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Increased Volumes Equal Better Outcomes

A current review in the AUA Update Series, titled “Surgical Volumes and Patient Outcomes in Urologic Oncology” notes that “higher surgeon volume is associated with improved outcomes”.  The AUA Update Series, authored by experts in the field, provides a detailed review of the current medical literature, including reports from academic and scientific journals, with large series of patients.  This comprehensive review clearly identifies that, “For surgery, like most technical and cognitive skills, total experience determines ability,” and furthermore notes that multiple studies arrive at the same conclusion, that there are “lower complication rates among high volume providers”. 

Our group has recognized and embraced this concept for years.  As new technology has evolved, physicians with particular expertise in that area have performed these procedures for all the patients for the group.  As one of our doctors has described it, “We are like a baseball team.  We are all baseball players, but we each do a specific job for the team.”  Rather than have each of the doctors in the group do “a few of these and some of those”, we have specified which doctors will do certain procedures on a high volume basis, with the recognition that those high volumes translate to better outcomes for the patients. 

To provide an example of surgical volumes, the AUA Review notes that a study of urologists nationwide reveals that 80% of urologists conduct 10 or fewer radical prostatectomies’s (an operation for prostate cancer) in a year.  By contrast, the surgeons in our group with particular expertise in radical prostatectomy perform that surgery two to four times per week.

We use the same approach for a variety of procedures, including pediatric procedures, female incontinence surgery, laparoscopic kidney surgery, surgical procedures for complex kidney stones, and laser intervention for the enlarged prostate.

Medicine in general and urology in particular, have now recognized that high volumes lead to better outcomes.  At The Urology Group, we have embraced this concept for years.  We continue to pursue the most current and up to date strategies in an ongoing effort to provide optimum patient care.