Raoul S. Concepcion, MD, Daniel R. Saltzstein, MD, Bryan A. Mehlhaff, MD, and Steve Dobbs, discusses some of the reimbursement and financial challenges that urology practices face as a business.

Steve Dobbs, FACHE, believes that evaluating all expense items in a practice is crucial, from insurance to products. When it comes to costs for physicians, bidding and transparency are important ideas to stand by, he believes. With regards to new lab tests, Dobbs says, physicians, urologists, and the pathology group must collaborate to determine its efficacy and appropriateness. The management team is then responsible for evaluating cost, reimbursement models, and the risk to the practice before a decision is reached with the operations committee.

More often than not, Dobbs says, a physician with subspecialty training is needed to advise the operations committee. Daniel R. Saltzstein, MD, echoes Dobbs' points but stresses the idea that every lab is different and can evaluate cost in unique ways, especially in regard to more expensive drugs such as Testopel, Xgeva, and Provenge.

The main concept, the panel agrees, is having a balanced discussion and trusting the other physicians in the practice. Moderator, Raoul Concepcion, MD, concludes the conversation by noting that the culture of practicing great medicine and taking care of patients needs to remain. The remaining hurdle that stands in the way is to educate physicians on providing the most optimal care that makes financial sense.

View part I of this conversation