The U.S. is facing an overall shortage of physicians, at least half of which is among specialty medicine physicians such as urologists. The declining urology workforce in the U.S. is at risk of primarily threatening access to care in rural communities. According to the American Urological Association’s (AUA) census report, in 2022 only 20.1 percent of urologists in the U.S. practiced in designated nonmetropolitan areas (defined as a population size less than 50,000). From another view, only 37 percent of all counties nationally were identified as having a practicing urologist. (AUA News, Urology Workforce Trends and Impact on Rural Practice)

This situation is also a disparity matter. Patients in rural communities are commonly older, poorer, sicker and more remote from health care services than patients in urban areas. The relative lack of a urological workforce in these communities contributes to health care disparity.

ECHO Colorado and University of Colorado School of Medicine Division of Urology started offering the urology ECHO in September 2022 to address the need for increased access to specialized knowledge and support for patients with urologic conditions, focusing on underserved patient populations and rural areas. The Urology ECHO program aims to mitigate the effects of the workforce shortage, preserve access to appropriate and timely urologic care, and expand access to care by expanding the knowledge base of primary care physicians and providers.

“The other faculty presenters and I greatly enjoy the interactive nature of the sessions,” said Janine Oliver, MD, FPMRS, lead ECHO partner; co-director, Anschutz Medical Campus Urogynecology Multidisiplinary Clinic; and assistant professor, CU School of Medicine Division of Urology. “The ECHO platform is engaging, and it is rewarding to hear and share experiences with our physician and APP colleagues in primary care. We love hearing the feedback from the participants about how the ECHO sessions have led to knowledge gains and directly had an impact on quality and access to care by changes in their practices.”

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ECHO Colorado was excited to support the CASCHEW 2024 Conference in March, in partnership with CO-CEAL and SNOCAP. A big thank you to our presenters and partners who came out to learn from each other and collaborate. Collaborating Across Sectors for Colorado’s Health Equity and Wellness (CASCHEW) 2024 brought together over 100 project participants, community partners, community members, public health departments/organizations, clinic staff, primary care clinicians and medical and academic partners committed to improving the health of all Coloradans.

Devin Miller, MPH, PMCC director of operations, was part of the planning committee and she presented with partners from HCPF and CDPHE on how to successfully conduct cross-sector collaboration to address medical and public health challenges. “Cross-sector collaboration is critical because it leverages diverse expertise and resources to address complex challenges more effectively than any single organization could achieve alone,” said Miller.

BreAnna Teeters, MPH, ECHO project coordinator; David Saxon, MD, PMCC medical director; and Melissa Griffith, MD, rheumatology ECHO partner, presented Keeping Care Local: eConsults and ECHOs in Rural and Frontier Counties. They presented on the scope of the work that’s being done to analyze eConsult and ECHO program data to understand educational needs in Colorado’s health care communities.

“My main takeaway from the conference,” said Teeters, “is that our work shouldn’t and can’t be siloed because there are opportunities that could be missed when we are trying to build something from scratch; working with others better supports work that’s already been started.”

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