This year’s annual Advocacy Summit included a brand new session designed to highlight urology trainees’ advocacy work. The Public Policy Forum on the second morning of the Summit was created by the Policy & Advocacy Resident/Recruitment Work Group as a route to increase trainee engagement. Of the approximately 120 trainees in attendance at the Summit—an exponential increase from years prior—13 had projects selected for presentation, 6 of which were presented as “winning selections” on stage during the Forum. Summaries of a sample of these projects are below. Virtual posters for each project can be found on the Summit website: auasummit.org/virtual-advocacy-posters.

If you or a trainee you know has a policy-related project that could be presented at the Public Policy Forum next year, keep an eye out for applications in the fall! The AUA fully funds attendance of the Summit for all trainees with winning selections.

Overutilization of Transfer for Testicular Torsion: An Opportunity for Multilevel Policy Intervention

Emily Clennon, PGY4

Transfer of pediatric and adolescent patients for testicular torsion has gradually increased and doubles both time to surgical intervention and cost of care for patients in Oregon. Drivers of transfer include institutional policies preventing emergent surgical care of patients < 18 years old, lack of local urology coverage, and lack of availability or willingness among local urologists. There are routes to intervene on the growing trend of transfer of these patients at multiple levels in the health system as outlined in Figure 1.

Dissemination of an Informational Video to Reduce Out-of-Pocket Spending for Prescription Medications

Benjamin Pockros, PGY2

Medicare Part D drug plans have highly variable out-of-pocket costs. Unfortunately, less than a third of patients compare drug plan pricing prior to selecting a new plan each year. We designed a patient-centered instructional video about the use and importance of the online Medicare Part D plan comparison tool and tested dissemination strategies to maximize viewership. Over a 6-week period, targeted advertising on YouTube led to 22,844 views. Clinicians and health care organizations interested in disseminating important policy or public health information to patients can utilize new affordable and accessible online technologies to quickly build videos and increase viewership (Figure 2).

Geographic Changes in Rural Access to Urological Care in the United States

Kelly Lehner, PGY3

Kelly Lehner presented on recent trends in rural access to urologic care. Using AUA Census data (2014-2022), she found that despite increased political attention and policy programs aimed at growing the rural physician workforce over the 8-year study period, less than 10% of US urologists work in rural areas, and this number has remained stagnant. The percentage of counties with no practicing urologist has also remained stable around 60%. Some regional variations were observed, with states in the Mountain West and South losing rural urology providers at a higher rate. The findings overall suggest that redoubling multipronged efforts to implement pipeline training programs and legislative policy solutions is imperative to begin to bridge the rural care divide.

National Cancer Drug Shortages: Policy Response and Potential Solutions

Taryn Ellis, PGY4

In the United States, there has been an ongoing issue with supplying the demand for generic prescription drugs. The COVID-19 pandemic further exacerbated these issues as a result of supply chain–related difficulties, as many factories were shut down during this time. There was a 30% increase in new drug shortages between 2021 and 2022 and a 10-year high in the number of active drug shortages at the end of 2023.¹ Low-cost generic drugs are more susceptible to shortages when the suppliers shut down, and many chemotherapy agents commonly used when treating urologic conditions fall into this category. Currently there has been a severe shortage of 2 important chemotherapy drugs—carboplatin and cisplatin—both of which are commonly used when treating multiple urologic malignancies. The National Cancer Comprehensive Network reported that 93% of surveyed cancer centers reported a shortage of carboplatin and cisplatin.² We identified proposed legislative and federal agency policy changes to address and prevent these shortages and worked to bring these matters to the attention of the urologic community as targets for future advocacy efforts.