Dr Marc Iseri confers with Janis Sutton in the Hallway of Iseri and Associates Urology.

Welcome to Iseri and Associates Urology --- a small town rural practice that treats patients with dignity, compassion, and humor --- while offering expert medical care. Since 1977, Dr. Marc Iseri has been practicing in Ontario, Oregon. Upon completion of his urology residency at the University of Washington in Seattle, there was no question that he was going to return to his hometown to establish the first urology practice. "This was home," he says, opting for Ontario over Seattle or Portland.

Iseri was part of a large extended family that grew up in the small rural town in southeastern Oregon. It was the strength of his family that gave him the belief that he could develop a thriving practice in a town that didn't have a urologist. In 1977, Iseri began his practice in the renovated house behind the hospital. Prior to the opening of Iseri's office, urologists traveled from Nampa to Ontario once a week.
 

Left: Brachytherapy is one procedure that had a major impact on Iseri's practice.  Right: A relaxed and friendly atmosphere is important to the success of Iseri and Associates Urology. Lynda Pape (left) and Wendy Hartman staff the front desk where patients are greeted.

Now patients travel from Burns, Baker, and Riggins, along with a few as far away as Mountain Home, to Iseri's office. "You can have state-of-the-art care without traveling to Boise, easy access and confidentiality in a rural setting," explains Iseri.

Since 1977, the number of physicians in lseri's referral base has tripled in Ontario and doubled in the surrounding areas. Approximately 60 percent of his patients are referred by physicians and 40 percent from past or current patients. "Because I've been here for more than 22 years --- and am part of a large extended family --- people know who you are," explains Iseri.
 
 
Access to Urological Health Care

One primary advantage of his rural practice is that Iseri is able to see new patients within a week. "I will take phone calls from referring physicians any time," says lseri, emphasizing his accessibility. Although many of his patients are referred by primary family doctors, physician referrals are not necessary. The urologist also encourages his patients to call with any medical questions or problems. "lt's easy to remember --- 1-877-DR.ISERI," he laughs. The toll-free number for referring rural physicians and new clients is just one of Iseri's many ways of providing easy community access to his practice. In order to provide better access to urological health care to the surrounding rural areas, Iseri has clinic in Baker, Oregon and Weiser, Idaho every other week.

More than 75 primary care physicians in southwestern Oregon and southeastern Idaho refer their patients to Iseri for urological problems, ranging from prostate cancer, bladder infections, kidney stones to sexual dysfunction and infertility issues. lseri respects their role as the patients' primary care provider. "I often receive phone calls from primary care physicians, where I consult with them to try this or that, and if it doesn't work --- then refer them."
 

Left: Iseri is a study in concentration during a brachytherapy procedure being performed at Boise's St. Luke's Regional Medical Center.  Right: Iseri treats patients for a range of urological problems ranging from prostate cancer to infertility issues.

 
 
Advances in Iseri's Practice

Two recent technological advances in urology have had the most impact on Iseri's practice --- lithothripsy and brachytherapy --- resulting in a third less time spent in surgery.

Extracorporeal Shock Wave Lithotripsy (ESWL) fractures and breaks up kidney stones while the patient lies on a water cushion, as a rapid source of high-energy sound waves pass through the water to the stone. Lithotripsy has replaced open surgery for more than 25 percent of his patients with kidney stones.

Once a week, Iseri meets patients at a mobile medical van --- Med Stone --- in Caldwell to perform lithotripsy. The portable medical unit allows for easy access to state-of-the-art medical care and avoids hospitalization. Iseri performs as many as four lithotripsies each week. "Many physicians are unaware the ESWL equipment is so easily available through Med Stone for kidney stone patients" he says.

Brachytherapy is a recent advancement in treating prostate cancer, with reduced risk of complications and side effects. Brachytherapy is the radioactive seed implantation of the prostate, and is an increasingly used option for treatment of prostate cancer.

Achieving good results in brachytherapy requires substantial technical skill. The technical and clinical results can vary substantially from one practitioner to another. Performing good implants requires surgical expertise, and attention to detail. There is also a significant dependence on manual dexterity and familiarity with the physics of brachytherapy.
 

Left: Tina Davis assists Iseri during an office procedure.  Right: The popular no-scalpel vasectomy is performed using a vasclamp.

Recently, Iseri completed brachytherapy training in Seattle and Phoenix. "I have always been a proponent of radiation therapy for prostate cancer," says lseri.

He and Dr. Charles Smith, a radiation oncologist, work in conjunction in treating approximately six new prostate cancer patients a month. Performing this increasingly large number of cases makes Iseri one of the region's most qualified and experienced brachytherapy urologists.
 
 
Dignity and Confidentiality

In a practice where many of his patients are men suffering with sexual dysfunction, Iseri recognizes the need for dignity and confidentiality in the provision of medical care. "Fortunately, with a practice ranging from men with prostate cancer to women with bladder infections to adults with kidney stones, a man with sexual dysfunction issues doesn't need to worry that when he walks in the door, everyone will know the nature of his problem," says Iseri. Many of his patients travel from outlying areas, seeking the privacy and comfort of confidentiality found at lseri's urology practice. As Iseri explains, "Our goal is to provide you with the same professional and considerate medical care we expect for our families and ourselves". ---TP

 

Marc Iseri, M.D. Marc Iseri is a board certified urologist practicing in Ontario since 1977. Dr. Iseri completed his urology training as well as his undergraduate training at the University of Washington in Seattle. Dr. Iseri has been past Chief of Staff, Chief of Surgery and Secretary Treasurer of the Medical Staff at Holy Rosary Hospital. He also serves on the Board of Directors for a malpractice insurance company, Northwest Physicians, Mutual in Salem, Oregon. Iseri is a member of the American Medical Association, Oregon Medical Association, American College of Surgeons and the Northwest Urologic Society. Dr. Iseri's hospital affiliations include Holy Rosary Medical Center, Ontario; Weiser Memorial, Weiser; St. Luke's, Boise; West Valley Medical Center, Caldwell; and St. Elizabeth, Baker City. He and his wife Becky have three children --- Matt, Scott and Amanda.