Urologists on a Tightrope: Have We Lost Our Balance?

The purpose of this review is to provide an analysis of recent changes in health care delivery and their implications for the future of urological practice. Google searches were conducted using keywords that served as section headings in the manuscript. The confluence of landmark changes in reimbursement, work hours, manpower issues, patients' expectations, litigation, and research funding has already had a marked impact on urological practice and will likely increase further. Urologists will need to intensify their efforts to educate the public and legislators as how to best preserve the most valued elements of urological practice and patient care.