Medical urologists…no longer an oxymoron

The bulk of what community urologists see could be called “medical urology.” We work through large numbers of patients each week — a week punctuated with stones, retention, and hematuria calls from our local hospital’s emergency room. We have surgical interests as well and they eventually define our practice. My partner is a stone guy, another department member loves lap kidneys, and I actually like male incontinence. It is difficult for me to justify a broad range of surgical skills when my colleagues can do a better job. This applies to advanced surgical skills only, as you can only be so skilled at circumcisions, vasectomies, and hydroceles. There is good published data that suggests that high-volume surgeons have superior outcomes. This does not mean that low-volume guys don’t as well — well, some don’t and we know that empirically