IWIRC: Raising Standards in Occupational Health

by Amy Groh

With a firm foundation as a one-stop shop to help injured workers get back to work as quickly and safely as possible, the Illinois Work Injury Resource Center (IWIRC) has become one of the largest occupational medicine providers in Illinois outside of Chicago. In just five years, IWIRC has grown from serving one local employer to 1,100 employers and has expanded its staff five-fold. 

When we spoke with IWIRC Vice President Michael Davis less than a year after the company opened its doors in 2003, he explained that he and the company’s president, Pete Duvendack, “were asked by multiple business owners and others in the industry if there was an opportunity for the Tri-County Area to offer an independent alternative for occupational medicine and industrial rehabilitation.”

Answering that call, the formation of IWIRC offered local employers an easier solution to pre-employment and post-injury services by becoming a one-stop shop. Over time, the company’s growth led them to open a second facility on the north side of Peoria in December 2007.

With 11 exam rooms between its two facilities, IWIRC sees close to 90 patients each day and serves 30 to 40 patients through its rehabilitation department during the peak season, from April to mid-October.

Changes in Industry and Protocol
Since we last spoke with Davis and Duvendack, the industry—and the company itself—have gone through major changes. The State of Illinois stepped in and capped the fees medical providers are able to charge for work-related injury treatments, giving patients and their employers a much-needed financial break.

On a local level, the biggest change has been the competitive landscape. Initially, work-related injury care could be found at all three of Peoria’s major hospitals, in addition to IWIRC. Since then, Methodist Medical Center has withdrawn and entered into an official partnership with IWIRC, believing they can work better together.

While technology in the field has not evolved much since 2003, drug testing is one service that has seen improvement, with better technology allowing for rapid-result tests and faster service than previous methods. The company focuses more on improving case management than on advanced machines or new medical procedures. Finding more efficient ways to manage patients’ care and get them back to work is the priority.

“In terms of the basics of what we do,” said Duvendack, “the improvements…[are] not so much technological, but how we can treat a patient medically and still give them the highest-possible medical care—and cost the employer less money to do that.”

Davis continued, “The ‘cutting edge’ is very much streamlining protocols and looking at what is the optimal, evidence-based care for patients so they get better more quickly, and we don’t have them return with an injury that recurs. It’s always been our goal to get them back to work as quickly and safely as possible.”

Occupational Medicine in Illinois
Illinois is one of the most difficult states in which to practice occupational medicine because in many cases, the law favors employees over employers. Yet Davis and Duvendack have turned that negative into a positive.

IWIRC is much more valuable in Illinois than they might be in other states where employers’ hands aren’t as tied. Here, employers have the right to specify where employees must go to be evaluated, but employees can then choose to go elsewhere for treatment. By managing cases efficiently, IWIRC costs employers less money while treating patients in a more complete manner. “Our goal is to keep them in here,” Davis said, “and in order to do that, you’ve got to serve that employee [and] give the best care. You’ve got to make sure they’re educated, and we strive to do that.”

“We’re here to provide occupational health services at a significantly higher level of customer service than any of our competitors,” continued Duvendack. “Secondly, we’re going to reduce lost work days and reduce OSHA recordables better than anyone else in town. If we can do all of those things, we’re going to be successful.”

By holding a vendor relationship with employers rather than a healthcare provider relationship, IWIRC understands that time is money and that employees’ days off work cost employers a considerable amount of money. According to Davis, this is one reason why employers are looking for the best value for their dollar.

“When we decided to do this years ago,” Duvendack explained, “our goal was to be different, not just another [occupational] health center, but different from the medical industry in general in terms of how we were going to treat patients and employers.”

Why IWIRC?
IWIRC runs much like a primary care practice, in which they do as much treatment as possible before referring patients to specialists. Duvendack noted that they do treat some things—eyes, for example—which other providers or primary care physicians would refer to specialists.

“One thing that has always set us apart is the fact that we take more acute injuries than most places,” reported Davis. “We do extensive suturing, reduce dislocations, etc.” On average, IWIRC treats one or two patients with fractures each day, when many physicians or occupational medicine specialists would send them to a specialist. This is one example of a protocol that saves employers money. “As long as [patients] stay under our care,” Davis explained, “we can reduce that cost.”

Yet the company is careful not to exceed their abilities in any way. “We do not overstep our bounds or what we’re comfortable doing, so we do not hesitate to send someone out,” said Davis, “but we do all of the full diagnostics and evaluate them to a point where we know that they are beyond our level of expertise, and then they go out to that specialist.”

Specialists tend to prefer this to having patients referred prematurely and, in a sense, wasting their time when a primary care physician or occupational medicine specialist could provide treatment. Specialists who work with the company regularly know that when IWIRC refers a patient, it’s because their expertise is truly needed.

A Team That’s Set Apart
When IWIRC first opened its doors, it expected to have more contact with and see more referrals from insurance companies, but, as Duvendack explained, “We’ve found that not to be the case. It’s not the direction the industry has gone. Employers tend to change insurance carriers like they do their socks, so we haven’t relied on them for referrals like we thought we would initially.” Instead, IWIRC has a full-time sales force that calls exclusively upon employers.

IWIRC employs two communication specialists who focus all of their time on working with clients on clinical issues. The company also employs two customer service representatives who work with clients on any concerns, questions or business issues they may have. While Davis and Duvendack gladly take calls from clients, the day-to-day customer service and communication specialists give a face to IWIRC from an employer’s standpoint.

Hiring the right staff is vital to the company’s success. “We work very hard to get the right people [at the front desk] so when patients come in, they see that first face,” said Davis. “It’s very important that that’s a positive experience, because nobody walks in our door and wants to be here,” he said, referring to workers’ comp cases. Patients who go to IWIRC for pre-employment reasons are a different story entirely.

What the Future Holds
With two successful locations amidst a down economy, one might expect IWIRC to take a breather, but that’s not what Davis and Duvendack have planned. After some initial market research, they have identified another community in which they would like to set up a third location, but have not yet released this information to the public. They hope to begin setting up shop this spring. With its successful track record and strong desire for continuous improvement, it appears that IWIRC will be helping injured workers return to work for a long time to come. iBi

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