Establishing Surveillance Clinics: The Road to Success

Abstract

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. KEYWORDS: Interventional radiology, referrals, surveillance program, aneurysm screeningObjectives: Upon completion of this article, the reader should (1) understand the importance of direct patient referrals and learn methods to change referral patterns of primary care physicians and (2) gain knowledge on how to establish surveillance programs within their diagnostic and interventional practices and the importance of working closely with their non-interventional radiology partners in establishing the clinics. Accreditation: Tufts University School of Medicine (TUSM) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Credit: TUSM designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit TM . Physicians should only claim credit commensurate with the extent of their participation in the activity.For interventional radiology to prosper, it needs to compete with established traditional medical practices. Competing effectively should result in increasing referrals, performing more desirable vascular procedures, and establishing a patient base for future referrals and procedures. The bottom line? Growth. We have effectively competed and improved our referral base by establishing outreach programs in the form of specialty clinics. These are surveillance programs with office visits, which help us build a patient referral base geared toward a common disease entity. We have established two programs, which have been successful, and are working on a third outreach program. Our first program was an abdominal aortic aneurysm-screening clinic (discussed in detail below); the second, a carotid stenosis clinic (staffed by a stroke neurologist, neurosurgeon, and an interventional radiologist); and our third program, a peripheral arterial disease surveillance clinic for local podiatrists, is in development. They require little additional effort and have blended seamlessly into our existing office practice. 333Below is information on our first surveillance program: the Abdominal Aneurysm Clinic (AC). BACKGROUNDWe have been treating aortic aneurysms for more than 11 years; our early abdominal aortic aneurysms (AAA) were treated with homemade devices ma...

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