On an early Tuesday morning, when many businesses are just ramping up, practice administrator John O’Rourke is wrapping up a briefing with a staff member. Their discussion includes the practice’s plan to begin administering Provenge, the prostate cancer vaccine, to their patients.
During the time that our publication Urologists in Cancer Care
spent at the more than 40-year-old practice, appointments with two of its senior physicians required rescheduling because both were called to consult in the operating room. Not to worry; two other partners graciously stepped in to discuss topics ranging from the establishment of the practice to the changing needs of urologic cancer patients in Tucson and beyond.
“The physicians here will help each other out, whether it’s consulting in a patient exam room or in the operating room,” O’Rourke explained. “They consult each other constantly, despite the fact that the reimbursement system has made collaboration very complicated.”
That’s no doubt one reason that in 2011, seven of the 11 top urologists in Tucson who were voted The Best Doctors in America were based at Urological Associates of Southern Arizona.
In terms of urologic cancer care, the practice has also kept its eye on collaboration, seeking to form alliances with its fellow cancer specialists. The practice is in a unique position: Tucson is a microcosm of the rest of the United States, with a graying population that carries a higher cancer risk. And given its long history, the practice has seen many milestones reached for urologic cancer, particularly prostate cancer.
O’Rourke and some of the physician partners shared their vision for their practice and how they are planning to thrive in an increasingly complex medical climate.
Setting Up in a “Specialist” Town
Urological Associates of Southern Arizona was founded in the mid-1960s by Donald Gleason, MD, who came to Tucson from the East Coast. During that era, Tucson saw its population double, and the local medical community followed suit. Tucson became known as a “specialist” town, with the highest number per capita of board-certified physicians in the country. More than 850 physicians were serving the community of 200,000 residents in the 1960s.
After Gleason established the practice, he called Robert J. Riley, MD, to join him. Practice lore has it that desert-based Gleason rang up his colleague from poolside on Christmas day, while Riley took the call in snowbound Connecticut.
Thomas Hicks, MD
Throughout the next three decades, Riley and Gleason saw their practice expand, often merging with single practitioners like Thomas Hicks, MD, who joined in 1998.
For Hicks, who spent six years as a solo practitioner, being a part of a large group held practical and professional appeal. “The physicians in this practice were interested in research, and I wanted to get more involved in research,” he said. “Joining a larger group practice also [offers] an efficiency of administration. For a solo practitioner to establish contracts is difficult, because you don’t have the leverage, so that’s another benefit of being in a larger group practice. The resources here and the collegiality of the physicians here appealed to me.”
A wealth of resources has meant that the practice has been able to reach beyond the city: opening satellite clinics in the small southern Arizona towns of Safford and Willcox; acting as a teaching facility for urology residents from the University of Arizona School of Medicine (Stanley Suffecool, MD, serves as the practice’s clinical instructor); partnering with not one but three major hospitals in town; and conducting clinical trials.
Curtis Dunshee, MD
Curtis Dunshee, MD, joined the practice in 1993 and serves as one of the principal investigators of in-house clinical trials (Susan Kalota, MD, is the other PI). In fact, the practice is currently involved in a clinical trial of MDV3011, an investigational drug for men with metastatic castration-resistant prostate cancer that has progressed after treatment with docetaxelbased chemotherapy.
The practice now boasts 12 full-time physicians, one nurse practitioner, and two physician assistants, based at two main Tucson locations.