Current Clinical Practice Patterns of Self-Identified Interventional Radiologists

Balthazar, Patricia; Hawkins, C. Matthew; Vijayasarathi, Arvind; Loehfelm, Thomas W.; Duszak, Richard

doi:10.2214/ajr.17.18592

Cited by 23 publications

(8 citation statements)

References 22 publications

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“…Experience over the last 20 to 30 years has consistently shown that, over time, other specialties learn the techniques of some of the procedures in which interventional radiologists excel. Although other specialists do not regularly achieve the same level of technical proficiency, they nonetheless control access to the patient, and as a result threaten to marginalise IR [60][61][62]. To become more independent, it is crucial not only to get direct access to the patient, but to communicate IR's portfolio to referring physicians, including GPs, and to provide a low-threshold access to IR.…”

Section: Marketing In Irmentioning

confidence: 99%

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CIRSE Clinical Practice Manual

Mahnken¹,

Seoane

Cannavale

et al. 2021

Cardiovasc Intervent Radiol

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Background Interventional radiology (IR) has come a long way to a nowadays UEMS-CESMA endorsed clinical specialty. Over the last decades IR became an essential part of modern medicine, delivering minimally invasive patient-focused care. Purpose To provide principles for delivering high quality of care in IR. Methods Systematic description of clinical skills, principles of practice, organizational standards and infrastructure needed for the provision of professional IR services. Results There are IR procedures for almost all body parts and organs, covering a broad range of medical conditions. In many cases IR procedures are the mainstay of therapy, e.g. in the treatment of hepatocellular carcinoma. In parallel the specialty moved from the delivery of a procedure towards taking care for a patient’s condition with the interventional radiologists taking ultimate responsibility for the patient’s outcomes. Conclusions The evolution from a technical specialty to a clinical specialty goes along with changing demands on how clinical care in IR is provided. The CIRSE Clinical Practice Manual provides interventional radiologist with a starting point for developing his or her IR practice as a clinician.

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Section: Marketing In Irmentioning

confidence: 99%

“…Many hospital administrations, and sometimes even diagnostic colleagues, would rather have the interventional radiologist reading plain films, covering CT, etc. [ 62 ]. This aspect of time needs to be built into any job plan, as it is an essential component for a successful IR team.…”

Section: Infrastructure For Ir Clinicsmentioning

confidence: 99%

CIRSE Clinical Practice Manual

Mahnken¹,

Seoane

Cannavale

et al. 2021

Cardiovasc Intervent Radiol

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“…In light of recent work indicating substantial geographic disparities in patient access to local radiologists (4,5), the concerns of Heitkamp and Gunderman (10) raise important questions about whether all radiology practices will, in the future, be able to adequately meet the broader needs of patients requiring less complex invasive image-guided procedures. If interventional radiology increasingly evolves in a subspecialty-focused (and largely urban-predominant [5,6]) manner and if generalists (who are much more likely to practice in areas with a less concentrated population [5]) lose expertise in invasive procedures, then the geographic access disparities were reported herein could be further exacerbated.…”

Section: Discussionmentioning

confidence: 93%

“…Radiologist subspecialization potentially affects access to invasive imaging-based procedures as well. While interventionalists perform a wide spectrum of both basic and advanced invasive procedures (6), other subspecialists (eg, abdominal, breast, and musculoskeletal radiologists, as well as neuroradiologists) also commonly perform selected invasive procedures relevant to their given subspecialty. Generalists are often expected to perform invasive procedures in their practices as well (7).…”

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confidence: 99%

Generalist versus Subspecialist Workforce Characteristics of Invasive Procedures Performed by Radiologists

et al. 2018

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Purpose To explore subspecialty workforce considerations surrounding invasive procedures performed by radiologists. Materials and Methods The 2015 Centers for Medicare & Medicaid Services Physician and Other Supplier Public Use File was used to identify all invasive procedures (Current Procedural Terminology code range, 10000-69999) billed by radiologists for Medicare fee-for-service beneficiaries. Radiologists were categorized by subspecialty according to the majority of their billable work-relative value units (wRVUs). Those without a single subspecialty majority work effort were deemed generalists. Procedures were categorized into three tiers of complexity (high, ≥4.0 wRVUs; mid, 1.6-3.9 wRVUs; low, ≤1.5 wRVUs). Total and tiered generalist versus subspecialist workforce composition was assessed. Results Just 25 unique services comprised more than 75% of invasive procedures performed by radiologists. Of radiologists who performed procedures, 57.5% were generalists, 15.8% were interventionalists, and 26.8% were other subspecialists. Of the radiologists who performed low-, mid-, and high-complexity procedures, generalists accounted for 46.3%, 30.9%, and 23.1%, respectively; interventionalists accounted for 35.4%, 30.9%, and 75.2%, respectively; and other subspecialists accounted for 18.3%, 14.6%, and 1.7%, respectively. Generalists were the dominant providers of six of the top 10 low-complexity and seven of the top 10 midcomplexity procedures. Interventionalists were the dominant providers of all top 10 high-complexity procedures. Nationally, over twice as many U.S. counties had local access to generalists (869 counties) for invasive procedures versus interventionalists (347 counties) or other subspecialists (380 counties). Conclusion Among radiologists, generalists perform far more procedures in more geographic locations and are more likely to serve patients with less complex service needs than are interventionalists or other subspecialists. Practices and professional societies must remain vigilant to ensure that the subspecialty evolution in radiology does not exacerbate patient access disparities. © RSNA, 2018 Online supplemental material is available for this article.

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“…In contrast, the significant majority of IRs in private practice-including all of those in my new group-routinely split their time between interventional and diagnostic responsibilities. 1 Had I been closer to my training, I would almost certainly have been expected to do this as well, perhaps attending some review courses to bring up my skills. Instead, my new IR partners agreed to pick up additional imaging rotations on my behalf.…”

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confidence: 99%

Academic vs. Private Practice: An Indistinct Distinction

Andrews

2019

Semin intervent Radiol

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Interventional radiology (IR) practices take many forms, but often are distinguished as following either an academic or private practice model. Both differences and similarities are seen when comparing these two general practice categories, and often the line between the two models is unclear. This article reviews some of the commonalities and differences between academic and private practice IR, and provides personal insights from an author who has significant experience in both practice models.

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Current Clinical Practice Patterns of Self-Identified Interventional Radiologists

Cited by 23 publications

References 22 publications

CIRSE Clinical Practice Manual

CIRSE Clinical Practice Manual

Generalist versus Subspecialist Workforce Characteristics of Invasive Procedures Performed by Radiologists

Academic vs. Private Practice: An Indistinct Distinction

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