Reflections on a Career in Clinical IR: Challenges, Growth, and Differences

In this episode of the "History of IR" series on BackTable, Dr. Alan Matsumoto, Chair of the Department of Radiology at the University of Virginia and a fellow of the Society of Interventional Radiology, joins our host Aparna Baheti. Dr. Matsumoto also serves as the Vice Chair of the American College of Radiology's Board of Chancellors. This installment provides a unique perspective on the life and career of Dr. Matsumoto and sheds light on the evolution of interventional radiology.

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Dr. Matsumoto's journey into IR commenced during his residency in the Department of Radiology at the University of North Carolina. The culture of independence within the department allowed him to gain extensive hands-on experience. Subsequently, after completing a four-year radiology residency followed by a one-year fellowship, Dr. Matsumoto ventured into private practice on the picturesque West Coast of Florida. However, his return to academic medicine was inspired by a profound appreciation for collaborative patient care discussions with referring physicians, marking a departure from the previous norm of merely appeasing them to maintain referral patterns. This transition led him to the University of Virginia, where he partnered with Dr. Tegtmeyer. Dr. Tegtmeyer's meticulous approach in running the IR suite, akin to a surgical suite, cultivated an appreciation for organizational precision and independence.

During this conversation, Dr. Matsumoto fondly reminisces about Dr. Tegtmeyer, who emphasized the art of presenting oneself as an IR doctor to patients. He recognizes Dr. Tegtmeyer's passion for renal angioplasty, acknowledging him and Dr. Thoman Sos as pioneers in the field.

Dr. Matsumoto also provides valuable insights into the technological landscape of IR in the past, underscoring the absence of contemporary tools like C-arms and pre-shaped catheters. Consequently, IR practitioners had to adapt and innovate, often crafting and modifying instruments, including innovative solutions like using styrofoam for embolizations or shaping catheters with bunsen burners.

Furthermore, Dr. Matsumoto delves into the challenges faced by early practitioners, highlighting the need for caution to avoid detractors exploiting mistakes to diminish the value of IR procedures and potentially restrict the scope of IR practice. Balancing the role of a friendly collaborator with technicians and nurses while assuming leadership in the IR suite is a pivotal aspect of his journey.

Dr. Matsumoto then elaborates on his pivotal involvement in aortic work in 1998, as he helped establish a core lab and collaborated with device companies along with CT and vascular surgeons. This work allowed him to be a part of the approval process of Medtronic’s AneuRx endograft in 1999, where he testified at the FDA hearing for this groundbreaking product designed to treat AAA’s.

The transition to leadership within the department of IR at the University of Virginia marked another significant chapter in Dr. Matsumoto's career. Despite assuming this role unexpectedly after the passing of Dr. Tegtmire, he embraced the challenge. His vision for the department revolves around a heightened focus on clinical operations and streamlining patient responsibilities to enhance efficiency while upholding a culture of excellence.

Dr. Matsumoto concludes this episode with valuable insights into strengthening an IR department by effectively promoting and communicating the value of services to the broader medical community.