What's vital for young urologists to have in their practice?

"Having four to five good physicians who provide good service is the important thing. Make yourself available and offer a good product; namely, yourself. Respond promptly to requests for consults.

Those are the most important things you need to have a quality medical practice-besides being adequately trained. Everybody has equipment; you are what makes the difference in a practice."

Francis I. Andres, MD
Elm Grove, WI

A good medical assistant is important. You need someone who works well with patients, handles your schedule, and understands the procedures you're doing.

A good medical assistant is very hard to find, because they need to be trained. It's a specialized field, so they need to understand the procedures, talk to patients about the medications they're taking, and handle a lot of phone calls.

You have to look for independence and intelligence; someone who is a hard worker and has organizational and communication skills."

Kenneth Berger, MD
Puyallup, WA

That's very important, especially just starting out. Make sure you appear well-organized, especially when you're mostly faking it as you get started.

It's key not to skimp on your office manager; a lot of practices starting out either have people do double-duty or don't hire an office manager. Chaos begets chaos, and organization begets organization.

Having an office manager allows you to build patient confidence and satisfaction. People may think they're not busy enough to need a good manager, and don't realize all the things that fall through the cracks. You don't get a second chance to impress the internists who want to give you a shot. If patients are poorly scheduled, inconvenienced, or have problems with insurance, a good manager can make the business aspects of the visit as seamless as possible.

The take-home message is that the people are more important than any piece of equipment you have."

Ian Atlas, MD
Morristown, NJ

Now, you need a good manager, an EMR, and a staff well-versed in insurance. Patient care seems almost secondary. My practice depends on patients being happy with the business office rather than with my interaction with them.

I would tell a urologist, first and foremost, your responsibility is to the patient. The other stuff-paperwork and so on-is important; it is a business. But in my opinion, bureaucracy can be overcome if you have a good, caring rapport with your patient. If I provide good care to my patients, they will put up with all the bureaucratic stuff, and say, 'But I like Dr. Dumbadze.'

Technologically, I would suggest a bladder scan. Everyone has a cystoscope; we have access to lithotripters. A bladder scan gives a good idea of what's going on with voiding issues, but patient rapport is more important."

Igor Dumbadze, MD
Cincinnati