Dr. Amanda North
speaker
75 appearances
1 recordings
1 series
first heard Sep 2024
last heard Sep 2024
Dr. Amanda North’s voice in public audio — every appearance, attributed to the second.
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In terms of what fellowships women do, we know pediatrics and female urology are the two most highest percentage of women in each of those specialties. Perhaps not surprising. I mean, we know in pediatric urology, the percentage of women is quite high now, especially compared to the overall urologic population.
And we know women see fewer patients each week, but they spend more time with each patient. And this we think is one of the contributing factors to the gender pay gap. That we talked about from the census a few years ago, we actually published a paper on that. And there are a lot of factors involved in the gender pay gap.
But the fact that women see patients who require a little bit more time, maybe a little more TLC may have an impact on their ability to see as many patients as their male counterparts.
Absolutely. And it's been said that women maybe work fewer hours per week. And we've looked at that over the census over several years. And men and women urologists work the same number of hours per week. I want to be very clear on that. So this women are not seeing fewer patients because they're working fewer hours. They're seeing fewer patients because
because they're spending more time with each patient from the data we have in the census. And we can surmise from other publications that it may be that the women are seeing the more difficult and time-consuming patients, although we haven't been able to show that in the census yet.
Yes and no. We've seen a trend towards employee practice over time that's been really startling. Like two-thirds of urologists are employees. Now, if you define...
employee as being a hospital employee but still being in private practice I think it can be a little vague to people am I in private practice if I'm not an academic maybe but when we look at the traditional the old school solo practitioner that almost doesn't exist anymore.
And I tell the story all the time that when I was growing up, my pediatrician lived across the street and had an office attached to his house. And if we were sick, my mom would call him and he'd go run over and open his office and we'd go see him. Nobody does that anymore, right? Or almost nobody does.
And I think a lot of people who are in solo private practice are running more concierge practices rather than the traditional old school way of, you know, hanging up a shingle and opening your practice. There are a lot of policy reasons why that's happened over time. And so we've been following that trend since the census started in 2014.
And I think as we use our census data for advocacy purposes, the fact that so many urologists are now employees, and it's so hard. to be in certainly solo private practice, but in private practice at all is really interesting.
And, you know, it also has led us to ask more business related questions like regarding private equity acquisition of urology practices, for example, to try to understand how that's going to impact practice in the future, because it's something that we're starting to see now. And we need to be on the forefront of understanding what that means for the
Well, I'll take that one because it goes back to how we structure the census every year. So we actually have a spreadsheet with rotating clinical topics that get asked on a cyclical basis. And so endourology and stones was up for this year. And then we partner with the Endourological Society and the data committee members who do endourology to solicit questions that are specific to endourology.
So you'll see in addition to the question about double J stents was a question about laser acquisition and trying to understand how quickly practices across the country are picking up new technology? And are rural hospitals picking up new technology or only academic centers? So these specific questions came from our endourology colleagues.
But the idea to put stones on this year's census, it was... It was Stone's turn to be on the census. So you'll see that there are different clinical topics. We try to do some that are related to hot topics in urology. For example, we recently asked about transgender care because transgender care has been a hot topic that was on last year's census. We felt that it was time to ask more about that.
But Stone's, it was Stone's turn this year. So that's why Stone's is on this.
So that's a great question. One of the things that I felt really strongly about when I became data chair was democratizing both the way that we create the census and the way that the census data is accessed by members. There was a feeling...
I had from having been a member of the data committee and having had unprecedented access to census data, that it probably wasn't fair that I had access to data that other people didn't. So there are two ways for people to access census data. Well, three, actually. One is there are committees in the AUA that get access to data to do publications. So I'll give you an example.
I'm on the AUA Workforce Workgroup, which falls under legislative affairs. And the AUA Workforce Workgroup gets two papers worth of data from the census in order to write papers that support the legislative agenda of the AUA. So I'll give you an example.
We published two papers looking at the impact of student loan debt based on census data, one for the resident fellow census, one for the practicing urology census that has now been used at the advocacy summit. many years in a row to support student loan debt forgiveness for urologists who practice in rural areas, right? And so we worked with the legislative affairs team.
We work with the advocacy team to come up with what topics they want on the census, but then to also publish papers. So we have peer-reviewed published data that we can bring to Congress and say, look, this is an issue. Here's good, strong data to support that issue. So you can join AUA committees and volunteer your time and have access to data.
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