What DR studies are IRs generally expected to read in Private Practice?

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m3db01

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What DR studies are IRs generally expected to read in Private Practice?

For those of you in a mixed IR/DR practice, do you read plain film and basic cross sectional imaging only (CT CAP, Head CTs, etc)? Do you read any Nucs, and if so, do you read PET? Do you do Mammo? Do you do any MRI, or do you leave that to the subspecialists in your group (MSK MR, Abdo MR, Brain/Spine MR, etc)?

I'm an IR/DR resident who is given the opportunity to pick some elective DR rotations, and I'm wondering if I should just add bread and butter rotations (Body CT), or try to get some extra time in Abdo MR, Neuro or MSK since I'm less comfortable reading MR in those sections.

Thanks!

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What DR studies are IRs generally expected to read in Private Practice?

For those of you in a mixed IR/DR practice, do you read plain film and basic cross sectional imaging only (CT CAP, Head CTs, etc)? Do you read any Nucs, and if so, do you read PET? Do you do Mammo? Do you do any MRI, or do you leave that to the subspecialists in your group (MSK MR, Abdo MR, Brain/Spine MR, etc)?

I'm an IR/DR resident who is given the opportunity to pick some elective DR rotations, and I'm wondering if I should just add bread and butter rotations (Body CT), or try to get some extra time in Abdo MR, Neuro or MSK since I'm less comfortable reading MR in those sections.

Thanks!

It depends on the type of private practice.

In smaller private practices in midwest or rural areas, IR may end up reading high end imaging like MR.

But in most practices, IR is expected to do 30-40% DR and that is mostly ER coverage and bread and butter stuff. In most places IR won't do mammo since it is its own separate rotation. Most places have their own Neuro, MSK and body rads to read MR and cancer imaging follow ups.
 
What DR studies are IRs generally expected to read in Private Practice?

For those of you in a mixed IR/DR practice, do you read plain film and basic cross sectional imaging only (CT CAP, Head CTs, etc)? Do you read any Nucs, and if so, do you read PET? Do you do Mammo? Do you do any MRI, or do you leave that to the subspecialists in your group (MSK MR, Abdo MR, Brain/Spine MR, etc)?

I'm an IR/DR resident who is given the opportunity to pick some elective DR rotations, and I'm wondering if I should just add bread and butter rotations (Body CT), or try to get some extra time in Abdo MR, Neuro or MSK since I'm less comfortable reading MR in those sections.

Thanks!

Obviously not mammo and not nucs/pet.

plain film, chest ct, abdomen ct, possibly some spine imaging. not hard stuff
 
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I live in a metropolitan area (>2 million people), and I read and do mammo procedures (by choice, though my group doesn't require me to as an IR), and I also read whatever MR I want, including MR neuro and body (within reason; I don't read more niche studies like MR prostate or MR breast). I also read nucs (aside from PET, but that's because of how our worklists are set up, not because they're hard). Probably the only general category I don't touch is MSK MRI aside from the occasional straightforward osteomyelitis rule-out, but that's because I've never been comfortable with them.

My group is big enough with a shared worklist that I don't have to read any of those, but I like being able to read as many different things as I can. And my residency gave us excellent MR body and neuro exposure.

Typically no single category of exam is difficult; it's the breadth of studies that we read that makes things tough. If you are willing to dedicate the time to learn a single study/modality combo, you can learn to read it pretty well quickly.
 
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Would most places allow/is it logistical for an IR to also do some Mammo?

Do you want to do mammo? Most rads don't want to do mammo. Except for @qxrt I've never heard of an IR doc reading mammo at all.

I wouldn't recommend it. It's a boring and litigious field with unclear benefits...and if you ever get sued you would be dead in the water.
 
I'm in a larger group where the IR guys do a small amount of mammo. If they're the solo guy covering a smaller hospital they're expected to read whatever screeners and diag's done on-site.

They also read a fair amount of general, both covering hospital body seats if IR is overfilled and also reading general when in between IR cases.

All MR and nucs goes to sub-specialty readers though.
 
Putting the "why would you want to read mammo?" question aside, most private practices would love to have a radiologist who reads mammo and does IR procedures, since most radiologists don't like picking up needles or doing mammo (although some will do one or the other). Kind of makes you a unicorn in the radiology world.
 
In my group, IR is expected to read and do the full spectrum of general radiology, including mammo. Not only are you expected to read studies competently, but also at a pace similar to other radiologists in the group, which is pretty fast. This is common for many groups. That’s why I wonder how groups will adjust as new IR’s graduate under the new curriculum. You are at a distinct disadvantage reading general radiology compared to IR’s trained under the former 4 years DR and 1 year IR fellowship. We just hired a few new IR’s under the new training model. I’m interested to see how they perform.
 
In my group, IR is expected to read and do the full spectrum of general radiology, including mammo. Not only are you expected to read studies competently, but also at a pace similar to other radiologists in the group, which is pretty fast. This is common for many groups. That’s why I wonder how groups will adjust as new IR’s graduate under the new curriculum. You are at a distinct disadvantage reading general radiology compared to IR’s trained under the former 4 years DR and 1 year IR fellowship. We just hired a few new IR’s under the new training model. I’m interested to see how they perform.


In most groups mammo is a separate rotation due to its different workflow and IR is not expected to read them.

This is what happens. IR can read outpatient and even inpatient but not ER Xray, US, CT or MR Between their cases using the regular monitor. But for mammo you need high resolution monitor and more importantly diagnostic mammo (and ER worklist) has its own workflow which can interfere with IR workflow.

Agree that the new IR Model doesn't work well with the current private practice set up.
 
In most groups mammo is a separate rotation due to its different workflow and IR is not expected to read them.

This is what happens. IR can read outpatient and even inpatient but not ER Xray, US, CT or MR Between their cases using the regular monitor. But for mammo you need high resolution monitor and more importantly diagnostic mammo (and ER worklist) has its own workflow which can interfere with IR workflow.

Agree that the new IR Model doesn't work well with the current private practice set up.
This is what I have seen. Many smaller hospitals want a radiologist who can do the full range of radiology. They want someone who can read most imaging studies but to also drop a central line, do para/thora, LP, biopsy, drain placement, etc. For most groups, it’s an IR trained rad or very experienced general rad. However, many hospitals including smaller ones also want to do mammo. They want not only screening but also diagnostic and biopsy services. These smaller hospitals are not busy enough to justify staffing a mammo rad as well. You can’t do mammo remotely most of the time. So if you’re that IR rad staffed at such smaller hospital, you have no choice but to do mammo. Most current IR rads aren’t very good at doing mammo and I can’t imagine how much worse the new IR rads would be.

If I were a new IR rad today, I would be very clear when I get hired that I don’t do mammo at all. You’re putting yourself at great liability.
 
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I read everything other than MSK MRI of joints (read foot MRI for osteomyelitis) and mammography. I also do high end endovascular interventions. I trained in the old paradigm which I believe was a better model .
 
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