There are thousands of interventional radiologist (IR) practicing throughout the United States, but if you ask a room full of IRs to define their role in medical imaging, you may get several different answers. To better understand the work patterns of IRs, researchers studied public datasets from CMS and the U.S. Census Bureau, publishing their results in the American Journal of Roentgenology.

“There is no uniform definition of an IR,” wrote lead author Patricia Balthazar, MD, department of radiology and imaging sciences at the Emory University School of Medicine in Atlanta, and colleagues. “Many radiologists trained before the era of dedicated fellowship training and board certification continue to self-identify as interventionalists despite not meeting the contemporary American Board of Medical Specialties description of an IR. In addition, one in eight fellowship-trained IRs no longer perform procedures, suggesting that the longevity of a procedure-oriented career in interventional radiology is variable.”

As physician reimbursement continues to be tied to practice-specific and specialty-specific quality metrics, the authors added, knowing more about work patterns within interventional radiology “will be critical for specialty sustainability.

Balthazar and colleagues studied the work relative value units (WRVU) of more than 3,100 physicians who self-identify to Medicare as an IR. These are three key takeaways from their research:

1. A tale of two trends: The majority of IRs attribute either less than 10 percent or 90 to 100 percent of their time to interventional services.

While more than 29 percent of self-identified IRs had less than 10 percent of their WRVUs attributed to interventional services, more than 26 percent had 90 to 100 percent of their WRVUs attributed to interventional services. Interventional services, the authors noted, were defined as “invasive procedures and clinical evaluation and management (E/M)” for this study.

2. E/M services are rarely reported.

“Despite recent emphasis from the Society of Interventional Radiology on the importance of E/M services, these services overall on average accounted for only 1.4 percent of all services billed by IRs,” the authors wrote. “Although increasing over time, E/M services are still infrequently performed—or at least reported—by IRs.”

Balthazar et al. do note, however, that IRs who attribute more WRVUs to E/M services tend to perform “both higher-complexity procedures and a higher volume of procedures.”

3. IRs tend to be male, work in an urban setting and belong to a nonacademic group.

More than 90 percent of self-identified IRs were male and more than 99 percent work in urban areas. More than 79 percent of self-identified IRs practice as part of a nonacademic group.