The Contemporary Ambulatory Urologic Practice

The vast majority of contemporary urologic practice is carried out in the ambulatory setting, including urologic surgery. From a financial perspective, much of the income of the average urologist arises from his/her office practice, and, indeed, the need for urologists, now and in the future, may be largely in the office setting. While the implications of this observation on future urologic training continue to be debated, there is no doubt that for current urologic trainees, more time should be invested in learning the management of urologic disease in the outpatient setting. At present, most urologic residencies are focused on the operating room, and most trainees primarily seek operative training.

Because time in the operating room is not well-reimbursed, and because it takes away time from the office, urologists have found ways to bring many of the simpler urologic surgical services back to the office or ambulatory setting, thereby improving efficiency and time management and providing more convenient care for the patient.

In this issue of the Urologic Clinics I have asked Dr Stephen Jones of the Cleveland Clinic Foundation to assemble up-to-date articles on the spectrum of contemporary ambulatory urologic practice. Not only is Dr Jones renowned as a urologic surgeon, but he has a wealth of experience in oversight of clinical practice, ambulatory care, and office efficiency. I have asked him to provide perspective, not only on the urologic issues surrounding disease management in the ambulatory setting but also on the practical issues of office efficiency, billing and coding, quality control, and safety. As urologists push the envelope of what can be done in the ambulatory setting, these aspects will be critical.

I am deeply indebted to Dr Jones and the outstanding authors he has invited to contribute to this issue. Each of the articles provides a very unique perspective that I feel will be incredibly informative to the reader. For those starting in practice, much of the content will not likely have been provided in training, and for those already experienced in ambulatory care, I am confident the pearls included will enhance their clinical practice in many ways.

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