitis

Kevin Carpenter, MD, FACSRyan Dempewolf, MD, FACSScott Huebsch, MD, FACSJeffrey Krivit, MD, FACSMary Susan Pruzinsky, MD, FACS

PCI–Ear, Nose & ThroatPhone: (319) 399-2022Fax: (319) 399-2014Hours: Mon-Fri. , 8:00 am to 5:00 pmpcofiowa.com/ENT













Chronic sinusitis often requires a complex combination of surgical and medical treatments. When sinusitis does not respond to medications, surgery to enlarge the openings that drain the sinuses may be an option.

The PROPEL® steroid-releasing implant has a spring-like mechanism that helps prevent closure and scarring of the sinus while treating sinus disease right at its source.

• Facial pain or pressure• Nasal congestion and difficulty

breathing• Discolored nasal discharge

• Loss of smell and taste• Headache• Fatigue and depression

• Antibiotics• Oral steroids• Nasal steroid sprays

• Decongestants• Antihistamines

contact:







Breast Reconstruction Education EventFREE seminar and reception.

Tuesday, May 5, 2015 from 5:30 - 7:00 pmCommunity Room (Level 3) at Physicians’ Clinic of Iowa Medical Pavilion, 202 10th Street SE, Cedar Rapids, IA

Breast reconstruction can be transformative in many ways. Unfortunately, many women eligible for breast reconstruction remain in the dark about their reconstruction options following a mastectomy. It’s time women understand all of their options. This FREE event will focus on education, awareness and access regarding post-mastectomy breast reconstruction. Attendees will hear from PCI surgeons, care team experts and patients.

Event topics include:

Women deserve to know all of their breast reconstruction options. Let’s close the loop on breast cancer. Sign-up at pcofiowa.com/BreastRecon or call (319) 247-3010. Light hors d’oeuvres and refreshments will be served.

This event is presented by:

Together in health.

• Breast reconstruction process• Options and timing• Implant based reconstruction

• Restoring the breast with your own tissue• Nipple reconstruction• Local resources and support services

• PCI general surgeons perform an average of 7,400 procedures each year. PCI has MORE surgeons, completing MORE cases, and with MORE expertise than ANY other general surgery group in Cedar Rapids. Experience matters.

• Our patients have a choice in where they have surgery. PCI general surgeons offer surgery at both Cedar Rapids hospitals, Surgery Center Cedar Rapids, and Jones Regional Medical Center.

• PCI general surgeons offer colonoscopies at Surgery Center Cedar Rapids—where patients typically pay less out-of-pocket then they would for the

same procedure at a hospital. Colonoscopies can be scheduled within two weeks of calling (319) 362-5118.

A great surgeon can make ALL the difference.Physicians’ Clinic of Iowa–General Surgery: where knowledge and experience matter.

Andrew Nowell, MD, FACS

P. James Renz, MD, FACS

Robert Keating, MD, FACS

Kerri Nowell, MD, FACS

Kevin Kopesky, MD, FACS

Robert Brimmer, MD, FACS

Jeffrey Nielsen, MD, FACS

Together in health.

Physicians’ Clinic of Iowa202 10th Street SE, Cedar Rapids, IA 52403(319) 247-3010pcofiowa.com

Proud Partner in the

In addition to offices at PCI Medical Pavilion in Cedar Rapids, many PCI doctors offer outreach clinics in neighboring communities. To refer a patient or schedule an appointment with a PCI specialist at one of the following locations, please call the outreach location directly.

Outreach Specialty Clinics

Buchanan County Health CenterPhone: (319) 332-0950

Ear, Nose & Throat K. Carpenter, MD—2nd Wed/MonthNeurology S. Chang, MD—2nd Wed/Month R. Buchanan, MD—4th Wed/MonthOrthopaedics D. Hart, MD—2nd Mon/Month S. Munjal, MD—4th Fri/MonthUrology S. Mindrup, MD—2nd & 4th Tues/Month T. Richardson, MD—2nd & 4th Tues/Month

J. Rippentrop, MD—2nd & 4th Tues/Month

Jones Regional Medical CenterPhone: (319) 481-6124

Ear, Nose & Throat J. Krivit, MD–2nd Fri/Month & 4th Thurs/MonthGeneral Surgery R. Keating, MD—Every Monday A. Nowell, MD—Every Tuesday K. Kopesky, MD—Every ThursdayNeurology & Sleep Medicine A. Peterson, MD—2nd Mon/MonthHematology & Oncology T. Warren, MD—4th Tues/MonthOrthopaedics L. Coester—1st Wed/Month G. Hill, MD—2nd Wed/Month P. Pardubsky, MD—3rd Fri/Month M. White, MD—4th Wed/Month

Jones Regional Medical Center cont.Urology L. Hoxie, MD—1st & 3rd Thurs/Month N. Mittelberg, MD—1st & 3rd Thurs/Month S. Wahle, MD—1st & 3rd Thurs/Month

MercyCare TamaPhone: (641) 484-3333

Ear, Nose & Throat R. Dempewolf, MD—2nd Thurs/Month

Mercy Iowa CityPhone: (319) 339-0300

Cardiothoracic Surgery (by appt. only) M. Wasif Ali, MD M. Barnett, MD J. Levett, MDVascular Surgery (by appt. only) K. Kopesky, MD

D. Lawrence, MD

Physicians’ Clinic of Iowa— Specialty Care in WaterlooPhone: (319) 234-2055

Ear, Nose & Throat (afternoons only) K. Carpenter, MD—2nd Wed/Month M. Pruzinsky, MD—4th Wed/MonthUrology Rotating physican—Every Thursday

Regional Medical CenterPhone: (563) 927-7301

Ear, Nose & Throat S. Huebsch, MD—Every WednesdayNeurology & Sleep Medicine R. Struthers, MD—Every TuesdayOrthopaedics C. Lange, MD—Every Friday K. Switzer, MD—2nd Tues/MonthRheumatology M. Brooks, MD—2nd & 4th Tues/MonthUrology L. Hoxie, MD—1st & 3rd Thurs/Month N. Mittelberg, MD—1st & 3rd Thurs/Month S. Wahle, MD—1st & 3rd Thurs/Month

UnityPoint Clinic - Family Medicine - Belle PlainePhone: (319) 399-2022

Ear, Nose & Throat (afternoons only) R. Dempewolf, MD—2nd Thurs/Month

Virginia Gay HospitalPhone: (319) 472-6200

Neurology L. Krain, MD—2nd Wed/MonthOrthopaedics F. Pilcher, MD—1st Wed/Month D. Fabiano, MD—3rd Fri/MonthUrology S. Mindrup, MD—2nd & 4th Tues/Month T. Richardson, MD—2nd & 4th Tues/Month J. Rippentrop, MD—2nd & 4th Tues/Month

Specialist Connection Spring 2015

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