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Urology Practice Management - April 2016, Vol 5, No 2

Never before has the concept of efficiency been more important than in 2016 and beyond. Urologists are experiencing a decrease in reimbursement and rising overhead costs, resulting in a potential contracture of their incomes. It does not matter the kind of practice you are in, its size, the location of your practice, or if you are in private practice or are an employed doctor—you will need to place an emphasis on how efficient you are in your practice.
Treatment with tadalafil can significantly improve the symptoms of erectile dysfunction (ED) as well as lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH), according to a new analysis (Roehrborn C, et al. BJU Int. 2016 Jan 13. Epub ahead of print). Tadalafil is indicated for the treatment of patients with ED or BPH and for those with the 2 conditions combined.
Patients with previously treated metastatic urothelial bladder cancer had response rates that exceeded historical standards when treated with an investigational immunotherapeutic agent, updated results of a large phase 2 clinical trial showed. Treatment with the PD-1 ligand 1 (PD-L1) inhibitor atezolizumab led to an overall response rate of 15% in 311 patients, including a 26% rate among patients who had the highest levels of PD-L1 expression. Historical data have demon­strated response rates of about 10% for second-line therapy and beyond.
Although it may have taken 17 years to repeal the sustainable growth rate formula, according to Lemeneh Tefera, MD, MSc, Medical Officer at the Center for Clinical Standards and Quality in the Centers for Medicare & Medicaid Services (CMS), it was, surprisingly, a bipartisan bill.
It is a new year. That means you have another chance to start over again, to take a fresh look at your finances, and to get on track for the future. So, where should you begin?
Contemporary treatment has led to improvements in survival for all patients with metastatic testicular germ-cell tumors (GCTs), including poor-risk patients, although they still have worse survival. A new study shows that if poor-risk patients receive curative therapy and survive for at least 2 years, their survival approaches that of favorable-risk and intermediate-risk patients. The study supports no further routine scanning 2 years after diagnosis in surviving patients.
Experience at a high-volume cancer center suggests that nonstereotactic body radiotherapy external beam reirradiation of the pelvis for cancer recurrence or for a second genitourinary malignancy is safe in patients with advanced cancer, and can achieve excellent and durable palliation of symptoms without severe radiation-induced morbidity.
TO THE EDITOR: I am writing in response to the article, “African-Americans Still Underrepresented in Urology,” by Ruth Cannon (December 2015). I have to take exception to this article. It is as though the author is advocating for some type of quota system.

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