Current clinical practice patterns of self-identified interventional radiologists

Patricia Balthazar, C. Matthew Hawkins, Arvind Vijayasarathi, Thomas W Loehfelm, Richard Duszak

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study was to assess patterns of procedural, clinical evaluation and management (E/M), and diagnostic imaging services rendered by self-identified interventional radiologists (IRs) across the United States. MATERIALS AND METHODS. Recent Medicare Physician and Other Supplier Public Use and Physician Compare national downloadable files were linked. IRs were defined as physicians self-identifying interventional radiology as their primary specialty on Medicare claims or as a specialty during Medicare enrollment. The primary outcome measure was percentage of work (in work relative value units [WRVU]) attributed to interventional services (both procedural and E/M) per IR. Secondary outcome measures included sociodemographic factors per interventional WRVU quartile and percentage of E/M service units per IR. Statistical analysis included chi-square and t tests and logistic regression. RESULTS. Overall, 3132 physicians nationally self-identified to Medicare as IRs. The distribution of WRVU attributed to interventional services was strongly bimodal. Procedures and E/M together accounted for ≥ 91% and ≤ 5% of total work for the most and least intervention-oriented quartiles, respectively, but were widely distributed in the middle two quartiles. The most intervention-oriented self-identified IRs were more likely out of medical school ≤ 30 years (odds ratio [OR], 2.5; p < 0.0001), men (OR, 2.2; p < 0.0001), and in academic practice (OR, 4.3; p < 0.0001). E/M accounted for only 1.4% of all billed services. CONCLUSION. Although most self-identified IRs perform both interventional and diagnostic imaging services, the subspecialty distribution is strongly bimodal, one-quarter each focusing ≤ 5% and ≥ 91% of work on interventional services. Despite ongoing emphasis on clinically focused interventional radiology, E/M services remain rarely reported.

Original languageEnglish (US)
Pages (from-to)663-668
Number of pages6
JournalAmerican Journal of Roentgenology
Volume210
Issue number3
DOIs
StatePublished - Mar 1 2018

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Physicians' Practice Patterns
Medicare
Diagnostic Services
Physicians
Interventional Radiology
Odds Ratio
Diagnostic Imaging
Outcome Assessment (Health Care)
Chi-Square Distribution
Radiologists
Medical Schools
Logistic Models

Keywords

  • Clinical practice
  • Interventional radiology
  • Medicare
  • Workforce

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Current clinical practice patterns of self-identified interventional radiologists. / Balthazar, Patricia; Hawkins, C. Matthew; Vijayasarathi, Arvind; Loehfelm, Thomas W; Duszak, Richard.

In: American Journal of Roentgenology, Vol. 210, No. 3, 01.03.2018, p. 663-668.

