Do changing urology practice models mean changing politics?


After seeing physicians in Maine ask legislators to delay a bill limiting medical liability, speculation is that because doctors who have joined large groups or hospital practices have fewer concerns related to running a business-eg, meeting payroll, hiring staff, malpractice premiums, and meeting overhead-their priorities might be shifting.

A story coming out of Maine this past summer has led to questions about the possibility that physicians' priorities, if not their political leanings, may be changing due to changing practice models.

The Maine legislature became Republican-controlled this year for the first time since 1962. With that conservative strength, state legislators thought they might have new support for a bill putting limits on physician liability. But to the surprise of many, physician lobbyists reportedly asked legislators to put the bill on hold. A New York Times report indicated that the increasing number of doctors joining hospital-based practices might be responsible for the about-face on that issue.

"The doctors in this state are increasingly going left," the state senator who sponsored the Maine liability legislation told the New York Times.

Urology Times wanted to know whether urologists around the country are seeing such shifts in priorities. Most say the changes are related more to practical issues than to philosophical or political beliefs.

"How could they not? Absolutely, priorities shift depending on your practice situation. You have one set of priorities in academics, another in private practice, and a third as a hospital-employed physician," she said.

"If you're less worried about things like malpractice, then you have the opportunity to spend more time concerned with your patients' care, and you don't have as many worries about being paid."

Having said that, Dr. Kerr, director of the urologic wellness program at Eastern Maine Medical Center, thinks different factors may play into the liability issue, rather than physicians becoming more "left" in their politics.

"One reason could be that most doctors in the state use one malpractice company," she said. "That gives us more bargaining power when it comes to rates, and they've actually ended up being fairly good."

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