The entire United States is experiencing a shortage of Urologists. There should be approximately 17,000 Urologists based on our population. Currently there are less than 10,000 active Urologists in the United States and over the next two years that number will decrease to 8,000 due to retirement. In order to address this shortage and continue to give you and our community the best possible urologic access and care in Southwest Ohio, we have developed collaborative health care provider teams in Urology. These collaborating teams will consist of our physicians and our specialty trained nurse practitioners to provide ongoing care for you.
Our collaborating teams of Physicians and Nurse Practitioners are listed below:
- Dr. David Key and Heather Shoup, CNP
- Dr. Mark Monsour and Rachel Perretta, CNP
- Dr. Blake Anderson and Kelsey Patterson, CNP
- Dr. Michael Yu and Bonnie Loesch, CNP
- Dr. Erik Weise and a soon to be announced Nurse Practitioner
We are excited to offer you this innovative model of Urology Collaborative Care and we look forward to seeing you in the office. As we transition to this new model, you may receive a phone call to change your appointment. We apologize for any inconvenience as we work hard to accommodate as many patients’ needs as possible to provide the best care and access.
For appointments at Dayton Physicians Urology, please contact our call center at (937) 293-1622.
We appreciate the opportunity to care for you.
Dayton Physicians Urology Team
Dr. Satheesh Kathula was a representative at a Capitol Hill meeting organized American Association of Physicians from Indian Origin. He met with several US congressmen including Rep. Phil Roe of Tennessee, Rep Joe Wilson of South Carolin, Rp. Ami Bera of California and discussed with them on the following health care issues mainly affecting community oncology care:
- The consequences of pharmacy benefits managers (PBMs) on community oncology care, which are not only more expensive, but have delays in mailing life saving drugs.
- Lowering the Cost of Prescription Drugs: The exorbitant cost of prescription drugs is a critical health care issue, as some life-saving drugs are too expensive for many patients.
- How hospitals get preferential reimbursement over independent practices (340B) which is driving the healthcare cost up.
In mid-April was the Ohio Urologic Society Annual Meeting in Columbus. At this meeting, Dayton Physicians Network’s Blake Anderson, MD took part of a panel about Management of Complex Stone Disease. The moderator for the discussion was Sri Sivalingam and other panelists were Mantu Gupta, MD, Smita De, MD, PhD, Michael Sourial, MD.
Dr. Anderson said “I really enjoyed being on the moderator panel for management of complex stone disease.” In the discussion several cases were presented and the panelists all weighed in on different approaches. One case discussed was, how to treat 10 cm of bladder stones in a man with BPH (enlarged prostate). Also discussed, was a case of a septic woman with recent chemotherapy for breast cancer with bilateral obstructing stones.
All the Panelists noted that there were multiple options for treatment but many factors had to be considered. Below is Dr. Anderson take on the discussion, treatment options, and considerable factors.
“How to treat 10 cm of bladder stones in a man with BPH (enlarged prostate. Options are: shockpulse and laser lithotripsy, then holmium laser enucleation of the prostate.
For the bladder stone cases in general, I am in favor a of combination approach to obstructive prostate tissue under the same anesthetic when feasible as bladder stones typically only form in the setting of obstruction. KUB should be done or can check scout film of CT if that has already been done to see if bladder stones are visible, if not may contain uric acid and preoperative medical therapy with potassium citrate could significantly decrease stone burden.
Kidney stone cases were numerous, incomplete left duplex kidney with large upper pole stone burden, difficult renal access and discussed special techniques to do this and accomplish PCNL.
Another case was of a septic woman with recent chemotherapy for breast cancer with bilateral obstructing stones, discussed ureteral stents or bilateral nephrostomy tubes as options, each with own advantages but both effective in prior studies. This decision involves a lot of patient specific variables, stone size, stone location, anticoagulation status and other anatomic considerations. In patients with low urine pH and low stone Hounsfield units on CT, especially in setting of recent chemotherapy, suspicion for uric acid stones should be high and stone dissolution therapy should be considered (medication, potassium citrate, raises urine pH and can dissolve uric acid stones).”
