Clinical Component

Navigating the Clinical Component

The urology program at Pella Regional is a well-rounded, bread-and-butter practice with a strong surgical component. The incoming physician will manage a full scope of general urology, with the opportunity to expand into robotic procedures that the current urologist does not perform. Patient access is strong, with most new and follow-up patients seen within one to two weeks.

Typical Schedule

Day	Activity
Monday	Clinic (currently held as open/flex; may shift once new physician is on board)
Tuesday / Wednesday	Clinic days
Thursday	Surgery block, 8:00 AM to 4:00 PM
Friday	Add-on surgical cases; vasectomy half-day

Clinical Volume

Metric	Detail
Avg. cases per month	50 to 60
Peak months (Nov/Dec)	Up to 80 cases in November; significant December volume
Patients per clinic day	25 to 30
New patient wait time	1 to 2 weeks
Current annual wRVUs	Approximately 8,400 to 8,447

Seasonal variation is notable. Winter months slow somewhat as the older patient population travels south. November and December surge as patients schedule elective procedures before deductibles reset. The incoming physician should plan for this cycle from year one.

Procedures and Services

Stone management, including laser lithotripsy (dedicated lithotripter/laser equipment on-site)
Vasectomy
General urology case mix (prostatectomy, ectomies, and standard urologic procedures)
Robotic surgery via Da Vinci XI platform (available immediately to a trained physician)
In-office procedures available in dedicated procedure rooms within the clinic suite
Complex cases referred to Des Moines as appropriate (radical prostatectomy, partial nephrectomy requiring robotic assistance previously covered by UCI)

Call Structure

Call at Pella Regional is well-managed and light by urology standards.

Call Detail	Description
Current coverage	Dr. Bandstra handles call with a collaborative arrangement with a urologist in Oskaloosa
Phone call frequency	Once or twice per week; most issues resolved during business hours
Physical callback frequency	Once every one to two months; rarely in winter
ED approach	Hospitalists stabilize and tuck in patients; urgent cases added to the next available surgery slot rather than requiring immediate callback
Sunday/Monday call	Currently off-call for Dr. Bandstra; arrangement being worked out with Aaron Smith (Oskaloosa) for cross-coverage

The ED and hospitalist team have a strong working relationship with the urology program. Acute presentations such as kidney stones are managed conservatively overnight and addressed the following morning in most cases.

Staffing and Support

2 to 3 clinical support staff (nurses and MAs) handle patient rooming, scheduling, and clinical tasks
Nursing staff manage catheter changes, treatments, and routine procedures independently within their scope
A PA from the Grinnell area is available on-call for select complex surgical cases requiring a first assist
An APP with OR experience (ortho, urology, general surgery background) is under consideration for a first-assist role to support robotic cases
No dedicated NP or PA embedded in the daily urology clinic at this time; the incoming physician can shape this as volume grows

Technology and Equipment

Da Vinci XI robotic platform
Laser lithotripter for stone management
Cystoscopy table
On-site lab with courier service to the clinic floor
New clinic building opening November 2026 will provide dedicated, purpose-built urology space

Patient Population

The service area covers a large swath of central Iowa, with patients traveling from Marshalltown, Grinnell, Newton, and surrounding rural communities. The population skews older, which drives strong stone and prostate volume. The program has served this region without interruption for approximately 30 years, giving it strong name recognition and patient loyalty across the catchment area.