Interventional Radiology: Treatments You Didn't Know Exist with Dr. Matthew Hawkins, MBA

What if some of the treatments you need… don’t require surgery at all?

In this episode of Take Care, Melody Mulaik sits down with Dr. Matthew Hawkins, a board-certified interventional radiologist, to explore a powerful yet often overlooked field in medicine.

Interventional radiology uses imaging modalities such as X-rays, ultrasound, CT scans, and MRI to perform procedures inside the body with few to no incisions.

That means:

• Less pain
• Faster recovery
• Fewer hospital stays

If you’ve never heard of this before, you’re not alone. And that’s exactly why this conversation matters.

What You’ll Learn:

• What interventional radiology is and how it works
• The surprising range of conditions it can treat
• Why are many patients never told about this option
• How to ask your doctor about minimally invasive procedures
• The role of interventional radiology in cancer care and pain management
• What to do if there’s no specialist in your area
• How pediatric patients benefit from these treatments

Timestamps:

[00:00] Introduction to Dr. Matthew Hawkins
[01:00] What is interventional radiology?
[02:00] Common procedures and real-life examples
[03:00] Why IR isn’t widely known
[04:00] How patients can find IR specialists
[06:00] Interventional oncology and cancer treatment options
[08:00] Pain management and palliative care
[09:00] What to do if there’s no specialist nearby
[10:00] Telemedicine and remote consultations
[12:00] Pediatric interventional radiology explained
[14:00] Conditions that require specialized care
[15:00] A day in the life of an interventional radiologist
[17:00] The future of interventional radiology
[19:00] Final advice for patients and caregivers

Resources Mentioned:

• Society of Interventional Radiology – Find an interventional radiologist near you: https://www.sirweb.org/ 
• Connect with Dr. Matt on LinkedIn: https://www.linkedin.com/in/matt-hawkins-md-93b6b737/ 

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Transcript

Grace 0:12

Today, we’re joined by Dr. Matthew Hawkins, a board-certified interventional radiologist and professor at the Emory University School of Medicine within the Department of Radiology and Imaging Sciences. Dr. Hawkins is the Medical Director of pediatric interventional radiology, and specializes in the treatment of vascular malformations, pediatric renovascular hypertension, and venous thromboembolic disease. He also serves as Medical Director of the Vascular Anomalies Clinic at Children’s Healthcare of Atlanta. Dr. Hawkins’ non-clinical interests include health policy, economics, and performance improvement, and specifically healthcare challenges where these disciplines intersect. Throughout his early career, he has actively volunteered for organized radiology and currently serves as the Health Policy and Economics Councilor for the Society of Interventional Radiology and as an assistant editor for the JACR. He has authored over 130 peer-reviewed publications, over 30 columns in radiology journals, and given over 220 national and international invited lectures. We’re so glad to have Dr. Matt Hawkins today and now, let’s get into the conversation.

Melody 1:22

Hello everybody and welcome to this episode of Take Care. It is my pleasure to have with us today, Dr. Matthew Hawkins, who is the medical Director of Interventional Radiology of Children's Healthcare of Atlanta. And also a friend and very appreciative of your time and grateful to have you with us today.

Dr. Matt 1:41

Happy to be here, Melody.

Melody 1:42

Well, I'm going to start with the question I was kind of mouthful there for intro is, what is interventional radiology?

Dr. Matt 1:51

Yeah. It's a specialty that I suppose a lot of people probably haven't heard of, but maybe have known somebody that's interfaced as even unknowingly. The way I describe interventional radiology is, it is a way of using imaging guidance, whether that's x-rays, ultrasound, CT, or MRI to do procedures inside of the body without having to actually make incisions and look inside the body with our eyes or with optical cameras. Again, a way to do things inside the human body, minimally invasively that hopefully can speed up recovery times for patients and keep them out of the hospital in certain situations.

Melody 2:34

What made you decide to become an interventional radiologist?

Dr. Matt 2:38

Yeah, I know. Full disclosure. I wanted to be a surgeon all the way through school. Early in my last year of medical school, got introduced to IR or interventional radiology and made a quick pivot at that point in time'cause the things that I was seeing people be able to do, I didn't even realize they could be done, without more traditional, surgical approach. So, obviously kind of seeing medicine moving in that direction towards continual, minimally invasive type of interventions. It kind of seemed like the place to be if you will. And I was kind of just taken aback by technology and glad I discovered it when I did.

Melody 3:14

Yeah. So, tell us a little bit about or like what are some of those types of procedures, maybe things that you do or you like to do or made you interested in transitioning over so people can think about what are some procedures either they've had or family members have had?

