The lone IR
What happens when you’re the only radiologist left? By Hope Racine
Summary: In a time of hospital closures, burnout and workforce shortages, it is commonplace for interventional radiology departments to be overburdened and understaffed. But what happens when you’re the only radiologist left in your entire hospital system?
In 2010, Vivek Padha, MD, FSIR, received a life-changing offer: Creating an IR service line within a group of four DRs in the West Virginia University
(WVU) Health System.
“There was pretty much nothing,” Dr. Padha said. “They didn’t have a room, nurses, equipment, inventory … nothing.”
Dr. Padha, a former family medicine physician and colonel in the U.S. Army Reserve, and the Radiology consultant to the Surgeon General of the Army, accepted the challenge and got to work setting up an IR service at the WVU Berkley Medical Center in Martinsburg. They went from zero IR presence to a strong clinical practice with six registered nurses, six radiologic technologists and two dedicated IR rooms. He had support from the hospital system and his DR colleagues. And although he still provided DR call coverage and image reading support, his partners would help in return by performing some of the simpler IR procedures, such as breast biopsies or thoracentesis and paracentesis procedures.
For 10 years, the service grew and the partnership flourished—until the COVID-19 pandemic. After providing telehealth services during the lockdowns, Dr. Padha’s colleagues decided they would not return to in-hospital services and did not renew their contract. Only Dr. Padha would remain, becoming a WVU employee.
“I spent 10 years building up very strong relationships with the community and the staff, and I did not want to leave,” Dr. Padha said. “The staff, referring physicians and patients relied on us, so I decided to stick it out and stay on site.”
The challenge, Dr. Padha said, became how to maintain both the IR and DR service lines, emergency room, and trauma coverage with only one board- certified radiologist in the hospital.
Covering the basics Despite advertising for new DR and IR physicians, the growing shift toward teleradiology, paired with the difficulty of hiring in rural West Virginia, meant that the hospital system was unable to
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