Urologists are well positioned for 2010

December 1, 2009

In spite of the chaos of health care reform, urologists' mix of office, outpatient surgery, and hospital practice ensures that we will continue to do well.

Urologists work hard, seeing an average of 83 patients and working about 51 hours per week. While only 14% of us are financially very satisfied with our practices, 49% are very satisfied professionally, and 88% feel we have professional autonomy. The two main financial concerns continue to be declining reimbursement and increasing overhead. Only 23% report that their total professional income increased in 2008 compared to 2007.

In the next 5 years, 38% expect to be performing more office-based procedures and 42% expect to be performing less hospital inpatient surgery. This reflects the continued migration of many procedures to the office and ambulatory surgery centers.

Of the 56% who have attempted to recruit a new urologist in the past 3 years, 78% were successful. Another 50% indicate that they want to add a urologist to their practice in the next 3 years. Another clear trend is the increased use of physician extenders, the most common being a certified medical assistant.

Not addressed in the survey is impact that health care reform, currently being debated by Congress, will have on our practices. One possible outcome will be more patients for us to see, as more will have access to insurance.

At this time, it appears that Congress will once again prevent the 21% proposed cut in Medicare reimbursement by keeping the conversion factor the same or increasing it 0.5% to 1.0%. However, this will not be known until the end of the year. Since 2001, when the conversion factor was essentially frozen, physicians have seen a 21% increase in office overhead.

In spite of the chaos of health care reform, urologists' mix of office, outpatient surgery, and hospital practice assures that we will continue to do well.

Dr. Gee, a member of the Urology Times Editorial Council, is in private practice in Lexington, KY.