Denver Archives

Antibiotic Stewardship for Procedures and Patients with Recurring Infections

Posted by Brian J. Flynn, MD | Mar 2024

Brian J. Flynn, MD, presents guidance on effective UTI management while minimizing antibiotic resistance. Dr. Flynn begins with an overview of recurring UTI pathogenesis and diagnosis.

Dr. Flynn then addresses common treatment options for recurrent UTI management, like Fosfomycin. He reviews the common first-line antibiotics, highlighting the importance of short-duration antibiotics after non-antibiotic treatments have failed.

Dr. Flynn then delves into other prophylactic strategies for treating recurrent UTIs. He discusses prophylactics relating to cleanliness, specific cranberry products, water intake, and methanamine hippurate.

Dr. Flynn concludes by addressing the social and psychological impact of recurrent UTIs, particularly in post-menopausal women. He stresses the importance of discussing contributing factors frankly, but empathetically, with patients to achieve the desired treatment outcome.

Caring for Underserved and Vulnerable Populations for Over 23 Years

Posted by Fernando J. Kim, MD, MBA, FACS | May 2023

Fernando Kim, MD, MBA, FACS, Chief Emeritus of Urology at Denver Health Medical Center and Professor of Surgery/Urology at the University of Colorado at Denver, shares insights gathered from his more than 23 years of caring for underserved and vulnerable populations. Dr. Kim describes some of the needs and characteristics of these populations, and gives examples of the traumatic experiences to which those populations are regularly exposed. He also emphasizes the importance of physicians understanding their patients’ cultures, communication styles, and needs so that they can effectively treat those patients.

He addresses time constraints for patients who cannot afford to be out of work, and how developing a minimally-invasive practice can help support those patients. He cites disparate oncological profiles along demographic lines, as well as research that supports multiple factors influencing patient treatment selection. For example, he explains that, especially for African-American men, the less invasive nature of cryoablation appeared to influence opinions regarding surgery for the treatment of localized prostate cancer.

Dr. Kim cites another study that reaffirms the importance in health disparities research of modeling interactions between race/ethnicity and variables that reflect diverse aspects of a patient’s socioeconomic circumstances, since the research showed that doctors’ treatment recommendations were less aggressive for poor or indigent populations. He concludes by reemphasizing the importance of empathy, cultural humility, and understanding when working with vulnerable and underserved communities.

The Business of Medicine

Posted by Ray Painter, MD, FACS | Jun 2020

Ray Painter, MD, FACS, co-founder and president of Physician Reimbursement Systems (PRS), discusses the business of medicine. He highlights how much has changed in recent decades and how regulation of medicine has increased. Dr. Painter then goes on to make some predictions about the future which will lead to less onerous regulation and more job satisfaction. Some of these changes are already in the works, affecting areas such as office documentation and how doctors are paid for their time. The changes provide opportunities to improve workflow, allow for spending more time with patients, and increased data accuracy. Dr. Painter then emphasizes the need for this data accuracy and goes over the main reasons why errors happen. Overall, he argues that it is imperative that doctors understand and accept their roles in data collection and how it will lead to greater job satisfaction.

Prostate Cancer Screening and Early Detection: Should We Follow the NCCN Guidelines? Con Argument

Posted by David Utz | Jan 2020

Robert E. Donohue, MD, argues against urologists adhering to the National Comprehensive Cancer Network (NCCN) Prostate Cancer Screening and Early Detection Guidelines. He proposes his own definitive answers to controversial questions relating to the use of digital rectal exams and PSA tests in baseline evaluation, indications for biopsy and biopsy technique, the age for initiation and discontinuation of testing, the frequency of testing, screening in high-risk populations, and which biomarkers to use.

The Opioid Crisis: Latest Developments, Impact on Urologic Pain Management

Posted by Brian J. Flynn, MD | Aug 2019

Brian J. Flynn, MD, reviews data on the current scope of the opioid crisis in the United States and factors contributing to rising opioid misuse and abuse. He outlines steps physicians can take to influence the opioid epidemic, as well as societal efforts to end the crisis, such as the Colorado Alternative to Opioids (ALTO) project.