Spring 2014 Newsletter

It was an honor for me to assume the Presidency of the Mid-Atlantic Section last October in my home state, West Virginia. As my predecessors have set the bar high for the position of President, I will be working hard during my tenure to make this year just as successful for the Section.

The Annual Meeting in West Virginia was a great success and I congratulate Drs. Lou Keeler and Kurt McCammon for their organization and facilitation of an outstanding program. For 2014, Dr. Jay Raman and I are working with the Program Committee on a program full of our traditional abstract sessions, point-counterpoint discussions, and a third consecutive year of resident/young urologist Jeopardy. New for this year’s program will be a video session on Friday and a ½ day extender program on the Saturday of the meeting. We are also planning for outstanding keynote addresses from Dr. Michael Droller at Mt. Sinai Hospital who will deliver the Paul Schellhammer Lecture in Urologic Oncology and Dr. Margaret Pearle from the University of Texas Southwestern who will give the annual Hugh Hampton Young Lecture.

Plans are also well underway for a memorable social program in Baltimore. Given that The Hilton Baltimore is a stone’s throw away from Camden Yards, we will be incorporating a “Take Me Out to the Ballgame” theme into Annual Meeting receptions and the exhibition program, and hope attendees will take advantage of some late summer baseball.

Over the years our Section has developed a rotation for Section Annual Meetings – we rotate between city venues, such as The Hilton Baltimore, and more resort locations, such as The Greenbrier or the Nemacolin Woodlands Resort. Baltimore is great city and has a lot to offer in terms of both night life, restaurants, and family-friendly activities, and I would like to take this opportunity to stress the importance of supporting the Section by staying at the Annual Meeting host hotel. Hotel reservations at The Hilton Baltimore are currently being accepted; please visit meeting.urologymanagement.org/maaua to book your accommodations.

Finally, I would like to remind the membership that we are quickly approaching the 75th anniversary of the Mid-Atlantic Section in 2017! The Board of Directors is working to identify an ideal venue to celebrate the Section’s 75th.

Thank you for the opportunity to serve as your President.

Stanley Zaslau, MD

Hello! I hope everyone survived this crazy winter in the Mid-Atlantic region! I would like to congratulate Dr. Lou Keeler on a successful Presidency last year; 2013 was a great year under his leadership. With his and Dr. Kurt McCammon’s planning, our annual regional meeting was a smashing success at the Greenbrier, with an excellent scientific program and energetic participation and attendance by our members.

As Section Secretary, I have the privilege to be very involved with the MAAUA’s business matters and educational initiatives in addition to serving as the Section liaison to the AUA Section Secretaries Committee. I am happy to report that the Section continues to maintain steady membership figures and our Annual Meetings continue to provide cutting edge, innovative content which supports increasing urologist participation each year. As we all know, these are challenging times in the healthcare field, and urology has its specific set of challenges. The Mid-Atlantic Section continues to stay on top of changes to the specialty of urology from a societal perspective.

With the healthcare, Obamacare, governmental regulation changes, etc. upon us and in the pipeline, this year was an important year to have Sectional representation at the AUA/AACU Urology Joint advocacy conference in Washington, DC. The leadership felt it even more important to ensure that the young urologists within our region be engaged and involved with the JAC. This year, in addition to many members of the Section who attended including Dr. Mark Edney, Section Representative to the AUA Health Policy Council, two trainees from the MAAUA – Dr. Jessica DeLong, a fellow at Eastern Virginia Medical School, and Dr. Timothy Ito, a fellow at Fox Chase Cancer Center – attended JAC2014. Drs. DeLong and Ito submitted outstanding essays about their interest in healthcare to receive funded trips from the Section. In 2013 the MAAUA funded one resident’s participation at the JAC; in 2015 the Board of Directors hopes to again fund participation of two residents or fellows.

Keeping with the thread of young urologist engagement, we know that with an aging population it is incredibly important to foster young urologists and their interest in our organization and the AUA. The Mid-Atlantic Section facilitated a new resident program at AUA headquarters in Linthicum, Maryland in March 2014 to do just this. This program brought together residents from around the region to present their work in a supportive, collegial forum, and included presentations with topics geared towards residents by established urologists.

