BackTable Vascular & Interventional

Dr. Waqaar Diwan, an interventional radiologist, shares his experience transitioning to building his own independent IR practice after sudden ownership changes. He discusses navigating challenges like securing hospital contracts and managing a small team. Dr. Diwan emphasizes the importance of trust-building for referrals and the differences between independent and combined practices. He also highlights leveraging networks for business development and adapting to patient care logistics, all essential for a successful independent practice.

In this engaging discussion, Dr. Alex Wallace, an interventional radiologist at Mayo Clinic, and Lisa Rotellini-Coltvet, a physician assistant, share their expertise on the groundbreaking percutaneous transesophageal gastrostomy (PTEG). They delve into patient selection criteria, emphasizing its importance for those who can't undergo traditional methods. The duo also highlights the substantial impact of PTEG on quality of life, detailing successful case studies and stressing the need for thorough education for patients and healthcare staff to ensure optimal outcomes.

Dr. Gary Siskin, Chair of Radiology at Albany Medical Center and an expert in liquid embolic agents, shares valuable insights into their practical applications. He discusses techniques for the effective use of Onyx and LAVA in complex cases, especially in trauma care. Key topics include managing catheter positioning and preventing reflux with tailored injection speeds. Siskin emphasizes the importance of understanding viscosity differences and minimizing complications during procedures, making it a must-listen for interventional radiologists seeking to enhance their skills.

Dr. Joshua Kuban, an interventional radiologist at MD Anderson Cancer Center, discusses the significant impacts of NeuWave's discontinuation of its microwave tumor ablation technology. He reflects on how NeuWave reshaped interventional oncology and held over 50% of the microwave market. The conversation explores strategies for adapting to alternative technologies and highlights the evolving landscape of ablation confirmation and emerging robotic technologies. Kuban emphasizes the importance of collaboration and innovation for the future of interventional radiology.

Dr. Sunandana Chandra, a medical oncologist and director of melanoma care at Northwestern, joins Dr. Riad Salem, an interventional oncologist specializing in metastatic melanoma treatments. They discuss the evolution of melanoma management, highlighting innovative approaches like immunotherapy and intratumoral oncolytic viruses. The conversation dives into key clinical trials, including IGNYTE-3, and best practices for administering therapies. Their collaborative approach showcases the importance of multidisciplinary teams in enhancing patient-centered care and improving outcomes in advanced melanoma.

Dr. Quinn Meisinger, the Program Director at UCSD, shares insights on the evolution of interventional radiology training. He discusses the shift from traditional fellowships to integrated residency programs, emphasizing the importance of mentorship. The transition to real-world practice reveals the need for adaptability and a supportive community. Dr. Meisinger also highlights the changing dynamics in the job market and the evolving roles of Advanced Practice Providers in interventional radiology, showcasing the potential for growth and collaboration in this field.

Dr. Stephen 'Andy' Vartanian, an expert interventional radiologist and medical director at PrecisionIR, shares his in-depth knowledge of outpatient prostate artery embolization (PAE). He discusses essential techniques, patient management, and the importance of collaboration with urologists. Vartanian also dives into the challenges of running an independent practice, including financial strategies and patient acquisition. Highlights include insights on uterine fibroid embolization and maintaining care quality in an evolving healthcare landscape.

How is reimbursement decided? Have an inside look from the committee itself as we unpack exactly how a new CPT (Current Procedural Terminology) code is created, assessed, and ultimately valued for physician Medicare reimbursement. In this episode of BackTable, Dr. Sabeen Dhand is joined by radiation oncologist Dr. Amar Rewari and interventional radiologist Dr. Curtis Anderson, both of whom sit on the RVS Update Committee (RUC).---SYNPOSISThe conversation covers who participates in the RUC, the preparation it takes to propose a new CPT code, and what it’s like to collaborate with physicians from all specialties. They discuss the confidential yet crucial role of the RUC in determining physician work and practice expenses, advocacy efforts, and the impact of healthcare policies on reimbursement. The doctors stress the importance of physician engagement—especially through member surveys—and share how providers can get involved. The guests also touch on their personal journeys and motivations within the RUC and introduce Dr. Rewari’s podcast, ‘Value Health Voices’, which focuses on healthcare policy and economics.---TIMESTAMPS00:00 - Introduction and Importance of Surveys01:18 - Understanding the RVS Update Committee (RUC)6:36 - How Does a New CPT Code Get Introduced?09:44 - Challenges and Dynamics within the RUC20:52 - Health Value Voices Podcast22:51 - Transparency in Healthcare Policy24:39 - Future of Healthcare Payments29:00 - Getting Involved in Healthcare Policy33:43- Final Thoughts and Call to Action---RESOURCESHealth Value Voices Podcast: https://open.spotify.com/show/0cxnf4Il3QK3cvFFKxwPWL?si=212d084a09034cf2

Dr. Martijn Meijerink, an interventional radiologist from Amsterdam UMC and principal investigator of the COLLISION Trial, discusses groundbreaking findings in metastatic colorectal cancer treatment. He emphasizes the potential of thermal ablation as a minimally invasive alternative to surgical resection. The dialogue reveals how advancing techniques, such as radiofrequency and microwave ablation, could reshape clinical practices. Dr. Meijerink also highlights the importance of standardizing care and interdisciplinary collaboration in improving patient outcomes.

Dr. Kavi Devulapalli, a physician at Image Guided Solutions, and Dr. Christopher Zarour, from a private practice in Ann Arbor, dive into the early career landscape of interventional radiology. They discuss the importance of finding the right practice model that aligns with one's skills as either an imager or surgeon. Personal experiences highlight the challenges of job searching, establishing clinical practices, and building strong professional networks. They also offer invaluable insights on the financial fundamentals and the significance of mentorship for new graduates.