Addressing Challenges in Urology Practice Management - Episode 1
John J. Kowalczyk, DO, FACOS describes his own urology practice, touching on patient demographics, staffing, and management strategies.
John J. Kowalczyk, DO, FACOS: My name is John Kowalczyk. I am a urologist.
My urology practice is independently managed. We are a small group. We would call ourselves a small group. We are located in downtown Los Angeles, California. There are 4 urologists and 1 extended practitioner; that would be our physician's assistant. We have an internal general manager. He supervises all of our nonprovider staff. I am considered the medical director; I manage the medical staff itself. We basically don’t have an outside firm that manages our company other than our human resources team. That is a separate entity. We do subcontract that.
How many do patients I personally see in a month? I see about 350 patients in a typical month. My other associates may see a few less than I do. From my general region, this would be considered pretty standard. We are a heavy HMO [health maintenance organization] practice, which is why we see so many patients downtown. It is an urban region.
The typical patient that I see is a male patient with a diagnosis anywhere between BPH [benign prostate hyperplasia] and erectile dysfunction [ED]. We see a great number of patients who are referred to us for microscopic hematuria, which may or may not include kidney stones. We see a large number of patients with bladder cancer who I think are referred. I think this is because of our general population. We have a large Eastern European and Middle Eastern population. Both come from a culture of heavy smoking. We also tend to see a great deal of interstitial cystitis—probably more interstitial cystitis than a lot of my associates in the community; maybe it's because I have a reputation for being able to manage, to console, and to offer some guidance for patients with interstitial cystitis. We have a wide range of patients. We are a large HMO [health maintenance organization] practice. Southern California is unique in terms of what we have in our management services as an HMO [health maintenance organization]. We have the independent physician’s association that makes certain rules and regulations outside the plan. I don't think you see that in many other states.
My group and myself are not affiliated with a LUGPA [Large Urology Group Practice Association] at this time. We have looked into it, and the majority of services that we would benefit from—discounts, et cetera we are able to get through membership in our local state associations, and we have a unique affiliation with our malpractice carrier, which is not just a malpractice carrier; they also provide other insurance services and other financial services. It's called CAP [Cooperative of American Physicians]-MPT [Mutual Protection Trust]. The basis behind this decision is that a lot of the services that you would get as a member of a LUGPA, we are able to get through these particular organizations. We haven't joined or needed to join a LUGPA, although we are looking into joining, and some of the larger, evolving LUGPAs are looking at us as well.