Volume 23, Number 4Editorial2024 LUGPA Advocacy Year in Review: Confronting Challenges, Advancing ProgressMatthew GlansIn 2024, independent practices nationwide faced new and mounting challenges, including increasing and expanding regulatory obligations and growing patient demands against a background of rising input costs and financial pressures. Amid a shifting health care landscape, urologists were tasked with the pressing challenge of doing more with less.Telemedicinehealth care costsinsurance, healthhealth services accessibility
Volume 23, Number 3EditorialThe Specialty Networks Localized to High-Risk Biochemically Recurrent Prostate Cancer Patient PlaybookGautam JayramKatie GrantJayme NalleyNicole SmithProstate cancer (PCa) is the second-leading cause of cancer death among men in the United States. The American Cancer Society estimates that more than 299 010 men will be diagnosed with PCa in 2024, with more than 35 250 PCa-associated deaths.1 It is estimated that of those patients treated for localized PCa, 30% to 35% will experience biochemical recurrence (BCR), which further increases the risk of PCa death. Although multiple definitions have been proposed, BCR is generally present when a man has a persistently rising prostate-specific antigen (PSA) value after definitive local therapy (Table 1) in the absence of radiographic evidence of metastatic disease. This definition has evolved and will continue to develop, with advances in genomics, next-generation sequencing, and digital pathology.
Volume 23, Number 2EditorialAdvanced Practice Providers, Urology Workforce Challenges, and Reviews in UrologyKenneth A. MitchellIn 2015, the American Urological Association published the Consensus Statement on Advanced Practice Providers (APPs) with the goal of providing up-to-date information on the training of APPs, the scope of practice legislation, and examples of APPs in urologic practices.1 This statement was co-written by an experienced team of physicians and APPs whose purpose was to provide a unique and collaborative perspective on urology APPs. The paper was inspired by a report from an American Urological Association ad hoc committee assembled in 2008, which concluded that there were substantial workforce shortages in urology and that physician assistants and advanced practice registered nurses would provide the “best solution” for the declining urology workforce.2 In 2009, reports estimated that there were 3.1 urologists per 100 000 people in the United States and that urology was the second-oldest surgical subspecialty, with a workforce median age of 52.5 years.2 A published update in 2021, which used data from 2018, revealed that there were 3.89 urologists per 100 000 people in the United States, with 65% of urologists reporting that they were “interested” in the integration and use of APPs; 72.5% of urologists reported already incorporating an APP into their practice, accounting for nearly 41% of a physician (ie, MD or DO) full-time equivalent.2 More recent data showed the use of APPs was lowest in practices with the youngest and oldest subgroups of urologists and was highest in urban urology practices, which represent groups most likely to be affected initially due to the disproportionate geographical urology patient population density.Physician assistantsnurse practitionershealth workforce
Volume 22, Number 3EditorialFailing to Prepare Is Preparing to FailDeepak A KapoorKathleen A Latino[Rev Urol. 2020;22(3):91-92] © 2020 MedReviews®, LLC