Our nation's health care has been undergoing an economic revolution. The practice of urology has not escaped. Speculation regarding the economics of urologic practice in the twenty-first century must be based on the continuation of policy trends begun over the last decade by government and managed care coupled with the impact of changes in the science of urology, shifting population demographics, and changing social factors. The hallmarks of the years ahead include increased physician accountability, expanded use of clinical care guidelines, continued relentless penetration of managed care, and reduced reimbursement for surgical services.
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