Vascular Practice Development Q&A with James F. Benenati, MD

How can vascular interventionists expand their practice in today’s market?

Peripheral arterial disease (PAD) is still not well recognized in the community and not well understood by many primary care physicians. There is a huge untapped market and many of these patients need help. With physician education and marketing, it is possible to build a reasonable practice. Developing relationships with primary care physicians is critical.

Are you involved in a multispecialty vascular practice? If so, how do you manage potential conflict and friction?

Our practice includes interventional radiologists and vascular surgeons in a partnership. Our relationship with our cardiology colleagues is very strong as well. By being in the same group, we eliminate all turf issues and there are no real conflicts since there are no real competitive forces working against each other. We are all on the same team.

What are some of the CPT coding issues you encounter in your practice?

There is somewhat a disincentive to perform many interventions in one sitting because of the reimbursement policies.

What clinical competence and accreditation do you require of your physicians?

All physicians in our group are fellowship-trained and all IRs have a CAQ. Our vascular lab is ICAVL-accredited and we will accredit our carotid stent program through ICACSF. We insist on yearly CME. We set standards for quality and outcomes that all group members must meet. Newer members are mentored by more experienced members regardless of their background when they first join the practice to ensure that we all can strive to achieve the best outcomes.

How are quality initiatives implemented and monitored in your practice?

We have routine QA meetings to discuss outcomes. All cases are reviewed for outcomes and complications. Our QA process is multispecialty so that all cases are reviewed by members of different specialties.

What are your recruiting methods for physicians and staff? What sort of training do they undergo once employed?
Word of mouth and personal recommendations are greatly valued when recruiting. We seek ACGME-accredited fellowship trained physicians who have demonstrated some interest in clinical research. Once employed, they are on either a 6-month or 1-year evaluation period where the majority of the cases they perform are proctored by an experienced partner.

What do you do to educate your patients about their conditions and the procedures they may undergo?

All patients we treat are seen in the office and are usually educated by the physician who is going to perform the procedure. We have teaching videos and pamphlets for the more complex cases.

What guidelines and methods do you use to communicate with the media and to educate the local/regional physicians and the community at large?

We work closely with the hospital marketing department and we have our own group marketing firm. We do use the local press when newsworthy events occur. We have found webcasts to be very valuable as well. The Internet is an incredibly powerful tool for most patients.

How have you created a “brand” for your practice vis-à-vis referring physicians and the community at large? How important is this?

Our brand is based on the highest quality work with excellent service. To build a good brand, the group must be able to accommodate new patients in a timely manner and deliver excellent service.

What do you envision your practice will look like in the next 5 to 10 years?

I see our practice growing, covering more hospitals and diversifying. I can easily envision cardiologists and vascular medicine specialists in our group along with vascular surgeons and interventional radiologists.

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James F. Benenati, MD, joined Baptist Cardiac & Vascular Institute in 1990 and is currently the Medical Director of the Peripheral Vascular Laboratory. He is Clinical Associate Professor of Radiology at the University of South Florida College of Medicine and Program Director of the ACGME-accredited fellowship program in interventional radiology at the Institute.

Dr. Benenati received his bachelor's degree from the University of Notre Dame and his medical degree from the University of South Florida College of Medicine. He completed a residency in diagnostic radiology at Indiana University Medical Center and a fellowship in cardiovascular and interventional radiology at Johns Hopkins Medical School.

Dr. Benenati is a Fellow of the Society of Cardiovascular & Interventional Radiology, a Fellow of the American Heart Association and a member of the Radiological Society of North America. He holds offices in several societies, including member of the Executive Council of the Society of Interventional Radiology and President-elect of the Intersociety Commission for the Accreditation of Vascular Laboratories (ICAVL). He formerly served as the annual meeting chairman for the Society of Interventional Radiology.

Dr. Benenati has participated in clinical research projects for abdominal aortic aneurysm repair with endografts; stents in peripheral vascular disease; prevention of restenosis in the femoral and popliteal arteries and in carotid stenting trials. He has participated in national trials evaluating uterine embolization for the treatment of symptomatic fibroids and has organized national educational symposia regarding fibroid embolization.

In addition to lecturing internationally, Dr. Benenati has authored and co-authored numerous scientific articles that have been published in medical journals including the Journal of the American Medical Association, Radiology, Journal of Vascular & Interventional Radiology and Journal of Vascular Surgery. He has also edited medical textbooks dealing with different aspects of interventional radiology, and is active in educational activities for the SIR.

Dr. Benenati is currently the president of both the Society of Interventional Radiology (SIR) and the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL).