Building an IR practice by walking the halls

Building an IR practice by walking the halls

March 06, 2020
Cardiology Operating Room
From the March 2020 issue of HealthCare Business News magazine

By Dr. Ankit H. Shah

A few months ago, I was walking down the hall of the county hospital ICU where I practice when I was confronted with what I thought was a most unusual question from the hospitalist on call:


“Are you lost?”

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Puzzled, I let her know that I was actually checking in on a patient that I had done an embolization on yesterday. I was still new to the hospital and to my role of section chief of interventional radiology, yet I assured her that I was quite confident that I knew the way to the patient’s room. But her concern wasn’t with my ability to navigate the hospital, as she later explained to me. She said she had not seen an interventional radiologist outside of the angiography suite in some time and she wondered what I was doing in her territory.

Her simple question crystalized what would become my greatest challenge in building up the IR practice: challenging the status quo to build a culture of collaboration, trust, and support that would make us all more effective and would bolster the status of the IR practice.

As one of the newest medical specialties, interventional radiology is still expanding its boundaries and clearly identifying what it has to offer to patients and to the rest of the clinical team. We do not have our own identifiable organ system, something that would put us on the anatomical map like other specialties and would give our patients and colleagues an easier frame of reference for thinking about IR. Our image-guided, minimally-invasive techniques inspire creativity for approaching some of medicine’s most difficult cases, but the specialized nature of our practice also creates a layer of mystique that can be difficult to overcome for building a strong and diverse IR clinical practice.

I faced this challenge head on as I started last year. While 90% of my clinical work happens in the angiography suite, I came to strongly believe that IRs need to spend time walking the halls of the hospital. I see it as a means to develop important relationships, to gain a true understanding of the value we bring to the hospital ecosystem, and to remind our colleagues and hospital administrators of the value we add to the enterprise.

With this in mind, there are five key themes that are critical for building a strong IR practice and working well with other specialists.

1. Get a grasp on the resources available at your hospital or health system
With any new role, one key element is understanding the resources of your institution. For new practice areas, you’re usually provided few resources. This can be intimidating and requires patience to realize that you will need time to build up the infrastructure, including clinic staff, patient referrals, and technology, rather than being able to establish the practice you envision on Day One. To do so, you need to understand what already exists to effectively use the tools at your disposal. What are the strong practice areas? Who are the leaders? What technology is available?

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