Department of Urology

Message from the Chair

Dr. Hunter Wessells

Dr. Hunter Wessells, Department Chair and Professor of Urology

January 2019

Dear UW Urology Community,

As we start a new year, I want to take the opportunity in this message to reflect on my 10th year as Chair, celebrate our successes, and offer my perspective on the current and future direction of UW Urology.

The Department has been committed to excellence since its inception in 1965. During our graduation celebration six months ago, I shared how our first Chair, Julian Ansell, and his alumni, proved, across a great span of time, that residents and faculty each benefit from the two-way interchange of ideas that occurs during training. Building on Julian’s foundation for greatness, Paul Lange led the Department to expand its research and clinical programs,

and encapsulated his vision in our motto: Heal-Comfort-Teach-Wonder.

Ten years ago we consisted of 17 faculty members, an equal number of trainees and an annual budget of $12M. In setting out as Chair in 2008, I emphasized the imperative to be innovative: in patient care, in high impact translational research, and in educating for the future.

We grew to capture the diversity of ideas and people needed to serve our patients and partner organizations. With the addition of 5 members in 2018, we total 45 faculty, who with our 30+ trainees and a dedicated staff support our mission across 10 hospitals, more than 20 outpatient facilities, and numerous research and training sites spanning a 1,500 mile radius. Our budget in 2018 of $21M reflects this growth.

The energy of our best and brightest people activates programs. This “energy of activation” is continually provided by members of the Department to great ends such as:

Urological care provided by UW Medicine and Seattle Children’s Urologists as measured in work RVU’s 2008-present

Urological care provided by UW Medicine and Seattle Children’s Urologists as measured in work RVU’s 2008-present

 

  • First to offer robotic cancer surgery at UWMC and Puget Sound VA; intralesional Xiaflex for Peyronie’s disease; expanded use of cytoreductive nephrectomy; robotic infant pyeloplasty at Seattle Children’s Hospital; and ultrasound guided PCNL access, to name only a few.
  • New multidisciplinary clinics in bladder and kidney cancer through Seattle Cancer Care Alliance; in reconstructive pelvic medicine through Seattle Children’s (SCH); and UW Medicine designated Men’s Health, Kidney Stone, and Female Pelvic Health Centers.Cheryl Lee tweet
  • Federal grants by DOD, NASA, NIDDK, NCI, and PCORI for research across a range of urological conditions that garnered #11 ranking in funding of all urology departments.
  • The Institute for Prostate Cancer Research and its extensive portfolio of basic and clinical research, and the successful recruitment of Li Xin, PhD Pritt Endowed Professor of Translational Prostate Cancer Research (see photo at top of banner, on right) to the department.
  • Differentiated ACGME accredited residency training paradigms to provide a range of scholarly options for residents including 5 year, 6 year, and 8 year pathways.

Each example represents an aggregation of faculty, trainees, institutional resources and ideas to drive exceptional clinical and translational impact. Innovations result from a forcing function in which collaboration and interaction are hard wired into the design. When we bring together the resources of the Department, the UW, and our various partner organizations, new ideas happen, repeatedly.

Some of our most exciting advances can be traced to a resident or fellow working closely with a mentor and practicing urologist on a clinically relevant problem. Examples include an automated continuous bladder irrigation device; patient derived bladder cancer xenografts; ultrasound technology to transcutaneously reposition and/or break kidney stones here on earth and potentially in space; a new grant to study patient choice between cystectomy and intravesical chemotherapy; and “organ on a chip” technology to study effects of gender affirming hormonal manipulation on Leydig cell function.men_s health update nutritionist Judy Simon

As the Department has grown, we collectively recognized the need for diversity in thinking to sustain innovation. We took stock of how we attract talented individuals into the Department, and adopted best practices to guide recruitment of our trainees and faculty. Equally important is inclusion, the corollary to diversity which allows all members of the Department to do their best work, to thrive and contribute to the success of the mission.

With the amount of growth I described, a strategy to manage intersections between new and old ways of thinking seemed necessary . Instead of trying to incorporate all members into an indistinguishable whole, the approach we use is one of integration. This acknowledges that the unique environments and individuality of our members together form a more complete, complex and coordinated entity that will better meet the needs of our stakeholders, wherever and whomever they are. Multi-pillared structures are more stable than monoliths!

It seems inevitable that the Department will continue to expand. The pressures of healthcare payors, competition for patients, funding and regulatory change and cost reduction create challenges for our health systems. Only by remaining at the true forefront of academic medicine can we retain our status as one of the best Departments. Our size allows us to “balance the portfolio” by distributing risk and preparing for the emerging needs of patients, learners, and health systems. The immediate future offers the chance to extend our clinical programs in urological oncology, pelvic health, and general urology to our NWH campus as it merges with UW Medical Center on January 1, 2020. A similar strategic plan of expansion is underway at SCH. A conundrum created by our growth is the evolution of surgical training and feedback. Whereas in the past a resident might have close surgical mentorship from 6-8 faculty members, the new paradigm requires a trainee to interface (and scrub) with several dozen surgeons over the course of residency. The ability to provide critical feedback and track progress over time is beyond any single member of the faculty and needs new solutions.

Lendvay investor of the year award

In closing, I leave you with three key initiatives that merit special mention and for which I will be seeking your support in the coming year(s):

  • Creation of a comprehensive program in Transgender Health that encompasses the entire range of UW Urology expertise, from management of adolescents at SCH to gender affirming surgery in UW Medicine.
  • Reinforcement of our internal research infrastructure through shared resources that encourage interdisciplinary and cross cutting collaboration amongst all of our faculty, wherever they may be practicing.
  • Implementation of assessment technology into the residency program to robustly track technical skills acquisition and progression with open, endoscopic and robotic surgery.

The future is bright for UW Urology. The outstanding individuals who contribute to the success of the department on so many fronts ensure the continued high level of recognition for UW and its urologists, past, present, and future.

urology football game

 

Sincerely,

Hunter Wessells, MD, FACS
Professor and Nelson Chair of Urology