I was recently having a conversation with a very successful urogynecologist that operates in on the East Coast. We were talking about diagnostics (such as urodynamics), the cost of the equipment, and the difficulty of retaining well-trained staff. He was surprised to learn that we served many large urogynecology practices and urology practices. He assumed that all of these large practices would perform their urodynamics testing in house. His thinking was that the clinic would be much more profitable if it owned the equipment, trained the staff, and dealt with all the other details to be able to deliver urodynamics testing services to their patients. This is true for some large urology and urogynecology practices, however it is certainly not true for many practices. Also, I believe he was not considering all of the pertinent details related to outsourcing diagnostics.