Reimbursement cuts, malpractice top urologists' concerns

National Report-With another year of Medicare payment cuts looming in 2007, declining reimbursement is no surprise as the number one current concern among practicing urologists, according to an exclusive survey from Urology Times and its sister publication, Contemporary Urology. Changes in reimbursement are followed closely by malpractice, office overhead, pay for performance, and increasing regulations as the top five issues that urologists are extremely or very concerned about, the first State of the Specialty survey found.

Shrinking reimbursement for traditional patient care services appears to be fueling interest in ancillary services as new sources of income. Survey respondents indicated that 20% of their income is derived from ancillary services. The downward slide in reimbursement also enters into urologists' decision about retirement, survey results suggest.

"Providing new ancillary services is a convenience to the patient, but it's also a business and, if you run it well, it will add to the bottom line of the practice. With ever-shrinking reimbursement for the medical services we provide, physicians must become better at managing their businesses to survive."

"My major concern, as well as the biggest concern of the vast majority of my colleagues, is clearly the ongoing lowering reimbursement for our services," said Barry R. Rossman, MD, a urologist in private practice in Princeton, NJ. "We have an inconsistent compensation system based on the flawed resource-based relative value scale and a faulty reimbursement update formula based on the misconception that the sustained growth rate accurately reflects the economics of medical practice. We spend more time 'gaming' the system to document more information, rather than taking care of the patient. This raises costs, while reimbursements continue to fall."