Q&A with AUA president: Urologists must protect their position

The challenges of health care reform, a work force shortage, and a range of significant health policy issues face all urologists in 2010. The AUA has taken steps to address these and other challenges, says Datta Wagle, MD, newly appointed 2010-'11 AUA president. In this interview, Dr. Wagle discusses current initiatives taking shape at the AUA and the AUA Foundation, as well as his goals and priorities as AUA president. Dr. Wagle is former chief of urology at Catholic Health Systems in Buffalo, NY. He was interviewed by Richard R. Kerr, Urology Times editor-in-chief.

A In terms of health policy, the number one issue is health care reform legislation and implementation. We continue to evaluate the components of health care reform and their implications for practicing urologists. As you know, issues concerning health policy are expanding astronomically, and we must remain proactive, not reactive, in addressing them.

The Health Policy Division is under the active surveillance and guidance of a talented individual, Beth Kosiak, PhD. Dr. Kosiak came to the AUA from the federal government and is extremely well versed in the quality and regulatory arenas. She is well connected.

The AUA has also taken a lead role in quality performance measurements and pay for performance. Quality care should not be defined by private payers or the government. It must come from the AUA and urologists themselves. Some examples of urology taking the lead in defining appropriate quality measures include antibiotic prophylaxis, deep vein thrombosis management, stress urinary incontinence (under development), and prostate cancer.

Q The AUA has been active in supporting legislation designed to benefit patients with urologic disease. Can you discuss these bills?

A The AUA recently took the initiative to introduce two pieces of legislation in Congress. One concerns urotrauma, and the other concerns prostate cancer.

The urotrauma bill calls for the establishment of a commission to assess severe genitourinary trauma and its impact on returning veterans. This is a significant issue. Although we cannot see urotrauma the way we see a missing limb or visible disfigurement, it is important that this type of injury be addressed. Considering what veterans have done for our country, we cannot turn our back on them. Rep. Zack Space (D-OH) and Rep. Carol Shea-Porter (D-NH) introduced this bill in the House and took the initiative to insert language in the National Defense Authorization Act to ask the Department of Defense to address this emerging area of concern.

The legislation on prostate cancer calls for the government to establish a federal interagency task force to assess current federal prostate cancer initiatives, including research, education, outreach, and health care delivery. The task force would ensure that federal resources for prostate cancer initiatives are being used more effectively. It's all about working smarter, not harder.