Q & A: Work force, health policy: Top issues on AUA's radar

A shrinking work force amid an aging population is among the pressing issues of organized urology in 2008. Urologists are also confronted with many of the challenges that all U.S. physicians currently face: declining reimbursement, rising overhead, and escalating malpractice insurance rates, to name a few. In this interview, John Barry, MD, who began his term as AUA president in May, discusses these concerns, how AUA is addressing them, and the challenges and opportunities that lie ahead. Dr. Barry is professor of surgery and chairman of the division of urology at Oregon Health & Science University in Portland. He was interviewed by Urology Times Editorial Consultant Richard D. Williams, MD, professor and chairman of the department of urology at the University of Iowa, Iowa City.

A There are several issues that need to be addressed. One is the need to see that we have an appropriate number of urologists to take care of our population, much of which is aging. We haven't increased the number of graduating urology residents for over a decade, and I think we need to do so.

Q I'd like to pursue the work force issue a little further. Is it your view that we don't have enough urologists currently or that we need more for the future because of the aging population?

Q Is that an AUA responsibility or another group's?

A The funding issues have to be dealt with through the teaching hospitals. A great deal of the funds provided for education are used for indirect expenses. It might be time to take a look at that practice and determine if more of those funds can and should be used directly for graduate medical education.

Q On the subject of education, I know the AUA is working on a defined curriculum for urology resident education. How is that coming along?

A It's a very ambitious and necessary project. Identifying a core curriculum for urology will allow certifying and qualifying agencies like the American Board of Urology to work with the AUA so that the examinations and course content can be developed and based on the core curriculum. Parts of a core curriculum could be adapted by other health care providers, such as primary care physicians and nurse practitioners, and could be added to the curricula of medical and nursing schools.

Q How long will it take before that curriculum is in place?

A Optimistically, it's projected to be online about Jan. 1, 2009. I hope that happens, but, realistically, I think it may take a little longer because we want it to be perfect.