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Built for the Long Haul: Michigan Institute of Urology Offers Reliable Care in Turbulent Times

Shalmali Pal
Published: Thursday, Feb 13, 2014
Michigan Institute of Urology

Michigan Institute of Urology’s St. Clair Shores building

The events of 2013 would seem to ensure a bumpy ride ahead for Michigan Institute of Urology (MIU). In July, the city of Detroit filed the largest municipal bankruptcy in US history. MIU is the largest group practice in the southeastern part of the state, with more than two dozen offices serving patients in and around the stalled Motor City.

A few months later, the Affordable Care Act (ACA) kicked into high gear and, along with the rest of the country, MIU watched the chaos that ensued during the federal government shutdown, not to mention the ongoing struggle to get patients on course with health insurance coverage.

Dr. Alphonse M. Santino

Alphonse M. Santino, MD

But for practice founder and CEO, Alphonse M. Santino, MD, unexpected twists and turns in the road seem inevitable. He has no doubt that MIU can stay on track as the area’s most established urology subspecialty care provider.

“At this point, we haven’t seen any fallout from those events,” Santino said. “Will it be coming? Sure. Change is definitely coming down the pike. But that’s a benefit of having a large-group practice. We are in a position where we can address these kinds of shifts without too much disruption. We have the resources available and are prepared for changes, both inside and outside medicine.”

Santino, along with practice partner and urologic oncologist Kenneth M. Kernen, MD, shared with Urologists in Cancer Care how MIU is successfully navigating a shifting healthcare and civic landscape.

The Road to Success

Santino opened his single-physician practice in 1967 in the Detroit area. A year later, he was drafted by the US Army and served as a major in the medical corps in Long Bing, Vietnam. Santino returned to his practice in 1970 and remained its sole urologist for a number of years. Between 1975 and 1980, two more practice members came on board. These physicians, James Boutrous, MD, and Robert Di Loreto, MD, are still with MIU.

Santino saw the oncoming changes in healthcare and prepared for them sooner rather than later.

“We stayed a three-man practice for some time. In 1991, the HMOs were starting, and my feeling was that the practice of medicine was going to change radically. I felt that a group of three urologists was not going to fit into the ‘new healthcare’ picture. A small practice wasn’t going to be able to respond to the demands of practicing medicine on a larger scale. So I decided to expand the group.”

Santino focused on recruiting fellowship-trained urologists from premier institutions such as Memorial-Sloan Kettering Cancer Center in New York City and the Cleveland Clinic.

“The goal was to bring on the best and brightest, not only for their skills, but because they are physicians who will respond to change the best,” Santino explained. “Each year, we added a new doctor. Along the way, we merged with several smaller, existing urology groups.” The most recent merger took place in 2011.

Jason Hafron, MD, reviews films.

Jason Hafron, MD, reviews films.

MIU now has 51 physician members, 24 locations, and professional relationships with every major hospital system in southeastern Michigan. The practice has more than 400 employees, including nurses, nurse practitioners, and medical assistants.

In the last few years, the practice has made major inroads in terms of technological expansions, including an electronic medical records (EMR) system that’s been online since 2011. Santino said MIU is pleased with what the EMR has done for the practice, namely bettering communication between the patients and their healthcare providers, and improving the practice’s overall efficiency, for example by reducing office wait times.

MIU also has a rigorous internal auditing system in place to ensure that patients see the right physician for their disease conditions.


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