"As a resident at Yale, I had the opportunity to work with great Yale faculty members like Bob Weiss and Harris Foster, as well as great clinical faculty members like David Hesse, Rick Dean, and Ralph Devito, who taught me the knowledge base and the surgical skills needed to be a good urologist. More importantly, they also provided an understanding of two other things. The first is that urology residency is kind of like an apprenticeship in that it provided the opportunity to watch them take care of their patients up close – to observe that urology is more than just mastering facts and surgical skills, but that it also requires development of the wisdom and judgment to apply those things to greatest effect. The second, and the one that most prepared me to be a faculty member at Yale, is that those who taught me and who are now my fellow faculty members showed me that being a good teacher of urology demands that you teach and lead those that are entrusted to you with kindness and encouragement and with a genuine interest in their growth and development as urologists. Twenty five years later, that’s how I try to relate to the residents I get to work with each day.
The practice of medicine in general and urology in particular has become increasingly complex. Most of the complexity has developed with good intention, but that complexity can also be an obstacle to what, at the end of the day, is our goal-providing great care to our patients. So many people fill such a wide variety of roles in our department, that chairing the Clinical Operations committee forces me to consider the various things that make each person’s job in providing care for our patients challenging and if possible, to clear those challenges away. The goal of Yale Urology being a world-class, destination department requires that we do everything well – whether it’s making appointments, taking phone calls, managing emergencies, providing patient education, or doing complex surgeries. Each of those is hard enough by itself, so it’s imperative that we clear obstacles that make each of our jobs harder. So, I’m proud that the clinical operations committee can consider the clinical roles of everyone in our department, find out what challenges they face, and then take steps that hopefully allow everyone to perform at the highest level. In the long run, that’s the best possible result for our patients and again, that’s our ultimate goal.
I look at how urology has changed in the 25 years since I finished my residency and it's very similar to how you might look at how various sports have evolved over the years as well. In sports, the athletes are clearly better and so is the equipment. If you look at old films of basketball or football or golf, they look like different games from what is played today. The improvements in both the athletes and the equipment has clearly lead to better performance than there was 25 years ago. But really, the object of the game is still the same – score the most points, hit the ball further, run faster etc. Urology is similar. As a specialty, urologists are undoubtedly smarter than we were 25 years ago (and there is no doubt that our residents are smarter than I was when I was a resident), and the improvements in technology and equipment are remarkable – from robotic surgery to endoscopic equipment to diagnostic tests to better medications. But the object of the game is still the same – take the best possible care of our patients. Being smarter and having better equipment puts us in a better position to do that than ever before."