Using midlevel providers in interventional radiology.

Developing and implementing clinical services, including consultations, rounds, and clinic, is time-consuming, and for the interventional radiologist this means time away from the interventional laboratory. Using a team approach to providing clinical services is logical, and the midlevel provider is a perfect fit for an interventional radiology team. Midlevel providers can be grouped into two categories, advanced practice nurses (APNs) and physician's assistants (PAs). Under the umbrella of APN are several specialties including the nurse practitioner (NP), clinical nurse specialist (CNS), certified nurse midwife, and certified nurse anesthetist. The midlevel providers that are particularly suited for interventional radiology are the NPs, CNSs, and PAs. This article discusses midlevel providers in-depth including skills, limitations, and expenses.

Establishing surveillance clinics: the road to success.

Interventional radiology interacts with all medical disciplines and historically has not had a patient base of its own. The specialty has depended upon referrals for procedures (often complex) and not referrals for the global management of the disease process or patient. Because of this, when referrers develop catheter-based skills, referrals to interventional radiology drop and competition for primary care physician referrals increase; a double strike. To compete, interventional radiology needs to offer clinical services to the primary care physician. One way to compete is by establishing particular disease surveillance programs. Below we discuss in detail the process of establishing surveillance clinics, which one worked for us, and the expected outcomes of these clinics.