The Growth of Integrated Care Models in Urology
With heightened awareness of health care outcomes and efficiencies and reimbursement-based metrics, it is ever more important that urologists consider the effects of integrated care models on physicians/staff/clinics fulfillment and patient outcomes, and whether and how to optimally implement these models within their unique practice settings. Despite growing evidence that integrating care improves outcomes, uncertainty persists regarding which approach is most efficient and achievable in terms of specialty considerations and financial resources. In this article, we discuss strategies for integrating urologic care and its ...
Source: Urologic Clinics of North America - March 12, 2021 Category: Urology & Nephrology Authors: Caitlin Shepherd, Michael Cookson, Neal Shore Source Type: research
Workforce Issues in Urology
The future supply of urologists is not on pace to account for future demands of urologic care. This impending urologic shortage sits on a backdrop of multiple other workforce issues. In this review, we take an in-depth look at several pressing issues facing the urologic workforce, including the impending urology shortage, gender and diversity concerns, growing levels of burnout, and the effects of the coronavirus pandemic. In doing so, we highlight specific areas of clinical practice that may need to be addressed from a health care policy standpoint. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - March 12, 2021 Category: Urology & Nephrology Authors: Ryan Dornbier, Christopher M. Gonzalez Source Type: research
Current and Future Status of Merit-Based Incentive Payment Systems
This article examines the history leading up to MACRA, the current pathways associated with the Quality Payment Program, and future expectation both from the Centers for Medicare and Medicaid Services, stakeholders, and patients. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - March 12, 2021 Category: Urology & Nephrology Authors: Kathleen L. Latino, Deepak A. Kapoor Source Type: research
Telemedicine in Urology
The emergence of the COVID-19 pandemic and subsequent public health emergency (PHE) have propelled telemedicine several years into the future. With the rapid adoption of this technology came socioeconomic inequities as minority communities disproportionately have yet to adopt telemedicine. Telemedicine offers solutions to patient access issues that have plagued urology, helping address physician shortages in rural areas and expanding the reach of urologists. The Centers for Medicare& Medicaid Services have adopted changes to expand coverage for telemedicine services. The expectation is that telemedicine will continue to be...
Source: Urologic Clinics of North America - March 12, 2021 Category: Urology & Nephrology Authors: Eric Kirshenbaum, Eugene Y. Rhee, Matthew Gettman, Aaron Spitz Source Type: research
The Role of Advanced Practice Providers in Urology
The nation ’s undersupply of urology services disproportionately affects Medicare beneficiaries compared to the general population. Advanced Practice Providers (APPs), most commonly nurse practitioners and physician assistants may be a vehicle to meet this need. The increased use of APPs in urology is hamper ed by physician discomfort with delegating responsibility to APPs. This discomfort may be compounded by complexities with billing issues and interstate variation in scope of practice regulations. To expand access to urological services while simultaneously ensuring service quality, it is imperative that urologists en...
Source: Urologic Clinics of North America - March 12, 2021 Category: Urology & Nephrology Authors: Deepak A. Kapoor Source Type: research
Development of Physician Leaders
The complexity of health care today along with the drive towards value-based care are strong forces in support of growing and expanding the physician leadership workforce. Physician led organizations are associated with improved physician engagement, quality of care and cost efficiency. Physicians would benefit from more formal leadership training which incorporates a structed leadership curriculum, mentorship and on the job progressive leadership experience. Special attention must be placed on increasing the diversity of our physician leaders. There are many important characteristics to look for in our physician leaders i...
