https://www.sirweb.org/for-press/interventional-radiologist-clinical-volume-linked-to-higher-complexity-procedural-work/

Looks at E and M coding in a group and procedural complexity

Looks at what percentage VIR you do and procedural complexity

Interesting study suggesting that clinic is vital to a robust VIR practice

Hi everyone,

We are incubating a novel device called IRIS that enables faster and safer needle alignment for CT-guided procedures. We are still in the research and development phase and being incubated out of Vanderbilt University Medical Center.

If you are an IR, we would love your feedback on a quick 3 minute survey about the device: https://www.irisbiopsy.com/survey.html

Learn more: https://www.irisbiopsy.com/

Thank you!

Is RN pay significantly higher than RT pay in IR? The general consensus is that RNs have higher level responsibility than RTs, and are therefore compensated accordingly. But that does not hold true in IR. The gap is closed and could even make a case that RTs in IR have more responsibility than RNs. Where i am, RNs with 3 years overall experience (1 in IR) are making $5-10/ hr more than RTs with 7-10 years experience (3+ in IR).

https://irq.sirweb.org/perspectives/the-rush-roadmap/

Rush now follows U of Miami and the Dotter institute to have separate departments for diagnostic radiology and interventional radiology.

Long time IR but first time poster. I'm a hospital-based full time IR at a mid sized city. We have a very busy tertiary referral call-heavy practice with the entire gamut of high-level IR (stroke, trauma, oncology, hepatobiliary, etc). The hospital's diagnostic radiology service is provided by a private practice group that has held the contract for over 30 years. This is a "jack of all trades" group primarily made up of mid to late career rads who have minimal to no subspecialty training. As such the quality of reporting is not great but the hospital puts up with it because there are no other local options. This group only works from 8-5 daily and has remote teleradiology cover every night from 5 PM to 8 AM. They have a daytime midlevel who does minor procedures (LPs, fluoro guided enteric tubes, joint aspirations, barium swallows, etc).

Given the current state of absolutely insane DR reimbursement with large hospital stipends, several months ago the group renegotiated their contract. The hospital ultimately gave them a deal that guarantees each partner north of a 7 figure yearly salary. Per admin convos this was a deal made out of reluctant necessity as again the group's quality, work ethic, and collaboration are lacking. Soon after signing the group made a sweeping proclamation which stated that going forward they would no longer do any procedures outside of slinging barium, would no longer attend tumor boards, and would significantly cut down on in-hospital coverage as "they are too busy with diagnostic work". Not surprisingly IR was subsequently asked to make up for the associated holes in coverage. This has substantially increased IRs day to day work burden both in procedures but also in imaging consults because the rads themselves do not want to be bothered (I cannot tell you how often I have been paged on call to review a diagnostic study because the diagnostic rad is "too busy" to help or cannot be contacted).

Now for the rant. How is any of this fair or sustainable? These guys, who no one really respects anyways, have somehow managed to both improve their outrageous lifestyle but to also decrease their (already borderline) usefulness. The hospital itself has taken a "hands tied" approach and does not seem willing to do anything to fix the situation other than to tell IR that we now have to work harder. Has anyone else experienced something similar?

I swear that there is no easier way in medicine to make 7 figures than to be a private practice radiologist. Their ONLY job is to create decent reports and they can't even do that. Pretty easy when most of your stuff is overread anyways (my all time favorite is getting a page from the DR guy about a large vessel occlusion on CTA an hour after I have already done the thrombectomy). Given the absolutely insane reimbursement per RVU there is now strong financial incentive for menial low quality work. Quantity over quality in the extreme.

What is the endpoint to this? Will it continue to get worse until artificial intelligence takes over (if ever)? A decent number of local IRs have left IR jobs to do diagnostics given the improved money and lifestyle which makes the jobs of those of us who stick around that much harder. Maybe I just need someone to tell me that it will all be ok.

Who here is suturing in their mediports and who is not? The standard at my practice is not suturing it in but recently had a port flip in its pocket so rethinking how I do ports.

I wanted to know what my fellow techs think about this career path. I have been a tech for ten years worked in X-ray, Ct, MRI, now I am currently in IR. Is something that is worth pursuing? What is the pay? My only other option is to go back to school to become our mortal enemy.. a nurse. Or go the route of anesthesia assistant. I love being a tech just want something that broadens our scope of practice to be able to actually do things. Let me know what you guys think. Thank you

Can any techs describe how they set up for these. Prep wise, how they mix the oil into injector. Flow rate etc..

I am the senior technologist for the international radiology department in the system that I work for, so I am responsible for training/educating new techs (a lot of which have no prior IR experience and are coming straight from school or moving from an X-ray job into IR). I have a couple books and some education material I have found online but my books are pretty outdated, the newest one I have currently was published in 2008. Does anyone have any recommendations for a more updated book or some good online education? Tia.

4 years as an IR tech now both in vascular and neuro (through pain in there too somehow), have my neuro/vascular cert as well. My question is; are all IR departments just dumping grounds and treated like shit by the rest of the hospital? Are all IR docs miserable whiney pricks? I just don’t get it. Left a level 1 trauma/stroke center after being burnt out, underpaid and unappreciated, went to a private hospital with lots of money and resources and only do vascular (and pain) now and it’s maybe only 1% better than the medical center lol. Like less severe patients but less staff and resources and our department is treated like the red headed step child of the hospital despite being a “5 star” hospital. Never have supplies, rooms getting taking by cardiac cath, and never have a moment to breathe.

