Practice Management

"Some of the issues have to do with the stressors of the physicality of being a surgical trainee," says Christine Van Horn, MD.

Options include rolling it over into your new employer’s plan or into an IRA.

In this installment, sisters Amy Pearlman, MD, and Michelle Pearlman, MD, highlight Prime Institute, the practice they co-founded in South Florida.

"The burden of preauthorization, reimbursements not keeping up with inflation, and consequently, our abilities to staff and maintain our offices and pay our employees at appropriate levels are also affecting our ability to care for patients," said urologist Ronald P. Kaufman Jr, MD.

“Burnout is the end stage of unmanaged stress in the workplace,” says Diana Londoño, MD.

"It's been pretty consistent that our second-year urology residents are really suffering," says Amanda C. North, MD.

In total, 77.8% of Black respondents, 72.7% of Asian respondents, 57.1% of Latino respondents, and 46.5% of White respondents indicated that the racial and ethnic diversity of residents at a program influenced their decision to preference signal or sub-internship with that program.

While practice ownership has declined among physicians of all ages, the sharpest drop occurred among doctors under age 45.

“I am lucky to work for a health care system that believes in serving the patients of the Bronx,” says Amanda C. North, MD.

"We're currently putting together... a toolkit that we can give to urologists and other providers in the community to help counsel their patients on some of the different avenues that they can go down to find more affordable medications," says Brian Cortese.

Dr. Vince has an interest in disparities in urologic care, specifically among patients with prostate cancer.

With healthcare data breaches approaching a boiling point, care providers need to adopt an approach that prioritizes operational continuity.

“Learning how to disengage from stuff that can be pretty toxic and engaged in the stuff that's most meaningful, I think makes our lives better,” says Amanda C. North, MD.

“I couldn't change the fact that it was going to be a few months until I had help. But I could change my own response to the situation,” says Amanda C. North, MD.

"CPT codes 50080 and 50081 describe the antegrade approach to stone removal requiring lithotripsy through a nephrostomy tract, with 50080 being reported for stones less than 2 cm in size in a single location, whereas 50081 would be reported for large or complex stones, stones in multiple locations, or stones in the ureter (such as in the example provided)," write Jonathan Rubenstein, MD, and Mark Painter.

The rule includes a proposed unadjusted national average payment rate of US$21,376.53 for the device in 2024.

"In 2021, we were finally able to demonstrate a statistically significant difference in burnout between men and women in urology with women having much higher burnout rates," says Amanda C. North, MD.

“Regardless of the size of the practice, medical scribes are a valuable resource for health care providers, helping to streamline workflow and coordinate patient care,” writes Brian Hudson.

"We did an additional study where we surveyed all of the medical students who applied to urology this year... 1 in 5 applicants took programs off their list because they were located in states where abortion is illegal," says Chloe E. Peters, MD.

“After I finished my fellowship, I came straight back to Montefiore. I was very drawn to taking care of the patients in the Bronx,” says Amanda C. North, MD.

When you add automation, your medical coding not only improves your margins but also plays a key role in improving patient care.

"There are likely, based on their other results, going to be urologists not willing to move to those states, it's going to exacerbate shortages in care," says Chloe E. Peters, MD.

"Another thing is to customize your EHR with favorite orders and grouped orders, and these things can be standardized across a practice," says Sarah Hecht, MD.

"Since 2021, there have been significant changes made to documentation and billing, where now our documentation can be more focused," says Jyoti Chouhan, DO, PharmD, FACS.

"Once you've decided that this is important to you, a good place to start is to identify your pain points; pay attention to what annoys you and don't be complacent about it," says Sarah Hecht, MD.

Overall staffing levels were up “marginally,” suggesting some stabilization and return to levels from before the COVID-19 pandemic, according to a report from the American Medical Group Association.

Recent advances in technology make it possible to access and harness the vast amounts of clinical data EHRs have produced.

"The integration of APPs in urologic practice could play a critical role in addressing the current urologist shortages, [issues with] access, and delivery of urological care across United States," says Omer Raheem, MD, MSc, MCh Urol, MCRSI.

The findings of harassment and inappropriate behavior come at a time when there is widespread agreement among health care leaders about the need for a more diverse physician workforce.