HJAR Sep/Oct 2020

HEALTHCARE JOURNAL OF ARKANSAS I  SEP / OCT 2020 55 Edgar St. Amour, MD Interventional Radiologist CARTI, Inc. to the point where these are routinely per- formed in an outpatient setting with easily manageable side effects experienced by the patient. While the field has evolved over the years in both technology and technique, allowing for more complex procedures being done less invasively, the greatest evolution to sup- port a move toward outpatient settings has “Interventional oncology has become such a critical component of modern oncology care, that it is often referred to as the fourth pillar of cancer care, supporting the more commonly known modalities of medical, surgical, and radiation oncology.” been an increase in comfort level for the interventional oncologists performing the procedures, cost reductions, and a drop in resource utilization. As with surgical specialties in the past, interventional oncologists have developed their own set of techniques and clinical acu- men, which has cumulatively led to an in- creased comfort level in treating patients in an outpatient setting. Interventional on- cologists are trained to manage the medical needs, as well as the perioperative needs of their patients. We see patients in clinic when necessary, and are always available to patients throughout their oncology care, even when the patient is not in a hospital. Consider, for example, a pneumothorax, or air trapped around the lung, which is a known complication of a lung biopsy. In some instances, this requires placement of a chest tube to relieve potentially serious complications. Historically, chest tubes have beenmanaged in a hospital setting. However, we now know these can be safely managed at home with a special valve that allows the air to escape the chest, but not re-enter. This ultimately leads to both a cost reduction, and a decrease in resource allocation. When a patient is admitted to a hospital for a procedure, there are significant asso- ciated costs and resource demands. These include personnel requirements, building regulations, and even the mental and emo- tional support services for the patient. When a patient must be tended to in a hospital, there are nursing and monitoring require- ments that do not exist within the patient’s own home. Moreover, there is no mainte- nance cost associated when you can recover at home. Additionally, and even more im- portantly, research shows that patients are more comfortable at home, and tend to heal quicker. While many positive advancements have occurred, financial reimbursement still re- mains an obstacle in the transition to outpa- tient care. While the procedures are cheap- er to be performed in an outpatient center, some insurance providers are hesitant to pay for procedures in these type of settings. For example, Medicaid will only pay for pro- cedures performed in a hospital-based set- ting. Overall, though, most procedures are covered in an outpatient setting, and the growth in this market has been tremendous. Ultimately, the benefit of practicing inter- ventional oncology in an outpatient setting is the ability to offer more individualized care to the patients being treated. This leads to the interventional oncology team devel- oping closer relationships with patients who are seen on a regular basis. Whether it be for drainage of chest or abdominal fluid to re- lieve symptoms, or actual tumor treatment procedures, the interventional oncologist becomes a regular part of these patients’ care team, which is extremely gratifying for both the physician and the patient. When this particular care team and specialty is under the same roof as the patient’s overall medical team members, it makes the pa- tient’s journey easier, and more tailored to their individual needs. n Dr.Hays completed a residency in diagnostic radiolo- gy at the University ofArkansas for Medical Sciences in Little Rock, Arkansas, followed by a fellowship in angio/interventional radiology fromMiami Cardiac and Vascular Institute in Miami, Florida. He earned amedical degree from the University ofArkansas for Medical Sciences. Dr. St. Amour completed a residency in diagnostic radiology at Columbia University in New York City, New York, followed by a fellowship in vascular and interventional radiology at Miami Cardiac and Vas- cular Institute inMiami,Florida.He earned amedical degree from the University of Arkansas for Medical Sciences.