Ep. 567 How to Manage Biliary Strictures with Dr. Premal Trivedi

Navigating the intricate world of medical billing can be challenging, and knowing the steps needed to ensure fair reimbursement can be even more challenging. Guests Dr. Bret Wiechmann and Dr. Jerry Niedzwiecki (private practice interventional radiologists) join host Dr. Ally Baheti to discuss how IRs in the OBL setting can legislatively rally behind the office-based facility concept and improve physician reimbursement in the light of developments addressed at the recent OEIS meeting. --- SYNPOSIS Dr. Wiechmann and Dr. Niedzwiecki begin the episode by defining several key-terms and processes in physician reimbursement in the outpatient setting to help orient us to the issue at hand. After explaining why and how reimbursement for more advanced procedures in the OBL setting has been lagging behind, the doctors introduce the concept of creating an office-based facility concept. This would help stabilize payments for complex procedures done in the OBL space. The episode concludes with emphasis on more physician involvement and advocacy in pushing reform forward, underscoring how a unified effort is essential for long-lasting, meaningful change. --- TIMESTAMPS 00:00 - Introduction 01:42 - Medicare Physician Fee Schedule 05:46 - Challenges with Current Reimbursement Models 11:28 - Proposing the Office-Based Facility Concept 17:58 - Legislative Efforts and Congressional Involvement 26:53 - Call to Action: How You Can Help 36:40 - Conclusion --- RESOURCES Outpatient Endovascular and Interventional Society: https://oeisweb.com

8 Apr 40min

What are the 10 Commandments of Being a Female Interventional Radiologist? Guest Dr. Maureen Kohi (Chair of Radiology at University of North Carolina Chapel Hill) sits down with host Dr. Ally Baheti to discuss the details of her popular lecture topic and how these 10 rules are actually applicable to all current and future interventional radiologists. --- SYNPOSIS Dr. Kohi begins by going through each of the 10 points - offering detailed advice throughout, while also acknowledging nuances and challenges women and men can encounter in medicine and best approaches. Dr. Kohi also speaks on how to build and navigate strong relationships with industry. The episode concludes with several more pearls of wisdom as Dr. Kohi shares the last of the 10 commandments. --- TIMESTAMPS 00:00 - Introduction 01:08 - 10 Commandments of Being a Female IR 23:06 - Importance of Involvement in Professional Societies 24:46 - Childcare Concerns in Professional Settings 28:58 - Making the Leadership Leap 35:24 - Navigating Gender Bias in Professional Environments 41:51 - Prioritizing Health, Family, and Personal Fulfillment --- RESOURCES From Good to Great (Book): https://a.co/d/gXWW1Qp Start With Why (Book): https://a.co/d/hgaadIt

4 Apr 46min

In honor of the 50th annual meeting of the Society of Interventional Radiology (SIR) in Nashville, let’s take it back to the beginning of IR and review how the field became what it is today. Guest host Dr. Andrew Niekamp (interventional radiologist at Miami Vascular) sits down with esteemed guest Dr. Barry Katzen, who began his training at the advent of IR, to discuss the origins and development of the field since its inception. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS The doctors discuss challenges and innovations that shaped IR’s growth, and the importance of clinical practice and patient-centered care. Dr. Katzen shares insights from his extensive career, including his early involvement in advancing image-guided therapies, his role in founding Miami Cardiac & Vascular Institute, and strategies to overcome turf-wars and complacency in medicine. Dr. Katzen emphasizes the need for continuous innovation and dedication towards improving patient outcomes in the evolving landscape of IR. The episode concludes with Dr. Katzen’s advice for future and early-career IRs. --- TIMESTAMPS 00:00 - Introduction 03:39 - Early Innovations and Training in Europe 09:08 - Founding the Miami Cardiac and Vascular Institute 17:13 - Challenges and Innovations 25:24 - Importance of Clinical Responsibility 34:07 - Birth of a Specialty 40:35 - Advice for Future Interventional Radiologists 43:29 - Conclusion

