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How to cite: Stringer TF. Transitions in Urologic Practice – Past/Present/Future. Grand Rounds in Urology. October 2025. Accessed January 2026. https://grandroundsinurology.com/transitions-in-urologic-practice-past-present-future/
Summary
Thomas F. Stringer, MD, FACS, Associate Professor of Urology, University of Florida Health, Gainesville, Florida, focuses on how urologic practice structures evolve over time and how changing economic, regulatory, and professional realities influence career decisions, workforce distribution, and organizational alignment. Dr. Stringer discusses historical context, current challenges, and practical considerations for clinicians navigating transitions in practice models.
Dr. Stringer reviews the movement from traditional independent practice toward increasing integration with hospitals and corporate organizations. He explains how these changes affect ownership opportunities, physician autonomy, workforce stability, and the ability to sustain private practice environments, particularly in smaller or rural regions. He emphasizes that shifts in reimbursement, cost pressures, and operational complexity contribute to these transitions.
Dr. Stringer highlights observations drawn from workforce trends, including how generational expectations, practice preference changes, and financial realities shape employment decisions. He also discusses how considerations such as cost-of-living balance, partnership expectations, compensation structures, and realistic timelines for advancement are key elements that influence early-career professional planning.
Dr. Stringer discusses the necessity of contract awareness. He describes how compensation models, workload expectations, benefits, restrictive covenants, and termination provisions determine long-term outcomes. He stresses the importance of recognizing legal and regulatory obligations, including compliance expectations and the serious consequences of violation.
The session also addresses consolidation trends and private equity involvement. Dr. Stringer explains how these arrangements affect practice direction, long-term independence, financial structure, and perceived advantages and risks. He notes that debt burden, uncertainty, and economic pressures make decision-making increasingly complex.
Throughout, Dr. Stringer emphasizes deliberation, preparation, and understanding how employment structures, financial realities, and compliance requirements interact. He concludes by encouraging careful assessment of opportunities, alignment of expectations with practice environments, and thoughtful navigation of transitions in urologic practice.
About The 12th Urology Today Conference:
Presented by chair Ryan P. Terlecki, MD, FACS, the 12th Urology Today conference was designed to keep urologists, urologic oncologists, and other healthcare providers educated on the most pertinent issues in urology practices. Areas of focus included urologic oncology, men’s health and reconstruction, female urology, pediatric urology, kidney stones and related conditions, and methods of providing the best care amidst the required logistics of the business side of medicine.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Thomas F. Stringer, MD, FACS, is an associate professor and urologist in the Department of Urology at the University of Florida (UF) in Gainesville. He is also the president-elect of the American Urological Association (AUA) for 2026. His clinical interests include prostate cancer screening, benign prostate disease, erectile dysfunction, and urinary tract infections.
