When minutes matter: the 24-hour stone center

Too often, patients are forced to accept longer waits in order to get access to the most cutting-edge research and advanced expertise. For routine care, community hospitals are able to deliver faster service, but lack access to breakthrough treatments. MUSC Health's Kidney Stone Center believes patients can have the best care with the least wait - and they are making that happen.

The Kidney Stone Center at MUSC Health operates with 24-hour turnaround from contact to operating room, matching community practice efficiency, proving academic medicine can deliver top-level care to patients without unnecessary delays. This approach is changing the lives of countless patients.

Take kidney stones. Stone management in academic centers typically involves 12+ hour waits, delayed consultations, and surgery scheduled days out.

At MUSC Health, we believe this delay is a system failure. Patients in severe pain occupy beds awaiting urology consultation. Some get sent home with narcotics to "wait and see." Others return repeatedly when conservative management fails. Meanwhile, community practices often operate within 24 hours of initial contact. If community hospitals deliver faster care for acute conditions, why choose academic centers for routine problems?

For over a decade, The Department of Urology at MUSC constructed systems specifically designed to answer this question - and ensure rapid access. Traditional academic systems route callers through multiple staff before reaching clinicians. Standard imaging queues create 6-12 hour delays. OR schedules built months ahead leave no room for urgent cases. 

MUSC Urology’s approach addresses these critical bottlenecks:

• A dedicated contact line: Patients reach urology staff directly - no phone trees, no intermediaries. Initial evaluation happens immediately.
• Streamlined imaging: CT protocols optimized for stones, with radiology prioritizing acute reads.
• Protected OR access: Time slots reserved for urgent cases enable surgery within 24 hours. This "well-oiled machine" required years of coordination across surgical scheduling, anesthesia, and nursing.
• Multidisciplinary integration: The Kidney Stone Center coordinates with emergency medicine and primary care for seamless patient flow.

The South Carolina context

South Carolina has significant uninsured populations who delay care due to cost, arriving only when pain becomes unbearable. By then, stones are larger and complications more common. Rapid access reduces this disparity-driven morbidity. Uninsured patients receive the same 24-hour response as insured patients. Treatment happens based on medical need, not payment status. Financial counseling engages after clinical needs are addressed.

This approach both serves vulnerable populations and reduces system costs: treating a 6mm stone with straightforward ureteroscopy costs far less than treating a 3cm infected staghorn calculus with staged procedures and prolonged hospitalization.

The Kidney Stone Center also serves as a regional backstop. Rural hospitals often lack urologists entirely, and now, an emergency physician with a patient in severe pain can transfer directly, knowing surgery will happen quickly. This regional access function matters as much as the local population served directly.

Comprehensive capability

The Stone Center offers the full spectrum: ureteroscopy with laser lithotripsy, percutaneous nephrolithotomy for large stones, shock wave lithotripsy, and advanced techniques including single-port robotic removal for complex cases.

This breadth matters because stones vary enormously. MUSC Urology handles everything, ensuring the 24-hour promise applies regardless of stone complexity.

For patients experiencing severe pain, rapid, expert intervention defines excellent care. For referring physicians, confidence that academic centers match community practice efficiency changes referral patterns. For the department, operational excellence creates referral volume supporting both clinical and research missions.

More broadly, the program proves a fundamental principle: great academic centers don’t need to choose between operational performance and research excellence. When institutions commit to building infrastructure that serves both missions, both succeed.

As health care consolidates and academic centers face budget pressures, programs like the Kidney Stone Center will define institutional success. Academic medicine that delivers innovation and execution will thrive. MUSC Health's Kidney Stone Center already delivers it - 24-hour access to comprehensive expertise, research integrated into clinical care, and operational performance exceeding community benchmarks. That's what destination centers should provide, and what patients increasingly demand from institutions claiming to lead American health care.