Practice Profile: Unique private practice focuses solely on sexual medicine

Urology Times’® Practice Profiles series takes readers behind the scenes of US-based urology practices. From solo practitioners to large groups, each installment highlights these practices’ unique qualities, successes, and challenges. To have your practice featured in this series, please email Hannah Clarke at hclarke@mjhlifesciences.com.

Rachel S. Rubin, MD

In this installment, Rachel S. Rubin, MD, highlights the practice that she began in Washington, DC.

Could you provide some background on yourself and your practice?

I'm Dr. Rachel Rubin. I'm a urologist, and I did fellowship in sexual medicine. I take care of all genders for sexual health complaints. I started my own private practice in January of 2022, which is a cash pay practice aimed at spending a lot of time with people and approaching sexual health concerns through a biopsychosocial lens.

What have been some challenges that you faced in getting started? How have you overcome those challenges?

When I got out of fellowship, it was difficult to have a job. Everyone said that what I do is weird and that I wasn't going to make enough money fast enough. I had a contract in hand from a big LUGPA urology group, and they took it away from me saying that I would not be profitable. Similarly, academic institutions thought that I would not make them enough money, because what I do takes a lot of time, and they did not see how it would fit the standard medical model.

And they weren't wrong. Insurance does not reimburse for comprehensive, long form care, which is what people with sexual problems truly need. So, I had to think outside the box and charge like a lawyer, where I spend time with people and I have an hourly rate, like a very well-trained, high-priced lawyer. People invest in spending the time to really go over their medical problems and their healthcare issues. I find that no problem is too challenging when you have the time to really go through it and get to know people.

Now, what do I know about business? I knew nothing about business. But I learned, "Hey, I can do a penile implant. How hard can learning business be?" Or I should say, "How hard can QuickBooks be?" You can learn how to start a business, and now it's easier than ever with incredible podcasts, incredible business coaching, and amazing crowdsourcing that happens on the Internet, where there are lots of Facebook groups and communities of people who are willing to help you and give you their time and their knowledge. They don't want you to make the same mistakes that they made.

What are some wins that you have experienced since getting started?

Unlimited wins. The more you think outside the box and help people, the more people talk about it and the more that fuels even more interest and excitement. Our ultimate goal is to serve people and to create their wins. We are saving marriages. We are helping women stay in high CEO positions by fixing their menopausal complaints. We are helping men [gain] more confidence [by helping] with their testosterone and erectile dysfunction issues. We are giving so much good that we're getting unbelievable amounts of business and press. You cannot pay for the press that I have gotten this year by just serving and being loud on social media about how much fun we are having.

I've had 3 New York Times articles. I've been on PBS; I've been on NPR; I've been in the Washington Post. Everyone asks me who my PR company is, and I don't have one. I am just loud on Twitter and Instagram and giving information out. I'm teaching people how to fish. You want to practice sexual medicine, here's how to do it. You don't have to be Rachel Rubin to do it. You are a board-certified urologist and can take care of men and women, you can do this too. By putting out evidence-based information, it's gotten us so much attention, which has been wonderful.

What conditions do you treat? What services do you offer?

I do 4 things as a sexual medicine doctor. All you urologists do a lot of things; I do 4 things. I deal with issues of libido, arousal, orgasm, and pain. We take care of a lot of menopause concerns. We take care of a lot of pelvic pain, a lot of low libido issues, and in men we take care of a lot of erectile dysfunction and low testosterone. I joke and I always tell my colleagues, “I do the [stuff] you don't want to do.”

The patients who take a lot of time: the ball pain, the post-finasteride syndrome, the post-orgasmic illness syndrome, the post-[selective serotonin reuptake inhibitors] SSRI, and sexual dysfunction. The patients who need your time and expertise, you can't do it in 10 [minutes]. You hate seeing those patients because it takes longer than 10 minutes to really make headway with those patients. I love seeing those patients, because when you give patients time, you can work together to make a progress in these conditions.

What is the makeup of your staff and the roles associated with your practice?

We are growing. I currently have a part-time doctor who is a urologist working with me. I have a physician assistant, and then I have 2 medical assistants.

What are some unique elements to your practice?

There are not many like it, although people are starting similar things because they are frustrated with the current medical landscape in that they are not feeling fulfilled. They're getting burnt out because they have no time. They are working on an assembly line, and people are not an assembly line. You cannot take care of people in 10 minutes. You can't truly learn about people, what their goals are, [and] what they care about in 10 minutes. For a quick stone case, maybe. But our patients have a lot of questions. They have a lot of needs. Sexual health and quality of life really matter to our patients, and they deserve the time and the expertise that urologists have to give them.

You can learn more about Rachel Rubin, MD, PLLC here.