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    Is bigger better in today’s urology practice?

    Henry Rosevear, MDDon’t let the headline fool you. This is not a discussion of PDE-5 inhibitors, nor am I comparing the AMS-700 to the Coloplast Titan (though the Coloplast folks certainly win the best name competition). Rather, this article is about the trend of independent doctors selling out to hospitals and why this trend may be about to change. 

    Given the lessons we all learned in a recent Urology Times article about urologists who transitioned to employed positions (“Private practice vs. employment: 12 lessons learned”), I think this topic is more important than ever.

    Also read: My six-digit mistake with a new health insurer

    About 10 years ago, when I started my residency, it seemed that the goal of every young urologist was to find a nice city to live in and either start a practice of their own or join a group of other urologists. But by the time I graduated from residency, my decision to join a single-specialty urology group instead of a larger hospital-based system seemed almost a relic of a past era. My residency director even went so far as to discuss my decision with me during one of my chief evaluations.

    This trend was well documented in a 2013 Urology Times article, which showed that between 2006 and 2012, the number of urologists in solo practice declined from 37% to 29%. It is not correct to say, though, that the trend of urologists preferring to work in larger groups instead of solo practice is new. Rather, it is the type of large groups they work for that has changed. If you look back 30 or 40 years, most medium to large cities had at least one relatively large urology group, and that makes sense. (My hometown is such an example, as is the city in which I did my residency.)

    Next: "What did change while I was in residency was the trend for hospitals to start acquiring specialty groups and directly employing them."

    Henry Rosevear, MD
    Dr. Rosevear, a member of the Urology Times Clinical Practice Board, is in private practice at Pikes Peak Urology, Colorado Springs, CO.

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