Diversify and grow your practice with female partners

Chicago-Women are increasingly becoming urologists, yet most pass up opportunities to go into private practice, instead choosing academic or hospital settings.

“We need to do a better job of attracting women into private practice because they bring significant value to our patients, as well as our practices,” said Jason Hafron, MD, director of clinical research at the Michigan Institute of Urology, Troy. “We have four women in our 52-person group practice. If we could, we’d hire four more today. Their schedules are full. They have significant wait times for the patients to be seen. Most women in our practice prefer to see women when it’s related to personal or sensitive issues.”

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Dr. Hafron also chairs LUGPA Forward, a LUGPA committee in which members are urologists who completed their fellowships less than 15 years ago. He said the young, forward-thinking committee members are charged with increasing leadership and diversity within private-practice urology ranks. Dr. Hafron and two female urologist colleagues presented “Secrets for success in large group practices: Incorporating female partners” at the LUGPA annual meeting in Chicago.

The urologic work force is becoming more female. For the first time, women in urology surpassed 20% of all practicing urologists under the age of 45. And among 12,517 U.S. practicing urologists, the percentage of women went up from 8.5% in 2016 to 8.8% in 2017, according to the AUA’s 2017 Annual Census report.

The problem, according to Dr. Hafron, is that while the majority of urologists-about 60%-work in private practice, private-practice settings are least likely to attract female urologists.

“Twenty-five percent of the urologists being trained today are women,” Dr. Hafron said. “It’s important we diversify and create a professional workplace. It will ensure that private-practice urology has a broad talent pool to increase patient demand. Many of the common conditions that we treat today affect women in significant numbers, particularly urinary tract infections, incontinence, female sexual dysfunction, and stone disease.”

Next:A value propositionA value proposition

Elizabeth Williams, MD, a urologist with Urology Consultants, St. Louis, presented data at the LUGPA meeting showing that as the sole female in her urology group practice, her relative value units are higher than those of her male colleagues in general urology.

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“There are some other benefits. I generate quite a bit of business for my partners. I see women and a number of their husbands end up wanting a vasectomy at our practice or want a second opinion for prostate cancer,” Dr. Williams said. “It’s a bit of a misconception that women can’t be as efficient as men in urology. We might not see quite as many patients, but the levels at which we’re billing and procedures that we’re doing actually make up for that.”

Dr. Williams, whose practice is in the process of merging with another urology group to total 24 or 25 urologists, said she had to carve out a maternity clause when she joined the group initially. Today, the group is doing more to promote practice flexibility, including implementing an 80% partnership.

“There doesn’t have to be just one model for partnership. There can be a different option if a woman wants to spend part of her time at home or doesn’t want to work a full 5 days a week,” Dr. Williams said.

A group’s efforts to add benefits that are attractive to women are worth it, according to Dr. Williams.

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“There are a lot of patients in the greater St. Louis area that seek out my practice because I am a female practicing urology, and they want to see a female. My partner that does female urology who is male gets some of my overflow. Patients call to make an appointment with me and sometimes it’s longer than they want to wait and that drives additional business to him,” Dr. Williams said.

Next:Tips for attracting women to practiceTips for attracting women to practice

Some of the things women in the work force want are maternity leave and flexible scheduling for improved work-life balance.

Tamra Lewis, MD, a urologist at the group practice Comprehensive Urologic Care in Lake Barrington, IL, said it’s important for many women that they have flexibility over the hours they work and types of patients that they see.

“I think one of the challenges for women in urology and other specialties is how to balance family and work,” said Dr. Lewis, who presented along with Drs. Hafron and Williams at the LUGPA meeting. “I don’t think this is necessarily unique to women as I think more men coming out of residency also have a greater understanding of work-life balance and are looking for opportunities to contribute more to family considerations.”

Female urologists might also want practice efficiencies that allow them to better care for their female patients, according to Dr. Lewis.

“Look at how your office is set up. Are the facilities that you have adequate to handle female patients that may be part of an aging population? Do you have enough bathrooms? Do you have enough support staff to help your female physicians to see a larger number of female patients efficiently?” Dr. Lewis said.

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Nurse practitioners or physician assistants can help female urologists more efficiently use their time.

“It has been shown that women patients tend to spend more time with their providers, especially with sensitive issues related to urology,” Dr. Hafron said. “For female patients who have chronic urological conditions, for example, a lot of those services can be provided by a midlevel provider in a quality environment.”

Dr. Hafron said his group urology practice has taken steps to attract women.

“We are open and accommodating to our partners’ needs. We are open to flexible scheduling. We have a solid maternity policy in place. We want to make our female partners’ quality of life as high as possible. And we will accommodate their scheduling, their workload, their office hours to develop strong work-life balance,” he said.

Dr. Williams said the things that drew her to want to be part of a urology group practice were some of the same things that attracted her to the specialty.

“It’s always been a male-dominated field, but I knew I had a niche. I’m the only female who is fellowship trained in female urology in the greater St. Louis area,” Dr. Williams said. “I also enjoy the business end of things. Currently, I’m on the board of my group. I like the pace of the private practice. And I like that most of my partners have a subspecialty, so I really feel like patients are getting the best care and getting to the right person.”