Why Expertise Matters in Prostate Surgery

Bigger Isn't Better.
Better Is Better.

When it comes to surgical and specialty care, the size of the hospital system behind your surgeon matters far less than that surgeon's individual experience, focus, and commitment to your specific condition. Here is what the research — and the reality — actually shows.

Dr. Childs built this practice around one principle: that a focused, high-volume specialist in private practice can deliver outcomes that no large institutional program can match — and do it with a level of personal attention that a hospital system simply cannot offer.

~1,000
HoLEP procedures performed since 2022 — nearly 200 in the past year alone, among the highest volumes in the Mountain West
Full Scope
General urology including kidney stones, vasectomy, urinary tract conditions, prostate cancer evaluation, and more — all under one roof
You
In private practice, you see the same surgeon at every visit — not a rotating resident or whoever is available that day

The Evidence

Surgical Volume Is the Most Reliable Predictor of Outcomes

"The more a surgeon does a procedure, the better they get at it. This is not an opinion — it is one of the most replicated findings in all of surgical research."

Across virtually every surgical specialty — cardiac surgery, orthopedics, oncology, and urology — studies consistently show that high-volume surgeons and high-volume centers achieve better outcomes. Fewer complications. Shorter operative times. Lower retreatment rates. Faster patient recovery.

For HoLEP specifically — one of the most technique-dependent procedures in urology — the data is particularly clear. The procedure has a well-documented learning curve, and outcomes continue to improve well beyond the initial 50–100 cases. A surgeon who performs HoLEP occasionally will never accumulate the repetitive experience that produces expertise.

Dr. Childs has performed nearly 1,000 HoLEP procedures since beginning practice in 2022 — including close to 200 in the past year alone. This places him among the highest-volume HoLEP specialists in the Mountain West. At the same time, he maintains a full-scope urology practice covering kidney stones, vasectomy, urinary tract conditions, prostate cancer evaluation, and more — offering patients comprehensive care in a single, coordinated practice rather than requiring referrals across multiple providers.

What the research shows
Studies of HoLEP outcomes consistently demonstrate that surgeons performing higher annual volumes achieve shorter operative times, lower complication rates, and better continence outcomes — with improvements continuing well past 100 cumulative cases.
The learning curve reality
HoLEP has one of the steepest learning curves in endoscopic urology. Most experts recommend a minimum of 50 supervised cases before independent practice — and outcomes for patients treated early in a surgeon's experience are measurably worse than those treated by an experienced specialist.
What this means for you
When you choose Dr. Childs, you are choosing a surgeon who has performed nearly 1,000 HoLEP procedures since 2022 — including close to 200 in the past year alone. He is well past the learning curve and accumulating experience at a rate that reflects singular focus, not occasional practice. Your procedure benefits from every case that came before yours.
The technique advantage
Dr. Childs employs the en bloc technique with early apical release — an advanced HoLEP refinement that requires both deep familiarity with the procedure and the technical confidence that only comes from high volume. This is not a technique offered at every center.

The Focus Advantage

What Happens When a Surgeon Dedicates Their Practice to One Thing

Deep Procedural Mastery
Dr. Childs performs a high volume of procedures across his practice — with particular concentration in HoLEP and prostate surgery. That accumulated volume translates directly into surgical precision and pattern recognition that lower-volume surgeons simply cannot develop at the same pace.
Current Knowledge
Dr. Childs stays at the forefront of BPH surgical literature precisely because it is his primary focus. New techniques, evolving data on outcomes, emerging alternatives — he tracks all of it closely and integrates the best evidence into his practice immediately.
Pattern Recognition
High-volume specialists develop an intuitive understanding of anatomical variation, unexpected intraoperative findings, and how to adapt in real time. This pattern recognition — built only through repetition — is what separates an adequate surgeon from an exceptional one.
Refined Protocols
Dr. Childs has refined every aspect of the surgical experience — from pre-operative evaluation to same-day discharge — based on accumulated volume and continuous improvement. These protocols benefit every patient regardless of which procedure they need.
Consistent Results
Consistency in surgical outcomes comes from consistency in practice. When the same surgeon performs the same procedure repeatedly with the same technique and the same team, results become predictable and reliably excellent.
Honest Counsel
A specialist with no financial incentive tied to any particular procedure is free to give you genuinely unbiased advice. Dr. Childs will tell you if HoLEP is not the right answer for you — because his goal is your best outcome, not a filled operating room.