Another important community in urology that deserves our attention is our Advanced Practice Nurse, Physician Assistant, and nursing colleagues. The Section, in general, has never devoted programming during its Annual Meeting to this community, but based on the membership’s response to a survey conducted in 2013 about the need to develop a ½ day program for our extender peers, the time to do so is now. Therefore, at the Annual Meeting in Baltimore, Maryland, Drs. Stanley Zaslau and Jay Raman, along with their Program Committee which this year includes Physician Assistant Courtney Anderson at Eastern Virginia Medical School, will be putting on a ½ day extender program on Saturday, September 20, 2014, focused on the APN, PA and urology nursing community. We hope for strong attendance and participation, so please promote this regional program to your office. Details will be available shortly at meeting.urologymanagement.org/maaua. In addition to our Sectional efforts, as the liaison to the AUA Section Secretaries Committee, I continue to keep the pulse of APN/PA/NP/nursing membership at the national level. Based on the national AUA’s actions and the success of the inaugural extender program at the Section Annual Meeting this year, the MAAUA may take additional steps to engage our colleagues.

Another important initiative undertaken by our Section has been the Paul Schellhammer Lecture in Urologic Oncology, initially endowed by the Dendreon Corporation. It is now in its 3rd year, with an excellent presentation by Dr. Ronald Hrebinko at the Greenbrier. As you see on your annual dues statement, we continue to solicit funds, with the hope to endow this lectureship in perpetuity. I thank the Dendreon Corporation and the individual donors, and I hope we can maintain the momentum in our Section to fully fund this important endeavor.

Finally, as the Mid-Atlantic Section as an organization needs to stay current in its operations, the membership will receive a series of By-Law amendments for approval in the summer of 2014. These changes will align our governance with actual day-to-day activity, specifically regarding membership and the Annual Meeting. Amendments will be circulated closer to the Annual Meeting in preparation for ratification at the Business Meeting in Baltimore.

I look forward to Dr. Zaslau’s Annual Meeting in Baltimore this coming September and hope to see many Section members there. I also want to remind everyone of the meeting in 2015, which will be a Joint Meeting with the New England Section in Paradise Island, Bahamas.

Thank you for the privilege to serve as your Section Secretary.

Edouard J. Trabulsi, MD

Total assets for the MA-AUA as of December 31, 2013, the Section’s fiscal year-end, were $1,093.071 and consisted of $150,022 in the checking account and $943,049 in the investments portfolio while taking into account $675 for 2014 prepaid dues, and a transfer from the 501(c)6 to the 501(c)3 in the amount of $45,000 to support operations of that second corporation. Total receipts were $104,333 and total expenses were $64,074 which, after consideration of a $135,696 gain in the investments portfolio, resulted in an operating surplus of $175,955 for the 501(c)6 at the close of 2013.I am pleased to report that 2013 was another strong financial year for the Section. As a reminder, the organization has two corporations financially; a 501(c)6 which is titled the Mid-Atlantic Section of the AUA (MA-AUA), and a 501(c)3 which is titled the MA-AUA Education Fund.

Total assets for the MA-AUA Education Fund 501(c)3 as of December 31st were $180,707 and consisted mostly of funds in the checking account, while taking into account the previously mentioned transfer of $45,000 from the 501(c)6 as a receivable. Total receipts were $428,450 and total expenses were $422,556 which resulted in an operating surplus of $5,894 for the 501(c)3 at the close of the Section’s fiscal year. Also within the 501(c)3 are restricted funds that have been collected to support the Schellhammer Lecture to date, and the Investment Committee will be looking into establishing a separate investment account for this in the coming weeks. As indicated in our regular dues notices, contributions to support this lecture in perpetuity are encouraged as are contributions toward the International Volunteers in Urology (IVUMed) traveling scholars from our Section.

As Dr. Zaslau mentioned in his Presidential message, our next meeting in Baltimore on September 18-21, 2014 is going to be another memorable one. Please visit the meeting’s webpage at https://urologymanagement.org/maaua/meeting/index.cfm regularly for registration details and hotel reservations for the Hilton Baltimore. Thank you all again and I look forward to seeing you at the Hilton Baltimore this coming September.

Michael D. Fabrizio, M.D

Report from the AUA Board of Directors 

Dear Colleagues:An executive summary from Dr. John Lynch, Section Representative to the AUA Board of Directors, outlines the AUA’s activities and initiatives as of February 2014, which include financial, Office of Education, guidelines, membership, policy, journal, and Urology Care Foundation highlights.

