Interventional radiology has proven benefits for patient care, enabling life-saving procedures to be performed less invasively than open surgery. But interventional radiology procedures are being concentrated among fewer radiologists, based on findings from a new study in JVIR by researchers from the ACR’s Neiman HPI group.
From its origins in pioneering work conducted in the 1960s by Charles Dotter, MD, in image-guided minimally invasive procedures, interventional radiology has evolved into a field with one foot in diagnostic radiology and another in therapy.
- The field achieved a major milestone in 2012, when it was recognized as an independent, primary medical specialty, and shortly thereafter an integrated IR/DR pathway was adopted that gives trainees additional dedicated interventional training.
- This replaced the previous practice of just tacking an extra interventional fellowship on to a diagnostic radiology program.
Has the new training structure changed who’s performing interventional procedures in the U.S.? Neiman HPI researchers examined this issue by analyzing Medicare claims from 2008 to 2023 for 46k radiologists.
- They focused on the volume of interventional procedures being performed by radiologists, and any shifts in volume that could have resulted from changes in the training program.
Over the study period, researchers found…
- The percentage of all radiologists who performed at least some interventional work fell (from 67% to 50%).
- But the percentage of super-specialists – those who spent more than 90% of their time doing interventional work – more than doubled (from 4.1% to 8.8%).
- Among radiologists who primarily performed interventional work, more were younger compared to older (25% vs. 12%).
- And super-specialists tended to be younger as well (9.2% vs. 6.8%).
The changes are most likely due to the new IR/DR training pathway. But they also raise new questions, such as whether interventional radiology should completely separate from diagnostic radiology in both training and practice settings.
- The authors weren’t ready to go that far, noting that the integrated IR/DR pathway was designed to ensure dual competency in both image interpretation and procedures, and such flexibility is still valuable in today’s healthcare environment.
The Takeaway
The new findings on the concentration of interventional radiology practice generally reflect the trend toward increased specialization that’s being seen in both radiology and healthcare. Patients are benefiting, as their procedures are more likely to be performed by specialists who not only received more training but also have more experience than in the past.