Regional Urology campus in Shreveport, Louisiana
Change may not always be pleasant, but it is inevitable, and nowhere has that been more evident recently than in US healthcare. The impact of the Affordable Care Act can be felt across the entire spectrum of healthcare. Those changes and updated practice guidelines—most notably the debate over the value of the prostate-specific antigen (PSA) test as a cancer screening tool—have rocked the boat for many urology practices.
But for the physicians at Regional Urology in Shreveport, Louisiana, these changes are really just business as usual. For instance, the American Urological Association (AUA) recently released guidelines (http://tinyurl.com/cc67nt6
) on how to use PSA-based prostate cancer screening in asymptomatic men, calling for the test to be reserved for men ages 55 to 69 after a discussion between physician and patient.
“These new guidelines basically describe what we’ve been doing all along: using the PSA test appropriately to make sure that the right patients get screened,” explained urologic oncologist Jonathan Henderson, MD. “The only substantial change was moving the age from 50 to 55 for the start of screening. These guidelines have a good scientific basis—unlike the US Preventive Services Task Force recommendations— but they’re not really new to us.”
Jonathan Henderson, MD
As for the ACA and its mandate to provide high-quality, cost-effective care, Regional Urology has embraced that model since the practice opened its doors over a decade ago.
“We’ve made patient care and convenience a priority,” said CEO Joel Young. “There are many regions where patients may have to wait a week or two to be seen by a urologist, even for something as simple as a kidney stone. Here, the patient can arrive with undiagnosed pain, receive appropriate testing to make a diagnosis, undergo treatment, and head home by noon. Our goal has always been to offer high-quality, cost-efficient healthcare.”
‘The Mayo Clinic of the South’
Regional Urology had its first incarnation in 1998, when two local practices joined forces. Eventually, a third group merged into the practice, but each group maintained its own offices. In 2001, after several other practices joined Regional Urology, the group decided to build one main office to house its 140 employees, including 15 physicians. The practice, which also has a satellite office in nearby Bossier City, Louisiana, sees patients from around the state, as well as others from Texas, Arkansas, and Oklahoma.
“Even though we were just a backwater of Louisiana, we built a 50,000-square foot-plus campus with office space, clinical research space, an ambulatory surgery center, and a radiology department, all in one place,” Henderson said.
In 2005, the practice opened an Oncology and Radiation Treatment Center, currently headed by Rod G. Krentel, MD. As it always does when considering expansion, the practice had the integrated care model in mind when it added the unit, Henderson said. Being able to offer on-site radiation treatment to patients, he said, brought the practice closer to its goal of being “the urologic Mayo Clinic of the South.”
While urology practices that have integrated radiotherapy services have seen their fair share of scrutiny for possible overutilization of the modality, Young and Henderson agreed that contending with that kind of criticism is well worth it.
“We brought this technology to our town because this treatment option didn’t exist here before,” Young pointed out. “To some extent, there was an increase in the utilization, but that’s because the technology simply wasn’t available.”
“This morning, I had a prostate cancer patient who came from 100 miles away,” Henderson added. “He was not a good candidate for robotic prostatectomy, which is what he was sent to me for. We talked about other treatment avenues, and he was able to walk over to the radiation center and see the radiation oncologist on the same day.”