2024

Physician Coaching and Embracing QI

Ryan P. Terlecki, MD, FACS, presents a model for quality improvement for healthcare providers, drawing from professional sports coaching. He begins by articulating the professional parallels between physicians and quarterbacks, noting that the best performers in each field have strong professional support networks and constant performance evaluation.

Dr. Terlecki then discusses how quality improvement measures used in professional sports apply to medical practice. He supports his points by presenting data from studies where “playbacks” of urologic surgeries were used to effectively improve surgeon performance.

Dr. Terlecki concludes by emphasizing the benefits of being open to feedback and making efforts to improve for both healthcare professionals and patients. He encourages healthcare professionals to be open to both giving and receiving coaching in their practices, and provides actionable advice for implementing these quality improvement measures.

Dr. Terlecki provides guidance on tailoring patient intake questionnaires to keep the focus on the patient’s issue and possible approaches. He gives examples of open and closed questions for male genital pain.

Dr. Terlecki then discusses the importance of setting patient expectations regarding diagnoses and what they should expect from the provider, particularly when the provider does not specialize in pain management. He then discusses common, uncommon, and overlooked causes of male genital pain.

Dr. Terlecki concludes by walking through this algorithm from intake to assessment to diagnosis and treatment. He emphasizes the importance of not dismissing patient input on treatment, but still strictly adhere to evidence-based treatment over unproven or alternative treatments.

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In-office Therapies for Men with Erectile Dysfunction

Jesse N. Mills, MD, discusses the effectiveness of a selection of experimental in-office therapies for erectile dysfunction treatment. Throughout his presentation, Dr. Mills explores the outlook, benefits, and challenges of experimental therapy options currently pushed by external market forces, including:

Low-intensity Shockwave Therapy (LiSWT)
Platelet-Rich Plasma (PRP)
Stem Cell Therapy
Intracavernosal Injection (ICI)
Hyperbaric Oxygen

Dr. Mills concludes by stressing that although these therapy options are still considered experimental, urologists should strive to observe these therapies and hold balanced conversations with patients regarding their efficacy. He encourages urologists to stay optimistic about erectile dysfunction treatment as stewards of male health, suggesting they watch for new data in the world of experimental treatments.

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Biomarkers Made Simple

Peter A. Pinto, MD, presents an overview of the roles of biomarkers in prostate cancer diagnosis and screening. In his presentation, Dr. Pinto covers:

Biomarkers Categorization
Tissue-Based Biomarkers
Emerging Urine-Based Biomarkers
Biomarker Detection
Challenges and Opportunities in Biomarker Research

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Metastatic Prostate Cancer: Can Urologists Work Alongside Medical Oncologists in Advanced Disease?

A. Edward Yen, MD, discusses the importance of collaborating with medical oncologists when using hormone-directed therapy to treat metastatic prostate cancer. He begins by illustrating changes in treatment approach, using a case study to contrast past treatment algorithms with modern treatment approaches.

Dr. Yen presents a treatment algorithm from the early 2000s, calling attention to the isolation of “urologist” versus “oncologist” options in patient treatment and the impact of those isolated treatment approaches on overall survival. Dr. Yen contrasts this approach with modern agents and therapies which require collaboration between urologists, medical oncologists, and other medical disciplines.

Dr. Yen then addresses practical challenges associated with increased multidisciplinary collaboration, including keeping up with rapid advancements, managing treatment toxicities, and sequencing and selecting treatment.

Dr. Yen concludes by presenting a model of collaboration used by his practice which integrates urology, medical oncology, radiation oncology, nuclear medicine, pathology, interventional radiology, palliative/supportive care, genetics, nutrition and dietetics, psychology, and social work in treatment. He notes that the involvement of these specialties in the treatment of advanced prostate cancer leads to comprehensive evaluations, tailored treatment plans, and better outcomes for patients.

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In-Office Management of Female SUI: Optimizing Productivity

Robert J. Evans, MD, FACS, presents guidance on how practice leaders can optimize in-office management of female stress urinary incontinence. He begins with a review of pre-visit intakes, and best-practices for gathering pertinent information in the office intake form.

Dr. Evans then turns to appropriate delegation of tasks within the practice, noting that APPs can evaluate patients in-office and initiate some treatments for female stress urinary incontinence. Additionally, the patient’s gynecologist can provide additional insight into treating female stress urinary incontinence.

Dr. Evans concludes by reviewing best practices for in-office procedures, and reiterates the importance of delegating tasks appropriately. APPs are a practice’s greatest resource for optimizing patient treatment in-office.

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