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    AUA president: In uncertain times, urologists must unify


    If more AUA members are accessing educational materials online, are we going to see attendance at the AUA annual meeting drop off?

    I don’t think so. In surveys and the AUA Census, urologists tell us often that they come to the meeting not just for the education but also for networking. A lot of networking opportunities and subspecialty meetings occur at the annual meeting that you can’t get any other time. Fifty-four percent of attendees are actually international; you don’t see that many international urologists at any other meeting.


    Talking about other projects at the AUA, is the association getting involved at the state level?

    We always have, and we remain involved in the State Society Network. As we’ve gotten bigger and more complex, our advocacy effort also has a lot more branches and we’re decentralizing some of the command. We are putting our major focus on the Urology Advocacy Summit, but our advocacy efforts—lobbying, supporting state society networks, working with the state societies—are ongoing.


    What excites you about being AUA president?

    Two things in particular excite me. Of course, it’s an honor and a privilege to lead an organization of 21,000 people. Another thing that excites me is the change I’d like to see, which is a call to unite. That is one of my big goals, and I think we can accomplish that. We can start bringing our subspecialty societies together as one voice. But we need to listen more. We’re a big gorilla, and we are trying to listen a lot more, including to the members of the subspecialty societies.


    What are the challenges we face on the horizon?

    There is a lot of uncertainty about health care reform and where it’s headed. Nobody knows. But as an organization and as a specialty, we have been very adaptable. It’s amazing how we’ve taken on new technologies, for example, and made it all work. We’ve adapted to a changing work environment. We don’t really know whether to bob or weave right now. We keep a finger on the pulse all the time, and if we have to bob, we will; if we have to weave, we will.


    Urology is a small specialty, and we don’t fill as many spots with new residents as we should. One way to expand the work force is with nonphysician providers—advanced practice nurses and physician assistants. What are we doing to educate these individuals and bring them into the fold?

    Together, nurse practitioners (NPs) and physician assistants (PAs) have become one of the fastest growing segments of the AUA. They have their own committees and their own big meetings. Their didactics are very strong. We’re starting to delve into how we not only educate them on the basis of how to work within a practice, but also potentially procedurally. I believe there will be another survey of practicing urologists that asks about this because the times have changed a bit.

    Read: Urologists show low adherence to value-based care pathway

    I do believe urologists need to be the quarterback, and proper supervision is the right thing for urology, for the PA and NP, and for the patient and his or her safety. There are urologists with nonphysician providers working within their practice who are saying, “We’d like to have a formative way of teaching them and maybe even teaching them procedures.” That’s being looked at again. I think we will be heading in that direction but we are also being cautious about the move.


    There are currently very few fellowships for PAs who come out of their basic residency training for urology. Does the AUA Board of Directors foresee a formal program developing?

    I don’t know, but I can tell you the idea of training that might allow the practitioner to earn a certificate or something similar has been discussed. The concept is not necessarily certification, but something that says, “This individual has been through a formal course. We feel this meets the needs of the specialty, and it’s safe.” Whether you call it a fellowship, an added qualification, or certification, that’s been talked about and may be what the future holds.

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