Election Day holds many keys to urologists' future

But urologists are being urged to become more involved than simply to vote on Election Day, because the decisions by the men and women who are elected can directly affect the way medicine is practiced and health care provided.

Those decisions will determine whether physicians who treat Medicare are fairly reimbursed; whether the Independent Payment Advisory Board (IPAB) is allowed to continue; and even how government agencies, task forces, and advisory boards that make recommendations on specific testing and treatment protocols are allowed to function.

"We are working together to get elected officials who will support legislation to replace the IPAB," he said. "We are optimistic that we may be able to succeed, particularly if there is a change in the White House in November."

But jettisoning that board, which is to be established under the Affordable Care Act and charged with holding down Medicare costs in a way that largely targets physician reimbursement, is just one of the key objectives of many physician groups heading into the election.

A second goal, of course, is gaining support in Congress for reform of the hated sustainable growth rate formula that is responsible for the annual havoc faced by physicians who serve Medicare patients. For example, the Centers for Medicare & Medicaid Services recently released its fee schedule for 2013, and it contains a 27% average reduction for physicians effective Jan. 1, 2013.

However, Congress has never allowed such cuts to be imposed and each year it acts at the last minute, or sometimes after the last minute, to prevent them from taking place.

So, most observers assume Congress will jump in, probably in a lame-duck session around Christmas, and enact another temporary fix. But then what will the new Congress do? Will there be even more lawmakers who will insist on cutting elsewhere to pay for the cost of reform no matter what? Or will there be an increased number of lawmakers who recognize the seriousness of the problem and work to develop some sort of practical and effective solution?

A third key issue for urologists is the U.S. Preventive Services Task Force (USPSTF) and the process by which it makes formal recommendations regarding preventive care services.

It was the USPSTF that recommended in May against performing PSA-based screening for prostate cancer in asymptomatic men, a recommendation that prompted organizations representing urology, as well as many prostate cancer advocacy groups, to criticize the manner in which the decision was reached as well as the conclusion itself.