Study details 'major shift' in procedural workload burdens
New findings hint at a “major shift in procedural burden” that is landing squarely on the shoulders of interventional radiologists.
The findings pertain specifically to paracentesis and thoracentesis—drainage procedures frequently used to manage ascites and pleural effusions. Historically, these procedures have been handled by internists, surgeons and critical care physicians, but the evolving landscape of patient care has shifted in recent years, leaving these cases in the hands of IRs increasingly often. In fact, the new data suggest that the number of these procedures completed by IRs in the U.S. has more than tripled over the past decade.
The good news is that IRs are well equipped to perform paracenteses and thoracenteses; multiple studies have shown that IRs typically produce higher procedural success rates with fewer complications during these procedures specifically. They're also more time efficient, experts involved in the analysis noted in Academic Radiology.
“Radiologists typically complete these procedures more quickly and with fewer resource expenditures compared to non-imaging-guided approaches,” Zachary Nuffer, MD, with Baylor College of Medicine, Baylor St. Luke’s Medical Center in Houston, and co-authors noted. “Understanding how these national patterns manifest within radiology departments is critical for optimizing staffing, credentialing, and quality improvement initiatives,” they added.
Nuffer and colleagues recently compared data from throughout the U.S. to get a better idea of how the burden of paracenteses and thoracenteses has shifted. They retrospectively analyzed internal billing data from 92 U.S. practice sites from 2014 to 2022, calculating radiologists’ portion of the procedures for each site and comparing those figures to publicly available Medicare Physician & Other Practitioners datasets.
The review uncovered a significant shift in procedural responsibilities since 2014. That year, radiologists throughout the U.S. completed around 3,100 paracenteses; by 2022, that figured skyrocketed to nearly 17,000—a nearly six-fold increase. Similar changes were seen in paracenteses procedures as well, with radiologists completing around 2,000 in 2014 compared to nearly 10,000 in 2022. These numbers also translated into a substantial spike in average procedures per radiologist and site.
It should be noted that there were no marked increases in procedural volumes during the time period studied. This suggests that there has not necessarily been a rise in demand for paracentesis and thoracentesis procedures, but rather a shift in the providers tasked with performing them.
“Our analysis demonstrates a pronounced shift in paracentesis and thoracentesis workload toward radiologists over the past decade,” the team noted. “Despite stable national volumes, radiologist-performed paracentesis and thoracentesis nearly quadrupled. Medicare claims analyses corroborate these findings, documenting radiology’s dominant and growing role.”
The authors suggested their findings could be used by hospitals and clinics to guide staffing models, recruitment and radiologist training.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.