Dr. Matt 3:26

Yeah. You know, the procedure that's probably best to most common we've done that's very similar to interventional radiology is, anybody that's had a cardiac cath or a stent place where they go through the blood vessels of the body, use the blood vessels, kind of like a roadmap. Use tiny wires and catheters to get to whatever vessel, anywhere in the body to provide some type of therapy. You know, and to really keep it simple, usually if a blood vessel is plugged up, we can unclog it. If the blood vessel is leaky, we can plug it up if it's bleeding. And we can do procedures in blood vessels, literally anywhere from the brain down to the toes. But the beauty of IR, at least in my opinion is we get to do procedures in all organ systems of the body. We do procedures in the lungs. We do procedures in the kidneys. We do it in the liver. In the GI tracts, we already talked about the blood vessels, the brain, the heart. It is truly a unique, specialty in that sense'cause our skillset can be applied to literally every organ system of the body. So, it makes for a very diverse practice. Again, that diversity sometimes is what hurts us from a public awareness standpoint. Because our title is not vascular surgeon or OB GYN or some of the other more commonly known surgical specialists. Even though, we take care of patients with vascular surgery type diseases or gynecological type diseases in multidisciplinary care with some of those other more commonly well known surgical specialists.

Melody 5:01

That brings up a good points'cause if somebody's hearing this and they're thinking, I've never even heard of this specialty, or you're mentioning procedures. How would somebody even get introduced into interventional radiology or you know, really how do you get your patients.

Dr. Matt 5:14

Yeah. I mean, I think more for patient awareness, if you call a lot of large healthcare systems to schedule an appointment or if you have gotten a referral for a specific disease. I think it's important for a lot of patients to know in many cases, again, in large healthcare systems, you're going to go to what's called central scheduling. Where they're going to have an algorithm of what type of physician you get scheduled with based on what disease type you're being referred for. Again, a classic one for middle aged women is uterine fibroids. And if you call central scheduling with uterine fibroids as your referral, you're going to get scheduled with a gynecologist or an OB GYN.

Melody 5:56

Right. Right.

Dr. Matt 5:57

If you do have interest in also seeing what other types of minimally invasive options are out there, you can always search start with the broader radiology group that provides services at whatever hospitals in your community. They're going to have hopefully, interventional radiology services. The other place you can always look, the Society of Interventional Radiology or SIR has a provider locator. You can look up IR docs in your state or if you are in an area that does not have sort of the IR specialist or that expertise. But those are some ways you can kind of navigate some of the more arcane, centralized scheduling mechanisms in healthcare systems.

Melody 6:38

Well, it sounds like, I mean, patients researching and knowing where to go get information is always really important. So, you mentioned SIR, which I think their website's, sir web.org. When you think about everybody you know, as, as physicians always hear concerns about it. While you want patients to be educated, there's that balance of them coming on and saying, well, Dr. Google said, you know, this is specifically, what to do. Are there other sources of information that you would point patients to or really advice and guidance you would give them to make sure that the information that they're looking at is accurate?

Dr. Matt 7:10

Yeah. If you are a patient in New York, getting a consultation from a traditional surgeon asking that question of whether there's a less invasive or minimally invasive option. Or if there are interventional radiologists that they work with in their healthcare system. It's a totally fair question, you know. And any good surgeon that works with an IR doc would gladly offer that information if it is appropriate for the condition the patient has. So, it doesn't mean that the initial point of contact after a specialty referral has to be with your IR doc. Certainly, you can ask specialists that you are referred to. That's going to be your best source of local knowledge, probably for IR docs in the community.

Melody 7:52

That's really good. I mean, I think about with interventional, I know there's a lot of different types of procedures that are done. But it seems one of the areas of growth really is around interventional oncology. Meaning, you know, as patients are diagnosed with cancer and they're evaluating all their different options that are available for treatment, is really making that consideration. Is there something that maybe is not the traditional radiation, traditional chemo? Even surgery, are there other options available? And really researching those things is when you think about interventional oncology that. And are there any other areas where you'd say this is really a growth area that you see specifically for interventional?

Dr. Matt 8:31

Yeah. You know, you talk about oncology. It's important point about oncology is in an interventional procedure, whether that's giving medicines through a catheter directly into a tumor, or ablating or burning a tumor locally, if it's in the appropriate or safe place. A lot of these things can be done in conjunction with chemotherapy, surgery, and radiation. And often, when they're done in conjunction with those other things, that's when they're most effective. The other time that people forget about oncology is we can do a lot at once patients reach the palliative stage to make those the last few weeks, months of their life as high quality as possible.'Cause we're able to do things to help treat symptoms, whether it's pain or other symptoms that can result from cancer. Treat them in a way that's minimally invasive. We can do it as an outpatient. Keep them in their homes as long as they can. I often see that part of Interventional oncology kind of get forgotten. But the other part of I see huge potential for IR is what we call interventional pain. The ability to treat pain through minimally invasive procedures rather than narcotics that are longer lasting than some of the old fashioned sort of nerve blocks or injections, that are much more durable. And really allow some people with chronic types of pain to lead completely normal lives. Again, that's just a field that's got endless potential right now. You certainly are going to have to do a little bit more research in that space to find a physician that does interventional pain.'Cause even in the physician community, that specialist is still not well known by many primary care and even specialty physicians. But it is growing. It's still got a waste to go.

