Highlights
- •The number of urologists increased from 9305 to 9570, while the number of urology practices decreased from 3588 to 2861 between 2010 and 2016.
- •The proportion of urologists in a multispecialty groups increased from 17.1% in 2010 to 28.2%% in 2016, while those within solo practices declined from 26.2% in 2010 to 15.8% in 2016.
- •A higher proportion of patients at hospital-owned practices were treated with observation and surgery, while those at large single specialty practices were treated with radiation therapy.
Abstract
Objective
To characterize national trends in urologist workforce, practice organization, and
management of incident prostate cancer.
Methods
Using Medicare claims data from 2010 to 2016, we identified all urologists billing
Medicare and the practice with which they were affiliated. We characterized groups
as solo, small single specialty, large single specialty, multispecialty, specialist,
or hospital-owned practices. Using a 20% sample of national Medicare claims, we identified
all patients with incident prostate cancer and identified their primary treatment.
Results
The number of urologists increased from 9,305 in 2010 to 9,570 in 2016 (P = .03), while the number of practices decreased from 3,588 to 2,861 (P < .001). The proportion of urologists in multispecialty groups increased from 17.1%
in 2010 to 28.2% in 2016, while those within solo practices declined from 26.2% to
only 15.8% over the same time period. A higher proportion of patients at hospital-owned
practices were treated with observation (P < .001) and surgery (P < .001), while a higher proportion of patients at large single specialty practices
were treated with radiation therapy (P < .001).
Conclusion
We characterized shifts in urologist membership from smaller, independent groups to
larger, multispecialty or hospital-owned practices. This trend coincides with higher
utilization of observation and surgical treatment for prostate cancer.
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Article info
Publication history
Published online: February 18, 2021
Accepted:
December 15,
2020
Received:
June 3,
2020
Footnotes
Funding: This study was supported by Agency for Healthcare Research and Quality R01HS025707. Dr. Skolarus is supported by National Cancer Institute R37CA222885 and R01CA242559.
TWEET: Urology practices are consolidating quickly. The plurality of urologists moved to multispecialty groups by 2012.
Conflict of Interest: The authors report no conflicts of interest associated with the publication of this work.
Identification
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