Revealing a Personal Face of Radiology
A new task force sets out to explore the clinical practice of interventional radiology and interventional neuroradiology and advocate for these vital subspecialties.
Mrs. Smith was in dire straits. She was bleeding to death during her C-section. Her experienced OB thought she might not survive a hysterectomy and asked for my help.
I consulted in the OR and then performed a uterine artery embolization. Later, I spoke with her husband. "Mr. Smith," I said, "I am Dr. Cook, an interventional radiologist. I have just successfully stopped your wife's life-threatening bleeding from her uterus." The looks of relief and gratitude on the faces of Mr. Smith and Mrs. Smith's father were heartrending. I was instantly reminded of how valuable my skills are and how important the work we do as interventionalists is in others' lives. Two days later, Mrs. Smith went home to her husband and four children, knowing a radiologist saved her life.
The clinical practices of interventional radiology (IR) and interventional neuroradiology (INR) provide a unique opportunity to present a personal face of radiology. Our patients and their families know us. IR/INRs discuss treatment options with our patients' physicians. However, many of our clinical colleagues still don't know the full scope of the clinical practices of IR/INR. We should ask ourselves, do our hospital CEOs understand the value of IR/INR? Does the public? Do the politicians? Do the insurers? Do these other stakeholders realize that our interventional clinical skills and procedures offer effective, less-invasive alternatives that save lives, shorten hospital stays, and improve treatment outcomes while providing cost-effective care? Unfortunately, all too often the clinical practices of IR/INR are underappreciated for their contribution to the quality patient care.
The skills of IR/INR are integral to a well-rounded radiology practice. Integrated diagnostic imaging practices combined with clinical practices of IR/INR maximize total quality care and outcomes necessary to any group's ability to maintain stable relationships with hospitals. The ACR recognized the importance of IR/INR in its 2004 white paper, "Clinical Practice of Interventional and Cardiovascular Radiology: Current Status, Guidelines for Resource Allocation, Future Directions" and later in "ACR-SIR-SNIS Practice Guidelines for Interventional Practice."
Despite its benefits, however, the clinical practice of IR/INR, within both private and academic radiology practices, has been implemented in varying degrees throughout the country. Why? The reasons could be lack of education about the subspecialty and failure to promote the value of IR/INR to all players in the health-care system.
To help educate radiologists and health-care stakeholders about the benefits of implementing IR/INR, Resolution 9, "Implementation of the Clinical Practices of Interventional Radiology and Interventional Neuroradiology," was passed at AMCLC 2012. I wish to thank Dr. Ellenbogen for my appointment as chair of the task force for the resolution and the opportunity to lead such an important effort.
To implement Resoultion 9, we have assembled an outstanding collection of accomplished radiologists from academic, private, and multi-specialty practices. The task force's goal is to propose strategies that enhance and promote the growth and demonstrate the value of IR and INR clinical services within radiology and to the entire health-care system. Their charge is to take a fresh look at the barriers to implementing clinical IR/INR practices and to propose solutions. Once both barriers and solutions are identified, the task force will critically evaluate past and present programs and resources, explore modifications (where appropriate), and determine what new endeavors may be necessary. The emphasis is on deliverables, which may include producing educational campaigns for fellow radiologists, physician colleagues, hospital administrators, and the health-care industry; developing targeted publications; recommending research that more rigorously demonstrates the value of IR/INR; and identifying practice management, financial, and IT support tools that need to be developed.
The strong support from the ACR council and ACR leadership and the enthusiastic response of the very busy, talented radiologists invited to serve on the task force validates the importance of the project and the issues at hand. The challenges and scope are broad, but the stakes for radiology as a whole are high. The more visible IR and INR radiologists and their skills are to patients and referring physicians, and the more those skills are identified as essential to quality patient care by the industry, the more our profession will be appropriately valued by all health-care stakeholders. I welcome your constructive input and ideas. This task force will deliver!
By Philip S. Cook, MD, FACR, Vice Chair, ACR Commission on Interventional and Cardiovascular Radiology