Urology Practice Succeeds With Transparency, Upfront Payment Model

Ariela Katz
Published: Sunday, Feb 25, 2018
Timothy A. Richardson, MD
Timothy A. Richardson, MD
It may be true that most people do not enjoy staff meetings, but the partners at Wichita Urology, the largest independent urology practice in Wichita, Kansas, have built their success over 60 years partly by holding frequent meetings, which they say build camaraderie and make it possible to address needs quickly.

Meetings, they say, create a transparency that prevents employees from being broadsided by any changes. “All the physicians come together at the board meetings. Even if you’re not yet a partner you still attend, and we hold board meetings 3 times a month,” said Twila Puritty, CEO of Wichita Urology. This makes the practice nimbler and, as a result, things that need doing don’t languish on the back burner. “We are able to accomplish a lot of things in a short period of time compared with other groups who don’t meet as frequently,” she said. This collaborative style also allows for everyone’s voice to be heard when practice-changing decisions are made.

Another pillar of the administrative structure at Wichita Urology is a collection model that ensures the physicians are fairly and efficiently paid for their hard work, Puritty explained. The practice requires payment upfront for elective surgeries—before the procedures take place. “We used to write off thousands of dollars for elective surgeries that patients didn’t pay for after receiving surgery. So, we adopted a policy that surgeries would be classified as either urgent or elective, and if they’re elective the surgery isn’t scheduled until the patient pays the out-of-pocket amount,” Puritty said. It was felt that these nonessential unpaid surgeries were not only an inefficient practice but also cost physicians time that they could have spent at home with their families.

Under the revised policy, the cost of the elective surgery is explained to patients, and numerous attempts are made to ensure payment is received upfront. The surgery will usually be rescheduled until that requirement is met. However, it sometimes happens that the practice will do an elective procedure without payment and accept the unpaid bill as a cost of doing business.

History of the Practice

Wichita Urology has grown organically, without merging with any other urology groups. It was founded by 3 urologists in 1955 and now has 9 physician partners. The support staff numbers 92 employees, including 84 who are full time and 8 who are part time. Although the practice has many employees, its efficiency is high, and this enables clinicians there to see a high volume of patients, Puritty said. From 2016 to 2017 the group saw 19,427 patients.

Wichita Urology is spread out over 3 offices in the south-central Kansas metropolis. The main office on the east side of town is large enough to have 3 clinics operating at once. By contrast, their west-side office offers just 1.

Physicians at the practice see adult and pediatric patients with all stages of prostate, bladder, and kidney cancer. “We have individuals from first diagnosis to those who walk in with metastatic disease. We not only get referrals for end-stage disease, we see every type,” said Timothy A. Richardson, MD, a physician partner.

The urology group participates in many clinical trials for prostate cancer and a smaller number for patients with renal or bladder cancer. Wichita Urology also enrolls patients in trials for general urologic disorders, such as overactive bladder and benign prostatic hyperplasia. There are no medical oncologists on staff, but the practice works closely with a local medical oncology group to address patients’ needs for chemotherapy or other specialized cancer treatments. Following outside care, patients usually return to Wichita Urology to resume treatment.

The practice often can provide in-house treatment for a wide spectrum of a patient’s needs. For example, the practice can provide surgical interventions for patients with resectable cancers. “For prostate cancer, we take care of those patients from diagnosis. If they need chemotherapy, we send those on, but we still try to manage everything else,” Richardson explained.

In 2014, Wichita Urology opened an office that is dedicated to radiation therapy. The availability of radiation oncologists enhances the practice’s ability to treat patients in-house. The practice also has an outreach program for about 15 communities. Wichita Urology physicians travel to those offices regularly for clinics that may be held multiple times per week.


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TitleExpiration DateCME Credits
Clinical Practice Connections™: New York Advanced Practice CollaborativeNov 15, 20191.25
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