The Journal of Vascular and Interventional Radiology (JVIR) published a paper in January 2023 examining the potential barrier that the name of the interventional radiology (IR) specialty poses to the US public’s understanding of the role of interventional radiologists. Mina Makary et al (The Ohio State University Wexner Medical Center, Columbus, USA) found that “less than half” of those surveyed were able to identify interventional radiologists as doctors.
Their findings also revealed that most IR referral patients who ended up having surgery “stated that a lack of IR awareness played a role in their decision”. The authors make recommendations, in their paper titled ‘Public awareness of IR: Population-based analysis of the current state and pathways for improvement’, of how to improve recognition and understanding of IR among the general public, which include patient education delivered by primary care providers.
The authors embarked on the study in order to “evaluate IR awareness among the public and identify methods for improvement”. One thousand participants responded to 69 questions anonymously on Amazon’s Mechanical Turk crowdsourcing platform, which required either Likert Scale or free text answers. The authors justified their choice of platform “to obtain a more accurate and reliable assessment of the current rate of IR awareness”, compared to previous study samples. The questions prompted respondents on their “medical and IR-specific knowledge, preferred methods of medical information acquisition, and suggestions for improving IR awareness”.
The study’s results
With regards to study results, 39.8% of participants were able to place IR as a medical specialty in and of itself—this specialty status is the case in the USA, where it is not elsewhere, such as in the UK. This is “improved” from 2000, when data demonstrated that only 2% of the US population knew what interventional radiologists did. Less than half of respondents knew that IR involved medical procedures, with over half feeling that the name of the IR specialty was “too ambiguous” and 458 stated that they wanted to “learn more” about it. Makary et al also specify that they found “no correlation between age, income level, residence, or race” and level of IR awareness.
As stated above, there were respondents who themselves had been offered an IR procedure, numbering 113, and of these, 66 also had the option of undergoing surgery. Twenty patients then went on to say that their choice of surgery over minimally invasive IR treatment was influenced by a “lack of IR awareness”, which amounted to 71% of those who chose a surgical procedure. This is despite the finding that “92% of participants preferred undergoing a minimally invasive procedure over surgery”.
Regarding the solutions to the lack of awareness proposed to participants, in terms of an alternative name for IR, ‘minimally invasive radiology’ was “most preferred”, opted for by 21.3% of respondents. ‘Procedural radiologist’ and ‘radiological surgeon’ also featured among the top choices, garnering 18.4% and 14.6% of responses, respectively. “Short (<10-min) educational videos and increased patient education by primary care providers (PCPs) were among the most suggested ways to improve awareness,” the authors detail. Other suggestions posed to respondents, in order of popularity as per the study, included websites dedicated to the dissemination of information on IR, increased social media presence, and some form of advertising campaign promoting the specialty.
Based on their study, Makary et al were able to conclude that “a lack of IR awareness may underlie underutilisation. When presented with the knowledge that IR improves patient outcomes, minimally invasive procedures with an interventional radiologist are more often desired by the public over surgical options.” Moreover, the authors posit that the current level of IR awareness among the general populace is “further exacerbated by low IR awareness within PCPs, which has led to low referral rates and underexposure of patients to IR”. Makary and his co-authors make the point that “initiating and maintaining professional relationships [between interventional radiologists and] local PCPs is the first step to improving patient referrals to IR. As IR awareness is low amongst PCPs, strong emphasis should be placed on educating PCPs about common pathologies such as peripheral artery and venous disease, fibroids, [and] chronic pain, that IR physicians treat.”
The importance of continued conversation
Speaking to Interventional News about the results, Makary noted how “the overall low level of awareness was not surprising as most patients who come to us for care are not familiar with our specialty or our procedures until we meet them and explain what we can offer.” However, he went on to add that he “did find it interesting that most found the name ‘interventional radiology’ ambiguous, and that ‘minimally invasive radiologist’ was the most preferred alternative”. Expanding on the appetite for a possible name change for the specialty, Makary expressed hope that his and colleagues’ work could “[support] the conversation [in the USA] regarding the identity and name of [the IR] specialty and [provide] helpful insight as the specialty evolves”—not just in terms of nomenclature, but also “educating the public and other healthcare providers about IR and the value of our care”.