Follow-up postoperative calls to reduce common postoperative complaints among urogynecology patients
INTRODUCTION AND HYPOTHESIS:The purpose of our study was to identify the most common reasons why postoperative urogynecology patients called their surgeon within the first 6Â weeks of surgery. We hypothesize that implementing a follow-up postoperative call (FPC) policy would decrease the number of patient-initiated calls within this postoperative period. METHODS:This is a prospective before-and-after cohort study that was conducted in two phases. The initial phase identified the most common reasons why patients call within 6Â weeks of their inpatient or outpatient urogynecological surgery. In the second phase, an intervention was implemented where each postoperative patient was called within 48 to 72Â h of discharge: the intervention group. The primary outcome was the number of phone calls initiated by patients during the 6-week postoperative period. RESULTS:There were 226 patients in the control group and 233 patients in the intervention group. Significantly fewer calls were initiated by patients in the intervention group, both groups having a median of 1 call per person, range 0-8 in the control group and 0-10 in the intervention group (pâ€‰=â€‰0.04). The five most common complaints were as follows: pain (20.4%), medication management (17.4%), disability paperwork (15.5%), and laboratory results (11.5%). There was a significant reduction in calls concerning constipation, laboratory/pathology results, and disability insurance claims after implementing the FPC policy. CONCLUSIONS:The implementation of the FPC policy resulted in fewer patient-initiated calls. As such, there were significant reductions in postoperative complaints of constipation, vaginal bleeding, incomplete bladder emptying, and inquiries into laboratory results and disability paperwork.
An update on the current status of medical student urology education in the United States
OBJECTIVE:To provide an updated report on the status of urology education in the United States. METHODS:Forty-one randomly selected accredited medical schools in the United States were surveyed concerning their urology curriculum. All schools were included in the randomization, even those that had not produced any successful urology applicants during the past 5 years. RESULTS:In 48% of the schools, there were no urology lectures or coursework required before third-year clinical rotations. Two schools (5%) had a mandatory urology clinical clerkship. All schools offered an elective urology clerkship during either the third or fourth year of medical school. Fifty-five percent of medical schools used a core curriculum, and 31% based their curriculum on the American Urological Association's medical student core curriculum. Twenty-nine percent used Web-based resources during their clerkship, and 21% had a urology interest group. CONCLUSION/CONCLUSIONS:This survey further reveals that there is a decline in exposure of medical students in the United States to formal urology teaching. In an attempt to minimize any possible adverse impact and to ensure that students are being exposed to the most important urologic topics and skills needed, some medical schools have instituted the use of a core curriculum in their clerkships. Despite the persistent decline in required medical student exposure to urology, urology residency programs remain extremely competitive.