Experts highlight Southwest Urology, LUGPA annual meeting

"One of the challenges, unfortunately, these days is making sure you have the financial resources to get these patients the treatments they need," says Connie Ferraro, RN.

During an interview at the 2023 LUGPA Annual Meeting in Orlando, Florida, Lawrence Gervasi, MD, and Connie Ferraro, RN, discussed their practice—Southwest Urology—as well as the LUGPA meeting and the field of urology in general. Gervasi is the director of the advanced prostate cancer clinic and clinical research, and Ferraro is an oncology nurse and administrator at Southwest Urology in northeast Ohio.

What are the biggest clinical challenges that you face in your practice right now?

Gervasi: The biggest clinical challenge is there's a lot that's been going on in urological cancers, with prostate cancer and now bladder cancer. It's been good as far as the patient standpoint, because there's a lot of new therapies that are available, but it's been challenging to us. We have been meeting that challenge and using the LUGPA resources to help do that, to try to provide our patients with the various types of therapies that are available for both advanced prostate cancer and bladder cancer.

Ferraro: One of the challenges, unfortunately, these days is making sure you have the financial resources to get these patients the treatments they need. You don't realize sometimes these patients are choosing between food and drink and medicine. When it comes to extending life, they want to choose the latter. So, I think one of our biggest challenges is constantly reaching out to the foundations to help provide support to get the patients the medicines that they so dearly need.

Gervasi: What Connie referred to is a term called financial toxicity. On one hand, all these therapies are very good, they extend quality of life, they extend overall survival, but there can be challenges with the finances. We have been trying to get foundation money and balance what these costs are for patients. That's been a big challenge.

What have been some recent successes or ‘wins’ for your practice?

Ferraro: Our practice has been wanting to roll out chronic care management. I'm very proud to say we have successfully done so starting July 5 this year. We've already had over 1300 patients choose to enroll in chronic care management. It truly is a great program. The patients are contacted every 6 weeks by somebody who reaches out on behalf of our practice. The goal of that is to make sure that patients are tended to between visits and stay out of the ER. I'm really proud that we were able to successfully navigate that and roll that out this year.

Gervasi: That has been a great success. It is recognized by [the Centers for Medicare & Medicaid Services] as being very important. It tries to ward off problems with patients to keep them out of the emergency room.

Ferraro: We also just rolled out a new scheduling EMR this week in our absence. I have reached out to my leaders that are back there, and that has successfully rolled out. Also, constantly growing your team, I believe that is a success. I think when a clinic can function when 2 of the leaders are here learning and networking as we need to do in the private world, to still have your clinic run seamlessly is a huge success. So, I think our team back home is one of our biggest successes.

Gervasi: Another success has been in our advanced prostate cancer clinic. They have a rating system that's done by Specialty Networks where they look at groups our same size—and they look at various metrics as far as follow-up appointments, etc—and we're very proud to have been ranked number 1 for 5 years now. That's really a tribute to the team effort. It takes a lot of people to be involved, make sure patients follow up, make sure they get good care. That's been a hit.

Ferraro: Absolutely. We use a metric that was supported by UroGPO called PPS Analytics. It's a beautiful tool to help you navigate your patients. We're, as Dr. Gervasi said, 5 years in a row number 1 in providing quality care to our patients.

Could you discuss this year’s LUGPA meeting?

Gervasi: This is the 15th year [of LUGPA,] and I think I've gone maybe 12, 13 years in a row or so, almost every year. It's the meeting I enjoy most out of all the meetings. I think foremost is getting together with the other urologists and administrators and talking about how things go in your practice. You become friends with these people after all these years. It's been helpful in figuring out problems, because there's a list of people [to whom] I can say, "How do you guys do this?" Or "We've had this issue; how did you handle it?" So, it's a great resource in trying to solve the regular problems that we all face in our practices, even in big groups. There are groups here that have over 100 providers. Our group is a smaller group, [but] a lot of the problems are the same. So, that's been that's been a big thing. In addition, the CME program is always very good; they do a good job. We get some CME credits [and] the topics are very timely. It's an excellent meeting.

Ferraro: I am the opposite; this is my first LUGPA. I have enjoyed getting energized at the motivational talks. It's motivated me to go back home and become a better leader. And the networking is priceless. I've only been in this field 9 short months, and I have a Rolodex full of people that I can contact so I do not feel like I'm on an island. As Dr. Gervasi said, there are practices here [that are] 100+ practitioners strong. We have 8 physicians and 4 APPs. And just to know that what I'm experiencing is not any different from what everybody else is experiencing, [both with] successes and challenges, is awesome.

Looking at the field of urology in general, what do you believe will be the biggest story in the coming years?

Gervasi: As far as cancer, I think the urologist’s role in prostate cancer, bladder cancer, and kidney cancer is expanding. We rely on LUGPA's expertise as far as how to handle this, how to incorporate this into our practice, and how to approach this with a multidisciplinary approach using radiation oncologists [and] medical oncologists. So, that's been very helpful. Really, the main goal and the reason for founding LUGPA was to try to maintain private practice. That's a constant challenge. They talk about different coding efforts that we're looking at and different efforts in Washington that LUGPA has been very instrumental in in trying to get our opinions and our concerns to our congressmen and representatives. So, that's an ongoing thing. Every meeting, you do get energized. There are different things that we need to do. It's a moving target and a story in progress that will continue.

Ferraro: I'm definitely grateful for the pharmaceutical industry support. I think everything in the R&D pipeline is just amazing as it relates to all cancers, especially urologic cancers. I'm pretty excited about being able to truly extend the life and the quality of life of all of my patients with prostate cancer. All of the new oral oncolytics that are becoming available and used in concert with each other to extend life is what I am so excited to see in the future.

Is there anything else that you’d like to add?

Ferraro: This has been a great meeting. The Disney Institute provided so much insight as to how to incite pride and change the culture in your company. It's been a great experience for me, so I'm very grateful.

Gervasi: I just hope I have the opportunity to keep coming, because you always get something out of it. It's fun to renew, see old and new friends, and it's a really good thing.