As an oncologist of 15 years, my work has been transforming. I have been a part of many cancer journeys, the fright and the fight, the hurt and the healing, the stress of finances and the journey of hope. I often succeed in the fight for my patients, but sadly even in this era of modern medicine and advanced research, I have to idly stand by and watch a few succumb.
I have humbly accepted the nomination to be a candidate for The Leukemia & Lymphoma Society’s (LLS) Man & Woman of the Year, 2019 fundraising campaign. The generous funding of LLS to my own patients has enabled them to receive the latest treatments without the stress of losing their homes. A young patient of mine is now undergoing CAR-T-cell immunotherapy, and due to the innovative therapies of LLS research, will survive in spite of recurrent aggressive Non-Hodgkin’s lymphoma. Since 2000, over 40% of all U.S. Food & Drug Administration (FDA) approved cancer drugs were for blood cancer, some even used to treat other forms of cancer and non-malignant diseases. A “win” for blood cancers, therefore, is a win for the cancer community overall. I run this campaign along with my patients Cynthia, Betty, Jeff, Ken, Chalonda, John, Edward, Tatyana, Bobbie, Toni, Jowana, Minnie, Patricia, Essie, Joan & many more; I run in honor of Tim, Anita & Donna.
I dream to erase the connotation of death from the word cancer one day. Every dollar raised in this campaign funds the work of LLS. Cancer research has come a long way. In the 60s, a blood cancer patient’s survival rate was 3%; today, it is 90%. Although 90% is remarkable, someday that 10% must be accounted for. With your support we are well on our way to making that someday today.
Please join the team and help us to cure every cancer patient. Donations can be made starting on February 28, 2019 through May 11, 2019 via credit card at https://pages.mwoy.org/soh/dayton19/jkoduri
or by mailing a check made out to LLS with Team Koduri in the memo and send it to 1029 Whispering Pine Lane, Dayton Oh 45458. Click here to know the impact of your donations. Thank you in advance for helping save lives through your generosity.
Jhansi Koduri, MD
Associate Professor, Wright State University
We are sorry to announce that the ability to send us messages through See Your Chart, has been temporarily turned off. We will update this post when it is turned back on. If you are having login troubles, please click on FORGOT YOUR USERNAME OR PASSWORD.
A local health care company is investing $22 million in facility upgrades and new equipment, including “game-changing” technology that could help save lives.
Dayton Physicians Network, a multi-specialty medical group that provides cancer treatment and urological services, is expanding one of its facilities and renovating two others to make room for new radiation equipment. The expansions also will lead to new hires, with up to 30 employees added in the next year as a result of the project. The group currently employs 400 people at its Dayton-area facilities.
The upcoming expansion also could provide work for area builders and suppliers.
The physician network recently purchased imaging machines and linear accelerators, which can be used as radiation treatments for patients with cancer. The equipment will touch nearly every facility the network operates — seven locations from Greenville to Middletown — but the bulk of investment will occur at the Greater Dayton Cancer Center in Kettering, Atrium Medical Center in Middletown and Upper Valley Medical Center in Troy.
The equipment purchase was a joint venture with Dayton Physicians and Dayton-based Premier Health. The physician network leases space from Premier in a few of its hospitals, including Atrium and Upper Valley, but it is an independent group.
Dr. Gregory Rasp, medical director and radiation oncologist at DPN, said the new equipment will turn “good treatment into great treatment.”
“It’s going to allow for more accurate treatment, and more accurate treatment means better cure rates and lower complication rates,” Rasp said. “Basically, it will help us diagnose cancers better and treat them better.”
