Famous Last Words: A Cut Above

Former surgeon finds his passion in interventional radiology

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Andrew Davis, MD, spent 6 years as a surgeon before changing fields and becoming an interventional radiologist. (Photo by Radiology Associates)

As a partner in Radiology Associates of Clearwater in Florida, Andrew Davis, MD, has spent the last two decades watching interventional radiology grow and evolve. (Photo by Radiology Associates)

Twenty years ago, the developing field of interventional radiology lured Andrew Davis, MD, away from his surgical training. Captivated by the constant introduction of new techniques and the potential for interventional radiology to go where surgeons could not, Davis said goodbye to the operating room to explore a field that uses small openings instead of large incisions, catheters instead of scalpels, and imaging technology instead of the naked eye.

As a partner in Radiology Associates of Clearwater in Florida, Davis has spent the last two decades watching interventional radiology grow and evolve exactly as he predicted. It’s now a field that continues to circumvent surgery and prevent the side effects of long recovery periods.

When Davis was in medical school at the Washington University of St. Louis in the early 1980s, the radiology field was known as “special procedures” and dedicated solely to diagnostic tests. A radiologist was more a “proceduralist” than a clinician, he remembers. Since Davis’ goal was to be involved in patient care, radiology didn’t seem like an option. Instead, he turned to surgery, knowing that he would have a significant impact on patients before, during, and after their operations.

But after 6 years of practicing general and vascular surgery, Davis saw the field of radiology changing. With the growth of interventional radiology, radiologists had options other than spending the day in a room reading cases. As they became directly involved with patient care, interventional radiologists could even perform some procedures more effectively than surgeons. After an interventional radiologist saved one of Davis’ liver transplant patients without having to take the patient back to the operating room, he saw the full potential of interventional radiology.

“I began to see that some of the things that were done in IR were interventions that mimicked some of the things we did in surgery, but with a 3 mm incision and with much lower chance of complications and death,” Davis says of the incident that made him contemplate a career switch.

Seeing an interventional radiologist save his transplant graft using basic tools convinced Davis he should be in a different field. He left his surgical career behind, completed a diagnostic radiology
residency, then a fellowship in vascular and interventional radiology at the hospital of the University of Pennsylvania, and received a CAQ in vascular and interventional radiology Davis describes interventional radiology’s advantages over surgery with an analogy: “It’s like a highway system. Surgeons are able to cut off the blood vessel at the major highway, where we’re able to go down the exit ramp and get to a much smaller network.”

The biggest difference Davis sees between his previous surgical career and interventional radiology is the variety. As a surgeon, the variety of disease entities one encounters and is able to render a therapeutic procedure for is limited in most surgical fields, Davis says. But because interventional radiology encompasses all parts of the body and combats various diseases, Davis rarely does the same thing twice in-a-row. Davis finds the pace of performing procedures such as eliminating uterine fibroids or chemoembolization, spending time with patients, and reading cases refreshing.

The constant shift between right-brain and left-brain stimulation keeps things interesting, he says.
In the process, interventional radiology continues to evolve. There is a new breakthrough every few years that keeps the field fresh and innovative.

“The instruments of the field are relatively primitive. We cut, we stretch, we put things in to keep things in place. It is pretty fundamental. But the creativity has been stellar. We are really only limited by the creativity of the application of the tools we have,” Davis says.

As long as interventional radiologists continue to apply their talents in new ways, procedures will continue to expand, which increases the minimally invasive care options for patients.

Twenty years ago, some of Davis’ co-workers thought he was making a bad decision by leaving surgery for interventional radiology. He had put in too many long hours, worked too hard, and gone too far to switch specialties. Davis made the leap anyway, and he has never looked back.

Justine Rosen is an editorial intern with rt image. Direct comments and questions to editorial@rt-image.com, or suggest a clinician to profile in Famous Last Words.