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    Urology, gynecology collaboration addresses rising demand


    How does the new generation of fellowship-trained urologists and gynecologists who are trained in cross-disciplinary programs in which the message of collaboration and integration is increasingly advocated serve as a positive force to help institutions fully integrate the FPMRS service line?

    To have an FPMRS service line, first and foremost you have to have the human capital. You have to have physicians who want to work in that type of situation and who understand the benefits of working in that type of situation; if you don’t, you can’t get anywhere. Having trainees come out of programs where they’ve been exposed to that is incredibly beneficial. My fellowship training was at Cleveland Clinic, where we had multidisciplinary conferences and research, and we served on each other’s services throughout the training. I absolutely understood the benefit of that, and it has always been my goal at UW to create a similar environment. All of my partners in urogynecology came from similar backgrounds. That really helps.


    Where do we stand now with integration and training, and what benefits have become apparent? Is there a geographic difference in harmonization?

    There are 56 fellowships that are accredited, and by my estimation about 32 of them accept both urology and gynecology backgrounds in the fellowship program. I think integration is there and I think it’s hard-wired going forward. To be an accredited fellowship, you have to have a urologist and a gynecologist background as part of your program. Exposure to that is part of your training.


    One of the very specific benefits I can talk about in our multidisciplinary program is increased patient compliance. We compared compliance with prescribed pelvic floor physical therapy in patients who were seen in our multidisciplinary clinic by both a physician and a pelvic floor therapist with patients who were prescribed that treatment option from a physician-only clinic. We found that compliance was much better with patients seen at the multidisciplinary clinic.

    I don’t know that there are geographic differences. The real issues are resources and commitment, the human capital. Those are the barriers to this getting fulfilled.

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    Philip M. Hanno, MD, MPH
    Philip M. Hanno, a Urology Times editorial consultant, is professor of urology at the University of Pennsylvania, Philadelphia.


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