By Debra Wood, RN, contributor Sep 17, 2019
As the U.S.
population ages and requires more urological care, urologist jobs remain
plentiful.
“There is a huge demand for
urologists, especially in small cities and rural areas,” said Fara
Bellows, MD, at The
Ohio State University Wexner Medical Center in Columbus. “Urology is an
exciting, ever-changing field, and there are many reasons to pursue a career in
urology. Job security, however, is an important factor.”
Christopher
Gonzalez, MD, FACS, chair of urology at Loyola University Medical Center in
Maywood, Illinois, and chair of public policy for the American Urological
Association (AUA), agreed, calling urology “very much an in-demand specialty.”
9
trends affecting urological practice
1. Coping with a shortage
Although
the number of urologists has increased slightly in recent years, Gonzalez noted
that the numbers are not keeping pace with an increasing population needing
care. Therefore, jobseekers will find there are plenty of urologist
jobs available, for both permanent and locum tenens positions.
Urologists
are coping with shortages in their profession and a geographic imbalance of urologists,
with a widening gap in the ratio between urban and rural urological practices.
Additionally, fewer new specialists are heading to rural areas, only about 8
percent, and those are primarily in solo urological practices. Sixty-three
percent of counties in the United States do not have a urologist, and that
presents access problems.
2. Rapid pace of retirements
The
median age of urologists in the United States is 56 years old, with 29 percent
of them 65 years of age or older, Gonzalez reported.
“A generation of urologists is
rapidly retiring, which will create a significant dearth of practicing
urologists,” Bellows said. “When we pair this with the aging general
population, we foresee issues with both lack of access and inferior quality of
care.”
Although
urology remains a sought after specialty, there has not been a substantial increase
in residency slots, so the pipeline is constrained.
3. Growing reliance on advanced
practice providers
Due to
the shortage of urologists, many urological practices are relying more on advanced
practice providers (APPs), including physician assistants (PAs) and nurse
practitioners (NPs).
Damon
Davis, MD, at Mercy Medical Center in Baltimore reported that his practice is
utilizing advanced practice providers, especially PAs, much more than in the
past. “They allow me to get new patients and quickly and efficiently manage
established patients with chronic illnesses.”
Bellows
also reported a demand for advanced practitioners in urology.
“APPs can see both new and
return patients and can even be trained to perform straightforward office-based
procedures,” Bellows said. “They can also assist in the inpatient setting, by
managing inpatients and seeing consults.”
Gonzalez
reported that 73 percent of urological practices include advanced practice
providers, up from 63 percent in 2015.
“We are
going to have to start thinking about a team approach to taking care of
patients,” Gonzalez said. “Integrating advance practice providers into our
practices will be an important component.”
4. Rising compensation
As the
demand for urologists has grown, so has their compensation. The Medscape
Urologist Compensation Report 2019 indicates urologists earn on average $408,000
annually, up from an average of $373,000 last year. The report also found that
self-employed physicians earn more than those who are employed, and 70 percent
of benefit packages have remained stable. Yet only half (49 percent) of the urologists
surveyed said they felt fairly compensated.
The pay
rates for locum tenens urologists
have also been rising, according to Staff Care’s data, with many assignments
now offering $170-$190 per hour, and some offering well over $200 per hour.
5. Increasing use of telehealth
Another
way that practices and hospitals are coping with the shortage of urologists is
through the use of telehealth. While less than 12 percent of practicing
urologists are currently using telemedicine, those who do use it expect its use
to increase, according to the AUA’s “The State of the Urology Workforce and
Practice in the United States.”
“Telemedicine is a hot topic for
nearly all medical specialties,” Bellows said. “There is a huge opportunity to
utilize telemedicine, but until we streamline processes to provide the same
quality of care, we still heavily rely on traditional office visits.”
6. Embracing new techniques and
updating standards of care
“New technologies and
medications are consistently arriving on the market,” Bellows said. “Robotic
surgery is quickly becoming the standard of care for urologic cancer
operations.”
Bellows also discussed “new, minimally
invasive therapies for benign prostatic hyperplasia, including Rezum, which
employs water vapor therapy to induce prostatic tissue necrosis, as well as
Urolift, which utilizes stainless steel brackets to widen the prostatic
urethra, are showing promise as alternatives to traditional transurethral
resection of prostate.”
7. More women choosing urology
While
the number of young women physicians selecting urology has seen a steady
increase, the proportion of women to men in the profession remains far apart.
In the United States, just 9.2 percent of the urology jobs are held by female,
but among urologists younger than 45 years old, 22 percent are female, and 26
percent of urology residents are female, Gonzalez reported.
“There
is a lot more awareness of the specialty to encourage women to go into the
field, and that starts in medical school,” Gonzalez explained. “That’s a very
good thing. It’s always good in a workforce, if your workforce mirrors the
population.”
8. Opting for employment vs.
private practice
The
number of employed urologists has increased to 58 percent from 49 percent in
2014, Gonzalez reported. In urologists younger than 45 years, 80 percent of
females and 69 percent of males are employed.
“That
is definitely a big change,” Gonzalez said.
9. Increasing satisfaction with
the job
The
Medscape Urologist Compensation Report 2019 found 92 percent of urologists were
satisfied or very satisfied with their own job performance, and most urologists
said they would chose the same specialty if they had to do it again.
Davis is
one of those physicians who likes urology, saying, “I enjoy the diversity of
conditions we treat, as well as the diversity of our patients.”
STAFF CARE matches physicians and advanced
practice providers with part-time and full-time locum tenen assignments across
the U.S.
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