CLEVELAND, Ohio — Americans are living longer, healthier lives partly because of research done at academic medical centers in the 1940s, 1950s and 1960s, says Dr. Firouz Daneshgari, new chair of the urology department at University Hospitals Case Medical Center.
“All of us know our cholesterol numbers. We eat fruits and vegetables because they reduce cancers,” said the urologist who also is Lester Persky Professor at Case Western Reserve University School of Medicine. “I love academic medicine for the good things it has brought to life.”
Now, Daneshgari and his colleagues are trying to bring good things to urological health, especially for Baby Boomers as they age. They’re creating a urological institute — a cross-disciplinary family of eight centers from female pelvic surgery to oncology to men’s health that will work together to help patients deal with urological problems that can rob them of quality of life, especially as they get older.
“The stars are lined up for urology here to create a new model,” Daneshgari said. “With the institutional support and the track record that we have, we will build a new role model for academic medicine.”
The urological institute also promises to be a profit center for University Hospitals. Many health systems are moving to an institute model, which aims at delivering top-quality medical care in a cost-effective manner while educating the best doctors.
And as the Baby Boom generation ages, the proportion of women requiring treatment for pelvic floor disorders like urinary incontinence or pelvic organ prolapse is expected to double or triple within the next two decades, according to a report by Daneshgari published in Urology. Meanwhile, up to half of women and men in the large generation are likely to develop urological problems like incontinence or enlarged prostates.
Patient need is growing. The trouble is, “our organization of medicine is not based on the customer need, it’s based on our subspecialty development,” Daneshgari said. For instance, women who have pelvic floor disorders traditionally have seen urologists or gynecologists.
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“Of course, with that comes the turf battles,” he said. “If my mother has incontinence, the last thing she cares about is which ‘ologist’ takes care of her. We need to develop new models and new tools to respond to the needs.”
To answer the needs, “what we have done here is put all services that are related to female pelvic floor disorders under one department,” Daneshgari said. We call it female pelvic surgery, which is one of the centers of the urology institute.”
Similarly, other specialists and subspecialists needed to treat the urological problems of men and children are being brought together in the institute. For instance, urologists, gynecologists, pain specialists and neurologists are gathering in a pelvic pain center. “So, to me, we have to break down the barriers, to bring all the specialties that work for this group together, and haven’t worked together in the past,” he said.
The urology institute will take its care-giving to Northeast Ohio communities. “We will have a bladder control clinic. We will have an organ prolapse clinic. We will have a pelvic pain clinic. We will have a prostate cancer clinic,” Daneshgari said. “You don’t have to figure out which ologist has to see you. That’s a promise.”
Instead of patients traveling to the main academic medical center for help, “We are going to bring the services of our specialists to every community in the region,” he said. “My promise is, we’ll provide 24-hour, 7-day-a-week services for urology in all these regions.”
The emerging institute offers Daneshgari an opportunity “to discuss, plan and implement some of the dreams I’ve had of health care, as a physician and as a patient,” he said. So in July, Daneshgari left his position as Department of Urology chair at SUNY Upstate Medical University after only a year to return to Cleveland.
He had been a professor of surgery and molecular medicine at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University from 2001 to 2008. Among several leadership positions at the Clinic, Daneshgari served as director of its Female Pelvic Medicine and Reconstructive Surgery Center where he founded and directed the fellowship and translational research programs.
Since returning, Daneshgari has been aggressively recruiting physicians to join the UH urological institute, which likely will be formally launched in February or March. “I’ve been here for three months. In addition to myself, we have hired the chief of pediatric urology, Jonathan Ross, at Rainbow,” he said. Other physicians who have been recruited:
- Dr. Lynn Woo — urology
- Dr. Adonis Hijaz — female pelvic surgery
- Dr. Jeanette Potts — pelvic pain
- Dr. Rabii Madi — robotic oncology surgery
- Dr. William Larchian — urological oncology
- Dr. Robert Abouassaly — urological oncology
- Dr. Melvin Lajin — erectile dysfunction
“There are active negotiations with six other urologists. So we have increased our pool of urologists by about 300 percent,” Daneshgari said.
He also is reaching out to urology practices to form nonemployment partnerships that could participate in what he calls an “open” institute. “And I have brought back my research team with me,” he said. “This is probably the most productive research team in the country in our field.”
