1999 American Urological Association Gallup Survey: Changes in physician practice patterns, treatment of incontinence and bladder cancer, and impact of managed care

Purpose: The Health Policy Survey and Research Committee of the American Ur ological Association and the Gallup Organization have performed a yearly su rvey of American urologists since 1992 to assess practice patterns. The res ults of the 1999 survey are presented. Materials and Methods: A random sample of 503 urologists was interviewed in February and March 1999. Major content areas were physician practice patte rns, the impact of managed care, and the treatment of pediatric patients, p rostate cancer and benign prostatic hyperplasia, female incontinence and bl adder cancer. Results: The average urologist is 46.8 years old, certified by the American Board of Urology, sees 78 patients and performs 3.1 major surgical procedu res weekly, refers moderate and complex pediatric procedures to specialists , and receives 40.6% of practice income from managed care. Conclusions: In an era when large group practices seem to be the norm remar kably 32% of urologists remain in solo practice. There has been a shift in where urologists spend their time, that is more in the office and less in t he operating room. Minor and major open surgical procedures increased from 12.4 weekly to 16.4 and 2.9 to 3.1 in 1995 and 1999, respectively. Most uro logists are comfortable treating straightforward pediatric problems such as cryptorchidism but refer more complex problems to pediatric urologists. Ma naged care represents an ever increasing proportion of urologist practice i ncome, while office expenses continue to increase.