Working for a vascular W


illiam Nghiem, MD, is an interventional radiologist employed by Horizon Vascular Specialists in


Maryland—a vascular surgery group in which Dr. Nghiem is the only IR. It’s an unusual collaboration, but one that offers its own unique opportunities. IR Quarterly spoke with Dr. Nghiem about his practice, his colleagues and the tools necessary for collaboration.


How did you join your current practice? William Nghiem: I finished my IR fellowship in 2014 and joined a community-based radiology practice, and


it was not what I was expecting. An interesting thing about IR training is that many of the things you do in your fellowship are very different from the realities of actual private practice, where many of us end up. You often don’t have a clinic, you don’t have midlevel support and you’re not doing many high-level procedures. Shortly after joining my radiology group, I realized their business model was far more based on DR work. I wanted to do cancer programs and offer specific IR therapies, and while my group was vocally supportive, there was a strong push for me to do diagnostic radiology. As a result, I wasn’t very satisfied with the situation.


During this time, however, I met some of the vascular surgeons who shared the catheter lab at the hospital. One of them was very progressive and aware that certain aspects of his vascular practice may take a hit in the future, so he was looking to expand his services.


8 IRQ | WINTER 2022 SUPPLEMENT


surgery group How one IR built a unique practice model


As we got to know each other better, he began to understand more about what IR is and what can be brought out of the hospital into a different setting. The vascular surgeons were aware that my group didn’t afford the IR-focused work I’d anticipated, and so the vascular practice offered me those opportunities. Since they are a surgical practice, they already had the offices, staff and midlevel providers. I joined them 6 years ago, and I am now able to practice 100% clinical IR.


Did you receive support in your decision to move to a vascular practice? WN: To tell you the truth, some of my vascular colleagues were hesitant at first because it was an unknown model. We all agreed that it was a trial, and they knew it was a huge risk for me—I could have stayed at my DR practice for guaranteed salary and service. Even my mentors were divided on whether it was a good idea and said they wouldn’t have done it, especially not a year out of fellowship. But I viewed it as an opportunity because I wasn’t set in my practice type. I had the ability to take a risk but still move on if it didn’t work out. Someone who is more established in their practice may be unwilling to take that kind of risk.


What services do you offer? WN: Starting out, I brought everything I could from the hospital to the outpatient setting. We have an office- based laboratory, so I was doing biopsies, women’s health, pelvic congestion, etc., just trying to figure out what would work. Over the years I’ve whittled it down to what we do


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