Research output: Contribution to journalArticle

Balthazar, Patricia ; Hawkins, C. Matthew ; Vijayasarathi, Arvind ; Loehfelm, Thomas W ; Duszak, Richard. / Current clinical practice patterns of self-identified interventional radiologists. In: American Journal of Roentgenology. 2018 ; Vol. 210, No. 3. pp. 663-668.
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abstract = "OBJECTIVE. The purpose of this study was to assess patterns of procedural, clinical evaluation and management (E/M), and diagnostic imaging services rendered by self-identified interventional radiologists (IRs) across the United States. MATERIALS AND METHODS. Recent Medicare Physician and Other Supplier Public Use and Physician Compare national downloadable files were linked. IRs were defined as physicians self-identifying interventional radiology as their primary specialty on Medicare claims or as a specialty during Medicare enrollment. The primary outcome measure was percentage of work (in work relative value units [WRVU]) attributed to interventional services (both procedural and E/M) per IR. Secondary outcome measures included sociodemographic factors per interventional WRVU quartile and percentage of E/M service units per IR. Statistical analysis included chi-square and t tests and logistic regression. RESULTS. Overall, 3132 physicians nationally self-identified to Medicare as IRs. The distribution of WRVU attributed to interventional services was strongly bimodal. Procedures and E/M together accounted for ≥ 91{\%} and ≤ 5{\%} of total work for the most and least intervention-oriented quartiles, respectively, but were widely distributed in the middle two quartiles. The most intervention-oriented self-identified IRs were more likely out of medical school ≤ 30 years (odds ratio [OR], 2.5; p < 0.0001), men (OR, 2.2; p < 0.0001), and in academic practice (OR, 4.3; p < 0.0001). E/M accounted for only 1.4{\%} of all billed services. CONCLUSION. Although most self-identified IRs perform both interventional and diagnostic imaging services, the subspecialty distribution is strongly bimodal, one-quarter each focusing ≤ 5{\%} and ≥ 91{\%} of work on interventional services. Despite ongoing emphasis on clinically focused interventional radiology, E/M services remain rarely reported.",
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N2 - OBJECTIVE. The purpose of this study was to assess patterns of procedural, clinical evaluation and management (E/M), and diagnostic imaging services rendered by self-identified interventional radiologists (IRs) across the United States. MATERIALS AND METHODS. Recent Medicare Physician and Other Supplier Public Use and Physician Compare national downloadable files were linked. IRs were defined as physicians self-identifying interventional radiology as their primary specialty on Medicare claims or as a specialty during Medicare enrollment. The primary outcome measure was percentage of work (in work relative value units [WRVU]) attributed to interventional services (both procedural and E/M) per IR. Secondary outcome measures included sociodemographic factors per interventional WRVU quartile and percentage of E/M service units per IR. Statistical analysis included chi-square and t tests and logistic regression. RESULTS. Overall, 3132 physicians nationally self-identified to Medicare as IRs. The distribution of WRVU attributed to interventional services was strongly bimodal. Procedures and E/M together accounted for ≥ 91% and ≤ 5% of total work for the most and least intervention-oriented quartiles, respectively, but were widely distributed in the middle two quartiles. The most intervention-oriented self-identified IRs were more likely out of medical school ≤ 30 years (odds ratio [OR], 2.5; p < 0.0001), men (OR, 2.2; p < 0.0001), and in academic practice (OR, 4.3; p < 0.0001). E/M accounted for only 1.4% of all billed services. CONCLUSION. Although most self-identified IRs perform both interventional and diagnostic imaging services, the subspecialty distribution is strongly bimodal, one-quarter each focusing ≤ 5% and ≥ 91% of work on interventional services. Despite ongoing emphasis on clinically focused interventional radiology, E/M services remain rarely reported.

AB - OBJECTIVE. The purpose of this study was to assess patterns of procedural, clinical evaluation and management (E/M), and diagnostic imaging services rendered by self-identified interventional radiologists (IRs) across the United States. MATERIALS AND METHODS. Recent Medicare Physician and Other Supplier Public Use and Physician Compare national downloadable files were linked. IRs were defined as physicians self-identifying interventional radiology as their primary specialty on Medicare claims or as a specialty during Medicare enrollment. The primary outcome measure was percentage of work (in work relative value units [WRVU]) attributed to interventional services (both procedural and E/M) per IR. Secondary outcome measures included sociodemographic factors per interventional WRVU quartile and percentage of E/M service units per IR. Statistical analysis included chi-square and t tests and logistic regression. RESULTS. Overall, 3132 physicians nationally self-identified to Medicare as IRs. The distribution of WRVU attributed to interventional services was strongly bimodal. Procedures and E/M together accounted for ≥ 91% and ≤ 5% of total work for the most and least intervention-oriented quartiles, respectively, but were widely distributed in the middle two quartiles. The most intervention-oriented self-identified IRs were more likely out of medical school ≤ 30 years (odds ratio [OR], 2.5; p < 0.0001), men (OR, 2.2; p < 0.0001), and in academic practice (OR, 4.3; p < 0.0001). E/M accounted for only 1.4% of all billed services. CONCLUSION. Although most self-identified IRs perform both interventional and diagnostic imaging services, the subspecialty distribution is strongly bimodal, one-quarter each focusing ≤ 5% and ≥ 91% of work on interventional services. Despite ongoing emphasis on clinically focused interventional radiology, E/M services remain rarely reported.

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