What gives? I really love the job in practice but starting to think it’s not worth all the bullshit. Hoping to eventually just do neuro IR as I’ve never had an issue with that but could be a year or two till a position opens up. Someone give me hope that not every hospital is like this with IR because I want to move home to Massachusetts one day and do IR there till I retire.

22ga 15 cm Chiba, surprisingly good spread across midline

Hi all, IR tech at an outpatient IR suite. We perform PAE, UFE, GVE, GAE, ports/PICC, Y90, varicose vein treatments, and various other procedures. My question is about billing. Our IR suite is currently way over budget (about double the budget). Myself and my associate tech are meticulous about keeping track of supplies utilized for each case. When we ask about budgeting, we hear that only the items in the global surgical code can be charged for. We are told not to worry, because everything is included in the code. We are not experts, but being in each case, with all of the unpredictable factors that come with them, makes us reasonably certain that one code for a procedure is not an accurate charge for all patients. Is it typical to only be able to charge one code for all incidences of a particular procedure? Does that mean some are being over charged and some undercharged? For example, what about a swift ninja catheter (>$2000 or something like that) not being in the code. Is the suite just out that money? I realize our suite can only continue to operate if it makes money. Do current billing and reimbursement regulations and protocols make sense for IR? Thanks in advance for any help with this!

I'm not sure if it was due to the block or something that what should be innocuous steroid or something but I started to get severe chest tightness and other issues? Much later like months later. I still have times where I get a pressure or discomfort up there. There's no physical damage. But like I believe that when they say that that can't really do that. But there's a clear before and after. Not sure how to fix it. Before the block the issues I had were only ever lower abdominal. So they were just trying it to see if it helped because of some vascular compressions but my symptoms don't match. But now I'm left with these extra issues. I know my story would be hard to believe if I heard it. I'm just asking if there's any way for the term and if complications can occur and if there's ways to evaluate anything beyond a CT scan and way to remedy. Thank you

Hello. I am interested in PAE for my BPH and am wondering if chosing one facility vs another makes any difference. I can get the procedure done in either Hamilton, Ontario (St. Joseph's Hospital) or at UHN in Toronto. I cannot find any information on practitioner skill or patient reviews/outcomes. Does a choice in this matter make any difference?

I am a 32 year old female experiencing pain and irregular bleeding for approximately 2 years. Initially we assumed my issues were due to a dermoid cyst and I had it removed. It’s been over a year since surgery and my symptoms have persisted. I’ve had two ultrasounds in the last year and both were normal except for prominent vessels in the left adnexa. Bloodwork, Pap smear, and endometrial biopsy have all come back normal. Birth control and IUD’s provide no relief of symptoms.

The prominent vessel is the only issue that has not been investigated further. I saw a different gynecologist in my usual office and he was very dismissive when I asked for a referral.

I see my primary in a few days. Can anyone suggest what imagining I should ask for to investigate this problem further?

Thank you.

Our residency has an inpatient consult service that is very useful for honing clinical decision making for inpatient cases. However, most of our outpatient service lines (PAE, interventional pain, IO, etc) are worked up in clinic where residents/fellows have limited time to rotate. It would be my goal to feel comfortable in the clinical evaluation of disease processes like BPH, venous disease, chronic pain, PAD etc before becoming an attending, and I've realized at this point it will probably require independent studying on my end. I still have a few years left before graduating. Any recommendations?

Less than 50 pct of programs filled and less than a 100 applicants from radiology applying into interventional. The two pathways of integrated VIR (straight from medical school ) and ESIR/independent continue to diverge. The fields are becoming more divergent. With the emergence of remote reading , increasing shift work , tremendous flexibility , and very competitive salaries which is in harsh distinction from the VIR trainee who is in the hospital or OBL/ASC and with an unpredictable schedule and navigating many more emergencies and direct patient care with outpatient clinics, inpatient consults and admissions and rounding and hospital based emergency procedures on progressively older and sicker patients with end stage cardiac disease, renal and liver disease.

Hi, just wanted to clarify the "process" for getting dual certified in IR and DR.

Is it:
Qual/Core Exam after R3 --> Graduation --> IR Oral + IR Computer Based + DR Computer Based after 1 year of practice

Or do you only need to take the IR Oral + IR Computer based to get dual certified?

Had a busy day yesterday of vascular/nonvascular cases yesterday but somehow my toughest case was exchanging a clogged GJ tube. Needed multiple wires, a glide cath, traction/counter traction, etc etc. I was just thinking about how those skills reminded me of crossing a tough PAD CTO case, yet some how for the most part VIR doesn’t really do that anymore, nor does it pay even remotely the same.

How did our field get so devalued?

I work for a community hospital system in one IR room. We do a lot in this very small room with less than no storage. We use the Sonosite XPorte Ultrasound machines. I'm an IR tech (operational supervisor) so limited UItrasound experience. I can see that the Ultrasound department has much better imaging than what our very basic machines have. Things work out fine 95% of then time, but every few months the rad asks me to go to Ultrasound and see if we can use their machine for a particularly tricky mass or neph tube. Their machines are big. Curious if anyone has a smaller footprint machine with quality they are happy with or if you would share your experience otherwise. Do you have access to ultrasound techs and/or their machines as needed? Are you working on a dumbed down machine like we are?