Every autumn, Arkansas Urology hosts its Kickoff to Men’s Health promotion to coincide with National Prostate Cancer Awareness Month. The premise of the event is simple — get men to take more ownership over prostate health as a way to head off prostate cancer.
The process of achieving that goal, however, is anything but easy, which is why the Little Rock-based health care provider resorts to myriad gimmicks to lure men in. Giving away big screen TVs is one, messaging appealing to a man’s mate is another. And then there are CEO Scot Davis’ personal favorites, the marketing tactics straight out of the male mind that have included handing each fella who attends a blue foam finger.
“Our marketing team wasn’t initially real crazy about this one blue foam finger, but it was funny,” Davis said. “Give prostate cancer the finger!
“We make a lot of fun of the exam, and I think that helps. There’s a great, what’s that series? Family Guy. There’s a great little skit there where he goes to get a prostate exam, and it is hilarious. Every now and then, I have to show that to our doctors and our team. Don’t take everything so seriously.”
Davis will do just about anything to get men over their discomfort with a digital rectal exam, the method for detecting prostate abnormalities. Knowing his audience and knowing what’s at stake, he’ll take a little implied crudity in the name of saving lives.
“I think that kind of messaging around it is not that big of a deal,” he said in between chuckles. “The key thing is we are finding guys who have early prostate cancer with these screenings. We’ve been doing them for 16 years, and we will find either an abnormal PSA or an abnormal DRE 10 percent of the time.
“With prostate cancer, if we catch it early, it’s almost a 99 percent cure rate. Once you become metastatic, you have about five years or less to live. So, to us, the number of screenings is somewhat important, just because we want to have an impact. But the reality is, if we found one guy with prostate cancer, we feel like we’ve done something very, very important.”
But for Arkansas Urology, men’s health issues in Arkansas would likely be far more muted than they are now, to say nothing of how many men (and women) might go wanting for treatment of urological issues of the bladder, prostate and in areas of sexual health. Through its 14 clinics statewide, the company sees about 110,000 patients a year, performs 10,000 procedures annually and has grown to $60 million in revenue in the process. All of which is double that of just eight years ago.
More than that, the company has helped bring specialized medical expertise closer than ever to Arkansas residents wherever they may live. Arkansas Urology employs 19 physicians, 17 physician extenders and 300 clinical and business staff systemwide.
“We’ve created this vision of being within a 45-minute drive of anybody who wants access to an Arkansas Urology physician or Arkansas Urology technology,” Davis said. “When we look at the state, we look at the heat maps and say, ‘Where are the people? Where are we going to have the most impact taking care of people?’ And that is exactly what we’ve done.”
Expansion has come by way of building new practices from the ground up, replacing urologists who are retiring or inviting current practitioners to join the fold. Attracting sufficient medical expertise is one of the hardest things to do, especially in rural health care, and one of the key accomplishments of the company’s rapid growth.
“In this state, we don’t have enough urologists. The average age of urologists in Arkansas is over 55 years old,” Davis said. “We got ahead of that. We’ve hired a lot of younger physicians, just out of training, so the average age of our physicians here is probably 47. And that’s including some of our older physicians, so we’ve got a whole crop of younger doctors who are below 40 right now, just starting their careers.”
Like nearly all health care providers, the company has spent the better part of 2021 running to stay ahead of patients who had put off exams and treatment out of fear of COVID-19 last year. Davis said this has not only taxed the company’s manpower and resources, but it likely endangered many men unnecessarily as well.
“‘Too busy’ is always better than ‘not busy,’ but the unfortunate side effect of ‘too busy’ is patients wait to get in to see us, and they generally have to wait longer when do they come and see us,” he said. “New patient appointments for us right now are probably about four weeks out.
“I was on a call yesterday, and the Journal of American Medical Association oncology division reported that during COVID, 10 million cancer screenings were missed. And it’s not just us; I think all health care providers in the market are seeing this resurgence of people trying to get in to get checked out. We’re definitely seeing it at our practice.”
Parsing actual need from pent-up demand complicates matters concerning new locations. Davis said the company is getting nearer to the logistical saturation they are after, save for portions of southwest Arkansas. But that doesn’t mean needs are totally being met in all cases.
