Maingard Julian, Kok Hong Kuan, Ranatunga Dinesh, Brooks Duncan Mark, Chandra Ronil V, Lee Michael J, Asadi Hamed
1 Interventional Radiology Service-Department of Radiologyz, Austin Hospital , Melbourne, VIC , Australia.
2 Interventional Neuroradiology Service-Radiology Departmentz, Austin Hospital , Melbourne, VIC , Australia.
Br J Radiol. 2017 Dec;90(1080):20170473. doi: 10.1259/bjr.20170473. Epub 2017 Oct 3.
The rapid progression of medical imaging technology and the ability to leverage knowledge from non-invasive imaging means that Interventional Radiologists (IRs) and Interventional Neuroradiologists are optimally placed to incorporate minimally invasive interventional paradigms into clinical management to advance patient care. There is ample opportunity to radically change the management options for patients with a variety of diseases through the use of minimally invasive interventional procedures. However, this will need to be accompanied by an increased clinical role of IRs to become active partners in the clinical management of patients. Unfortunately, the development of IR clinical presence has lagged behind and is reflected by declining rates of IR involvement in certain areas of practice such as vascular interventions. Current and future IRs must be willing to take on clinical responsibilities; reviewing patients in clinic to determine suitability for a procedure and potential contraindications, rounding on hospital inpatients and be willing to manage procedure related complications, which are all important parts of a successful IR practice. Increasing our clinical presence has several advantages over the procedure-driven model including enhanced patient knowledge and informed consent for IR procedures, improved rapport with patients and other clinical colleagues through active participation and engagement in patient care, visibility as a means to facilitate referrals and consistency of follow-up with opportunities for further learning. Many of the solutions to these problems are already in progress and the use of IR as a "hired gun" or "technician" is a concept that should be relegated to the past, and replaced with recognition of IRs as clinicians and partners in delivering modern high quality multidisciplinary team-based patient care. The following article will review the history of IR, the challenges facing this rapidly evolving profession and discuss recent developments occurring globally that are essential in maintaining expertise, securing future growth and improving patient outcomes in the modern multidisciplinary practice of medicine.
医学成像技术的快速发展以及利用非侵入性成像知识的能力意味着，介入放射科医生（IR）和介入神经放射科医生处于将微创介入模式纳入临床管理以推进患者护理的最佳位置。通过使用微创介入程序，有充分的机会从根本上改变各种疾病患者的管理选择。然而，这需要IR在临床中发挥更大的作用，成为患者临床管理中的积极合作伙伴。不幸的是，IR临床角色的发展滞后，这体现在IR在某些实践领域（如血管介入）的参与率下降。当前和未来的IR必须愿意承担临床责任；在诊所对患者进行评估，以确定其是否适合进行某项操作以及潜在的禁忌症，巡视住院患者，并愿意处理与操作相关的并发症，这些都是成功的IR实践的重要组成部分。相较于以程序为驱动的模式，增加我们在临床中的参与有诸多优势，包括增强患者对IR程序的了解和知情同意，通过积极参与患者护理改善与患者及其他临床同事的关系，提高知名度以促进转诊，并通过进一步学习的机会确保随访的一致性。这些问题的许多解决方案已经在推进中，将IR用作“雇佣军”或“技术员”的观念应成为过去，取而代之的是将IR视为临床医生以及提供现代高质量多学科团队式患者护理的合作伙伴。以下文章将回顾IR的历史、这个快速发展的专业所面临的挑战，并讨论全球范围内最近的发展情况，这些对于在现代多学科医学实践中保持专业技能、确保未来发展以及改善患者预后至关重要。