1 Apr 45min

Is social media an effective patient acquisition tool for interventional radiologists? In a word: absolutely. Learn how to reach more patients in this week’s BackTable Podcast, where Dr. Gustavo Elias joins Dr. Ally Baheti to discuss the benefits he has seen with social media, and the content strategies that he uses in his medical practice. --- SYNPOSIS The episode begins with Dr. Elias sharing his journey of overcoming initial reservations around posting content. The doctors emphasize the importance of individuality and passion in showing what IR can offer to the public in easily-digestible ways. Dr. Elias then discusses the impact of social media on patient engagement, and shares practical tips for physicians who are looking to enhance their online presence. Dr. Elias also touches on optimal posting schedules, collaboration tips, and balancing professionalism with approachability. --- TIMESTAMPS 00:00 - Introduction 04:02 - Social Media for Interventional Radiologists 08:56 - Building a Social Media Presence 19:24 - Optimal Posting Strategies 21:58 - Collaborations and Platforms 25:27 - Conclusion

28 Mars 28min

Let’s talk liver ablations. This week’s episode of the BackTable Podcast provides a thorough review of modern microwave ablation methods, tools, and tech, featuring Dr. Asad Baig (interventional radiologist at Columbia University) and host Dr. Michael Barraza. --- This podcast is supported by an educational grant from Medtronic . --- SYNPOSIS Dr. Baig shares practical advice on how to become a key contributor at your tumor board and how to position your skillset as an interventional radiologist. He talks through his microwave ablation procedure technique, highlighting the role of ablation zone visualization software. The doctors go on to discuss a variety of ablation approaches, needle placement, intra- and post-operative imaging, and tips for dealing with challenging tumor locations. The episode concludes with Dr. Baig summarizing best practices for ensuring safe and effective ablations, and underscoring the importance of solid patient-physician communication throughout care. --- TIMESTAMPS 00:00 - Introduction 08:28 - Microwave Ablation Techniques 12:54 - Collaborative Approach in Tumor Boards 23:30 - Combined Ablation Cases and Techniques 36:12 - Challenging Liver Ablations 45:56 - Tips for Safe and Effective Ablations 50:07 - Balancing Biopsy and Ablation 01:00:34 - Conclusion --- RESOURCES The Emprint™ Ablation System with Thermosphere™ Technology: One of the Newer Next-Generation Microwave Ablation Technologies: https://pmc.ncbi.nlm.nih.gov/articles/PMC4640908/ Comparison of microwave ablation and surgical resection for treatment of hepatocellular carcinomas conforming to Milan criteria: https://pubmed.ncbi.nlm.nih.gov/24628534/ Percutaneous microwave ablation of hepatic lesions near the heart: https://pubmed.ncbi.nlm.nih.gov/34805581/ Microwave Ablation of Hepatic Tumors Abutting the Diaphragm Is Safe and Effective: https://ajronline.org/doi/10.2214/AJR.14.12879

25 Mars 1h 2min

Targeted, image-guided interventions can make a big difference for patients with hereditary hemorrhagic telangiectasia (HHT). Learn how in this week’s BackTable episode featuring Dr. Clifford R. Weiss (Director of the Johns Hopkins Vascular Anomalies Center and HHT Center of Excellence) and host Dr. Michael Barraza. --- SYNPOSIS Dr. Weiss delves into the complexities and multisystem nature of HHT, emphasizing the significance of early diagnosis and multidisciplinary care. He goes on to explain the clinical criteria for diagnosing HHT, the role of genetic and imaging screenings, and the evolving approaches to treating pulmonary arteriovenous malformations (AVMs) in adults and children. The doctors discuss the potential impact of anti-angiogenic medications on the future management of HHT. The episode closes with a nod to the pivotal role that HHT Centers of Excellence play, and the ongoing dedication to improving patient outcomes through collaborative care and innovative research. --- TIMESTAMPS 00:00 - Introduction 03:57 - Diagnosing and Screening for Hereditary Hemorrhagic Telangiectasia (HHT) 07:37 - Treatment Approaches for HHT 12:12 - Embolization Techniques and Safety Measures 19:02 - Future of HHT Treatment and Research 22:30 - Conclusion and Final Thoughts --- RESOURCES The Johns Hopkins Hereditary Hemorrhagic Telangiectasia (HHT) Center of Excellence: https://www.hopkinsmedicine.org/interventional-radiology/hht

