Innovation grows out of everyday care in Washington County, earning national recognition

WASHINGTON— On a typical day at McCreedy Medical Clinic, Dr. Lindsey Van Duyn moves from managing chronic illness to addressing acute mental health needs, often within the same visit. In Washington County, where access to specialized care can mean long wait-lists, that kind of continuity she provides is necessary and a natural part of the daily work of rural family medicine.

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It was work rooted in those realities — caring for patients who could not wait months for counseling or psychiatric services — that recently drew national recognition. Van Duyn, founder of Immersive Medical Technology and a family physician at Washington County Hospitals and Clinics, was named the 2025 National Emerging Leader by the American Osteopathic Foundation, an honor awarded annually to one osteopathic physician nationwide.

The recognition places work that began in southeast Iowa alongside initiatives from large health systems and academic centers across the country.

“When I look around, I see a lot of really amazing physicians,” Van Duyn said of receiving the award. “I don’t go about this expecting recognition.”

For Van Duyn, the award reflects a response shaped less by innovation for its own sake than by the demands of rural medicine and the patients who arrive first, and sometimes only, at a primary care office.

Meeting a growing rural demand

The challenge Van Duyn encounters is familiar across rural Iowa and much of the Midwest: a widening gap between mental health needs and available services. Family physicians in small communities often serve as the first point of contact for patients experiencing depression, anxiety or crisis, even as referral options remain limited or delayed.

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“We don’t have the luxury of immediate specialty access in rural medicine,” Van Duyn said. “Family physicians are often managing mental health needs while patients wait for the rest of the system to catch up.”

That gap became more difficult to work around in 2020, when Van Duyn began seeing an increasing number of adolescents with severe depression. Counseling and psychiatric services in the region were booked months in advance. For families seeking immediate help, primary care was often the only accessible option.

The situation was not unusual for rural medicine, where family physicians routinely manage complex conditions that would otherwise be referred to specialists. But the stakes were higher when patients were adolescents in acute psychological distress.

“The wait times were measured in months,” Van Duyn said. “That’s a long time when someone is struggling, especially a teenager.”

In Washington County, those realities often play out quietly. Appointments stretch beyond their scheduled times as conversations turn from physical symptoms to mental health concerns. Parents arrive unsure where to turn next, and adolescents often sit silently at first, uncertain how to describe what they are feeling.

Those visits rarely fit neatly into appointment slots. They unfold slowly, shaped by trust built over years and by the understanding that, for many families, this may be the only place to start. In a small community, the boundaries between professional and personal are often thin.

“Treating patients in my hometown becomes super personal,” Van Duyn said. “Two of [the patients that inspired me] were friends I grew up with, and this was their children. So it became very personal.”

With limited local resources and long waitlists elsewhere, Van Duyn began looking for additional tools informed by primary care principles that could help stabilize patients while they awaited specialized care. In rural communities like Washington County, physicians often fill multiple roles — clinician, advocate, educator and community member — a reality that shaped how she responded when mental health resources were scarce.

Rather than relying solely on medication or crisis referrals that could not be fulfilled quickly, she turned to medical literature to see what evidence-based options existed beyond traditional pathways. That search led her to research on the therapeutic use of virtual reality.

From emerging research to clinical use

By the time Van Duyn began looking more closely, virtual reality had already been studied in medical settings including pain management, rehabilitation and procedural anxiety. What stood out was not novelty, but evidence.

“What convinced me was the research,” she said. “There was already peer-reviewed evidence showing this could be used therapeutically.”

In primary care visits already constrained by time, those moments mattered. A calmer starting point allowed space for discussion that might otherwise be rushed or postponed, helping patients articulate what they were feeling and what they needed next.

The shift was especially visible among adolescents. Patients who struggled to sit through traditional conversations were often more receptive after a short immersive experience.

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“You can see the shift,” Van Duyn said. “Their shoulders drop. They’re breathing again. And then you can actually talk.”

Over time, those early sessions took on a more consistent shape, evolving into the business, Immersive Medical Therapy, founded by Van Duyn. IMT offers a structured approach that combines virtual reality with guided conversation, behavioral strategies and, in some cases, movement-based activities. While WCHC supports her innovation in care, Immersive Medical Therapy is separate from her official work with the hospital as a family physician.

“This isn’t just putting a headset on someone,” she said. “It’s a sequence. Regulation first, then conversation, then skills.”

When the headset comes off, the visit continues much like any other. Van Duyn works with patients to process what they experienced and connect that calmer state to practical coping skills. Conversations focus on identifying stressors, reframing thought patterns and planning next steps.

“The calm is the entry point,” she said. “Once they’re there, we can actually talk about what’s going on and what comes next.”

Defining limits and guardrails

Van Duyn does not use immersive therapy with every patient. Screening is part of the process, and some visits move forward without it.

