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    Is your ideal practice fit within reach?

    Evolving models mean careful self-examination to learn what’s best for you

    Private practice, including solo, single, and multispecialty settings, remains the most popular choice among U.S urologists. But it’s by no means a dominant option for practice setting in the specialty. In fact, just under half of urologists who are age 45 and younger choose private practice. Nearly 40% of today’s urologists work in institutional settings, including academic centers and public and private hospitals, according to the 2016 AUA Census.

    Gray Tuttle, CHBCMr. TuttleDeciding on whether to go into (or switch to) private practice, academic, or an employed model means weighing potential pros and cons of each setting and looking in the mirror at character traits, likes, and dislikes that would make one setting more suitable than another.

    For example, private practice demands lots of non-clinical, business-related contributions, compared to academia and hospital employment. (Also see Henry Rosevear, MD’s blog post, “Physician employment: Both good and bad results.")

    “An entrepreneurial spirit is a must, as is the commitment of time—well beyond 40 hours a week,” said Gray Tuttle, CHBC, principal at Rehmann’s Healthcare Management Advisors in Lansing, MI.

    Going it alone

    Perhaps the most challenging of the options today is solo practice. Less than 10% of practicing urologists have chosen the model, according to the 2016 AUA report. By comparison, 20% of urologists were in solo practice in 2009 and 26% were solo practitioners in 2001, according to an American College of Surgeons report (Bull Am Coll Surg 2012; 97:46-9).

    Private practitioner and Long Island, NY, urologist Richard A. Schoor, MD, says it’s difficult but he makes it work by offering what others can’t or won’t. His niche is male infertility.

    Richard A. Schoor, MDDr. Schoor“Over the past 12 years, I have developed not just a reputation [and] brand in the community, but an infrastructure that is difficult, if not impossible, for others to replicate,” he said.

    Dr. Schoor has an andrology lab, which offers semen testing and fertility preservation services.

    “I do the overwhelming majority of andrology surgical procedures, such as vasectomies, vasectomy reversals, testicular biopsies, and sperm retrieval procedures, in my office. Not only does this save my patients the extra costs associated with hospital and ambulatory surgical centers, it makes my office an efficient and delightful place to work,” he said.

    The big con of solo practice: cost.

    All costs, from payroll to office supplies, fall on the urologist. Still, it’s worth it, according to Dr. Schoor.

    “If you can make it work financially, it is a wonderful way to practice medicine,” he said.

    Next: Single-specialty group

    Lisette Hilton
    Lisette Hilton, president of Words Come Alive, has written about health care, the science and business of medicine, fitness and wellness ...


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