The double whammy of declining reimbursement rates and rising overhead costs continues to plague practicing urologists in the United States.
Those are among the findings of the 2009 State of the Specialty survey, an exclusive study by Urology Times. For the fourth straight year, urologists responding to the survey were most concerned about declining reimbursement. This was followed by increasing government regulations (which moved up from third place in the 2008 installment of the survey), increasing overhead, and increasing malpractice premiums.
Unless Congress takes action, urologists and other physicians paid under the Medicare fee schedule face another significant pay cut in 2010. At press time, the Centers for Medicare & Medicaid Services announced that the conversion factor for services on or after Jan. 1, 2010 would be reduced by 21.2%.
"I think everybody in medicine, particularly in urology, is well aware that the Medicare program is not financially sustainable in its current form, and therefore they're worried that something has to be done," Richard Rutherford, CMPE, director of practice management at AUA, told Urology Times. "Judging from history, it's always on the backs of the physicians."
Related survey questions documented respondents' dissatisfaction with the economics of practicing medicine. Less than half (47%) feel that urologists are fairly compensated for their services, and 56% say they are fairly compensated when compared to other surgical specialists.
Declining practice reimbursement also proved to be one of the two leading factors influencing respondents' decision to retire (chosen by 52%); the other was their retirement plan's value/other savings (also 52%).