Practice Profile: Colorado Urology

Urology Times’^® Practice Profile series takes 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 Colorado Urology, a Denver-based practice within the United Urology group. Suzanne B. Merrill, MD, FACS, a urologic oncologist specializing in bladder cancer, and Dan Humer, PA-C, a clinical services manager, and physician assistant, highlight the practice.

Could you tell us about the origins of your practice and its reach?

Suzanne B. Merrill, MD, FACS

Merrill: Our practice was formed when three private practices merged to create Colorado Urology. Our offices are located along the front range stretching north and south of the Denver metropolitan area. By combining our resources, we are able to provide patients with more comprehensive care, including access to subspecialty care, radiation, ambulatory surgeries, and other ancillary resources.

Dan Humer, PA-C

Humer: Currently, we have a team of 20 urologists, 2 radiation oncologists, and 12 advanced practice providers, with a plan to expand. We operate 3 ambulatory surgery centers and will soon have a fourth. We also have the capability to conduct in-office dispensing and research.

What are some of the challenges you have faced in your practice, and how have you addressed them?

Merrill: While having a large urology group practice offers many benefits, such as increased access to subspecialized care, it also presents challenges due to geographic distance. For example, patients in the northern part of our territory may need to travel a significant distance for certain procedures, such as a radical cystectomy. We try to offset this by offering virtual visits and providing care wherever the patient is located. We have also created a wider net for our infusion therapy services and implemented navigation services for specific disease states.

What are some of the wins that your practice has experienced since you've gotten started?

Merrill: Colorado Urology has experienced a win in providing patients with the most current and advanced care possible by implementing disease state protocols recommended by the group's disease specialists. These protocols are designed to be homogeneous and follow guideline-based care, which is helpful for patients living in remote areas as well as those in dense urban areas like Denver.

Humer: Being part of a larger organization like Colorado Urology has also allowed for more centralized initiatives such as training for medical assistants (MAs) and advanced practice providers. This growth opportunity also enables these individuals to learn new skills or move into different roles, which can be more difficult to do in smaller organizations.

What conditions do you treat? What services do you offer?

Humer: All of our urologists provide general urology care and offer a wide range of services to our patients. Our specific disease state specialists include advanced prostate cancer, benign prostatic hyperplasia (BPH), bladder cancer, stone disease and men’s sexual health. Our stone disease specialist focuses on stone prevention and provides minimally invasive treatments for kidney stones. Additionally, we are equipped to treat BPH and use the latest technologies available in the market to do so. We have several specialists, or champions as we call them, who have received the Center for Excellence designation for UroLift and GreenLight. We were the first practice in the state to offer Aquablation. Another specialist focuses on female pelvic health, and we plan to expand in that area in the future. Our research primarily focuses on advanced prostate cancer and bladder cancer. We have a team of specialists in treating overactive bladder and incontinence, and we offer innovative therapies like Bulkamid.

Merrill: Our practice also focuses on men's health, specifically sexual health, infertility, and low testosterone. With our large group of over 30 providers, we have at least 1 provider who specializes in every area of urology. This means that we are able to provide the full spectrum of urologic care to our patients under a specialist who is often fellowship trained in that particular area.

What is the make-up of your staff and some of the roles that are associated with your practice?

Humer: Our practice is composed of 20 urologists, 12 advanced practice providers, medical assistants, and a variety of specialized roles such as infusion nurses, nuclear medicine technicians, and nurse navigators for our specialized disease states. We also have in-house ultrasound, in-office dispensing, a team of research coordinators and radiation oncology techs.

Merrill: We also have a large back-office team with different roles that are dedicated to helping patients receive the recommended care.

What are some unique elements to your practice?

Merrill: Our large urology group practices offer comprehensive, subspecialist care with cutting-edge technology that is very similar to what is expected in an academic setting. However, what sets Colorado Urology apart is their ability to keep patients in their community, which is especially beneficial when patients need frequent follow-up appointments. We have good community relationships with other subspecialty care providers and allied health professionals.

Humer: Many advanced practice provider candidates express a desire to become experts in their field, and having access to subspecialists within the practice can make that goal easier to achieve.

Merrill: In addition to these factors, we are also able to provide unique clinical opportunities for patients such as clinical trials and hold a tumor board that engages our urology colleagues and other subspecialists outside of our practice. These partnerships are real and cohesive, and are available in the community, something that people might not think is possible. The clinical trials we offer to patients are mostly industry sponsored, which is different from the predominantly investigator-initiated trials that are seen in academic centers. We do this all while keeping patients in their community and with their primary urologist. For example, in prostate cancer, a patient may be able to receive advanced therapeutics such as oral oncolytics from their primary urology team instead of seeing another specialty. Large urology group practices have resources to provide these services safely and effectively.

You can learn more about Colorado Urology Associates here.