Answering the Call… Again

A few months ago, there was a series of exchanges on SIR Connect, the chat board (I guess that's what you'd call it) of the Society of Interventional Radiology (SIR). I don't often go to sites like these, but there are a few reasons I like to keep my eye on it. First, it automatically pops up in my email on a daily basis, so I don't (God forbid) actually have to do any work to open it up. Second, there are some good tips in there for doing certain procedures, how to handle certain patient populations, or sometimes individuals commiserating about having the same complication and what to do to avoid it the next time. Third, I find it refreshing to hear about things that the Society, Foundation, and SIRPAC are doing to represent us during increasingly difficult times. Fourth, I like hearing from some of the new breed of interventional radiologist and understanding what some of their challenges are—it really gives me a flavor for what is going on in circumstances other than my own practice model. And fifth, I really, really enjoy reading some of the postings that by default make me feel stable, well-grounded, fair-minded, outward thinking, intelligent, and collegial. Because, as it turns out, not everyone who has access to that site meets all (or in some cases any) of those characteristics. Enough said.

The exchange I'm thinking of loosely fits into number three above. In short, some individuals—often the same handful of SIR members—question the value of their SIR memberships, and more specifically questioned what the SIR was doing for them during difficult times (this specifically had to do with the CMS final rule from 2020). It is right and fair that they do that. As we've all seen over the past many years, IR is always on the chopping block. Radiology as a whole is bad in this regard—IR in particular is worse. I'm not sure why this has to be, other than the fact that as a specialty (used to be subspecialty) that is heavily procedurally focused we are constantly viewed as too expensive with too little return for the societal investment. Clearly, to you the reader I'm preaching to the choir—we know, and I believe the vast majority of our referring clinicians know—what value we bring to their patients. Personally, I feel that administrators, insurance carriers, and even patients are better educated on what we bring to the table than in the past. I fully understand that we have some way to go with this, particularly with the latter, but as someone who has been at this for 25+ years I have seen many of the changes that have occurred with our own “branding.” We have come a ridiculously long way.

By way of background, the exchange to which I'm referring started out with three or so people questioning where their annual fees were going, and in particular what their return on investment was. I think a little bit of that is reasonable, and indeed healthy. Now, personally, I think if I asked myself that question more than once or twice I would probably look for a different organization in which to invest my funds. But I get it—I really do. I mention the exchange on the site for a few reasons. First, the exchange itself was lively but respectful. There was no calling out of individuals, no “academic vs. private,” “young vs. old,” “this group vs. that group” finger-pointing. Second, the Society did a good job of letting the members speak among themselves. There are some other chat boards where I personally feel the staff from the sponsoring organization does a little too much intervening. Now admittedly there are times (and perhaps a few people) that I wish could be reined in a little bit (if for no other reason than to protect them against themselves if they ever look for another job), but for the most part these exchanges belong to the people. But third, and perhaps more importantly, this particular exchange took an incredible right turn in a hurry.

After some initial discussion about the value that the SIR/SIRF/SIRPAC brings to the members as a whole, one thing became obvious. As a response to the challenges faced, instead of continued bitching and finger pointing, instead of grousing and whining, the IR community did something incredible (but predictable). During the era of “watch out for yourself and your own self-interests,” in the midst of a pandemic where nobody knew what was coming down the line, when we could have gone our own separate ways, our community did something extraordinary and I believe unique. We bonded together. Completely, and with total abandon. It became a near-feeding frenzy, with first a trickle of dollars being given to the SIRPAC, then hundreds, then many thousands. Posts came in from everywhere—private, academic, West, East, Middle, young, old, men, women, rank and file, leadership—it didn't matter. A need was identified, and we as a group bonded together. And I hope this next point doesn't offend anybody, and I hope it is clear that I as an individual drank the Kool-Aid a while ago with regard to the SIR and its dedication to our mission. But we didn't even need the SIR and their dedicated staff and volunteers to accomplish this. Sure, we needed a platform and someplace to give—but it was our belief in ourselves, in what we do in providing cutting-edge and life-changing care to our patient populations, that kept this ball rolling. It wasn't being protective, or provincial, or disingenuous—it was simply that we know what we bring to the table, and decided collectively that it was worth investing in.

This is certainly not the first time I have seen this kind of bonding together in times of need. (I think I've even written about it in a prior editorial, but in searching for it online I found myself reading my own crap, got nauseated, and had to give up. But you keep right on reading). I see it nearly every day in every setting from my own IR colleagues to national initiatives to international collaborations. It surrounds us, but most importantly in one person's opinion it is what makes us different. I have seen the sniping that occurs in other organizations and in other fields of medicine, and sometimes I can't look away from the train wreck. Now, I'm certainly not saying we are perfect as a field, nor am I saying that we should never question one another. That would be unhealthy, and I understand that. However, it is so incredibly refreshing to see professionals who believe in what they do bond together to not only protect what they have but to further promote what they do to change the face of medicine. And once again, I remain impressed by my colleagues who make it happen and continue to prove that we are all in this together.

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24. November 2021