Source: Urologic Clinics of North America - March 11, 2021 Category: Urology & Nephrology Authors: Laura Crocitto, Deepak A. Kapoor, Kevin R. Loughlin Source Type: research
Clinical Research 2021
Clinical research is of great benefit to patients and rewarding to clinicians. Clinical research in the United States is highly regulated. There are significant penalties for violating protocols. Clinical research requires a good infrastructure in each practice. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - March 11, 2021 Category: Urology & Nephrology Authors: Evan R. Goldfischer Source Type: research
Health Policy and Advocacy
This article reviews mechanisms by which urologists can engage in health policy and political activity and avenues to expand the number of urologists involved. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - March 11, 2021 Category: Urology & Nephrology Authors: Thomas H. Rechtschaffen, Deepak A. Kapoor Source Type: research
Understanding the Millennial Physician
The millennial generation has become the largest generation thus far and continues to grow, as it makes up a substantial part of the workforce. Often misunderstood, those identifying as millennials offer skills, traits, and characteristics that previous generations have been unable to provide. Learning to understand these millennials and all they have to offer serves key to a successful training program or practice. A millennial ’s understanding of technology, grasp of patient-provider relationships, and desire to work hard contribute to their success as urologists. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - March 9, 2021 Category: Urology & Nephrology Authors: Jake Quarles, Jason Hafron Source Type: research
Women in Urology
The presence of women in genitourinary (GU) specialty training and practice has lagged significantly behind other fields. Current challenges include maternity leave, sexual harassment, and pay disparities. Despite these obstacles, the prevalence of women in GU specialty training has risen rapidly. One consequence of retiring male providers and higher numbers of female graduates will be a notable demographic shift in the percentage of GU care provided by these younger women. It will be essential to anticipate and acknowledge the unique concerns of this workforce, particularly in light of the concomitant aging of the US popu...
Source: Urologic Clinics of North America - March 9, 2021 Category: Urology & Nephrology Authors: Mara R. Holton, Kari Bailey Source Type: research
Private Equity and Urology
This article examines the role of private equity in urology and the potential benefits of private equity investment. It also looks at what firms look for in investment partners, how to prepare for private equity investment, and how private equity investments are structured. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - March 9, 2021 Category: Urology & Nephrology Authors: Gary M. Kirsh, Deepak A. Kapoor Source Type: research
Finance 101 for Physicians
This article by a private wealth advisor with 29 years of industry experience provides physicians with the basic building blocks to understand and manage their finances. It focuses on 3 pillars of financial planning: (1) protecting themselves, their families, and their assets; (2) reducing their taxes; and (3) growing their wealth. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - March 9, 2021 Category: Urology & Nephrology Authors: Christopher G. Stappas Source Type: research
Immune Escape in Prostate Cancer
Complex immune evasion mechanisms and lack of biomarkers predicting responsiveness to immune checkpoint blockade therapies compromise immunotherapy ’s therapeutic efficacy for patients with prostate cancer. The authors review established and nominated immune evasion mechanisms in prostate cancer and discuss how the precise treatment strategies can be developed to improve efficacy of immunotherapy. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - December 9, 2020 Category: Urology & Nephrology Authors: Boris Reva, Tatiana Omelchenko, Sujit S. Nair, Ashutosh K. Tewari Source Type: research
Optimizing Surgical Techniques in Robot-Assisted Radical Prostatectomy
Robot-assisted radical prostatectomy (RARP) is the most common surgical treatment of localized prostate cancer. The ideal procedure would achieve maximum oncological efficacy while minimizing associated side effects, such as erectile dysfunction and urinary incontinence. Surgeon experience and surgical technique affect RARP outcomes. Here, the authors review RARP technical modifications aimed at optimizing cancer control and postoperative urinary and sexual function. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - November 18, 2020 Category: Urology & Nephrology Authors: Camilo Arenas-Gallo, Jonathan E. Shoag, Jim C. Hu Source Type: research
Recent Advances and Current Role of Transperineal Prostate Biopsy
“Approximately 1 million prostate biopsies are performed each year in the United States. This procedure has traditionally been performed using a transrectal approach, which is associated with a significant risk of infectious complications including sepsis. In recent years, transperineal prostate b iopsy has been increasingly adopted due to its lower associated infectious risk. In this review, we explore the benefits of the transperineal approach for performing prostate biopsy and detail technical advancements that have allowed for this procedure to now be routinely performed in the outpatient settings under local anesthe...
Source: Urologic Clinics of North America - November 18, 2020 Category: Urology & Nephrology Authors: Yasin Bhanji, Mathew J. Allaway, Michael A. Gorin Source Type: research
