In a recent publication featured in the American Urological Association’s (AUA) June 2024 Advocacy Focus Issue, Dr. Matthew Nielsen, Chair and Professor of UNC’s Department of Urology and a member of Lineberger Comprehensive Cancer Center, alongside Dr. Logan Galansky (Johns Hopkins Brady Urological Institute), has shed light on the pressing issue of patient access in the field of urology, and outlined innovative strategies to address this challenge.
The article emphasizes the critical need to expand the urologic workforce to meet the increasing demand for urologic care, driven by an aging population and the high average age of practicing urologists. Projections from the Association of American Medical Colleges indicate a potential shortage of up to 100,000 physicians by 2034, with a significant portion being specialty physicians, including urologists.
Key legislative efforts proposed include loan repayment programs to incentivize practice in rural areas, increasing Medicare-funded graduate medical education slots, and waivers for international medical graduates. These measures aim to ease the supply-and-demand burden and enhance access to quality care.
Furthermore, acknowledging the longer time horizon of initiatives described above, Dr. Nielsen and Dr. Galansky highlight the importance of interdisciplinary collaboration between urologists and primary care providers (PCPs) as a key, immediately actionable strategy to address access challenges. By working together, these healthcare professionals can ensure optimal management of the many prevalent conditions in urology, ultimately improving patient outcomes and mitigating workforce shortages.
The article underscores the necessity for pragmatic health policy solutions and clinical guidance that reflect the realities of both urologic and primary care practices. Recognizing the substantial burdens already facing PCPs, the authors discuss empowering PCPs through educational materials, clear communication, and innovative approaches like e-Consults as measures to bridge the gap between clinical guidelines and quality care.
“At UNC Urology, we are grateful to contribute to a variety of efforts in flight with UNC Health’s Forward Together 2030 Strategic Plan, including e-Consult and other innovative care models, to address the complex problem of access to specialty care, particularly among Americans in rural communities. In tandem with efforts nationally through the AUA, we are optimistic that promising solutions are on the near horizon.”
Matthew Nielsen, MD, MS, FACS
Professor and Chair of Urology
