One of the key factors of CIRSE’s vision for the future of IR is to increase interventionists’ involvement in clinical care. We have asked our members to share what clinical involvement in their daily practice looks like. Read their answers here!
“In my practice, every patient is seen in consultation both before and after their interventional radiology procedure. I take the time to explain the treatment, discuss alternatives, and outline potential risks – something many patients appreciate – especially those unfamiliar with our specialty.
On the day of the procedure, before anaesthesia or sedation, I meet with them again to answer any last-minute questions and provide reassurance. Before hospital discharge, I conduct ward rounds to explain how the procedure went, inform them of any complications, explain medication regimens, and outline the symptoms patients can expect in the coming days.
The main ongoing challenge I face is the lack of dedicated IR inpatient beds, as patients currently stay in the surgical unit. However, this also presents an opportunity to collaborate with surgical residents and increase awareness of our specialty within the hospital.
In my view, patient interaction is invaluable. Seeing positive clinical outcomes not only motivates me to continuously improve my skills but also enhances my desire to provide better care and improve patients’ quality of life.
My advice to new IRs is to focus on continuous, incremental improvement. Over time, this approach will position you as a key decision-maker within your hospital and elevate the profile of IR as a game-changing specialty.
The main lesson I’ve learned is that clinical outcomes are far more rewarding than technical achievements alone.”
“My clinical practice started with regular attendance of multidisciplinary meetings (with oncologists, nephrologists, and surgeons) and joint vascular anomalies clinic with paediatric surgeons. It has slowly grown to clinic visits and ward rounds for complex procedures such as ablation, angioplasty, and intra-arterial chemotherapy.
When I first started in my hospital, many of our paediatric colleagues were unaware of what IR could offer to their patients. Many procedures still fall under the surgeon’s purview. As a radiologist, I had the advantage of chairing multidisciplinary team meetings and tumour boards. These meetings provided excellent opportunities for paediatric interventional radiologists to demonstrate their value and educate others on how we could assist. Additionally, I made it a point to visit wards and clinics to meet patients and their families before procedures and to follow up with them afterwards.
Having a clinical practice allows us to be seen as clinicians and not merely proceduralists. It is most rewarding when patients show us their appreciation after a successful case. Having this trusting relationship also makes difficult conversations easier when complications arise or when things don’t go as planned.
My advice to IRs starting their clinical practice is to have a collaborative attitude and be available to both their clinical colleagues and patients.
One of the main lessons I learned when starting a clinical IR practice was to be humble, think like a clinician, and avoid using technical jargon when speaking to patients. Visual aids help a lot when explaining complex procedures. I also like to use the patient information leaflets available on the CIRSE website!”
“We are happy to share with you that after a few years of working “behind the scenes,” our small IR division has achieved full recognition! In addition to the already active outpatient clinic, we now have our own inpatient beds. An active IR outpatient clinic and our own inpatient beds mean more commitment and paperwork, but also the chance to clearly demonstrate that our procedures are not only beneficial for patients but also cost-effective.
We are currently focused on building a solid clinical foundation by standardizing protocols and procedures, optimizing workflows and turnovers, and, last but not least, reinforcing collaboration with the other specialists. Ultimately, this additional effort allows us to be seen as a clinical specialty—by patients, colleagues, and administration alike.”
“When we first began practicing interventional radiology in Sakarya, our unit consisted of only one angiography and one biopsy room. At that time, we could only follow up with two patients in our unit. We started by providing clinical services to dialysis patients. Over the course of three years, we expanded our unit with the support of other departments and the administration and broadened our spectrum of procedures.
We took an important step towards making interventional radiology a clinical department by setting up our inpatient service. In this way, we established one of the country’s largest and most comprehensive interventional radiology units. Our clinic, which started with just three nurses, now provides services with over 30 nurses and support staff.
There are three essential factors for interventional radiology to function effectively as a clinical department. The first is that interventional radiology should be considered as a discipline in itself, and patient care should be provided throughout the entire pathway. The second, and most important, is that the interventional unit should operate on a 24/7 basis to provide services for emergency patients. Finally, every interventional radiologist should be responsible for following their patients in both inpatient and outpatient services.”
“It has been a difficult yet rewarding journey to establish a dedicated IR service in our region. We started small, initially starting our own service and creating day care admissions for patients who were referred to us for lung and liver biopsies about nine years ago. Changing the name of our department to include ‘Interventional Radiology’ was a small but paradigm-shifting step, which transformed how our colleagues in other clinical departments perceived us.
Starting slowly but steadily, we began admitting patients with peripheral arterial disease from different locations. Today, we serve as the primary clinical care specialty for all patients requiring interventional procedures, including those with aortic diseases and intracranial aneurysms. We adopt a team approach, where the patients and their outcomes are the initial priority. We cross-refer our patients when they require the care of other specialists, and in turn, we receive referrals from them. This collaboration has been our primary strength, as together we learn better.
Currently, we have seven stand-alone beds in IR, which remain occupied most of the time, along with an outpatient footfall of over 25 patients per day. We have conducted sensitization sessions for our colleagues in emergency and critical care teams, from whom we receive direct referrals for stroke, pulmonary embolism, acute limb ischaemia, deep vein thrombosis (DVT), and aortic trauma.
Our hospital has become the preferred training centre in India, for prospective candidates who wish to pursue a career in IR. Despite resource constraints in staffing and equipment in a university hospital primarily catering to the underprivileged, we see each day as an opportunity to improve and provide the best possible care for our patients.”
“I was lucky enough to be inspired by my mentors to recognise the potential of IR to develop as a standalone speciality. After my basic IR fellowship in India, I pursued extensive training in the UK, which helped me gain the confidence and expertise to set up a dedicated IR department. This allowed us to offer innovative, minimally invasive IR treatments to our patients under one umbrella.
Now, as we are nearing 100 days of St. Gregorios Advanced Interventional Radiology Services (STAIRS), we offer novel IR treatments to patients including out-patient consultations, workups, diagnosis, and management. We work as any other independent speciality in this hospital.
Initially, convincing the hospitals about the need for an independent IR department was a challenge. However, I was able to meet with visionary leadership who fully supported me. This hospital management assisted in every aspect from procuring equipment to recruiting motivated
team members, including trained nurses and interventional radiographers.
The clinical presence of IR is the need of the hour, especially when patients and other speciality doctors are looking for problem-solving skills and alternatives to surgical options. Now, patients can just walk in and consult an IR in the OP like any other speciality.
My suggestion to IRs starting a clinical practice is to strengthen your foundation by visiting different IR departments and learning about the workflow. Always try to learn a particular procedure from the best – at least a short observership during your practice is enough to boost your confidence.
Being an independent clinical department is the best thing you can do to your patients, to your speciality, and to yourself. It will ensure that IR is at its full potential and your patients will benefit tremendously.”
