Urologists bemoan 1-2 punch: Falling pay, rising overhead

National Report-They are signs of the times for today's practicing urologist: declining reimbursement, increasing overhead, an increasingly stringent regulatory environment, and rising malpractice premiums. Urologists ranked these issues as their most pressing concerns in the 2007 State of the Specialty survey, an exclusive study developed by the editors of Urology Times and Contemporary Urology.

In its second year, the survey's findings about challenges concerning urologists nearly mirrored those of the 2006 study. Electronic medical record usage among urologists is on the upswing, with more than one-third of respondents to the current survey indicating they use an EMR compared with one-fourth in 2006.

Among other key findings: About one-fifth of urologists' income derives from ancillary services, 15% of urologists plan to merge with another urology group within 3 years, 6% sell complementary/herbal therapies from their offices, and only half said they would definitely choose medicine as their career if they had to do it all over again.

Professional satisfaction/concerns

Declining reimbursement topped the list of issues that respondents said they were "extremely concerned" or "very concerned" about in both the 2007 and 2006 surveys (85% and 80%, respectively). Rounding out the top concerns in 2007 were increasing overhead (78% vs. 74% in 2006), increasing government regulations (78% vs. 66% in 2006), increasing malpractice premiums (68% vs. 79% in 2006), and pay for performance (52% vs. 68% in 2006).

In contrast, those issues eliciting the least concern related to urologists' ability to keep pace with clinical developments. Keeping abreast of evolving surgical techniques (27%), evolving drug therapies (22%), evolving technology (22%), and evolving diagnostic modalities (21%) all ranked relatively low on the list of matters about which urologists were extremely or very concerned.