Ep. 374 Independent IR: More Than Locums, It's a Calling with Dr. Ian Wilson and Dr. Kavi Devulapalli
10/13/23 • 55 min
In this episode, host Dr. Dana Dunleavy engages in a thought-provoking discussion about independent interventional radiology practice with two esteemed IRs, Dr. Kavi Devulapalli and Dr. Ian Wilson. Together, they discuss the complexities and opportunities in the ever-evolving landscape of IR.
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SHOW NOTES
We start off the discussion with Kavi expanding on early experiences in working a standard DR / IR split that most IRs tend to work in. He elaborates on how this split was not what he, as well as most IRs, intended to practice in when they entered the field. Thus, he then shifted over to the OBL space, a gratifying journey, but one he notes was difficult to navigate due to the intricacies. As Kavi finally transitioned to locum tenens work, he reflects on its appeal, despite the scarcity of opportunities. He notes that locum tenens work is usually in areas with an extreme dearth of IRs, such as rural areas. This conversation also explores the topic of exclusive contracts. Their impact on independent IR practices' access to hospital privileges is also explored, shedding light on the challenges faced by IRs seeking to expand their reach.
Ian then notes that his locum tenens work was also in a rural setting, and how he had served this location for an extended period of time due to their lack of retention of IRs. The discussion then reveals a growing trend among physicians, as more and more are turning to locum work due to its exclusive focus on the IR aspect of the job that initially attracted them to this field. It's a mutual demand, as physicians seeking to specialize in IR find locum work to be a well-suited avenue, while areas of healthcare dearth are equally eager to tap into the expertise of these specialists.
Both guests emphasize the urgent need for sustainable solutions to address this growing public health crisis in rural areas. This is precisely where organizations like Travelier come into play. Travelier was established by IRs, one of whom is Kavi, with a mission to bridge this critical gap by offering world-class IR services to communities with unmet needs. Their approach involves assembling dedicated physician teams and creating interventional radiology practices that generate revenue while providing viable work solutions for radiologists. This discussion is a testament to the adaptability and innovation that drive the field of IR, characterized by the commitment to improving healthcare access in areas where it is needed the most. It's also a testament to the increasing mutual demand for specialized IR services and the unique opportunities that come with it.
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RESOURCES
Travelier:
https://travelierir.com
In this episode, host Dr. Dana Dunleavy engages in a thought-provoking discussion about independent interventional radiology practice with two esteemed IRs, Dr. Kavi Devulapalli and Dr. Ian Wilson. Together, they discuss the complexities and opportunities in the ever-evolving landscape of IR.
---
CHECK OUT OUR SPONSOR
Philips SymphonySuite
https://www.philips.com/symphonysuite
---
SHOW NOTES
We start off the discussion with Kavi expanding on early experiences in working a standard DR / IR split that most IRs tend to work in. He elaborates on how this split was not what he, as well as most IRs, intended to practice in when they entered the field. Thus, he then shifted over to the OBL space, a gratifying journey, but one he notes was difficult to navigate due to the intricacies. As Kavi finally transitioned to locum tenens work, he reflects on its appeal, despite the scarcity of opportunities. He notes that locum tenens work is usually in areas with an extreme dearth of IRs, such as rural areas. This conversation also explores the topic of exclusive contracts. Their impact on independent IR practices' access to hospital privileges is also explored, shedding light on the challenges faced by IRs seeking to expand their reach.
Ian then notes that his locum tenens work was also in a rural setting, and how he had served this location for an extended period of time due to their lack of retention of IRs. The discussion then reveals a growing trend among physicians, as more and more are turning to locum work due to its exclusive focus on the IR aspect of the job that initially attracted them to this field. It's a mutual demand, as physicians seeking to specialize in IR find locum work to be a well-suited avenue, while areas of healthcare dearth are equally eager to tap into the expertise of these specialists.
Both guests emphasize the urgent need for sustainable solutions to address this growing public health crisis in rural areas. This is precisely where organizations like Travelier come into play. Travelier was established by IRs, one of whom is Kavi, with a mission to bridge this critical gap by offering world-class IR services to communities with unmet needs. Their approach involves assembling dedicated physician teams and creating interventional radiology practices that generate revenue while providing viable work solutions for radiologists. This discussion is a testament to the adaptability and innovation that drive the field of IR, characterized by the commitment to improving healthcare access in areas where it is needed the most. It's also a testament to the increasing mutual demand for specialized IR services and the unique opportunities that come with it.
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RESOURCES
Travelier:
https://travelierir.com
Previous Episode
Ep. 373 Sharp Recanalization Using the RF Wire with Dr. Marcelo Guimaraes
In this episode, host Dr. Ally Baheti interviews Dr. Marcelo Guimaraes about using radiofrequency wires for sharp recanalization. Marcelo is an interventional radiologist at the Medical University of South Carolina.
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SHOW NOTES
Marcelo begins by telling us about the Sniper technique, what RF wires are, and how they are used in sharp recanalization. He provides indications for using RF wires and his general workup and intraoperative flow for recanalization interventions. Marcelo also discusses the use of RF wires for iliocaval occlusions, SVC/upper extremity occlusions, and chronically occluded stents.
Marcelo gives a comprehensive explanation of how and why the Sniper technique has evolved over the years. We also cover RF wires’ capabilities in crossing particularly, long occluded segments and the importance of cone-beam CT in complex cases. Ally and Marcelo then discuss applications of IVUS in sharp recanalization.
Marcelo also shares his thoughts on possible alternatives to the RF wire and speaks about current and future applications of RF wires in non-vascular cases. Marcelo ends the episode by sharing tips on how to avoid unfavorable outcomes when using an RF wire, which includes his caution against using the Sniper technique in the office-based lab (OBL) setting.
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RESOURCES
JVIR Paper from Dr. Marcelo Guimaraes on RF wires in recanalization of central vein occlusions:
https://pubmed.ncbi.nlm.nih.gov/22739648/
PowerWire Radiofrequency Guidewire:
https://baylismedtech.com/radio-frequency-wires/powerwire-rf-guidewire/
Next Episode
Ep. 375 How to Get Independent IR Hospital Privileges with Dr. Bill Julien
In this episode, host Dr. Ally Baheti interviews Dr. Bill Julien about strategies to secure independent IR hospital privileges. Bill is an experienced vascular interventional physician at South Florida Vascular Associates.
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Reflow Medical
https://www.reflowmedical.com/
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SHOW NOTES
Bill starts the episode by telling us why it is crucial for vascular and interventional physicians to have hospital privileges. We learn about Bill’s career progression. He discusses the growing pains he faced, how he effectively tackled these challenges, and how he became staff at a number of hospitals.
Bill and Ally then unfold Bill’s detailed roadmap for how IRs can join hospital staff. They explore different pathways, and Bill shares his anecdotes and advice throughout. The doctors discuss how many contracts leave little opportunity to build longitudinal care practice, since the majority of time can be dedicated to large volumes of diagnostic reading time and consults for non-complex cases.
At the conclusion of this episode, Bill emphasizes the need for SIR and other societies to step in and usher change. He also shares his 13-point action list for what SIR can do to accomplish this and help IRs secure hospital privileges (linked in Resources section).
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RESOURCES
SIR Strategic Plan:
https://tinyurl.com/SIRstrategicplan
SIR Policy Statement:
https://tinyurl.com/SIRpolicystatement
Dr. Bill Julien’s Clinical Practice Position:
https://tinyurl.com/clinicalpracticeposition2
ACR Policy Statement:
https://tinyurl.com/ACRpolicystatement
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