032 - PAD Practice Building: Guide for VIR Trainees
Geogy Vatakencherry, MD – Interventional Radiology, Kaiser Permanente Los Angeles Medical Center
Purpose: Introduce PAD practice building to VIR trainees who are underexposed through the standard training paradigm, but whose early introduction in addition to a mastery of evidence-proven medical and lifestyle management is necessary for successful patient outcomes and market competitiveness.
Material and Methods: This exhibit will detail perspectives from PAD practices as it relates to the longitudinal management of disease in the clinic, referral streams, and economic strategies via literature review.
Results: PAD prevalence is high at baseline. There are an estimated 8.5 million sufferers >40 y.o. in America; all can benefit from a trained VIR. The rise of obesity, diabetes, and the aging population offers a platform for VIR trainees to cultivate the critical clinical and technical skillset to manage disease and build future volume. Treating PAD necessitates the VIR to assume longitudinal clinical care. Central to this is a mastery of the evidence-proven optimization of comorbidities such as diabetes, obesity, hypertension, hyperlipidemia, and lifestyle management of diet, exercise, and smoking cessation before and after the event an endovascular intervention becomes necessary. Practice infrastructure, including equipment, space, personnel, and admitting privileges is central to the VIR taking responsibility for patients and is an important aspect that facilitates direct referrals. Referrals come from physicians likely to identify at-risk patients, such as family practitioners, internists, cardiologists, endocrinologists, and podiatrist. Successful patient recruitment can also result from multimedia advertising and community-based outreach programs. The VIRs comfort with the SWOT (Strengths, Weakness, Opportunities, and Threats of business) analysis is an essential tool for developing and adapting a practice’s economic strategy.
Conclusions: Clinical success for VIR’s involvement in the outpatient PAD space requires trainees to first master the medical management of comorbidities and lifestyle for their future patients, before and after any endovascular interventions that may become necessary. Market success requires the trainee’s knowledge of referral stream integration, practice infrastructure, and VIR’s economic impact. Overall, PAD training is an endeavor of continuing education as our understanding of disease and management evolves. Opportunities to solidify and expand one’s knowledge base should be sought during medical school, residency, and beyond.