How to 'transition' your practice without retiring


Maybe there's a little of Dr. Kaye, Dr. Childs, and Dr. Cumes in all of us.

Many of us will be making a transition from one form of urologic practice to another before completely deciding to take down our shingle. Most urologists, myself included, enjoy their practices and derive a great deal of gratification from them. However, others have decided-by choice or out of necessity-to shift gears to another practice style that still involved their expertise as a urologist.

Fewer patients, more recreation Stacy Childs, MD, was a busy urologist who saw 40 to 50 patients a day in Cheyenne, WY. Four years ago, he underwent a radical retropubic prostatectomy, gave away his practice in Cheyenne, and moved to Steamboat Springs, CO. He has opened a urology practice in Steamboat, sees 15 patients a day, and spends the rest of his time hiking, fishing, and skiing competitively.

He talked to a career change consultant at CareerLab ( in Denver. Shortly thereafter, he was invited by another urologist in Steamboat to share call and made the decision in 1 day to accept the position there. After arriving in Steamboat in the summer, he began hiking, biking, and fishing. He found that his love of medicine returned, and he was eager to begin practicing urology in a similar fashion as he had done in Wyoming.

Now Dr. Childs sees half as many patients and spends twice as much time with each one. He found that he could reduce his overhead from 55% to 30% and, as a result, still maintain his previous income level. As a result, his quality of life has increased immeasurably. He skis 4 days a week and participates in the competitive Nordic and Alpine Masters programs. He also shares that his weight, body fat, and blood pressure have decreased. While he once thought of retirement, he now enjoys his practice and plans to continue practicing for the next 5 years.

"I have a newly found hobby-urology. My new job is ski racing," Dr. Childs said.

Industry alternative Keith W. Kaye, MD was an academic urologist living in Minneapolis who moved to Perth, Australia, to become a professor and chairman of urology at the University of Western Australia. He built a very reputable university practice specializing in prostate cancer. Four years ago he moved back to Minneapolis and became a consultant to ProVation, a software company that focuses on computerized operative notes.

After returning from Australia, Dr. Kaye decided he did not want to join someone else's urology department nor begin a private practice. He knew he didn't want to completely give up his urologic career, and he got the chance to continue it when he learned that a software company was looking for a urologist to develop medical content to generate operative reports. He had no computer programming experience but taught himself this skill and is now comfortable talking to programmers.

Dr. Kaye said he works with a superb group of dynamic young people, physicians, programmers, technicians, sales, and service personnel. The work now involves not only developing the program, but demonstrating it to urologists and hospital information technologists throughout the country. He installs the software and educates urologists about its benefits, such as accurate coding and prompt reimbursement, and how the program should be used.

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