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    Payment slide, regs, ACA: Urologists' least-favorite things

    National Report—In health care’s modern era, change is constant. Yet the more some things change, the more they stay the same.

    Both axioms are true for urologists who responded to this year’s Urology Times State of the Specialty survey.

    More than 80% of urologists now use an electronic health record, compared to 27% in 2006, when the first State of the Specialty survey was conducted. Robotic procedures comprise 7% of the surgical procedures urologists perform, up from less than 2% in 2006. More than one-third (37%) of urologists were solo practitioners in 2006 versus less than one-fourth (23%) today. The expected age of retirement has inched up from 65 to 67.5 years, as has the mean age of urologists overall (51 vs. 56).

    Nevertheless, the following have held true over the survey’s 8-year history: Declining reimbursement remains the number one concern of practicing urologists. Professional satisfaction far outpaces financial satisfaction. About 60% of urologists expect their use of non-physician providers to increase. And only half of urologists would still choose medicine as a career if they had to do it over again.

    The State of the Specialty survey is designed to capture the current state of your profession. It examines key concerns and controversies facing U.S. urologists, business and employment trends, clinical practice shifts, demographics, and future plans, including plans for retirement.

    The survey now divides responses by practice size, setting, and tenure. This uncovered significant differences in financial satisfaction (those in larger groups and with shorter tenures are more satisfied), whether intensity-modulated radiation therapy (IMRT) ownership represents a conflict of interest (twice as many academic vs. private practice urologists believe it does), and EHR usage (reported by nearly twice as many urologists in large groups as those in solo practice).

    The survey questionnaire was developed by Urology Times and administered by Readex Research in September 2013. The survey was closed for tabulation with 391 usable responses: a 9% response rate based on a net effective mailout of 4,301. The margin of error was ±4.7 percentage points at the 95% confidence level. (Also see, “How the survey was conducted")

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      I find the survey interesting but as in other surveys I wish the data regarding hours worked and income to be more discerning. Specifically, I would like to see the actual hours worked and the hours spent on call delineated. I find it hard to believe that 14% of Urologists work the equivalent of six 12-hour days weekly.