© Springer International Publishing Switzerland 2015David A. Schulsinger (ed.)Kidney Stone Disease10.1007/978-3-319-12105-5_17
17. Who, What, Where and When to Treat!
Department of Urology, Stony Brook Medicine, Stony Brook, NY, USA
David A. Schulsinger
Who Should Be My Urologist? Pick Your Doc to Break Your Rock!
Just as all stones are not created equally, not all Urologists are trained the same! One should know that in 2013 there were 29,171 first-year residency positions offered to graduating medical students  and that there are only 239 urology resident spots each year. This number accounts for only 0.82 % of graduating medical students who go on to do a urology residency. With the few number of urology residencies, typically in university programs, urologists are generally well trained. They are trained to do general urology after completing 1–2 years of general surgery and 3–4 years of urology residency. If a graduating urology resident wants to pursue further training in a particular subspecialty of urology, then they would pursue a fellowship. The fellowship for stone disease is an Endourology fellowship. In summary, a Urologist who has been training longer will generally have greater experience.
You will see that there are some very important steps that you are going to need to follow when it comes to choosing the best urologist. Taking the time, if time allows for it, to choose the best urologist will be critical for your long term well-being.
In order to find the best doctor you are going to need to start by making a list of all of the different qualities you want in a doctor. You can also make a list of questions that you can ask the doctor to help you find out who is going to be the best. Some of the most important questions that you are going to want to ask will be related to how long the doctor can spend with you when you are in their office, if you can contact them by email if you need to, as well as how long you must wait to see them for an appointment. All of these answers will help you determine who is going to be the best doctor for you.
You may have your stone diagnosed in the ER, by your PMD or nephrologist and now it is time to choose your urologist. You want to feel confident in your decision as choosing a urologist will be critical in making the right decision on treating your stone, getting you stone free and keeping you stone free.
Unlike the circumstances of choosing your primary care physician, choosing a urologist is not always an elective situation. Circumstances prevail that in an emergency situation, you may only get to see the urologist on call for treating an obstructing stone. If a stent is placed or a nephrostomy tube inserted, then you have an elective period for which to choose your ideal urologist for the definitive procedure.
Finally, you will always want to write down notes about the doctor and the office when you are finished meeting with them. Keeping a diary is a great way to remember which experiences were positive and which ones may have been less than positive.
One of the most important things that you are going to want to look for when you carry out a doctor search will be the type of insurance that the doctor will accept. This is important because you are going to see that your visit may not be covered, if the doctor does nor participate with your insurance company. In this situation, you will likely be faced with paying for your visit out of your own pocket. Other times the doctor may not accept you as a patient if you do not have a certain type of insurance.
Consider next, the amount of time that you might find yourself waiting on the doctor when you go in for the visits. There are some doctors that will make you wait in the waiting room for an extended length of time. Most of the searches that you are do are going to give you reviews that will also mention the average waiting time that you can expect when you go to the office.
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How to Pick Your Urologist?
Questions you should ask:
Where is the urologist located? Is his office accessible?
Which hospital is the urologist associated with? Are you comfortable with the possibility that this facility may be the location of your future surgery?
Is there a significant period of time for you to get an appointment with your urologist? If you are having pain, waiting any period of time may not be acceptable.
Is the office conscientious of your needs?