Lori Rathbun, chief executive officer of Van Diest Medical Clinic, said everything seems to be running smoothly.

“I ask Dr. Sahai and the rest of the providers and staff how things are going and I get totally positive responses,” said Rathbun. “We still have room for improvement, in scheduling and building depth in the clinic. But I think we’re all pretty amazed how well the transition went with Webster City Medical Clinic.”

Van Diest Family Health Clinic, a 16,400-square-foot medical office, opened May 9, 2016, replacing the in-hospital clinic which had been used since 2013. The clinic is one of three operated by VDMC. The other two are located in Stratford and Jewell.

The merger of the Webster City Medical Clinic and the Van Diest clinic was announced on June 1, 2016.

“We know that unifying the two practices will strengthen both organizations and is the right thing to do to ensure that access to healthcare for Hamilton County residents and those living in surrounding areas continues well into the future,” Rathbun said at the time of the announcement.

“Our focus is to move from competitive to cooperative efforts to provide seamless care to our patients with synergies that would not be possible otherwise,” said Dr. Subhash Sahai.

“With this joint decision, we will collectively take their investment in the future of health care to a new high level for the communities we have been privileged to serve,” Sahai said.

Sahai opened his practice in Webster City in 1976 and opened Webster City Medical Clinic in 1978. He operated the clinic with his wife, Dr. Sushma Sahai, and his brother, the late Dr. Anil Sahai. The scheduled opening of the joint clinic was originally set for August, but management soon found that was a bit ambitious. The opening was rescheduled for early October.

“We had to measure how realistic that was and bumped the opening back a bit,” she said. The merger added 10 providers and 36 staff members to the clinic and hospital.

Both admit the process wasn’t easy. Combining two sets of employees, learning how the providers work and merging medical records into one compatible format took months of meetings.

“Dr. Sahai had to shut down his clinic and we had to get all of the employment issues worked through. We also had to make sure the patients knew where they would be going,” she said. “I think it was a nervous time for Dr. Sahai’s patients.”

There was much to be considered as the transition moved forward, she said; things like all of the contracts Sahai had in place for equipment, which items were owned or leased, employment relationships, and a staffing analysis. About 90 percent of the team from Webster City Medical Center came along with the move. Team members from each hospital department and each department of Sahai’s clinic were involved in the process in the transition meetings, which were held weekly and often, more frequently.

Complicating the transition was the hospital and clinic’s move to a new electronic medical records system.

“If we didn’t have a new electronic health system and if we had both been on the same system and then created the merger — it would have been much smoother,” she said.

Attitudes of the staff from both clinics helped make the transition successful, Rathbun said.

“Everybody wanted to make this work, so it did. But we didn’t get through without any glitches,” she said.

Rathbun said the merger came about as both hospital officials and Sahai recognized the benefits of combining the efforts.

“We’re lucky to have a provider in Dr. Sahai who has spent 40 years — nearly his entire career in this community in an independent practice,” she said.

“Really it came down to this — we wanted the same things for our patients and his community. We wanted to ensure the viability and long-term future of health of Webster City and Hamilton County,” said Rathbun. “When you strip everything away and make that your goal, it kind of makes it easy to come together and remove barriers.”

Sahai said the bureaucracy in medicine today has created a burdensome process for medical practitioners. As a result, many independent clinics have now joined with larger care organizations and hospitals to overcome that hurdle.

“In the state of Iowa, we were one of only a handful of independent clinics. The rest are owned by hospitals,” Sahai said.

Rathbun said she would like to see one more family practice provider or a family practice-obstetrics provider added to the staff.

“We are interviewing constantly due to the difficulty and competition in recruiting to rural locations. Subhash has been instrumental in providing guidance to the administrative team about some service the clinic and hospital might explore,” she said.

An unfinished area in the clinic was recently completed to house mammography, ultrasound and bone density testing equipment. The 10 providers are sharing office space now and expansion of the facility is already on the minds of the clinic administration.

“We’re looking at future expansion, but we won’t be aggressive in moving forward with that,” said Rathbun.

Now at three months into the arrangement, Matt McKinney, director of clinics and radiology, said his perspective is on looking to opportunities for improvement.

“The 14-week transition covered so many issues,” said McKinney. “There were weekly and often bi-weekly meetings of staff and management.”

All of the incoming staff had 12 to 16 hours of training on the electronic medical records system, something the hospital staff had undertaken just a few months earlier.

“Matt found himself actually out on the floor as an administrator working with physicians to keep the flow going and to help them develop their skills with the system,” Rathbun said.

McKinney said he was ready to do whatever he could to make sure the providers and staff had what they needed to be successful at the clinic.

“Because it all comes back to the patient getting the health care that they need and they are satisfied with,” he said.

“This was a big deal merger. This wasn’t just bringing on one or two local doctors,” she said. This was Dr Sahai’s clinic that he was very proud of. The staff was a family and now they’ve joined our family.”