An artist’s rendering of The Urology Group’s $20 million campus in Norwood, Ohio.
The week that Urologists in Cancer Care
was scheduled to speak with members of The Urology Group in Cincinnati, Ohio was a hectic one. The American Urological Association (AUA) had just wrapped up its annual meeting, and urologists were contending with some bad news: The US Preventive Services Task Force (USPSTF) confirmed its recommendation against routine prostate cancer screening with prostate-specific antigen (PSA) testing.
The Urology Group took action without hesitation, releasing its own position statement within 48 hours of the USPSTF edict. “We are more than disappointed with the task force’s recommendation,” said Gary M. Kirsh, MD, president of The Urology Group in Cincinnati, in the statement. “We will continue to offer free prostate cancer screenings in underserved areas of Greater Cincinnati as part of our community outreach program because we know early detection saves lives.”
Making such bold moves is not new to this practice. In its relatively short 16 years, this 35-physician group has become one of the largest single-specialty groups in the country. Headquartered in Cincinnati, the practice has 19 other locations, extending beyond Ohio to Kentucky and Indiana. This summer, the group will move to a $20 million, 55,000-square-foot campus in Norwood, Ohio.
Gary M. Kirsh, MD
In tough economic times when many medical practices have scaled back or even shut down, The Urology Group has flourished. Urologists in Cancer Care
spoke with Kirsh, along with Chief Medical Officer Phillip J. Buffington, MD, and Bernard L. Hertzman, MD, director of Clinical Research, about their phenomenal growth.Consolidation and Community
The Urology Group came together in 1996, the product of many smaller practices joining forces. “In order to meet the challenges of the healthcare system, you just couldn’t exist effectively as a two- or three-person practice,” Kirsh said. “Consolidation of our industry was needed in order to bring efficiencies. And by efficiencies, I don’t mean lowering overhead. It was about gaining access: access to professional management; access to information services: access to human resources; access to legal advice for contracts; access to market power.”
But getting a disparate group of urologists together to “super-size” was not easy. As Kirsh pointed out, physicians have no history of corporate culture. “When you take physicians who have already established themselves in practice and try to bring them together, that’s going to be a challenge. Physicians are generally not followers. They are used to making individual decisions about patient care on a day-to-day basis. They are used to being in charge, whether it’s in the clinic or in an operating room.”
Technician Linda Lohr performs a histology exam of a tissue sample in The Urology Group’s lab.
One of the first steps the group took toward meeting this challenge was to ensure that the leadership understood their roles. “Physicians like me, who are essentially business people now, we weren’t trained for that,” Kirsh said. Next was to bring the group members on board with regard to accountability—measuring productivity and quality outcomes, as well as developing and adhering to clinical guidelines.
Another key to its success has been community outreach. To that end, the group has sponsored everything from 5K walk/runs for prostate cancer awareness, to underwriting a comical play about menopause, to “adopting” two classes at a local school as part of a mentoring program.
“If our group is viewed as an indispensable community asset, then we are going to be a pretty secure business,” Kirsh pointed out. “That means delivering highquality, subspecialized, streamlined, measured, cost-effective care. We have to be a community asset.”Consolidation = Critical Mass
Another boon of consolidation was the ability to achieve enough critical mass for its physicians to subspecialize. For example, when robotic surgery first came on line, many physicians in the group were interested in learning this new technique. But getting everyone trained in robotic prostatectomy or cystectomy wasn’t realistic, Buffington said.