The imaging component will include new software called Smart Metal Artifact Reduction, which eliminates what medical professionals call “streaking.” Streaking is common in patients with fillings, artificial hips or other procedures involving the insertion of metal, which makes it difficult to visualize where a tumor starts and stops.
In addition, the equipment will allow physicians to more accurately position patients for treatment. This will cut down on errors that can occur if a patient moves during treatment, and helps doctors pinpoint the exact area needed for radiation therapy.
“With the newer equipment, the computer automatically adjusts for those shifts and rotations, and puts us right on the money with treatment,” Rasp said. “It’s kind of a game-changer because it allows us to treat a smaller area. Small areas mean less complications.”
The hope is enhanced treatment will decrease side effects and increase cure rates by 3 percent to 4 percent. Rasp said even if cure rates improve by just a few percentage points, it will save lives.
“Even if the cure rate stays the same, which we don’t anticipate, we can reduce the number of people having complications from the radiation,” he said. “It’s going to make it a lot easier on them and their families.”
The new equipment is expected to be installed in the first and second quarter of 2019, but before it is up-and-running, DPN must make some upgrades to its facilities.
At the Greater Dayton Cancer Center in Kettering, a new addition will be constructed onto the existing facility, and “significant remodeling” will occur at Upper Valley and Atrium, Rasp said. Wayne Cancer Center in Greenville also will be remodeled, though he said it will be less significant.
Each facility is likely to see an increase of 900 to 1,000 square feet, which include seven-foot-thick concrete walls needed to shield the radiation. Most of these walls are already constructed, though another “vault,” as Rasp described it, may need to be added at the Kettering center.
DPN has contracted with Dayton-based Sharp Conway Architects to design the project. Once the drawings are finalized, construction bids will be released. Rasp said the hope is one construction company will work on each facility.
Construction on each location will be staggered, and the first facility is expected to be completed in four to six months. Rasp said they’ll likely start in Middletown.
The facility upgrades and new equipment add to millions of dollars in investment DPN has been making in the last few years. Rasp said they’ve reinvested $18 million in the practice since 2012, and the latest project will bring them up to $40 million over a six-and-a-half year period.
“In a lot of groups, that money would just funnel to shareholders,” he said. “But we’ve always known that we need to reinvest it to be at the cutting edge of things, and in turn the practice grows. The other thing is we always put patients first over profits. I know that sounds like something every doctor says, but we’ve always had this belief that we need to have the highest quality standards for our patients.”
Urologist Michael Yu of Dayton Physicians Urology Answers Questions about Symptoms and Discusses
a Minimally Invasive Breakthrough Treatment Option
What Are the Symptoms of Enlarged Prostate and When Should Men See a Urologist?
Over 70% of men in their 60s have symptoms of enlarged prostate1. This can cause loss of productivity, interrupted sleep and, in some cases, can cause depression.2
Common symptoms include:
- Frequent need to urinate both day and night
- Weak or slow urinary stream
- A sense that you cannot completely empty your bladder
- Difficulty or delay in starting urination
- Urgent feeling of needing to urinate
- A urinary stream that stops and starts
Enlarged prostate can wreak havoc on a man’s quality of life, so it’s important to see a physician if these problems persist.
What Treatment Options Do You Recommend to Your Patients?
Treatment options for enlarged prostate range from medications to surgery, with minimally invasive options in between.
Medications can be helpful in relieving symptoms for some men, but patients must continue taking them long-term to maintain the effects. Some patients may suffer side effects including dizziness, headaches, or sexual dysfunction. And some may not get adequate relief of their symptoms.
Surgical options, such as transurethral resection of the prostate (TURP) or photovaporization of the prostate (PVP), are very effective. However, these typically require general anesthesia, overnight hospitalization, and post-operative catheterization. Surgery can also increase the risk of erectile dysfunction or loss of ejaculation.
Can You Describe What Minimally Invasive Treatments are Available?
