Interventional Interdisciplinary Struggle

[Jacques Cartier]

Hey guys,

 

I'm a medical student with a strong interest in interventional procedures (specifically neurointerventional). I've heard from a few different staff physicians that there is some tension between neurologists/neurosurgeons with interventional training and neurointerventional radiologists in terms of who the primary care physicians refer the patients to. i.e. the attending neurologists in the stroke/neuro units tend to refer their patients to interventionalists from their own specialty.

 

I've also heard that there's a trend pushing many interventional procedures into the hands of the respective specialties (like interventional cardiology). Is this true?

 

I recognize that I've got a long way to go before I start thinking about subspecialties but this is very confusing - its very daunting having to pick a specialty now not knowing where interventional is going to fit in after I finish my residency and even as I enter the workforce.

 

Does anyone have any suggestions or insight into the true nature of this power struggle?

[JCTulip]

Turf battles are every where in medicine

 

Cardiology is notorious for having taken away cardiac echos, nuks and IR from radiologists who are now fighting hard to keep the turf for the upcoming cardiac CTs and MRs.

 

Similarly neurosurgeons have been taking parts in the interventional procedures.

 

Radiology is not alone in this battle. There is ophthalmologists vs optometrist, anesthesiologist vs anesthesia assistant, family doctor vs nurse practitioner, radiologist vs nuc meds for PET-CTs etc.

 

With reimbursement cuts in the states, clinicians who are not as proficient in reading the studies in the US will probably find it hard to operate their own imaging center. The American College of Cardiology has recently failed their lawsuit over the reimbursement cuts.

 

It's a complex area with lots of dynamics and be interesting to see how things evolve with changes in politics and technology.

[tooty]

I hear from a couple of residents here that neurosurgeons are expected take over that turf eventually. You best stay away from that subspecialty imo.

[cheech10]

I hear from a couple of residents here that neurosurgeons are expected take over that turf eventually. You best stay away from that subspecialty imo.

 

This is exactly the problem with interventional radiology, and it's the same thing that happened to cardiac surgery, IMO. When you are dependent on another specialty for most referrals (eg. cardiologist does angiogram, then refers patient for CABG; or neurosurgeon orders interventional procedure, etc.) as opposed to being the primary physician for that patient's illness, you run the risk of losing that procedure if the original specialty becomes proficient in it or an alternative.