Where Are the Physicians?

Raoul S. Concepcion, MD, FACS
Published: Sunday, May 06, 2018
Raoul S. Concepcion, MD, FACS

Raoul S. Concepcion, MD, FACS
Aa a specialty, urology has always been at the forefront of technology and innovation, improving outcomes and enhancing patient care. In the late 1980s and early 1990s, we were quick to operationalize and employ lithotripsy, which provided noninvasive treatment for our patients with stone disease and reduced the need for open surgery, long hospital stays, and weeks of recovery. Despite this, I do not believe that extracorporeal shock wave lithotripsy has received enough recognition as a significant medical breakthrough, especially considering how stone disease was managed prior to its introduction. During that period, we did not shun innovation, and neither do we now. We have led the charge for minimally invasive and medical therapy for benign prostatic hyperplasia (BPH).

When one looks at the common denominator in the aforementioned mergers, all of these companies ingest and accumulate large tranches of data that they can then leverage. This data pool is the engine behind the predictive analytics and artificial intelligence that everyone is trying to develop. In all industries, collaboration and consolidation are inevitable. Outside the healthcare world, performance and outcomes are the norm, not the exception. As I see it, the opportunity that presents itself to us as urologists, especially in this new environment of value-based care, is that we are a small percentage of the dollar spent, but we are one of the most highly networked. The disease states that we manage, specifically prostate and bladder cancers, BPH, and overactive bladder, are associated with a significant annual cost in the United States. Standardization of care, tracking compliance, and outcome development are opportunities for us, like these major corporations, to aggregate our unique patient data—given our control of the healthcare dollar—and then leverage to our partners in industry, who desperately want this real-world data.


  1. NHE fact sheet. Centers for Medicare & Medicaid Services website. cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html. Updated February 14, 2018. Accessed February 19, 2018.
  2. Health expenditures. Centers for Disease Control and Prevention website. cdc.gov/nchs/fastats/health-expenditures.htm. Updated May 3, 2017. Accessed February 19, 2018.
  3. Bloom E. How doctors are experimenting with cutting health-care costs. Atlantic. theatlantic.com/business/archive/2015/12/medical-savings-patients-doctors/422277/. Published December 30, 2015. Accessed February 19, 2018.

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