When a new procedure is added, or an older procedure has a mandatory review, our committee representatives must present a proposed RVU for that procedure to the RUC Executive Board. Their presentation is highly dependent on inquiries from our members. If you get an electronic request to fill out a RUC survey, and if you do the procedure in question on a regular basis, PLEASE answer the survey. It takes only 10-15 minutes. Your responses help us to present an accurate reflection of the pre/intra/post operative service time and effort that it takes to complete that procedure. Please answer this survey as accurately as you can. LARGE membership responses and HONEST reporting of the time and effort involved in the procedure will add credibility to the our presentation. Ultimately, the outcome of this process is the final RVU assigned to a procedure. Quite obviously, this affects how you will be paid. Bottom line – do the RUC surveys when asked, and do them carefully and thoughtfully. To the credit of our CRC members, we are well regarded by the RUC and we are working hard for the benefit of all of you.

Roger E. Schultz, MD – Vice Cahirman and Mid-Atlantic Section Representative

Jessica DeLong, MD
Fellow, Eastern Virginia Medical School

It was truly a privilege to attend this year’s JAC as a young urologist through a generous grant awarded by the Mid-Atlantic Section of the AUA. When I hoped to attend the conference, I had several key goals: to gain a basic understanding the legislative process, to learn from the experts, and to meet other physicians who shared a similar interest. My experience far exceeded my expectations.

Upon arriving on Sunday we heard several interesting presentations and I can finally say that I understand more than 10% of the Affordable Care Act. Experts from various fields including a former presidential advisor gave us their take on healthcare reform, helping me to see new legislation from a different perspective. I think these talks were particularly valuable as they followed the State of Urology Address given by several leaders in our field.

As Monday dawned early I quickly lost myself in acronyms – an alphabet soup composed of IPAB, PQRS, CBO, USPSTF and the dreaded SGR. By the end of the day, each letter combination meant something and I felt I had a reasonable handle on active issues. Some of the data presented amazed me – though I realized there was and would be a worsening shortage of urologists, I had no idea the gravity of the situation. Those statistics, combined with the frightening numbers associated with GME, became a main talking point for me during our meetings on Capitol Hill the following day.

After attending this conference I have a renewed interest in the process of health care policy. I believe, even more so now, that these policies have a profound effect on us as physicians. Visiting the House and Senate was a great opportunity to share the issues most relevant to us with our representatives.

Since attending this conference, the issues we discussed most have already come up several times. I found that it was a pleasure to be well-informed and to not only talk about relevant issues intelligently, but to help inform my colleagues and spark their interest as well. Thank you for this opportunity and for the chance to participate in such a great event.

Timothy Ito, MD
Fellow, Fox Chase Cancer Center

I consider myself as good a citizen as training will allow – I vote when I can get time away to do so, and I try to keep up with political topics that interest me. As a “Gen X”-er backed with a Hawaiian upbringing and a liberal education, my political interests have lied primarily in social justice. Coming closer to the end of fellowship has made me appreciate the need to explore issues of immediate relevance to my future career. Attending the JAC was the perfect opportunity not only to educate myself but also to take part in advocacy.

The meeting was well-timed as the deadline for passage of a permanent fix to the SGR formula was quickly approaching. With a vote in the House looming in the coming days, the atmosphere was electric. Discussion around the various “asks” of the urologic community focused on this as well as three other topics: preserving the in-office ancillary services exception; addressing the potential significant shortage of physicians in the future, particularly within subspecialties like urology, by increasing the number of GME residency slots available; and increasing transparency and accountability with regards to the USPSTF. The room was filled with urologists dedicated to advocacy and it was interesting to hear stories of how many of them first became involved. From first-timers curious about the process, like myself, to life-long DC-ers familiar with the ins and outs of Capitol Hill, each brought a different energy and passion that was inspiring. Many of the attendees voiced the lack of enthusiasm for political action within their own practices however. One speaker highlighted how many more of the urology community could be involved, as only 18% of urologists contributed in the last year to UROPAC, the voice for urology on the Hill.

