Not every physician works in a surgical subspecialty that he had a hand in creating, using equipment he had a hand in developing and prescribing pharmaceuticals he had a hand in formulating. But not every doctor is Alexander Gershman, MD, a Russian-born urologist. Dr. Gershman is one of the few doctors in the country performing robotic laparoscopic prostatectomies, after becoming one of the first, in the late 1980s, to perform laparoscopic prostatectomies the "old-fashioned" way.

Dr. Gershman's American education started in 1989 with a research fellowship at Cedars-Sinai Medical Center, followed by a clinical fellowship in urolithiasis and endourology at UCLA Medical Center. He also completed an internship in general surgery at UCLA, as well as two residencies there, one in general surgery and one in urology. He did a stint as clinical chief of urologic surgery at Cedars and at the former Midway Medical Center. He's now director of urologic laparoscopic surgery at Harbor-UCLA Medical Center, head of endourology at the VA Greater Los Angeles Healthcare System and assistant clinical professor in the Department of Urology at the David Geffen School of Medicine at UCLA. And he manages his own private practice at the Institute for Advanced Urology in Los Angeles.

Hired as a visiting professor at Cedars almost 20 years ago, Dr. Gershman worked with a group of general surgeons who were honing their laparoscopic colecystectomy skills, a task that "gave me the idea to start developing things in urology," he says now. "There was no laparoscopic urologic surgery then." From there, he started training other surgeons throughout the country and all over Europe--including leading courses in Holland, Germany and Austria--in urologic procedures. Indeed, he estimates he's trained more than 350 urologists in laparoscopic surgery in the United States alone. He also worked for a spell at the Laser Research Institute at Cedars, where he helped develop laparoscopic techniques for a variety of pathologies, including laparoscopic lymph node dissection and laparoscopic nephrectomy.

But Dr. Gershman hasn't just played a key role in disseminating a new surgical technique, he's also consulted with manufacturers to develop the tools he uses in performing it. For example, he worked with U.S. Surgical Corp. for several years, assisting the device manufacturer in developing a number of instruments for laparoscopic urologic surgery. In addition, he consulted for the urology and gynecology division of Gyrus ACMI Inc., testing new developments for the firm by training residents to use the manufacturer's cutting-edge technologies.

That hands-on experience of laparoscopic surgery led him to his latest project, robotic laparoscopic surgery. "It's sort of futuristic," he quips. A surgeon uses a specially designed console to manipulate the robotic arms that actually perform the surgery. There's also a telemedicine aspect. A surgeon in Boston, for example, could use the technology to operate on a patient in Paris, he says.

Dr. Gershman's enthusiasm extends beyond medical technology to organized medicine as well. In addition to being a member of the Los Angeles County Medical Association, the Moscow-area native took the reins of the American Russian Medical Association three years ago. "There are a lot of Russian emigres in the United States, primarily in New York and Los Angeles," he says. Advocacy for those transplanted physicians is the mission. "Our primary goal is physician education. We hold meetings and lectures. We also operate patient education services, free clinics and various fundraising programs." The group has about 1,000 members.

If it seems like Dr. Gershman eats and breathes medicine, it may be because he has it in his blood. Both parents and a brother are doctors, and his father in particular is both a colleague and a role model. He was a well-known surgeon in Russia before coming to the United States with the junior Dr. Gershman's mother.

Like many physicians--especially those with a high-tech bent--Dr. Gershman indulges his left brain with jazz music. "If I wasn't a surgeon, I'd be a musician," he says. "There's an old Russian joke that every Russian mom wants her son to be a lawyer, a doctor or a musician." Two out of three ain't bad. Dr. Gershman plays bass, rhythm and classic guitar, and piano. "I'm not great, but I'm shameless," he jokes. "I have a little band and we play together when we can." And he's also fearless when it comes to pursuing his other pastime--skiing. An avid downhill racer, he participated on a team in Russia.

"I have a lot of energy," Dr. Gershman says. And he's delighted with his hectic mix of private practice, academic appointments, and research and development activity. "My practice allows me to dedicate quite a bit of time to my patients, and that goes hand in hand with my academic activities. I love teaching, and I feel I have a lot to offer the residents," he says.

Moving forward, he'd like to spend more time in the R&D space. He participates in several clinical trials in his office practice and is currently involved in eight projects for pharmaceutical companies developing new tests and drugs for urologic conditions. Overall, he describes his role in changing the future of urology as "really satisfying."