Academics vs Private practice procedures

[agolden1]

Med student who is a newcomer to the idea of IR. In some fields such as Occuloplastics and ENT, it seems like there is a significant difference between the work attending physicians are doing in private practice vs at the academic level. For instance, at my institution there is an occuloplastician who revels in trauma cases while a private practice doctor I know doesn't touch much of that work and sticks mainly to cosmetics. I've read similar things there being divisions between "bread and butter" ENT cases in academics and private practice in the past as well. Is there a similar divide in IR?

I've also seen several posts on sdn that IR call can be pretty frequent, with many people taking call 1:3 or 1:4. For those at the attending level, is it difficult to maintain that frequency without feeling burnt out?

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[Fab5Hill33]

IR practices are quite variable - just like with ENT. Some are primarily outpatient whereas others have a heavy inpatient volume with lots of trauma.

IR call is equivalent to any surgical subspecialty like ENT or Urology. Personally, I've never been even close to being burnt out from call.

 

[Doctor D]

Another question to ask is how much diagnostic reading time is required? This will range from 80% to 0% depending on the practice. I have a feeling with the changes in IR currently going on the trend will be more procedures and less time in the reading room.

 

[irwarrior]

So call frequency is variable depending on group size and how many hospitals you are covering and size of hospital (typically q3 to q4). I would say that at academic places you are more likely to do cancer related therapy and transplant affiliated procedures. So, there is limited interventional oncology in the outpatient arena as the primary treatment is focused on hepatocellular cancer and current treatment should include liver transplant. In real world independent IR practices out in the community there is going to be more biopsies, drainage procedures, nephrosotomy procedures, central venous access etc. You can build a heavy practice in PAD (lower extremity arterial interventions, fibroid therapy, pain treatments (vertebroplasty/kyphoplasty), dialysis interventions including peritoneal dialysis, deep venous disease (chronic and acute), varicose vein treatments. It is possible to also provide stroke therapy especially with the more recent positive intra-arterial stroke trials.

Call can be fairly busy with a fair amount of consults and mixed in with procedures. Again, in a conventional diagnostic group you may be asked to take diagnostic call on top of IR call and while on IR you may be asked to read imaging in between cases. It is getting harder and harder for clinical IR to see patients, do consults, perform procedures in a busy IR practice and interpret high volume imaging as well. As newer grads come out and want to practice in a more clinical fashion (more like a surgical specialty) it will become more and more of a challenge to align these goals with conventional diagnostic radiology groups.