The Vascular and Interventional Program at Central DuPage Hospital in Winfield brings together a vascular surgeon and interventional radiologist to offer patients one-stop treatment shopping. This new trend in dual consultation means patients can learn about surgical and less-invasive treatment options in one visit.

Common conditions treated are non-cardiac circulatory problems, including lower-extremity peripheral arterial disease, carotid artery disease, aortic aneurysms, varicose veins and dialysis access. Patients also learn about less-invasive techniques used in cancer care including radiofrequency ablation of tumors (using heat to kill tumors) and chemoembolization (delivering drugs directly to a tumor under x-ray guidance).

“We’re partners, not competitors,” said Dr. Joseph Schneider, a vascular surgeon at Central DuPage Hospital who works with Dr. Nilesh Patel, interventional radiologist and medical director of the program. “We’ve agreed to collaborate in any way and think it’s best for the patient by expanding their range of treatment options.”

Patients make one phone call and see either of the two doctors within days. Schneider and Patel discuss each case and choose the best treatment option. At some hospitals patients wait three to four weeks to see a single specialist. “We think patients get through the system much faster with our arrangement,” said Schneider.

It’s a paradigm shift because traditionally, vascular surgeons and interventional radiologists have been competitors in parts of the country. “Dr. Patel and I thought this didn’t make sense,” said Schneider. “Much of our work overlaps. The two of us are pretty far along in our careers and we don’t have anything else to prove. We advocate for one another.

“Competition is a distraction in terms of patient care,” Schneider said. “Patients are better off because we’re working together. They will have instant access to a broader range of approaches to problems within the realm of interventional radiology.”

Most procedures are done by one of the two. But sometimes they work together, such as in the repair of an aortic aneurysm. This bulge in the main artery that leaves the heart can be fixed with a minimally invasive technique. “Either of us could perform this procedure alone, but we agree that patients benefit by having both of us in the room,” said Schneider. Sometimes there are incisions that benefit from Schneider’s expertise. Patel offers his catheter and guide wire skills.

“We will succeed because of efficiencies,” Schneider said. “I will still do open surgery alone and Dr. Patel will do interventional radiology. The area where we intersect is getting bigger. We can offer higher levels of expertise working together.”

Similar arrangements are cropping up across the country. “You see these programs when you have an integrated organization with hospitals and physicians all working under the same umbrella,” said Rick Wade, spokesperson for the American Hospital Association. “It’s a change in the way physicians and hospitals are organized. You can create all kinds of team partnering arrangements that make decision making easier for patients and integrates care so there’s less fragmentation. It saves patients time and heightens the quality of care by giving patients choices.”

The model has been used for prostate cancer, too. “This gives the patient a consultation in which all doctors potentially involved are looking at the same information,” said Wade. “It’s in the best interest of the patient, since there’s not one doctor looking at it in isolation of what they do best.”

At Northwestern Memorial Hospital, vascular surgeons and interventional radiologists share patients in a collaborative arrangement. “Patients get optimal treatment performed by the specialist who does it best,” said Dr. Robert Vogelzang, chief of vascular and interventional radiology at Northwestern Memorial Hospital.

“This is the future of vascular medicine,” said Dr. Joseph Caprini, a professor of surgery at Northwestern University Feinberg School of Medicine and spokesperson for the Illinois Medical Society for Venous Disease. “If you go to a Ford salesman he’ll sell you a Ford. If you go to a Chrysler salesman he’ll sell you a Chrysler. With this model both specialists are sitting there together discussing what you need and picking out what’s best for you.”

By Terri Yablonsky Stat

Special to the Tribune