Break
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P38 3:25 p.m. Panel Discussion: The Hospital is Bending Over Backwards for the Other Guys but Takes Us for Granted What's an m to Do? 3:45 p.m. Break 4:05 p.m. Competing for Endografts: North Dakota Corey L. Teigen, MD Merit Care Medical Imaging Fargo, ND 4:15 p.m. Competing for Endografts: South Florlda MichaelC. Cohn,MD Memorial Regional Hospital Weston, FL Learrung Objectives Upon completion of this presentation, the attendee should be able to: 1. Explain how one can increase their physician referral base for the endovascular repair of MA; 2. Realize the importance of running a clinical service to build your interventional praetice; 3. List variollS ways that can improve build and run your stent-graft program efficiently. In the past three years our interventional radiology group, a division cif a 35-physician radiology group, consisting of 8 full-time interventional radiologists, 2 nurse practitioners, and 3 assistants have been able to build a successful Abdominal Aortic Aneurysm (MA) stent-graft program. We currently repair an average of 2 to 3 infrarenal MA a week using endovascular tech- niques. AlI MA stenl-grafts are placed in the operating room (aR) mainly due to time constraints on our inter- ventional radiology (IR) suite. aur aR stent-graft team includes an interventional radiologist, vascular surgeon, anesthesiologist, IR technologist, aR technologists, cir- culating tech., and nurse. We perform almosl al/ these procedures with spinal anesthesia and our patients rarely go to the ICU post procedure. aur patients usually stay 1 to 2 nights. These patients are initially either referred and worked-up by a vascular surgeon or US. We get a significant number of patients referred di- rectly to our service, which has been increasing daily. There are a number of reasons our referrals have been increasing. We provide 24 hour a day vascular consul- tation service. We provide regular office hours in our office across the street from the hospital. Evely non- emergent case is seen in our office where a comprehen- sive history and physical is performed. We order the proper diagnostic tests (je, CfA +/-angiogram) and refer each patient for further workup if clinically indicated (je, cardiologist for cardiac clearance). We keep comprehen- sive records on al/ our patients. A check-off list in front of the chart tells us when the patient is ready to go for the procedure. We keep very close written and tele- phone contact with the referring physician. We take fuli responsibility for the care of our patients while in the hospital. We fol/ow our patients with periodic follow-up office visits and follow these patients many years post procedure making sure annual follow-up CTs are per- formed. Aside from our clinical practice, things that have been valuable in building our service include weekly lunch visits to referring physician's offices. We bring lunch and give a 30-minl1te presentation on the services we offer. We also give monthly referral dinners, hospital grand rounds and have a comprehensive web site explaining our services. We have formed alliances with various groups inclllding a large cardiology grolIp where they send us all their peripheral vasclllar patients and we send them our patients for cardiac work-up or cardiac treatrnent. We keep ciose track of our referring physi- cians and monitor their refen'al patterns. We have found hospitalists to be an important refen'al base and go out of our way to win them over. Politically, in our hospital, there is a vascular services department, which includes members from IR, interven- tional cardiology and vascular surgery. Ali credentialing, problems and hospital issues pertaining to these 3 de- partments are discussed and voted on in this depart- ment. It was decided by this department that rwo phy- sicians, one a vascular surgeon, and the other a physician credentialed in endovascular interventional techniques are required to perform endovascular MA repairs. Although this has left the door open, as of this point no stent graft thoracic or abdominal has been done without the invoJvement of an interventional radioJogist. 4:25 p.m. Competing for Endografts: Oregon Stephen F. Quinn, MD Radiology Associates Eugene,OR 4:35 p.m. Rebuilding Your PVD Practice Better Than Before: South Florida William H. ]ulien, MD NOl1hwest Medical Center Parkiand, FL The following article appeared in M.D. News Ft. Lauder- dale/Broward County, June 2002 and is reproduced here with permission of the publisher, Sunshine Media. Also available at www.mdnewsmagazine.com (See next page,)
Transcript of Break
P38
3:25 p.m.
