Practice Profile: Chesapeake Urology

Urology Times’® Practice Profile series take readers behind the scenes of US-based urology practices. From solo practitioners to large groups, each installment highlights these practices’ unique qualities, successes, and challenges. To have your practice featured in this series, please email Hannah Clarke at hclarke@mjhlifesciences.com.

In this installment, we learn more about Chesapeake Urology, a Maryland-based practice within the United Urology group. Michael W. Witthaus, MD, a reconstructive urologist, and Michael Ritmiller, PA-C, MPAS, a physician assistant and clinical director of urodynamics, highlight the practice.

Could you provide some background on your practice?

Michael Ritmiller, PA-C, MPAS

Ritmiller: Chesapeake Urology serves the state of Maryland, excluding Western Maryland. Our coverage extends to the Eastern Shore, Southern Maryland, the DC area, parts of Delaware, and the majority of the Baltimore metro area.

I joined the practice 17 years ago, right after graduating from PA school. Dr. Sanford Siegel, the owner/Chairman of the Board whom I've known and worked with for many years, offered me a position working with spinal cord injury patients in a rehab facility in Baltimore, Maryland. Over time, Dr. Siegel mentored me and helped me expand my role as a physician assistant, including running a program at the hospital. This collaboration was with the late Dr. Andrew Shapiro. As the years went by, I consistently managed a clinic at the hospital, providing care to inpatients and performing procedures at an outpatient facility.

Michael W. Witthaus, MD

Witthaus: My practice specializes in genitourinary reconstruction, cancer survivorship, and men's health. I work at a new hospital in the Capital Region of Southern Maryland where I care for upper and lower tract traumatic injuries to the urinary tract. I also provide comprehensive care for prostate cancer survivors, addressing the effects of erectile dysfunction and male incontinence. Additionally, I manage men's andrology, which involves testosterone management and treatment for erectile dysfunction.

What are some challenges that you currently face in your practice?

Witthaus: I work in a county of one million people that has historically lacked the local access to a reconstructive urologist. The county has historically been underserved, prompting our collaboration with the University of Maryland to establish a medical center that meets the needs of patients in Eastern DC and Southern Maryland.

Unfortunately, the region experiences a significant number of traumatic injuries, with our hospital being the second highest volume trauma center in Maryland. Previously, there was no urologic support available to the trauma teams in the area, which resulted in my role as the Medical Director of Genitourinary Reconstruction with involvement in providing both open and robotic reconstructive surgical support for our patients.

Ritmiller: In my specific area of focus on spinal cord injuries, one of the challenges lies in raising awareness about the intricate complexities and associated issues that arise in caring for individuals with neurological impairments. Managing patients with spinal cord injuries, traumatic brain injuries, or multiple sclerosis involves addressing a myriad of problematic factors. These patients face numerous challenges, and it requires substantial effort to effectively manage their care and provide assistance.

What are some wins that your practice has experienced?

Witthaus: In the past 6 months, we accomplished several notable milestones. We performed the first ileal ureter surgery in Prince George County. Additionally, we successfully created the protocols and conducted the initial prosthetic procedures and urethroplasties for the medical. Moreover, we established a robotics program, where our patients previously did not have access. Among our accomplishments were the first robotic ureteral reconstructions and completing our first 100 robotic cases within the first half-year.

What conditions do you treat?

Ritmiller: Chesapeake Urology covers a wide range of conditions, including urethral reconstruction, diversion, and pelvic floor dysfunction. We have dedicated physicians who specialize in addressing these issues, as well as managing cancer-related concerns and erectile dysfunction. If necessary, we refer patients to other specialists within our practice who can provide the specific care and assistance they need.

In my practice, I primarily focus on voiding dysfunction, particularly in patients with neurological impairments such as spinal cord injuries and traumatic brain injuries. I assess their condition and perform various procedures, including Urodynamic studies, cystoscopies, and Botox injections. I also assist patients with self-management strategies, obtaining necessary medical equipment such as catheter supplies, and making adjustments to optimize their daily routines.

Witthaus: I specialize in the reconstruction of the urinary tract, encompassing the ureter, urethra, and bladder. This involves acute care management as well as delayed repair strategies for urinary tract injuries. Additionally, I handle cases related to urethral and ureteral stricture disease, employing both robotic and open surgical approaches. In terms of cancer survivorship and men's health, I also perform penile prosthetics and surgeries to address male incontinence, aiming to enhance the quality of life for individuals who have undergone prostate cancer treatment.

What is the makeup of the staff and the roles associated with your practice?

Witthaus: Chesapeake Urology comprises a diverse staff, including both pure private practice professionals and those affiliated with universities. Through our collaboration with United Urology, we have access to state-of-the-art resources, enabling us to provide the best possible care for our patients. We are proud to accept all insurances, including Medicare and Medicaid, which allows us to prioritize the well-being of our patients without limitations or restrictions. As a Chesapeake urologist, our primary focus is always assuring the best care for our patients.

Ritmiller: I work across three different offices, where I interact with multiple office managers, medical assistants (MAs), and urodynamics technicians during procedures. The office managers and urodynamics techs I collaborate with are extremely supportive and competent. They possess extensive knowledge in their respective roles and are genuinely good individuals who contribute significantly to our team.

What are some unique elements to your practice?

Witthaus: One unique aspect of our practice is the specialized expertise in complex robotic reconstruction. Prior to my arrival, the traumatic ureteral reconstructions in the area were being performed by General Surgeons, highlighting the significant underservice in the county. Within the first six months, we have made a profound and rewarding difference in the community with collaboration with the Trauma Surgery team. Additionally, we have also had a significant impact on addressing urethral stricture disease and cancer survivorship in the area.

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

Witthaus: One remarkable aspect is the strong support we receive from Chesapeake Urology, allowing us to provide optimal care to our patients. Furthermore, our practice stands out due to the collaborative effort between Chesapeake Urology and the University of Maryland. This partnership aims to reach historically underserved areas and make a substantial clinical impact. It's a rather unique situation that isn't commonly found across the United States. Apart from my clinical practice, I also have the opportunity to teach within the University of Maryland School of Medicine. We envision this practice growing into a prominent academic site in the future.

Ritmiller: Personally, I have had the privilege of working with excellent supervisors and physicians who have been incredibly supportive. Whenever I need assistance, I can always rely on them to listen and help me understand various processes. There is never a problem when reaching out to the physicians I work with. As a seasoned PA managing numerous conditions, I often consult with physicians to ensure the appropriateness and accuracy of my care plans. They not only agree with my decisions but also offer valuable insights and educational opportunities. This aspect of our practice has been highly beneficial, and I appreciate the collaborative environment I have.

You can learn more about Chesapeake Urology here.