Private Practice vs. Hospital Systems

What Most Patients Never Think to Ask

Most men with BPH are referred to wherever their primary care doctor has a relationship. That usually means a large academic medical center or hospital-employed urology group. There is nothing wrong with those systems for general care — but for a specialized procedure like HoLEP, the differences matter more than patients typically realize.

Specialist Private Practice — Dr. Childs
You see Dr. Childs at every visit — consultation, pre-op, post-op, all follow-ups
Appointments available within 1–2 weeks in most cases
Dr. Childs's income depends on excellent outcomes and patient satisfaction — his incentives are aligned with yours
Unhurried consultations — questions are welcomed, not managed
High-volume surgical practice — particularly in HoLEP, with nearly 1,000 cases since 2022
Same-day discharge and catheter removal for most HoLEP patients — an approach refined through high volume
Direct access to Dr. Childs's team with questions before and after surgery
Full ecosystem of BPH options coordinated from one practice
Large Hospital Urology Group
May see a different provider at each visit — residents, PAs, and attendings rotate
Wait times of 6–12 weeks for new appointments are common
Salaried physicians have no direct financial incentive tied to your outcome or satisfaction
High patient volume creates time pressure — consultations are often brief
HoLEP may be one of many procedures offered across a large department — not necessarily concentrated in one high-volume surgeon
Standard overnight stay and multi-day catheterization protocols typical
Post-op questions often routed through nursing lines or patient portals
Options may be limited to what that department offers

Setting the Record Straight

What Patients Assume — and What's Actually True

Common assumption
"The university hospital has the best surgeons because they're a teaching institution."
The reality
Academic medical centers excel at research and training. But for a highly technique-specific procedure like HoLEP, teaching environments mean residents are involved in your care and attending surgeons are spread across research, teaching, and clinical duties. A private specialist performing HoLEP daily — without those competing demands — consistently outperforms an academic surgeon performing it weekly.
Common assumption
"A big hospital system means better resources and better outcomes."
The reality
For complex inpatient care — trauma, cancer, intensive care — hospital resources matter enormously. But HoLEP is an endoscopic outpatient procedure. The outcome is determined almost entirely by the skill of the surgeon, not the size of the institution behind them. Dr. Childs operates at accredited surgical facilities with the same equipment used at any major center.
Common assumption
"If my doctor referred me somewhere, that must be the best option."
The reality
Primary care physicians refer to the specialists they know — often their former colleagues, their hospital's employed physicians, or the practice they've always used. Referral patterns are built on relationships and habit, not rigorous outcome comparisons. You have the right — and the ability — to seek a second opinion or choose your own surgeon. Many of Dr. Childs's patients sought him out specifically after researching their options independently.
Common assumption
"Private practice doctors are less qualified than hospital-employed physicians."
The reality
Dr. Childs trained at the same level as any academic urologist — medical school at the University of Vermont, residency at the Lahey Clinic in Boston, with additional training at Beth Israel Deaconess Medical Center, a Harvard Medical School affiliate. He chose private practice because it gives him the freedom to build a specialty-focused practice centered entirely on patient outcomes — not institutional priorities, committee assignments, or departmental quotas.

The Dr. Childs Difference

What You Get That You Won't Find Anywhere Else in Utah

01
Same-day discharge & catheter removal
Dr. Childs sends most HoLEP patients home the same day of surgery and removes the catheter before discharge. This is not standard practice — it is the result of high-volume expertise and refined protocols that most programs have not achieved. No other program in Utah currently offers this routinely.
02
Advanced surgical technique
The en bloc enucleation with early apical release technique Dr. Childs employs is a cutting-edge refinement of standard HoLEP. It requires deep familiarity with the procedure and produces better apical precision and continence outcomes. It is not widely performed in the region.
03
A true prostate center of excellence
No other practice in Utah combines high-volume HoLEP, UroLift removal, Optilume for BPH, and coordinated access to Aquablation, Rezūm, and PAE — all under the guidance of one specialist who understands every option deeply and has no agenda beyond finding the right solution for you.
04
The private practice experience
Every patient sees Dr. Childs personally — at consultation, before surgery, and at every follow-up. There are no residents, no rotating attendings, no patient portal delays. When you have a question, you reach his team directly. This level of continuity is simply not possible in a large hospital system.
"You deserve a surgeon who has dedicated his career to this — not one for whom it is an item on a long procedure list."

Schedule a consultation with Dr. Childs and experience the difference that focus, volume, and genuine expertise make. Most patients are seen within 1–2 weeks.

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(801) 432-3022