“Virtual reality isn’t appropriate for every patient,” she said. “Part of using it responsibly is knowing when not to use it.”

Immersive therapy is not a cure for depression or anxiety. It does not replace long-term therapy, medication management or crisis intervention. Instead, it is used as a short-term tool intended to support stabilization and engagement while patients wait for or participate in other forms of care.

As the approach included more patients, Van Duyn began to wrestle with questions that extended beyond individual encounters. What was helpful for one patient might not be appropriate for another. What felt promising in practice still needed to be tested carefully.

In a rural setting, innovation often happens out of necessity. That reality, she said, also heightens the importance of accountability — ensuring that new approaches are examined with the same rigor expected in larger systems.

So, Van Duyn moved to formally evaluate the work through institutional review board–approved research in partnership with the Edward Via College of Osteopathic Medicine.

“In order for me to do IRB research, which is internal review board, I have to partner with a university or medical school to make sure that all the I’s are dotted, the T’s are crossed, and I’m compliant with patients that I’m testing on,” she said. “It’s a very controlled, safe environment to do trials.”

The research focuses on adolescent patients and examines changes in symptoms, engagement and overall functioning over time. Institutional oversight provides a framework for evaluating both potential benefits and limitations — an important step as immersive technology continues to draw interest in health care settings.

Beyond her own study, immersive technology has gained broader recognition in medicine. In 2024, the U.S. Food and Drug Administration approved the first virtual reality–based treatment for chronic pain, a milestone that moved the technology further into clinical consideration.

“The science behind virtual reality is rooted in how the brain forms new neural connections,” Van Duyn said. “When you enter an immersive VR environment, your brain begins to adapt and change — a process known as neuroplasticity.”

Care rooted in daily practice

For Van Duyn, balancing innovation with daily practice has never meant choosing one over the other. Research and recognition may extend beyond Washington County, but the rhythm of her work remains shaped by the same exam rooms, staff conversations and patient relationships that defined it long before national attention arrived.

While her research and innovation have drawn recognition, her day-to-day work remains grounded in family medicine at Washington County Hospitals and Clinics’ McCreedy Medical Clinic. As a rural family physician, she treats patients across the life span, often managing chronic illness, acute conditions and mental health concerns within the same visit.

One visible part of that approach is Arrow, her therapy dog, who is incorporated into her family medicine practice to help ease anxiety for patients and staff.

“Dogs speak to patients and staff in ways that I can’t, and I’m fine with that,” Van Duyn said.

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Arrow became part of the clinic during a period of heightened stress for health care workers and patients alike. Van Duyn said the decision grew out of the strain of practicing medicine during the COVID-19 pandemic, particularly in a small community where staffing challenges and patient needs often collided.

“I just felt like our office needed higher morale,” she said.

In practice, Arrow’s presence helps calm patients who arrive anxious or overwhelmed, sometimes lowering the emotional barrier to care before a visit even begins.

“If somebody is super anxious, he responds,” Van Duyn said. “He does pressure therapy. He’ll get on their lap or lean in for a hug and people just respond.”

Van Duyn also brings Arrow with her when she serves as medical director in local nursing homes, where residents often respond immediately to his presence. In rural communities where physicians frequently care for multiple generations of the same families, those moments of connection can matter as much as clinical interventions.

The role Arrow plays reflects the same philosophy that shapes Van Duyn’s broader work: meeting patients where they are. While her research extends beyond her primary care role, her daily practice in Washington County remains rooted in relationships, trust and continuity of care.

Looking ahead

In rural medicine, progress often looks incremental rather than transformative. It shows up in small adjustments, in tools added carefully, and in relationships maintained over time.

Van Duyn is cautious about expansion, watching how evidence develops before moving forward. One long-term goal is to make immersive mental health tools available earlier for adolescents, allowing intervention before problems escalate.

“Teen health needs help, and it will be really amazing when we can give them another tool,” she said.

Her work in Washington County reflects a reality shared by many rural physicians — responding to immediate need with the tools available, guided by evidence and shaped by place. It is work defined less by recognition than by continuity, carried out one visit at a time.

Recognition beyond Washington County

What began in Washington County has since drawn national attention. The American Osteopathic Foundation selects its National Emerging Leader Award from among physicians first recognized at the state level.

Van Duyn previously served as president of the Iowa Osteopathic Medical Association, representing physicians across the state on workforce, education and advocacy issues, including during the COVID-19 pandemic. The national award reflects both her innovation in practice and her leadership within the osteopathic profession.

For Van Duyn, the recognition is less about individual achievement than about drawing attention to work happening in small communities across the country. Rural physicians, she noted, often innovate out of necessity, adapting evidence-based tools to meet immediate needs.

Comments: AnnaMarie.Kruse@southeastiowaunion.com