The last day of the conference was a unique opportunity to observe and immediately take a hand in the advocacy process. As an advocacy neophyte, the trip to the Hill was thrilling and eye-opening. Shuffling through the halls of the House and Senate office buildings, it was difficult not to be filled with a swelling sense of patriotism. The receptiveness of the staff of the Representatives helped to shatter my impression of the aloofness and inaccessibility of government, and it further underscored the need to promote pro-activity within the urology community. In many ways politicians are very similar to physicians—they listen to the maladies of their constituents and work to find ways to ameliorate their concerns. They are not able to address issues they are not aware of however, and thus it is incumbent on us to ensure that the Representatives hear our viewpoints. Of all the lessons learned during the conference, this is the one that will resonate most with me. I am grateful to the MAAUA for the opportunity to attend the JAC. I intend to carry everything I have learned with me into my future career.

Jack Lambert, MD
Eastern Virgina Medical School
Mentor: Kurt McCammon, MD
Sponsored by: Mid-Atlantic Section

Through the sponsorship provided by the Mid-Atlantic Section of the AUA, Dr. Jack Lambert traveled to Dakar, Senegal with mentor, Dr. Kurt McCammon, to conduct a reconstructive urology workshop.

Reporting on his experience, Dr. Lambert stated:

“We ate our ritual hotel breakfast – chocolate croissants, slices and ham and swiss and bread. We would quickly change into our scrubs after a cup of coffee and head to the ORs. We reviewed the films for the day and Dr. Gueye would give us the case line-up and then we plunged in. This was the tone for the rest of the week, and as the week progressed I felt like we more quickly became integrated into their hospital and there became more of an exchange of surgical technique between the American and Senegalese doctors. We did approximately 20 cases over the week and some of which we would rarely do in the United States.”

“Although it would have been nice to bring our own instrumentation to the OR, I think being in the environment in which you are forced to simply “make do” is important. We may not always have access to the best instruments or technology and it’s important for surgeons to experience operating in a resource-limited country. It gave me a new appreciation for our country and the simple things we take for granted.

“We had numerous exchanges which provided a pleasant camaraderie between our group and the doctors from Senegal. Also, on our final work day in Dakar, myself, Dr. Brown and Dr. McCammon each gave a lecture for the Senegalese staff and residents on several urology topics in a seminar they organized for us to exchange ideas and understand how we might manage certain urologic diseases differently. This didactic session was very insightful and was a great way to the end our week with our wonderful hosts.”

Each year the Mid-Atlantic Section sponsors the IVUmed experience of a urology resident. The many Section members and urology residents who have participated in the IVUmed experience have found it extremely valuable and enriching to their careers. With support from the MAAUA membership, the Section will be able to fund the experience of more urology residents. Contributions to the MAAUA IVUmed Resident Fund are tax-deductible. If you are interested in making a contribution to the Section to support additional IVUmed experiences, email info@maaua.org.

2014 Residents Bowl Team 2014 Chief Residents Debate Team
Ahmed Aboumohamed, MD, Egypt
Kellen Choi, MD, Charleston Area Medical Center
Steven Kheyfets, MD, Geisinger Medical Center
Syed Kirin, MD, Rowan University
Lang Nguyen, MD, George Washington University
Matthew Steele, MD, Charlottesville, VA
Jared Bieniek, MD, Geisinger Medical Center
Zachary Smith, MD, University of Pennsylvania

With 272 registrants, over 45 exhibiting companies and sponsors, a sound educational program and a wonderful social program at The Greenbrier, the 2013 Annual Meeting was a great success. Below are some highlights from the meeting.

2013 Resident Prize Essay Competition Winners
1st Place: Justin Gyorfi, MD for his work “Peri-Procedural Povidone Iodine Rectal Preparation Reduces Infectious Complications Following Ultrasound-Guided Needle Biopsy of the Prostate”

2nd Place: Eugene Pietzak, III, MD for his work “High-Grade Prostatic Intraepithelial Neoplasia or Atypia on Prostate Biopsy are not Predictors of Pathologic Upstaging in Patients who are Eligible for Active Surveillance”

3rd Place: Kenneth DeLay, Jr., MD for his work “Pathology at Radical Prostatectomy of Men Eligible for Active Surveillance: Impact of Gland Size”

Paul F. Schellhammer Lecture in Urologic Oncology Video:
Dr. Ronald Lee Hrebinko form the University of Pittsburgh Physicians