Q&A with Dr. Robert Barr: What Patients and Families Need to Know About Radiology

MRA Neuroradiologist Robert Barr, MD

In September 2022, Mecklenburg Radiology Associates neuroradiologist Robert Barr, MD, was elected president of the Board of Governors (BOG) of the American Board of Radiology (ABR). Below, Dr. Barr shares his insights on the field of radiology – including answering some of our patients’ most frequently asked questions.

Q. What does a radiologist do?

A: Radiologists are doctors who interpret X-rays, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), mammograms, and nuclear medicine studies, and perform image-guided procedures to diagnose and treat patients.

Q. What kind of training and education does a radiologist have?

A: The educational process for a radiologist includes four years of medical school, one year of internship, four years of residency, and frequently, one or more years of fellowship or subspecialty training.

Q: What is interventional radiology?

A: Interventional radiology (IR) specifically refers to the use of image-guided procedures to diagnose and treat disease, often with the use of catheters or other minimally-invasive techniques.

Q. Why would someone need interventional radiology?

A: Many patients today can be treated without requiring major surgery, but instead using catheters, needles, or other tools. Examples include patients with uterine fibroids, enlarged prostate, varicose veins, leg swelling, poor circulation, and varicoceles. There is a whole separate field of neuro-interventional radiology that treats patients with diseases in the brain, neck, and spine, such as aneurysms, stroke, vascular malformations, and painful spinal compression fractures from osteoporosis.

Q: You mentioned minimally invasive – what is minimally invasive image-guided therapy?

A: Minimally invasive is a broad term usually referring to therapy that uses small wires and catheters (or tubes) that can be directed to specific locations in the body using X-ray, ultrasound, or CT imaging. That same imaging can then be used to monitor patient response to different forms of treatment which can be delivered by wire or catheter.  Most IR treatments are minimally invasive alternatives to surgery.

Q: What should patients and families know about radiation?

A: Certain procedures including CT scans, nuclear medicine procedures, and X-rays involve radiation. An important part of our training and certification involves learning the appropriate safeguards of those tests. Remember that a certain level of radiation occurs naturally. A general principle in radiology and in radiation safety is to keep radiation exposure “as low as reasonably achievable” – this doesn’t mean no radiation. It means we take steps to ensure that any radiation necessary is kept to the absolute minimum that is reasonable to perform the necessary test or procedure. That may mean NOT doing tests or procedures that aren’t necessary. But when tests or procedures are necessary, patients can be assured that the use of radiation has been minimized and that it has been taken into consideration in weighing the overall risk versus benefit of the test or procedure.

Q: You were recently selected as president of the American Board of Radiology (ABR) Board of Governors (BOG). What is ABR, and why is it important?

A: The ABR is an independent, not-for-profit organization and is one of 24 national medical specialty boards that make up the American Board of Medical Specialties (ABMS). It serves as the certification board for over 30,000 diagnostic radiologists, interventional radiologists, radiation oncologists, and medical physicists. It was founded to protect the public by certifying doctors who meet specific educational, training, and professional requirements. Our job is to make sure that these specialists have the appropriate knowledge, skill, and understanding to benefit patients.

Q: What do you do in your new role?

A: I work closely with the other 7 members of the BOG and the Executive Director to set the strategic direction of the organization and oversee all aspects of certification. The BOG also works closely with the ABR Trustees and Item-Writing Committees tasked with all aspects of exam development. Importantly we also communicate regularly with various stakeholder groups including those involved with graduate medical education as well as the numerous specialty and subspecialty organizations that represent radiology, interventional radiology, radiation oncology, and medical physics.

Q: How do you make sure that radiologists are adequately trained to care for patients?

A: We have exceptionally talented and dedicated staff at ABR who work with approximately 1,200 volunteers from around the country to develop and administer our board exams. Since the pandemic, we’ve switched to completely virtual written and oral exams, and we continue to focus on making sure that our exams are testing the right things and the most important things – in the case of radiology, that means ensuring that we are testing what it is that a radiologist needs to know today to take the best care of patients.

Dr. Robert Barr served as president of Mecklenburg Radiology Associates from 2005 to 2016. In 2019 Dr. Barr was the 57th President of the American Society of Neuroradiology (ASNR) and was the first to hold that position from a non-academic practice. Dr. Barr has been a strong advocate for neuroradiology practice and has been actively involved in coding, reimbursement, and coverage policy as past chair of the ASNR Health Policy Committee and prior ASNR Advisor to the AMA/Specialty Society Relative Value Scale Update Committee. He also serves as immediate past-chair of the board of trustees of Novant Health and as an advisory board member of the Harvey L. Neiman Health Policy Institute.