Atlantic Urology Clinic, LLC

GRU Challenging Case: Androgen Deprivation Therapy

Neal D. Shore, MD, FACS, Medical Director for the Carolina Urologic Research Center, discusses the physiological and economic factors impacting the ADT selection process. He particularly emphasizes the impact of the current volume-based and economically incentivized model of treatment and how this can restrict urologists. He also discusses the physiological impacts of drug-drug interactions, alternate modes of administration, and the complex prospect of an oral alternative.

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Preserving Independent Urology: LUGPA’s First Decade

Neal D. Shore, MD and E. David Crawford, MD, discuss Dr. Shore’s recent MedReview article (excerpted and linked below) on the ways in which the Large Urology Group Practice Association, or LUGPA, has advocated on behalf of community urology physicians and patients over the last ten years. Dr. Shore discusses how the organization has fought for legislative change to improve patient access to physicians of their choice, worked to ensure the availability of the latest in imaging and diagnostic technology for community urologists, and, in the face of increased consolidation of the healthcare industry, promoted value-based healthcare above volume-based healthcare, concluding in the article that:

“Eleven years after LUGPA’s inception, its passion and commitment to protecting and preserving the independent practice of urology remain stronger than ever. Without LUGPA, there would be far fewer opportunities for independent urology practices, fair-balanced education, networking, or external benchmarking than we have today. LUGPA groups have been able to integrate essential urologic services at a lower cost than their hospital competitors. Many of our member practices have become urologic centers of excellence with subspecialty lines of service and innovative, cost-effective pathways that optimize patient outcomes.

“Innovation springs from independence, not bureaucracy. Independent practitioners have the freedom and flexibility to share decision-making with their patients and to rapidly implement, test, and adapt new diagnostics, therapeutics, and pathways. Backed by a robust organization such as LUGPA, independent urologists can implement innovative approaches that significantly improve the health of their patients and the sustainability of their practices. Such nimbleness is especially crucial given the current rapid pace of change in urology. Aligning the interests of patients, providers, and payers by promoting value-based care at independent, integrated physician practices is LUGPA’s ongoing mission; our rallying cry should be to continue that mission in an open, transparent, and inclusive fashion.” (Used with permission from MedReviews / Reviews in Urology, which holds the copyright to the original article.)

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The Gold Standard for Bladder Cancer Detection

Neal D. Shore, MD, discusses the benefits of using blue light cystoscopy (BLC) in adjunct with white light cystoscopy (WLC) in the diagnosis and treatment of bladder cancers. He then reviews the body of evidence evaluating the accuracy of BLC in detecting significant tumors and briefly compares BLC and narrow band imaging.

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Navigating the M0 Space- Results of RADAR III

Neal D. Shore, MD, reviews the recently-published guidelines focused on next generation imaging for early detection of disease progression in M0 prostate cancer in the Prostate Cancer Radiographic Assessments for Detection of Advanced Recurrence III (RADAR III). He also reviews the goals and conclusions from RADAR I and II.

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