MP02-08 ARE UROLOGISTS USED DIFFERENTLY IN PRIVATE VERSUS ACADEMIC HOSPITALS? A COMPARISON OF UROLOGIC CONSULTATIONS IN THE TRANSITION FROM A NONTEACHING TO TEACHING HOSPITAL

Abstract

INTRODUCTION AND OBJECTIVE: Urology residents demonstrate the highest prevalence of burnout amongst trainees, whereas post-residency, urology burnout rates do not top the charts. One potential cause for this discrepancy may be the consult burden in teaching hospitals. A unique opportunity presented itself when Bergan Mercy Medical Centerda nonteaching hospitaldtransitioned to a teaching hospital when it became Creighton University Medical Center - Bergan Mercy (CUMC) in the summer of 2017. We sought to determine how often urologic consulting services were used in the nonteaching vs teaching setting. METHOD(S): A retrospective chart review was performed on all inpatient urology consults placed at CUMC from July 2014 to June 2019. To account for variation in hospital census, all consults were weighted using patient days. RESULT(S): A total of 1,882 urology consults were placed during the study interval with 803 occurring prior to and 1,079 occurring after the transition to teaching hospital. Figure 1 compares monthly rates of consultations between the nonteaching and teaching settings and is arranged as an academic year. The consult rate was significantly higher in the teaching vs nonteaching setting until the end of the year when rates statistically equalized. Interestingly, the rate of consults placed in the nonteaching setting was stable throughout the year, whereas the teaching rate rose from July to November and then steadily fell until matching the nonteaching rate at the end of the academic year. CONCLUSION(S): In this novel analysis, inpatient urology consults were ordered more frequently in the setting of a teaching hospital compared to nonteaching. This was more pronounced in the first half of the academic year. The rise could potentially be explained by senior residents entrusting more control of patient care to junior residents as the year progressed, and the fall potentially representative of junior residents becoming more comfortable managing simple urologic problems. Recognizing these practice patterns may have far-reaching implications in quality improvement, high value care and physician burnout. (Figure Presented).