Melody 10:20

I know, that's a really good point. You know, and if you think about it as people research, in some states there's a lot of interventional radiologists. And some of it's'cause there's a lot of big cities or other things. And then, you might go to some other states that there's not as many. And some of that again is just because of population and things like that. What would you tell a patient or caregiver if they've done their research and they say, well gee, I think there's this really great, whether it's interventional pain, to your point, interventional oncology. And they think this is a really good option, but they live in an area where there is not an interventional radiologist anywhere? What should they do? Where should they look to say, where do I go?

Dr. Matt 10:58

Yeah. There's a few ways you can go about it. And you're absolutely right that. Like many medical specialists, interventional radiologists are very clustered to the urban areas with what we call sort of IR deserts out in rural spaces. I think in many instances, the IR physicians or their practices or their groups, usually we'll have a mechanism where you can reach out to the practice to at least sort of tell your story and your situation. And if there's a really long trip, where you're trying to figure out whether or not it's worth, worth making the trip for. Again, most IR docs, they have traditional clinics where they can see patients. And see if you can do a telemedicine consultation. If you have outside imaging, imaging can be transported electronically now to give the physician a chance to review imaging, talk with you about your clinical symptoms, the course that you've gone under, and whether or not a trip. To seek care at that facility is worthwhile. But you know, in the 21st century, all of this now can be done remotely. And so, I would encourage people to take care of that.

Melody 12:05

That's a really good point because I think, even though it's one of the things that's kind of post COVID and COVID where the insurance payers started paying for stuff more so as patients we knew that was an option. Or just organizations set up the ability to be able to have these, as we kind of say telemedicine or tele conference visits with that. And just picking up the phone sometimes, or through a portal, finding out if somebody's willing to see you. That's a really good point.

Dr. Matt 12:29

Any self-respecting interventional radiologist that's getting referrals from long distances is going to have either a nurse coordinator, a nurse navigator, helping him or her, take in referrals such as this. So, seek it out. And a lot of practices are very good at making it easy on the patients when there is some distance between home and where the healthcare facility is.

Melody 12:53

Oh, that makes sense. So, just to spend a little bit of time on pediatrics,'cause I know you're in the pediatric side of things. And we look at, we have far less children's hospitals across the country than we do adult hospitals. And you know, as a parent, how do people make determinations of when do they need to really go to a specific children's hospital versus I can make it at a hospital that addresses both kids and adults.

Dr. Matt 13:18

The Pediatrics certainly has some additional challenges. It is amazing though, it's probably not surprising. But people are willing to travel for the kids way less than they are willing to travel for themselves. But Pediatric interventional radiologies, it's not necessarily new, but it's exploded really in the last 10 to 15 years. Estimates say, somewhere between 120 and 150, pediatric interventional radiologists in the United States. So, there's not a large number, you're only talking about 13 or so fellowships in North America. They're few and far between. However, there's only a couple of states that don't have a children's hospital.

Melody 13:55

Okay.

Dr. Matt 13:55

But if your state has a children's hospital, they probably have interventional radiology.

Melody 14:00

Okay.

Dr. Matt 14:00

But anyhow, if your child is unfortunately sick enough to need subspecialty level care. Pediatric IR is one thing that as a parent, you're going to want to advocate for a little bit more strongly similar to some other things we talked about earlier.'Cause a lot of people in the pediatrics community don't even realize what we're able to do now with minimally invasive and image guided techniques. No fault of their own. Again, this is a specialty, peds IR that has, again, really exploded in the last 10 to 15 years. Again, your major metropolitan areas with big children's hospitals, they're going to have at least some level of IR. If you're getting into some very specific disease states, you may have to do a little extra research. And here, just like many other children's hospitals have families that travel from very far away across state lines frequently, if needed. So, I'd say the specialist out there, it is growing. Awareness is increasing. But a little extra advocacy on the side of the parents can often go a long way.

Melody 15:05

That's true. And again, just for educational purposes, I mean, what are some of the top things when you talk about people traveling across state lines that I won't say your normal things, but things that you don't find as commonly. What are a lot of the procedures that you see and do?

Dr. Matt 15:18

Yeah. We see a lot of kids that travel with something that's called vascular malformations, which is just disorganized development of the blood vessels. They can happen anywhere in the body.

