Steve Dobbs, begins the conversation by stating that an opportunity exists to form group purchasing organizations (GPOs) in urology. Dobbs explains that the "strength in numbers" concept is currently present and that GPOs tend to lower prices based on volume. However, Dobbs warns, a GPO may become a middleman for the manufacturer and because of this the price of a product needs to be monitored at all times, since it could change.

Bryan Mehlhaff, MD, notes that it is important to follow AUA practice guidelines for prostate cancer, hematuria, and BPH, especially when it comes time to negotiate private payer contracts. Daniel R. Saltzstein, MD, echoes Mehlhaff by saying that efficiency and standardization are becoming more of a priority in his practice as they try to evolve to centers of excellence.

In Dobbs' practice, they are creating a health scoring system using algorithms based on the AUA guidelines to determine how well doctors are performing within the guidelines. This health scoring system is reviewed monthly and helps prove that the physicians are following the proper guidelines in an easy to use system. This system provides data and ties the guidelines to results and costs.

Raoul Concepcion, MD, says that the challenge will always remain controlling physician behavior. Dobbs says that the way to handle physician behavior is evolving and that physicians react to data and measurements over time, not a snapshot. It's crucial, Dobbs says, to measure both costs and outcomes.