Pandemic brings new challenges, opportunities-and resilience

Dr. Burnett, a member of the Urology Times Editorial Council, is professor of urology at Johns Hopkins School of Medicine, Baltimore.

The current COVID-19 viral pandemic has upended all of our lives, both personally and professionally. Because of it, we are enduring a sobering new reality with its threat to health and life.

I suspect the communications from many of my colleagues on the Urology Times editorial board will echo similar sentiments of a constructive call to action, messages of collective sacrifice, and unity of purpose. Given that our medical profession as urologists is not commonly centered on emergent or intensive care matters, unlike that of so many of our clinician colleagues, we recognize that much of our craft is not as urgent in these times as for others. Our responsibility has been to participate rightly in medical triage efforts, therefore deferring “non-essential” surgeries and clinical activities.

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Willing as we are to prioritize the management of urologic conditions that truly rate as having urgency or high mortality risk, this new reality has nonetheless impacted our professional practices organizationally and economically. As for all business concerns at this time, the economic slowdown affects the livelihood of health care providers, urologists included. The American Medical Association has acknowledged that the pandemic has harmed the practices of health care providers universally, and the crisis presents costs of treating COVID-19-positive patients as well as sustaining revenue losses with costs for payroll and overhead. As urologists, we will have to adjust in terms of what we clinically manage but also how we will do it and how we will finance it.

Undoubtedly, we will be challenged by the circumstances of this pandemic. Our response may well be to adapt to fill positions that are unfamiliar and possibly unappealing. For many of us, we will repurpose in new enterprises, new business models, and new opportunities for work productivity and life utility. We will be resilient.

Some areas of urology will be impacted considerably more than others. In these times of resource conservation, benign and quality of life conditions, and subspecialty concerns in urology may be perceived to be less serious or life threatening than malignancies or conditions risking loss of an organ. Such non-urgent conditions would aptly be relegated for management sometime in the future.

Next: Sexual medicine impactSexual medicine impact

Sexual medicine conditions are predictably included in the category of conditions whose management may well be deferred. These conditions include erectile dysfunction, Peyronie’s disease, and testosterone deficiency. Penile prosthesis surgery, surgical reconstruction of the genitalia, and other surgical procedures in sexual medicine conceivably are deemed “non-essential” and are being rescheduled.

On the other hand, sexual medicine issues remain active and can be readily met with newfound telehealth consultation practices. Whether the need for sexual interactions is heightened or reduced in these times in which social distancing is practiced remains an open question.

Read: How to code for urologic care during the COVID-19 pandemic

Specialty organizations in sexual medicine are grappling with canceled professional meetings as much as institutions are wrestling with limited in-person training exercises. This reality is the same for all professional organizations and institutions currently. The value of new science and training in sexual medicine and elsewhere is recognized, and educational programing must continue.

Thankfully, we are in an age of remote electronic learning. Using various media to promote discovery and learning offers a new way of life. Look for “virtual” conferences and training sections focused on sexual medicine that will be vital for progress in our profession and service to our patients.