Panel Discussion: The Hospital is Bending OverBackwards for the Other Guys but Takes Us forGranted What's an m to Do?
3:45 p.m.
Break
4:05 p.m.
Competing for Endografts: North DakotaCorey L. Teigen, MDMerit Care Medical ImagingFargo, ND
4:15 p.m.
Competing for Endografts: South FlorldaMichaelC. Cohn,MDMemorial Regional HospitalWeston, FL
Learrung ObjectivesUpon completion of this presentation, the attendeeshould be able to:1. Explain how one can increase their physician referral
base for the endovascular repair of MA;2. Realize the importance of running a clinical service to
build your interventional praetice;3. List variollS ways that can improve build and run your
stent-graft program efficiently.In the past three years our interventional radiology
group, a division cif a 35-physician radiology group,consisting of 8 full-time interventional radiologists, 2nurse practitioners, and 3 assistants have been able tobuild a successful Abdominal Aortic Aneurysm (MA)stent-graft program. We currently repair an average of 2to 3 infrarenal MA a week using endovascular techniques. AlI MA stenl-grafts are placed in the operatingroom (aR) mainly due to time constraints on our interventional radiology (IR) suite. aur aR stent-graft teamincludes an interventional radiologist, vascular surgeon,anesthesiologist, IR technologist, aR technologists, circulating tech., and nurse. We perform almosl al/ theseprocedures with spinal anesthesia and our patients rarelygo to the ICU post procedure. aur patients usually stay1 to 2 nights. These patients are initially either referred
and worked-up by a vascular surgeon or US.
We get a significant number of patients referred directly to our service, which has been increasing daily.There are a number of reasons our referrals have beenincreasing. We provide 24 hour a day vascular consul
tation service. We provide regular office hours in ouroffice across the street from the hospital. Evely nonemergent case is seen in our office where a comprehensive history and physical is performed. We order theproper diagnostic tests (je, CfA +/-angiogram) and refereach patient for further workup if clinically indicated (je,cardiologist for cardiac clearance). We keep comprehen-
sive records on al/ our patients. A check-off list in frontof the chart tells us when the patient is ready to go forthe procedure. We keep very close written and telephone contact with the referring physician. We take fuliresponsibility for the care of our patients while in thehospital. We fol/ow our patients with periodic follow-upoffice visits and follow these patients many years postprocedure making sure annual follow-up CTs are performed.
Aside from our clinical practice, things that have been
valuable in building our service include weekly lunchvisits to referring physician's offices. We bring lunch andgive a 30-minl1te presentation on the services we offer.We also give monthly referral dinners, hospital grandrounds and have a comprehensive web site explainingour services. We have formed alliances with variousgroups inclllding a large cardiology grolIp where theysend us all their peripheral vasclllar patients and we
send them our patients for cardiac work-up or cardiactreatrnent. We keep ciose track of our referring physicians and monitor their refen'al patterns. We have found
hospitalists to be an important refen'al base and go out ofour way to win them over.
Politically, in our hospital, there is a vascular servicesdepartment, which includes members from IR, interventional cardiology and vascular surgery. Ali credentialing,problems and hospital issues pertaining to these 3 departments are discussed and voted on in this department. It was decided by this department that rwo physicians, one a vascular surgeon, and the other aphysician credentialed in endovascular interventionaltechniques are required to perform endovascular MArepairs. Although this has left the door open, as of thispoint no stent graft thoracic or abdominal has been donewithout the invoJvement of an interventional radioJogist.
4:25 p.m.
Competing for Endografts: OregonStephen F. Quinn, MDRadiology AssociatesEugene,OR
4:35 p.m.
Rebuilding Your PVD Practice Better Than Before:South FloridaWilliam H. ]ulien, MDNOl1hwest Medical CenterParkiand, FLThe following article appeared in M.D. News Ft. Lauderdale/Broward County, June 2002 and is reproduced herewith permission of the publisher, Sunshine Media. Also
available at www.mdnewsmagazine.com(See next page,)
