Raoul Concepcion, MD: Overlooked OAB Patients

Raoul Concepcion, MD, the director of the Comprehensive Prostate Center: [When it comes to unmet needs in OAB management] I think the problem that we see, at least from the urology community, is that depending upon the sophistication of the urologist, and depending upon the way a urologist or a urology group wants to get into specialization of care, it really can be a problem where OAB - or the OAB patient - may actually fall through the cracks.

And what do I mean by that? In your typical community independent practice, especially in a bigger practice, you may not necessarily see a provider that has a special clinical interest in what the thing that you're being referred for. We know that patients, if they go to a larger community practice where there is no element of defined subspecialization, we seem to think that if an OAB patient goes into that practice as a first-time patient and does not see a provider that specializes in incontinence or OAB, there's about a 40% chance that that patient will not come back for a second visit.

I think people - especially because I do believe that especially women, do tend to present a little bit later - they think that [OAB] is manageable. If they don't get that feeling like this particular practitioner is interested more than [just giving them first-line therapy], they probably won't come back. However, we also know that if they do happen to see a provider that is routinely interested or wants to go beyond just, "Here, take a pill," and really does do a good job and follow up, the likelihood of getting follow-up therapies and follow-up appointments is much higher - north of 80%. So, unfortunately, some of it starts from your very first visit.