I’m very excited to offer my patients a revolutionary treatment option called the UroLift® System treatment. The UroLift System treatment is a breakthrough, minimally invasive option to treat enlarged prostate. It does not require any cutting, heating, or removal of prostate tissue.
Here’s how it works: a urologist uses the UroLift System device to lift and move the enlarged prostate tissue out of the way so it no longer blocks the urethra (the passageway that urine flows through). Tiny implants are placed to hold the tissue in place, like tiebacks on a window curtain, leaving an unobstructed pathway for urine to flow normally again.
What are the Benefits of the UroLift® System?
I perform the UroLift System treatment in the hospital, which patients like. The treatment typically takes under an hour, preserves sexual function, doesn’t require cutting, heating or removal of tissue. Compared to other BPH surgeries, the UroLift System treatment has a strong safety profile with minimal side effects.3
Most common side effects are mild to moderate and include pain or burning with urination, blood in the urine, pelvic pain, urgent need to urinate and/or the inability to control the urge. Most symptoms resolved within two to four weeks after the procedure.
1. Berry, et al., J Urol 1984
2. Speakman et al., 2014 BJUI International
3. Roehrborn, et al., J Urology 2013
Congratulations to The University of Texas MD Anderson Cancer Center in Houston for being ranked America’s best cancer hospital for 2018, according to the annual rankings from US News and World Report.
We are affiliated with MD Anderson as our doctors are participating in MD Anderson Cancer Network®, a program of MD Anderson Cancer Center at Premier Health.
B.S. Washington and Lee University 2007, magna cum laude
M.D. Virginia Commonwealth University, Medical College of Virginia 2011
General Surgery Internship: The University of Chicago Medical Center 2011-2012
The University of Chicago Medical Center 2012-2017
IU Health Methodist Hospital, IU School of Medicine: 2017-2018
- Board Eligible Urology
- Benign prostatic hyperplasia (BPH)
- Stone disease
- Minimally invasive surgery for prostate and kidney cancer
- American Urological Association,
- Endourological Society
- American Medical Association
Currently seeing patients at the following locations:
- Miami Valley Hospital South
Dr. Anderson was born in Cincinnati, OH but spent his childhood in Virginia where he became an Eagle Scout prior to graduating from medical school. Dr. Anderson has various research publications in peer-reviewed journals and has presented numerous times at the American Urological Association (AUA) Annual Meeting, with award winning abstracts including a plenary. Dr. Anderson and his wife, who grew up in the Loveland/Milford area, are excited to return home to Ohio and raise their daughter in the Miami Valley community.
Did you know there was a shortage of urologists in the United States? The American Urological Association recognizes that there is a growing national shortage. This deficit is compounded by an aging U.S. population that will require more urologic care. The 65 and older population will comprise 17% of our population by 2020.
The projected number of urologists needed to meet the population needs in 2020 is 16,000. The number of practicing urologist in 2016 was 10,954. Over 50% of the urologists are currently over the age of 52. The projected number of practicing urologists will decrease to 7500 by 2020.
Compounding the workforce shortages are the challenges facing urology graduate medical education. There are currently 295 residency spots per year. The Balanced Budget Act of 1997 capped Medicare residency funding which means that money is one of the limiting factors affecting addition of any new residency spots. This issue applies to all surgical specialties.
Our mission at Dayton Physicians Network Urology is to provide you with the highest quality personalized urologic care in southwest Ohio. We currently see patients from 11 surrounding counties with a population of 1,762,366 people. We are fortunate to have 7 urologists and 5 specialized trained urology advanced practice providers to carry out our mission.
The manpower shortage does create some issues with wait times. Over 50% of our patients have complex medical problems or cancer and there is no way to predict a patient’s needs when they schedule an appointment. This means that not everyone fits into a 15-minute slot. We appreciate your patience and understanding as we try to care for our community’s urologic needs.
If you have any questions please ask for our Operations Manager. We wish all of you the best of health!