Dr. Mark Leo wakes to a ringing phone at 5 a.m. It’s an Israeli company regarding a summary of a presentation submitted to a conference by the European Association of Urology. (It is only 3 p.m. in Israel.) The caller is interested in the presentation Leo made and would like to research the laser technology referenced in the presentation. After discussing the matter briefly and concluding the conversation, Leo receives another call. Owing to consulting work he is doing for Boston Scientific, Urology Specialists of Nevada (USONV) has the opportunity to be the first urology practice in the West to be able to use disposable ureteroscopes, beginning the following week. (Ureteroscopy is an examination of the upper urinary tract, performed with a ureteroscope that is passed through the urethra and the bladder, and then directly into the ureter. The procedure is useful in the diagnosis and treatment of disorders such as kidney stones.)
5:30 a.m.
Leo wakes his kindergarten-age daughter and prepares her breakfast, and then gets ready himself.
7 a.m.
Leo arrives at the Central Campus location (Goldring Avenue in Las Vegas) of USONV’s three local campuses. The focus of USONV’s medical practice, which has been in place since 1996, is on the urinary tracts of both males and females and on the reproductive system of males. After he arrives, it’s more phone calls — messages from the previous day that still need his attention. Among the calls he answers, he is able to accommodate a patient request for getting a surgery in before the end of the calendar year. “There actually is a bit of a seasonal rush,” he said. “It’s an annual thing — between medical deductibles, tax reasons and their available schedules, many people want to get in before the end of the month.”
8:30 a.m.
His patients include several cystoscopic exams this morning. Cystoscopy is a nonsurgical procedure used to examine a person’s urinary bladder via the urethra (the tube that carries urine from the bladder to the outside of the body). Using the cystoscope’s flexible tube with its light and camera, he views the areas of concern on a video monitor.
Between patients, Leo attends to some office issues. As director of operations for USONV, he schedules the clinical staffing for all three USONV locations, which include 11 health care providers and more than 70 employees. “It’s an ongoing effort to meet our patient’s needs, while still addressing administrative responsibilities and other duties,” he said. His next call is about a potential new doctor USONV is looking to hire. Over the course of his morning, he sees 20 patients, noting that “kidney stones seemed to dominate the day.”
12:30 p.m.
It’s not all medicine; Leo heads out to have his car serviced.
1:15 p.m.
It’s a working lunch for the doctor, who also takes the opportunity to meet with
his administrative assistant, Jessica. Then there is more time in his office taking patient calls.
Three days of his week are reserved for seeing patients (Mondays, Wednesdays and Thursdays), while the other two days are dedicated to surgical procedures. “One of the highlights of my patient care work today was the satisfaction expressed by a patient who had just undergone penile implant surgery,” Leo remarked. “He said he feels like his life has been given back to him,” and that it meant even more to that patient heading into the holidays.
2:30 p.m.
Leo is meeting with the regional managers of a medical device company to discuss new ideas for preceptorships opportunities. Both the doctor and his USONV colleague Dr. Mulugeta Kassahun conduct preceptorships for local medical students. In medical education, a preceptor is a skilled practitioner or faculty member who supervises students in a clinical setting to allow practical experience with patients. Both doctors teach at the University of Nevada School of Medicine and at Touro University. They provide this one-on-one understudy relationship in week-long rotations, where local students follow them at their medical clinic or on their local hospital rounds. “We’ve been supporting Southern Nevada’s medical education in this way for the past 10 years,” said Leo, “and we’re the only doctors providing this training in urology at UNSOM. A community’s quality of life is directly related to the health of its members, and the key lies in our medical education system. Supporting and improving the healthcare education system in Nevada improves our overall healthcare system.”
Jessica A. has been working with Leo as part of her surgical rotation. She is a third-year medical student at UNSOM who has expressed an interest in possibly pursuing a career in urology. Leo finds that one of his patients presents with what is initially described as a relatively straightforward case of kidney stones. As it turns out, the patient actually has a much more complex case of “xanthogranulomatous pyelonephritis,” or XGP. Pyelonephritis results when a urinary tract infection progresses to involve the upper urinary system (the kidneys and ureters); xanthogranulomatous pyelonephritis is an unusual form characterized by formation of abscessed nodules. It is a case that will likely require major surgery. Leo uses the teaching opportunity with Jessica to reinforce how diverse things are in urology and how things are often “not as they first appear.” It turns out to be a great teaching opportunity. He takes the time to go over the condition in detail and asks Jessica to prepare a short presentation of the condition for discussion the following day.
5 p.m.
Leo is wrapping up still more phone messages, as well as answering emails from the morning and early afternoon while he was caring for his patients. He sets a number of emails aside to answer at home, as they require a lengthy response.
6:30 p.m.
Leo enjoys a brief respite from his long day by attending a membership appreciation party at the TPC Summerlin golf club.
After 7 p.m.
His work day behind him — more or less — Leo spends quality time with his daughter.
“Of course, the end of your day is the start of your kid’s day!” he joked. After play time, he puts his daughter to bed.
There is still a bit more to his late evening. Leo happens to be working on attaining his MBA degree.
Into the evening he reads his coursework for classes, followed by online discussion threads, until he falls asleep, which can be anytime between 9 p.m. and 1 a.m.