Q&A with LUGPA Forward: Advice for Urology Residents

Ahead of the 2024 Urology Resident Summit & Job Fair, LUGPA connected with Kari Bailey, MD, urologist and leader of the women’s health department at AAUrology in Annapolis, MD, and David Morris, MD, president of Urology Associated in Nashville, TN. Dr. Bailey is chair of the LUGPA Forward Committee and Dr. Morris is one of the most recently elected LUGPA Board members. These two young physician leaders are the co-chairs of LUGPA Forward, a group for early-career physicians within LUGPA member practices that provides education and networking opportunities. We sat down with them to discuss their advice for urology residents  -  including what to consider when choosing a practice and why to consider independent practice.

Can you briefly describe your early professional journey, including your time as a resident?  

Dr. Bailey: I completed my residency at Lahey Clinic in Massachusetts. It was a six-year program, which was a unique experience because we could take a full year for research during the middle of our residency. It was helpful for me to have that experience because it made me realize that academia was not the path I wanted to take as a urologist.  

Dr. Morris: In terms of my path, I completed my residency at the University of Michigan. By contrast, I was academically inclined. I considered pursuing an oncology fellowship, but I also wanted to establish my career. I knew that academic jobs would mean a higher chance of frequently moving to different centers. I was encouraged to consider large independent groups that offer some specialization and opportunities for research within general urology practice.

When did you decide to join an independent group practice and why?

Dr. Bailey: I did not want to pursue a fellowship or research, so I considered joining a hospital-based group or an independent practice. After looking into my options, I found that an independent practice was a better fit. One of the major factors for me was work-life balance, which I felt my practice really valued and supported. As a new mother at the time, the structure of call at my practice was more flexible to my schedule so that I could have time with my family. Right now, I have a four-day work week, and our compensation model supports that.

What advice would you give to a urology resident who is considering whether to join an independent practice?

Dr. Morris: If you value your independence within work decisions, work-life balance and limiting moving between locations, independent practices, like LUGPA groups, are an excellent choice for you. Groups also allow you to tailor your job to your clinical interest, while also playing an important role in caring for your patients and community.

What are the pros of working for an independent practice versus a large health system?

Dr. Bailey: An important benefit of working in an independent practice is that you have more autonomy over your work. There are also fewer barriers when implementing new initiatives. I was able to start our women’s health arm of AAUrology without having to go through a hospital board or several levels of leadership.

There is often more transparency in an independent practice as well. As an early career urologist, I was privy to much of what was going on in my practice, and that was really helpful for my professional growth. My practice also made it clear that my opinions were valued and that I was respected as a member of the team.

What are the cons of working for an independent practice versus a large health system?

Dr. Morris: Business management is an important part of running an independent practice. Unfortunately, regulatory and policy decisions like the recent cut to Medicare physician reimbursement have a heavier impact on independent practices than large hospitals and health systems. As independent urologists, it is important that we advocate for reforms to ensure our practices can thrive and that we can care for our patients to the best of our ability.

How does LUGPA support urology residents?

Dr. Bailey: LUGPA has amazing resources for you as a resident and a urologist just entering your practice. These can help you understand the wide range of independent practices, what you are looking for in a practice and how to find the best fit for you. LUGPA also provides trainings on topics that you may not have been taught in residency, like contract negotiations.

Also, no matter which practice you join within LUGPA, you have an incredible built-in network of urologists nationwide who you can use as mentors and lean on for support. LUGPA Forward, our group for early-career urologists, is a tight-knit cohort where you can share ideas and discuss solutions to the different challenges you may face.

What is something you think urology residents should know about LUGPA?

Dr. Morris: The group atmosphere of LUGPA groups often mirror that of residency programs. They are highly functional with multidisciplinary care, specialty focus and innovative adoption of technology. I have been part of multiple clinical trials without the headache that can often accompany research in academic centers. I still feel intellectual stimulation and comradery in a LUGPA practice.

What do you wish you could go back and tell yourself when you were a resident?

Dr. Bailey: When looking for a practice and making career decisions, think less about the first year and focus on long-term goals. For example, what do I want my practice to look like in five or ten years? Coming out of residency can be a very stressful time, and it is easy to get wrapped up in what is going on right now. Reach out to a wide range of groups and practices to understand how they differ. Take the time to understand what your priorities are, and make sure the group you choose has the resources you need to succeed in the long term. This will help guide you to make the best decisions for your individual career path, and I wish all residents the best of luck on their professional journey!