By Lawrence W. Jones, M.D.

There are two notable aspects of the California Urological Association's development, The first is that the CUA was not incorporated until 1986. The second suspect is that within two years over 400 members, almost half of California's urologists, joined the CUA.

Several significant actions contributed to the evolution of the CUA over many years. First of all, it wasn't until 1926 that the Western Branch (Western Section) of the American Urological As association could no longer hold its annual meetings in conjunction with the annual meetings of the California Medical Association, in accordance with a new CMA Council exclusionary rule.

The CMA's ruling was partially reversed in 1966 by the creation of scientific panels to the CMA Scientific Board established in 1963. The panels were designed to develop educational specialty based epitomes on Sundays during the CMA Annual Meeting. This is a program that remains today.

In 1978, the CMA House of Delegates created a "specialty" delegation. The CMA Bylaws required that CMA Advisory Panels not be responsible for the seating of specialty representatives in the CMA House of Delegates. In 1980, lames L. Goebel, M.D., President of the Western Section American Urological Association, received a letter from the Executive Director of the CMA informing him that his "society's 80% membership" in the CMA of eligible members entitled the Western Section AUA to one seat in the CMA House of Delegates. Dr. Goebel then appointed Stanley Brosman, M.D. as general chairman of the "Specialty Organization of California includ ing the four G.U. Societies, the sole purpose of which was to seat a delegate. He then asked each society to contribute $100 toward a fund to cover incidental expenses. Dr. Goebel's request for component support was well received by the Northern California Urological society, Orange County Urological Society and San Diego. However, the Los Angeles Urological Society did not contribute. The society, in a letter, stated that "The Los Angeles Urological Society has adequate legislative representation in the CMA through local organizations and there does not exist any necessity for the formation of any new formal body in the state to represent urologists." Nevertheless, seating in the House of Delegates was rotated between participating societies over the next few years.

The turning point came in 1986 when the California Urological Association, assisted by Arthur Dick, M.D., developed a set of bylaws and its own Articles of Incorporation. These were filed with the State and CUA was granted a tax exempt status, formally classified as a 501 (c)(6) organization, by the Internal Revenue Service. An invitation letter to join along with a request for $5O.OO dues was mailed to all the urologists on the CMA list and yielded an encouraging response.

In 1988, several events occurred. Dr. Carl Biorn was formally elected President of the CUA. He subsequently attended a meeting of the Los Angeles Urological Society and addressed a speech, "Politics and the California Urologist" which stressed the importance of socioeconomic issues and unification for clout with Congress. In May, the California Medical Association Specialty Delegation was notified that the Western Section American Urological Association would no longer hold representation for the California urologists and that they would now be represented by the California Urological Association.

At the 1989 Board Meeting, the CUA faced its biggest challenge: recommendations to modify criteria for TURP. Dr. Donald Gartman, president of the CMRI had written to Dr. Biorn solicit ing CUA's input and asking for names of members who would assist with physician review. The CUA's strong stance and the resulting cooperation from CMRI helped to finally unite the California urologists.

The CUA continues to provide valuable input to the CMRI, other regulatory agencies and the government representatives. The CUA offers an 800 number "hotline" to assist members with in insurance billings, or reimbursement infractions. The organization has grown to over 400 dues paying members and has built a responsive Board who are ready to respond to the needs of California urologists.