P38

3:25 p.m.

Panel Discussion: The Hospital is Bending OverBackwards for the Other Guys but Takes Us forGranted What's an m to Do?

3:45 p.m.

Break

4:05 p.m.

Competing for Endografts: North DakotaCorey L. Teigen, MDMerit Care Medical ImagingFargo, ND

4:15 p.m.

Competing for Endografts: South FlorldaMichaelC. Cohn,MDMemorial Regional HospitalWeston, FL

Learrung ObjectivesUpon completion of this presentation, the attendeeshould be able to:1. Explain how one can increase their physician referral

base for the endovascular repair of MA;2. Realize the importance of running a clinical service to

build your interventional praetice;3. List variollS ways that can improve build and run your

stent-graft program efficiently.In the past three years our interventional radiology

group, a division cif a 35-physician radiology group,consisting of 8 full-time interventional radiologists, 2nurse practitioners, and 3 assistants have been able tobuild a successful Abdominal Aortic Aneurysm (MA)stent-graft program. We currently repair an average of 2to 3 infrarenal MA a week using endovascular tech­niques. AlI MA stenl-grafts are placed in the operatingroom (aR) mainly due to time constraints on our inter­ventional radiology (IR) suite. aur aR stent-graft teamincludes an interventional radiologist, vascular surgeon,anesthesiologist, IR technologist, aR technologists, cir­culating tech., and nurse. We perform almosl al/ theseprocedures with spinal anesthesia and our patients rarelygo to the ICU post procedure. aur patients usually stay1 to 2 nights. These patients are initially either referred

and worked-up by a vascular surgeon or US.

We get a significant number of patients referred di­rectly to our service, which has been increasing daily.There are a number of reasons our referrals have beenincreasing. We provide 24 hour a day vascular consul­

tation service. We provide regular office hours in ouroffice across the street from the hospital. Evely non­emergent case is seen in our office where a comprehen­sive history and physical is performed. We order theproper diagnostic tests (je, CfA +/-angiogram) and refereach patient for further workup if clinically indicated (je,cardiologist for cardiac clearance). We keep comprehen-

sive records on al/ our patients. A check-off list in frontof the chart tells us when the patient is ready to go forthe procedure. We keep very close written and tele­phone contact with the referring physician. We take fuliresponsibility for the care of our patients while in thehospital. We fol/ow our patients with periodic follow-upoffice visits and follow these patients many years postprocedure making sure annual follow-up CTs are per­formed.

Aside from our clinical practice, things that have been

valuable in building our service include weekly lunchvisits to referring physician's offices. We bring lunch andgive a 30-minl1te presentation on the services we offer.We also give monthly referral dinners, hospital grandrounds and have a comprehensive web site explainingour services. We have formed alliances with variousgroups inclllding a large cardiology grolIp where theysend us all their peripheral vasclllar patients and we

send them our patients for cardiac work-up or cardiactreatrnent. We keep ciose track of our referring physi­cians and monitor their refen'al patterns. We have found

hospitalists to be an important refen'al base and go out ofour way to win them over.

Politically, in our hospital, there is a vascular servicesdepartment, which includes members from IR, interven­tional cardiology and vascular surgery. Ali credentialing,problems and hospital issues pertaining to these 3 de­partments are discussed and voted on in this depart­ment. It was decided by this department that rwo phy­sicians, one a vascular surgeon, and the other aphysician credentialed in endovascular interventionaltechniques are required to perform endovascular MArepairs. Although this has left the door open, as of thispoint no stent graft thoracic or abdominal has been donewithout the invoJvement of an interventional radioJogist.

4:25 p.m.

Competing for Endografts: OregonStephen F. Quinn, MDRadiology AssociatesEugene,OR

4:35 p.m.

Rebuilding Your PVD Practice Better Than Before:South FloridaWilliam H. ]ulien, MDNOl1hwest Medical CenterParkiand, FLThe following article appeared in M.D. News Ft. Lauder­dale/Broward County, June 2002 and is reproduced herewith permission of the publisher, Sunshine Media. Also

available at www.mdnewsmagazine.com(See next page,)