Melody 15:27

Mm-hmm.

Dr. Matt 15:27

There are a couple of very big multidisciplinary, very well run vascular anomalies clinics around the country. We're very blessed to have one here in Atlanta, but there's a handful. So, we get a lot of out-of-state referrals for that. The other two most common that we get kind of distant referrals for are kids that have some rare benign bone tumors. So, we're able to treat a lot of benign bone tumors in kids, without doing open surgery. So, it gets your kids back to being active and getting back to sports much quicker than open surgery. And the last one is kids that have narrowing in the arteries that feed their kidneys that lead to high blood pressure.

Melody 16:09

Okay.

Dr. Matt 16:10

Got a really obnoxiously long name, but it's pediatric renal vascular hypertension. Again, there's a few centers around the country that have a lot of expertise in that. But those are the big ones that we see parents tend to travel across state lines for.

Melody 16:24

Okay. Well, thinking about just in pediatrics, and this may apply for IR as a whole, but tell us about a typical day in the life of an interventional radiologist.

Dr. Matt 16:34

Yeah, I'd say it's evolving. You know, we're very proud in interventional radiology to, we've really adopted and are promoting and teaching a true clinical model. And so, our a day in the life of an IR in 2026 is much more closer to that of a typical surgeon. We have our clinics, our outpatient clinics where we see patients consultation and then follow up after we do procedures on them. We have inpatient services where we actually go and we see patients in the rooms, in the hospitals that we've done procedures on. In between all of that yes, we're doing procedures. We're scrubbed into sterile IR suites, doing procedures not that dissimilar to the type of environment that our surgeons are working in. So, you know, we're not surgeons. I don't mean to say that. Most people typically think of as a radiologist, that is certainly not what the typical day is for a contemporary and dimensional radiologist.

Melody 17:26

Well, I like that you said, you know, the whole issue of clinic and visits. And having it where it is more, we shouldn't say like other doctors'cause they said interventional radiology is its own specialty. But if I recall, I think interventional officially got it designation in 91 or 92. Does that sound about right?

Dr. Matt 17:41

I think

Melody 17:42

as time period, even though

Dr. Matt 17:42

subspecialty and then became its own individual residency in 2017.

Melody 17:48

Okay. Wow. I know procedures were being done way before then. But maybe it just wasn't officially as recognized as much for that. So, compared to a lot of the specialties, a relatively newer specialty, which also I think makes it exciting in terms of all the different things that are being done from a technology standpoint. So, when you think about that, I mean, what makes you excited about interventional or just healthcare as a whole? I mean, what motivates you to do what you do?

Dr. Matt 18:13

Yeah. You know, we're very blessed here that we have the most cutting edge technology in the world. Healthcare is one sector of our economy, at least here, that continues to grow, continues to hire, continues to build facilities, continues to purchase infrastructure. So, there all signs point to continued progress. Which is perhaps different than some of the other sectors of our current economy or society. There's a lot of interest in this space, not just from physicians and scientists but also from investors, right? People are in the health innovation startup space. It's booming right now. And the more people you have in that space, the more likely you're to come out with some meaningful innovations and things that are going to change the course of care. So, you know, I love what I do right now, every day. I also know that five years from now it's going to be quite different. 10 years from now, it's going to be really different. So, that's exciting.

Melody 19:13

Yeah. I think it's that balance between you know, there's so many things that are getting more automated and people talk about a artificial intelligence with things. But yet that can't replace that patient physician interaction. Well, there is a lot of things that are going to change in the next 10 years. At least, I don't think. I don't think that piece of it, it's ever going to go away'cause we're always going to have to have those relationships. Well, it's been great having you on and learning about interventional radiology and all the different intricacies of that. And so, I guess as we wrap things up, what would you really say is, kind of your parting words that you would want patients or their caregivers to really know about interventional radiology to ensure that they're aware of the different types of procedures and that they're really getting the best care that's available.

Dr. Matt 19:56

I mean, one, I just would love for patients to just even know that interventional radiology exists and it's a specialty and it's an option. And I would say, nobody in healthcare would disagree that the best kind of care is multidisciplinary care. And if you are faced with a complex illness, any multidisciplinary care team that can carry its own weight in water is going to have an interventional radiologist as part of that team. So, don't hesitate to ask. Don't hesitate to look and see what's out there in your community. From an IR standpoint, doesn't mean that a minimally invasive image guided option is always going to be the best for you. But as long as you know that it's out there, especially if you can find a team that has an IR as part of that team, I think it can give patients a lot of confidence that they're getting the best type of care that they can get.

Melody 20:50

Oh, that's great advice. Thank you again for your time today, Dr. Hawkins. As always, enjoy spending time with you.

Dr. Matt 20:56

Thank you, Melody. It's been fun.