21 Mars 26min

Teleradiology, artificial intelligence, and private equity takeovers—how do we navigate these rapid changes in the radiology landscape? In this episode, our co-hosts Dr. Ally Baheti and Dr. Mike Barraza bring Dr. Ben White back to the show to provide an update on the current radiology job market and share his insights on reclaiming value for the profession. Dr. White begins by reflecting on the changes since his last appearance with us in 2022, focusing primarily on the ongoing shortage of radiologists, which has lasted longer than anticipated during the pandemic, and the explosion of teleradiology. --- SYNPOSIS Today’s radiologists are more mobile than ever, with remote work options and the appeal of sensationalized job postings. Dr. White also discusses the instability of more established practices, particularly when legacy partners depart after fulfilling their contractual obligations. In response, many practices are refinancing their debt, which has led to a decrease in practice acquisitions. Dr. White believes that large-scale healthcare operations often result in increased inefficiency and reduced agility. The downstream effects include the commoditization of teleradiologists, concerns about decreased quality of reads, a limited scope of practice for procedures, reduced access to imaging for smaller hospitals, longer wait times, and more unstable locum staffing. The doctors also speculate about the future division of radiology into different service tiers, depending on the level of access each hospital has to radiologists. Finally, Dr. White highlights his Independent Radiology job board, which lists open positions from physician-owned practices. His goal in creating the website is to address the pain points of other job advertisement sites, where misleading postings are common. He wants radiologists to consider joining a team of physicians, rather than simply accepting a job. His advice to all radiologists is to expect uncertainty in the job market and to remain flexible. --- TIMESTAMPS 00:00 - Current Radiology Job Market 07:43 - Updates on Private Equity in Radiology 16:26 - Role of Artificial Intelligence 22:46 - Growing Imaging Volume and Efficiency 26:51 - Challenges in Radiology Staffing 36:49 - Independent Radiology Job Board 50:07 - Future of Radiology and Final Thoughts --- RESOURCES BackTable VI Ep. 277- Private Equity and the Radiology Job Environment with Dr. Ben White: https://www.backtable.com/shows/vi/podcasts/277/private-equity-the-radiology-job-environment Independent Radiology Job Board: https://www.independentradiology.com/

18 Mars 1h 7min

Do you ever wish you could be a fly on the wall at a tumor board meeting? In this episode of BackTable, we’re excited to give you an insider’s view of the real case discussions that take place during hepatocellular carcinoma (HCC) tumor boards. Host Dr. Zach Berman sits down with a multidisciplinary team, including Drs. Adam Burgoyne (medical oncologist), Heather Patton (hepatologist), Siddharth Padia (interventional radiologist), and Gabriel Schnickel (transplant and hepatobiliary surgeon). Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125743 --- This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific. --- SYNPOSIS The team walks through a range of diverse HCC cases, reviewing patient histories, imaging, and treatment options. They cover eight cases in total, each featuring patients with varying treatment histories, comorbidities, liver function, and lesion characteristics. For the full educational experience, we recommend watching the video format on our YouTube channel. --- TIMESTAMPS 00:00 - Introduction 00:47 - Case 1: Small Lesion in a Young Patient 05:01 - Case 2: Moderate Sized Lesion in an Older Patient 11:10 - Case 3: Multifocal HCC with Dominant Lesion 21:09 - Case 4: Dominant Lesion with Portal Hypertension 32:08 - Case 5: Ruptured Solitary Lesion 34:34 - Case 6: Rupture with Multifocal Lesions 44:08 - Case 7: Portal Vein Invasion 52:12 - Case 8: Metastatic HCC After Transplant --- RESOURCES CME Accreditation Information: https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf

14 Mars 58min