In the course of a typical week, Dr. Robin Epp treats a host of minor workplace injuries that might otherwise send workers to the emergency room.

“We do a lot of acute work,” said Epp, a staff physician at Iowa Methodist Occupational Medicine’s West Des Moines office. Some of the most common injuries she treats are sprains, fractures, minor lacerations and foreign objects in the eye, she said. “And we do lots of physicals.”

Each year between 300 and 400 Greater Des Moines businesses use the occupational medicine services provided by Iowa Methodist Occupational Medicine, which operates clinics at Lakeview Medical Center and Penn Medical Park on the East Side.

A subspecialty of preventive medicine that came into its own in the 1980s, occupational medicine programs are becoming more competitive in Central Iowa as employers increasingly recognize the benefits of having a program that focuses on preventing and treating workplace injuries to minimize lost time.

A handful of private physicians also offer occupational medicine services in Des Moines, as does the Des Moines University Clinic. Mercy Medical Center – Des Moines, which provides some limited occupational medicine-related services at its clinics, is considering whether to establish an occupational medicine clinic.

Though Iowa Methodist’s program was established by Iowa Health – Des Moines less than 20 years ago, it’s probably the most established occupational medicine program in Central Iowa, said Kathy Goranson, marketing manager for the program.

“A difference we have from family physicians is that we’re much more familiar with the work environment,” Goranson said. Because the occupational medicine physicians have toured the worksites of the companies that use the program, they “are tuned in to the work and how employees may be injured,” she said.

Because Iowa is one of the few states that allow employers to direct the care of their employees following a workplace injury, it’s also to companies’ advantage to use an occupational medicine program, she said.

You want to be in the loop,” Goranson said. “If you let your employees go to their own physicians, you can very easily become out of the loop.”

Occupational medicine involves a wide range of services related to employee well-being, among them pre-employment physical examinations and drug screenings, handling of workers’ compensation injury cases and on-site education programs on topics such as ergonomics and injury prevention.

Besides coming to the clinic to have a suspected broken bone X-rayed or to have a cut stitched up, workers may also be referred to occupational medicine providers for physical therapy services following an injury, or to have regular lung screenings if they’re in hazardous professions such as firefighting.

The Des Moines University Clinic, which was recently awarded a second three-year contract to provide occupational medicine services to city of Des Moines employees, is currently undergoing an expansion within the clinic building.

“Usage has gone up significantly and the space has not really increased since we’ve experienced that growth,” said Jessica Sleeth, practice manager for the clinic’s occupational and student health services department. “In 2003, we probably doubled in size in terms of patient volume, and it’s maintained at that level ever since.”

The department will more than double its space later this summer when it moves from the fifth to the sixth floor of the clinic building at 3200 Grand Ave. The new space will have a larger reception area and waiting room, a bigger laboratory and three patient restrooms, two of which will be specially set up for specimen collections for drug screenings.

With its clinic location, DMU’s occupational health practice has access to services that include physical therapy, radiology, podiatry and ophthalmology, said Dr. Colin Kavanagh, the department’s director.

“And, of course, it’s a clinic site available to providing experience to our medical students. I think it’s a neat opportunity in that respect,” he said.

Mercy had an occupational medicine clinic until the 1990s, when two of its physicians practicing in that field moved into different specialties, spokesman Gregg Lagan said. Mercy at that point referred patients to a national provider, Concentra, but continued to provide some occupational medicine services on a more decentralized basis through its clinics, he said.

Several Mercy clinics, including Mercy West, Mercy Urbandale, Mercy Indianola and Mercy East, do handle occupational medicine cases, which are often seen first in the urgent care area of the clinic, and then followed up on by the family practice area, Lagan said. Additionally, Mercy West has contracts with some companies to handle occupational medicine needs as required.

Lagan said Mercy is evaluating whether re-establishing a central occupational medicine clinic would make sense.

One way it’s gaining feedback from employers is through a relationship marketing firm it hired in January to visit companies to make them aware of Mercy’s services and locations. The representative, an employee of Nashville-based Aegis Marketing Group Inc., has contacted more than 230 companies and arranged health information displays at 45 businesses, Lagan said.

Communication with businesses is a critical aspect of occupational medicine, said Jane Wyatt, director of Iowa Health’s occupational medicine program. “So when (the employer) knows we’ve been there and know what they do, that makes a difference.”

There is “peace of mind” in having that relationship, said Dory Goodman, director of human resources for Sysco Food Services of Iowa Inc.

“These specialists have worked with us to develop tests to determine whether our new associates are physically capable of doing their jobs safely and correctly. Having an established relationship with a hospital-based program also makes it easier to meet the urgent medical needs of all our associates, even those who work at night, and to coordinate their aftercare at the occupational medicine clinic.

Though Sysco has no formal procedures for evaluating the quality of the occupational medicine services, “usually we don’t hear from associates unless something goes wrong or they are unhappy with the services received,” Goodman said. “Quite frankly, we get very few complaints of that nature.”