Office Practice in Urology

[docmd]

Is it possible to start a purely office based practice after finishing residency in urology? or its better to do a fellowship before that.
How much do the completely office based urologists earn as compared to those who perform large scale surgeries. Is there a marked difference in the lifestyles of the two groups?

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[bobbyseal]

Is it possible to start a purely office based practice after finishing residency in urology? or its better to do a fellowship before that.
How much do the completely office based urologists earn as compared to those who perform large scale surgeries. Is there a marked difference in the lifestyles of the two groups?

It's hard to just do office based urology. I think I've reiterated this a number of times. To be a subspecialist you need referals. To get referals you need to develop relationships with pcp's. These relationships form by taking care of their patients well. Therefore, a pcp will only continue to refer to you if you continue to take the cases. If you decide that you only want to do prostate biopsies in the office and send the actual prostatectomy elsewhere, I tend to doubt you would continue to get prostate biopsy referals. The PCPs will just send the patient to the urologist who would actually do the case.

That being said, urology is becoming more and more of an office based practice. However, you still need to realize that it requires spending time in the operating room. Sure, many of the cases tend to be endourology, but you still need to know how to cut.

 

[cytoskelement]

It's hard to just do office based urology. I think I've reiterated this a number of times. To be a subspecialist you need referals. To get referals you need to develop relationships with pcp's. These relationships form by taking care of their patients well. Therefore, a pcp will only continue to refer to you if you continue to take the cases. If you decide that you only want to do prostate biopsies in the office and send the actual prostatectomy elsewhere, I tend to doubt you would continue to get prostate biopsy referals. The PCPs will just send the patient to the urologist who would actually do the case.

That being said, urology is becoming more and more of an office based practice. However, you still need to realize that it requires spending time in the operating room. Sure, many of the cases tend to be endourology, but you still need to know how to cut.

For the most part, I couldn't agree more. However, there is A LOT of hematuria in the world. And you can do cysto's for several days a week. Also, get a good reputation for ED treatment - and that can fill the rest of the week. I think it is possible to be office-based - but who wants to do that. Urology is a SURGICAL subspecialty.

I wonder how often you get the chance to do big whacks in private practice. It seems that most of those cases are sent to the academic centers.

 

[mysophobe]

I know a couple of private practice urologists that get a fair number of big cases, i.e., nephrectomies, prostates, etc.

Nice UHF quote, btw. I met him last year. Cool dude (Weird Al).

 

[flop]

nephrectomies and prostates are not really considered "big whacks." Those are really bread and butter cases.

 

[nimbus]

My cousin in private practice operates when necessary but he says a day in the office>>>an OR day in terms of $$$.

 

[bobbyseal]

My cousin in private practice operates when necessary but he says a day in the office>>>an OR day in terms of $$$.

I think that's pretty much true. For some reason, spending 2-3 hours doing prostate biopsies tends to generate a hell of a lot more than 2-3 hours doing a prostatectomy.

 

[Playmakur42]

x

 

[henson]

The office is where the money's at. You want to spend as much time in the office as possible.
You need to do your prostatectomies, and the occasional nephrectomy, but most of the time you want to do as much prostate biopsies and cystoscopies as possible.
If you do one really big case, that takes up your entire day, you only bill once for the case, and there is a lot of post op care/visits. You need to, of course, and that is part of the reason you go into urology, but practical considerations (like making money) become important later.