Session 15 This week, I speak with Dr. Fayyaz Barodawala, a community-based Interventional Radiologist from Atlanta, Georgia, about his career decisions, what an IR physician does on a daily basis, the struggles and triumphs that come along with his practice and specialties opportunities outside IR and other interesting topics like exclusive hospital contracts and artificial intelligence replacing diagnostics. [01:15] Choosing Interventional Radiology Practicing medicine since 2005, Fayyaz knew he wanted to be an Interventional Radiologist on one particular day during his third day of medical school. He initially found interest in plastic surgery, vascular surgery, and orthopedics. He had exposure to medicine growing up with his parents both physicians but it was on his third year, surgical rotation that he remembered being chewed out after having observed a surgical procedure passively for so long. During that same day, he went to see a family friend how happened to be called in for a pulmonary arteriogram and surprised at how quick the procedure was. At that point, he was considering orthopedics or radiology with the full intention of going into interventional, if he did the latter. What he likes about the field is the fact that you get to do different and relatively short procedures that make a difference and people happy. [04:10] Traits of a Great Interventional Radiologist Fayyaz says the things that make great interventional radiologists are knowledge of imaging and problem-solving. A lot of what he has to do is a lot of problem-solving. There may be defined pathways to do certain things but If they don't go as planned, then you have to improvise a lot. You have to be able to figure out how to accomplish your goal using the tools you have. A running joke during his fellowship was that IR was the last name on the chart so when everybody thinks a procedure is too high-risk for them, they'd call IRs to take care of it. IRs do so much work like put filters in, arterial work, oncologic work, spine work, etc. So they have their hands on a whole bunch of different places but problem-solving and thinking outside the box are good traits to have for Radiology. And of course, you need to know your Anatomy. [06:22] Types of Patients Interventional radiologists treat younger, healthier patients that they might see for as simple as venous access like a PICC or younger women who have heavy menstrual bleeding due to fibroids. They do uterine artery embolization. They treat veins for cosmetic and medical reasons like a vein ablation and sclerotherapy. They also treat older patients with spinal fractures for vertebroplasty or kyphoplasty. They treat a lot of oncologic patients which branches off into its whole own sub or super-specialty, even treating hepatic tumors such radio embolization, chemo embolization, or radiofrequency or microwave ablation or cryoablation. Hence, the see a full spectrum of patients who are younger and healthier to older and very, very sick. [07:32] A Typical Day for an Interventional Radiologist His current practice is less hard core and interventional than he would have liked. Bread and butter for them would be paracentesis, thoracentesis, chest port placement for chemo, various biopsies, vertebral kyphoplasty for spinal fractures. In his latest practice, he had gotten into a lot of pain management procedures such as epidural steroid injections, lumbar puncture, and myelogram. In between, he reads diagnostic imaging. Interventional radiologists do a wide variety of cases. Today, Fayyaz did paracentesis, thoracentesis, fluoroscopy, breast biopsies, and red PET scans. Other days, he could be doing a lot more like nephrostomies, biliary drainage, kyphoplasties. They're also currently ramping up their oncologic work at the new group he's in, doing ablations and radio embolizations that are starting to pick up now. Even if you're a little ADD, you can find stuff that's good because it's not monotonous. On the flip s