The sustainability of the urology practice continues to confront unprecedented change and mounting financial pressures. The combined effects of declining reimbursements, rising operating costs, increasing market competition and risk, government mandates and regulatory burdens, and growing uncertainty continue to reduce practice incomes. How do you react to these pressures? Can you expand your practice in the face of all these challenges?
One of the areas that we see as an opportunity for expansion is men’s health. Currently, an overarching trend in health care reimbursement for both the public and private sector is to increase payments for preventive care and, more generally, primary care. An opportunist would follow the money.
It has been estimated that 80% of decisions to seek health care are made by women. As males, we can relate to the training since birth that you do not need medical help unless you are injured or dying. However, men have started going to the urologist because they’ve heard that there may be ways to help them urinate less frequently or obtain a working erection without surgery.
Depending on the available operational expertise, market position, and size and scope of a practice, developing a men’s health and wellness program offers a pragmatic option that capitalizes on urologic expertise, patient demographics, payer incentives, and demand. Men are often attracted to a urology practice for a problem that is frequently related to general health or diet and often requires other medical services. Additionally, now that preventive services are mandated for coverage under most programs, patients in general will be more inclined to seek these services. This combination could lead to repeat visits for those preventive services required to address general health and diet.
Integrating a men’s health program will take vision and some restructuring. Providing state-of-the-art, comprehensive urologic care and wellness services for men requires the ability to diagnose, educate, and treat with a goal of enhanced quality of life. Implementing new service lines is a common business response to growing financial pressures and deteriorating margins, especially if those services can meet a growing demand. A urology practice is no different. If patients are seeking services that are covered by insurance or are willing to pay out of pocket for them, adding these services to your practice instead of referring them to others is common sense.
A men’s health program could consist of a group of comprehensive, integrated programs designed to provide resources for men in such areas as erectile dysfunction, penile reconstruction, Peyronie’s disease, infertility, low testosterone, incontinence, and sexual rehabilitation medicine following prostatectomy. Service lines may include specialized care and patient lifestyle education under the following general groups:
vasectomy/vasectomy reversal
infertility
erectile dysfunction treatment options (oral medications, external vacuum devices, penile injections, penile implants, testosterone therapy)
sexual rehabilitation programs
cancer and quality of life programs
overactive bladder/control issues
testosterone deficiency
general preventive health.
Some of these service lines may already be offered; others may need to be fleshed out with additional resources. As you develop these service lines, you will find that you can now provide more comprehensive support for your existing patients, and with advertising, attract new patients without relying heavily on referrals.
