title: Five-year results of a merger between vascular surgeons and interventional radiologists in a university medical center.
abstract: OBJECTIVE
  We examined economic and practice trends after 5 years of a merger between vascular surgeons and interventional radiologists.
  
  
  METHODS
  In 1998 a merger between the Division of Vascular Surgery and the Section of Interventional Radiology at the University of Rochester established the Center for Vascular Disease (CVD). Business activity was administered from the offices of the vascular surgeons.
  
  
  RESULTS
  In 1998 the CVD included five vascular surgeons and three interventional radiologists, who generated a total income of $5,789,311 US dollars (34% from vascular surgeons, 24% from interventional radiologists, 42% from vascular laboratories). Vascular surgeon participation in endoluminal therapy was limited to repair of abdominal aortic aneurysms (AAAs). Income was derived from 1011 major vascular procedures, 10,510 catheter-based procedures in 3286 patients, and 1 inpatient and 3 outpatient vascular laboratory tests. In 2002 there were six vascular surgeons (five, full-time equivalent) and four interventional radiologists, and total income was $6,550,463 US dollars despite significant reductions in unit value reimbursement over the 5 years, a 4% reduction in the number of major vascular procedures, and a 13% reduction in income from vascular laboratories. In 2002 the number of endoluminal procedures increased to 16,026 in 7131 patients, and contributions to CVD income increased from 24% in 1998 to 31% in 2002. Three of the six vascular surgeons performed endoluminal procedures in 634 patients in 2002, compared with none in 1998.
  
  
  CONCLUSIONS
  Gross revenues increased in a declining reimbursement and conventional practice environment, because of the increased number of endoluminal procedures, in part provided by vascular surgeons. The implications of these data should be considered by those responsible for training vascular surgeons.
authors.affiliation: Division of Vascular Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA. Richard_Green@urmc.rochester.edu
authors.forename: Richard M
authors.initials: RM
authors.lastname: Green
authors.forename: David
authors.initials: D
authors.lastname: Waldman
mesh_terms: D000046:Academic Medical Centers / Q000191:economics*; D017598:Efficiency, Organizational / Q000191:economics; D006273:Health Facility Merger / Q000191:economics*; D006801:Humans; D007182:Income; D010818:Practice Patterns, Physicians' / Q000191:economics* / Q000639:trends*; D015642:Radiology, Interventional / Q000191:economics*; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000191:economics*; D016526:Workload / Q000191:economics