“If we look at the state right now, there are pockets where there are needs in urology,” Davis said. “One big consideration is population in general, you know, how many people are there? And another big factor is statistics around instance rate of disease. There’s a heat map, strangely or not, that shows there’s a higher instance rate of prostate cancer in Northwest Arkansas. And you wouldn’t think that about the northwest, but that’s what the data shows. All those are definitely determinants in deciding where we need to be.”
As the self-professed “numbers guy,” Davis readily admits once the data changes, so too does the master plan. And when that happens, everything’s on the table, from expanding nearby clinics to creating new ones to engaging existing resources in strategic partnerships.
“We like to go into markets where we’re invited or where physicians in that market feel that being part of an independent, single-specialty group makes sense for them,” he said. “In Jonesboro for example, there are seven urologists, all employed by the hospital. The hospital reached out to us and said, ‘We need help. The patients are driving down to Little Rock to get robotic surgeries. Do you have a robotic surgeon that can come up and do cases?’ We said, ‘Absolutely.’
“So, certainly, partnering with facilities makes sense. A lot of the patients we see in urology are chronic conditions that need some type of intervention. We’ve got to be able to have access to a surgery center or a hospital so that we can do those things.”
few years ago, the company took a bold new step toward improving its educational and outreach efforts by founding the Arkansas Urology Foundation. Chris Shenep, foundation director, said putting on events in 2020 such as Kick Off to Men’s Health was tricky but vital.
“Despite being in a pandemic and despite people not going to the doctor and being hesitant about health care, we were still able to maintain events in Little Rock and North Little Rock, as well as expand them to Bentonville, El Dorado and Pine Bluff,” he said. “You look at the number of patients that came in, and we had some positive test results of those people.
“We were also able to really focus on Mental Awareness Month and Prostate Cancer Awareness month, as well as No Shave November, and do some fun things around some of those campaigns. I think that’s an indication of the impact that this foundation will have.”
The foundation also plays a major role in promoting the Mack Moore Fund, named for a well-known Arkansas urologist.
Davis said, “A lot of people know Mack, and he’s still very well-connected. He was gracious enough to allow us to use his name to start raising funds. The intent with that connects to my philosophy of we’re not going to build it and wait for you to come, we’re going to come to you. We’re looking to provide mobile services whereby we partner with the Prostate Foundation and primary care doctors in various locations, working with local hospitals to bring services where it’s needed.”
As for the future, Davis said it’s less about headcount and square footage as it is about lives saved and patients treated, so that’s where he sets his focus.
“I’ve been asked a lot of times, ‘What will you look like three to five years from now?’ A lot of people will say they want to be at $10 million in revenue, or to be at this number of employees or this many providers,” he said. “I don’t really look at it that way. The way I look at it is, how can we improve processes, workflows, that make it easier for people to access health care?
“We treat chronic conditions, and there’s no cure for those. But there are interventional procedures, mildly invasive procedures, where we can help people. Overactive bladder and BPH are two really good examples of that. I think we do a great job in prostate cancer of early detection, treatment, all those things. But there’s other areas where we need to focus. It all gets down to personalized clinical pathways, and if I had to say where we’re going to be three to five years from now, it’s going to be focused on helping urologists and urology groups around the country in developing those clinical pathways.”
Even as the company continues to expand to all reaches of the state, there are still elements of operations many don’t know about, especially on the treatment side. Arkansas Urology operates the Arkansas Prostate Center in Little Rock, a premier treatment facility that is, to Davis’ chagrin, an all-too-well-kept secret.
“We see people migrate out of the state, going to other areas to get treatment for prostate cancer. They’ll go to the Mayo Clinic or Sloan Kettering or some of these big institutions,” he said. “No one has to leave this state. We’ve got Dr. Jack Wong, who has done more prostate cancer treatments probably than any other radiation oncologist in the region. That’s all he does. For the last 11 years, he’s treated 2,500 to 3,000 new patients in radiation oncology.
“We have the latest technology in the state, stuff most groups don’t have, in terms of treating prostate cancer. We have three robotic surgeons who have done more robotic prostate procedures, what we call RPs, than anyone in the region.
“If you’re going to go to see any type of specialist, any professional, you want someone that’s done it a lot and is really good at it. In our mind there’s no one in the state that treats prostate cancer more than we do, or that has more successful outcomes with prostate cancer than Arkansas Urology. You don’t have to leave Arkansas to get the best treatment for prostate cancer — it’s right here.”