What practice-related changes do you anticipate in 2019?

Urology Times reached out to three urologists (selected randomly) and asked them each the following question: What practice-related changes do you anticipate in 2019?

"In my case, I’m not really planning any major changes. I’m in my 53rd year of practice right now. I’m comfortable with what I’m doing. I don’t have EMR and I don’t plan to add it. I don’t plan to hire any new staff. The only change I might make is selling my practice if I decide to retire, but I’m not really planning on that.

The variable in that is that my wife is my office manager and she is tired of the business end of things because of all the problems with insurance companies. It takes so much time dealing with explanations, and their mistakes. They lose things. They’ve written letters telling our patients we no longer accept their insurance, when we do. Then they say, ‘Oh, sorry.’ It’s all just burning her out.

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I enjoy practicing because I don’t have to deal with the economics of it. It’s not like my wife is a 9 to 5 employee who can go home and just forget about the practice’s problems. She’s my wife, so she has a vested interest in the financial side of the practice from that vantage point.

So if she decides she’s ready to hang it up, I’ll probably retire in 2019.”

Barry Rubin, MD / Brooklyn, NY

Next:"I’m in a good place with my practice""I don’t think I’m going to have a lot of changes in 2019.

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I’m in a stable group, owned by the hospital. I’ve been in practice for 17 years and I’ve been with my hospital for 4 years now. That’s been pretty stable and there are no real changes being planned. I’m in a good place with my practice. Our referral base is the same. I always worry about Medicare reimbursement rates changing, so that worries me, but I don’t know that I envision any changes there either. It’s been pretty stable since I’ve been here.

Maybe I’m not the right guy to really ask. There’s nothing worrying me or bothering me that I would want to change, or that I can see wanting to change. I don’t really see anything happening.

I haven’t heard that were going to add any new services or any new techniques. There is really nothing planned to go on differently with that.

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I think everything’s pretty stable from my standpoint right now. I’m hoping that stays that way. I’m kind of happy with the security of all that.”

Keith Steinbecker, MD / St. Louis

Next: "I think the biggest change is that people in this country are realizing that the most important thing in medicine is to figure out how we get everybody covered, regardless of their ability to pay"

"I think the biggest change is that people in this country are realizing that the most important thing in medicine is to figure out how we get everybody covered, regardless of their ability to pay. And I think we’re all going to have to figure out how to adjust to those changes.

That’s really beyond any technical or marketing shift. That’s the biggest thing on the horizon. I don’t know exactly what it will look like, but, hopefully it will cover everyone, regardless of their ability to pay.

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It will require a lot of adjustment on the part of practitioners, hospitals-service providers of all kinds. I think that’s the biggest thing coming down the pike, maybe not completely in 2019, but it’s starting.

That’s one thing everybody’s really talking about-moving left on single-payer health care, Medicare-for-all, something in universal health care that’s not a market-based, Heritage Foundation-type program like Obamacare where we just try to manipulate the market to make sure that people who can’t afford health care can still afford it. That’s been shown to not really be successful. It’s better than nothing, but it hasn’t been successful providing health care to everybody, regardless of the ability to pay.

Every industrialized nation provides this to its citizens except us. That’s embarrassing. So I think it’s going to happen. It will require a lot of work. It’s not going to be really fun for me, or others in the industry. It’s going to shake things up quite a bit, but it will be better than having patients tell me they can’t do what I think they should be doing for their health because they can’t afford it.

I know it won’t get done this year, but I hope it starts, but that’s just my particular bent.”

Sean Clark, MD / Hillsboro, OR