The need for high-quality prostate clinics has been on the rise lately, and this gives the partners at SouthWest the sense that they are well positioned for this trend. “What’s been documented across the country, amid the controversy about PSA screening, is that in general fewer of the primary care physicians are screening, so we have seen the number of biopsies and the number of people being diagnosed with prostate cancer decreasing over the last few years, and that also corresponds to an increase in incidence of higher-grade and higher-stage prostate cancer,” Gervasi said.
Struggles for Growth, Future Goals
The goal for SouthWest is to continue to grow their practice, but they must compete with Cleveland Clinic and University Hospitals for employee candidates. It’s difficult to recruit urologists because hospitals are able to offer higher salaries, and because more urologists are retiring than are graduating. “It just seems that the old-school urologists and the new-school urologists may have different types of mindsets. The new urologists coming out of school may be looking to go toward the [hospital] system to get more security and not be on call so much,” Zanin says.
SouthWest’s partners have discussed growing by merging with other private practices so they can continue to provide integrated, high-quality, efficient care to their patients. Zanin believes that they need to recruit more urologists or partner with other independent practices. Until now, urologists have come to the practice 1 at a time, instead of through mergers. “Part of what makes this group successful is that we’ve made a culture that allows us to continue to grow, and now we need to grow more,” Zanin said.
Despite the recruitment challenges, SouthWest has a lot to offer a urologist, including autonomy and the possibility to work up to a partner position. “Because of the bricks and mortar, the physicians, the salaries they get paid, and the size of an institution, the cost of delivering care in [hospital] systems is much higher than the cost of delivering care in an independent practice like ours,” Barkoukis said. “If you can get the same quality care, and you can get it done efficiently and easily by a group like ours at a lower price, and as the patient becomes a consumer with higher deductibles and health savings accounts, they’re going to be looking for treatment that can be done cheaper as long as it’s comparable, especially if it can be done in their own backyard.”