Radiology: Excellence at MUSC

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Radiology: Excellence at MUSC




Guest:  Dr. Philip Costello – Radiology, MUSC

Host:  Dr. Linda Austin – Psychiatry, MUSC


Dr. Linda Austin:  I’m Dr. Linda Austin.  I’m interviewing Dr. Philip Costello, who is Professor and Chair of the Department of Radiology here at the Medical University of South Carolina.  Dr. Costello, how long have you been Chair of Radiology?


Dr. Philip Costello:  It will be fours years in June of this year.


Dr. Linda Austin:  There’s an awful lot going on now that’s very exciting at MUSC.  What is your vision for the Department of Radiology?  How do you really want to position and develop the department so that we stand out in this area?


Dr. Philip Costello:  Thanks for asking that question, because, really, when I came here four years ago; almost, I saw the tremendous opportunities that lay ahead of us.  Not only with the new facilities that were being developed and built at that time, but also the commitment of the institution, at MUSC, to really develop a world class medical center.  It’s been a privilege for me to have been part of that development through the Department of Radiology.  And I’d like to emphasize some of the things that we saw clearly necessary to build the strength and commitment to excellence that we’ve all attained, I believe, over the last three and a half years.  Number one, we were going to get the best faculty on staff.  And, really, we have achieved that.


Dr. Linda Austin:  Have we grown the faculty in the last few years?


Dr. Philip Costello:  I have recruited thirteen clinical radiologists and a total of three PhD research faculty members in that period of time.  The strengths that they bring with them are diverse backgrounds of institutional expertise; coming from as far as Harvard, USC Children’s Hospital, Mayo Clinic, St Louis, and Baltimore.  These people have all brought with them strengths that have enhanced and captivated the performance of our department.  For example, we’ve built world class programs in Neuro-interventional Radiology and Cardiac Noninvasive Imaging.  And, we’re strengthening, even more, with the new facility, our Cardiovascular Interventional Research program.  Each one of these components, that we’ve been building on, have led us to the conclusion that we actually provide, probably, the best imaging and interventional program in the city of Charleston, and probably in the state of South Carolina.   


Dr. Linda Austin:  It sounds as if one of the great strengths is the subspecialization; maybe, in some cases, sub-subspecialization, that these experts from all over the country, and the world, bring to us.


Dr. Philip Costello:  That is correct.  As radiologists; imaging, we’re all physicians.  And we’ve recognized that the major benefit we bring, to our patients and the consultants with whom we work, is our in-depth knowledge of imaging and interventional procedures that we are engaged in.  So, for instance, if I’m going to be working with a cardiologist, my knowledge of anatomy, physiology, and patient management has to be on a par with that specialist.  The only way we can achieve that is by becoming subspecialized to a level that mates the commitment that the cardiologist needs. 


Dr. Linda Austin:  One of the things I think is important to underline about that is that when people choose a doctor, they don’t think about choosing the doctors behind the doctors.  They don’t think about the pathologist.  They don’t think about the radiologist.  And, yet, their cardiologist, or their neurologist, or their neurosurgeon is so dependent on the skill of that, let’s say, neuroradiologist, who is reading the films.  To be able to depend on the institution to hire the best of the best is, really, key. 


Dr. Philip Costello:  That’s absolutely correct.  In fact, as our institution has developed and grown, we have certainly capitalized on that opportunity; of working with the top first-line specialists who are managing the patients, but also, then, being part of the team.  We have built interdisciplinary teams that approach the patient care.  So, for instance, on any day of the week, we have at least two conferences where we go and participate with the surgeons, the pathologists, the medical oncologists; if it may be, or hepatologists.  We work hand in hand with them in deciding patient management, patient intervention, or patient care.  And that is the strength of, really, building programs based upon subspecialty levels of knowledge and strengths. 


So, you’re absolutely right.  And a university institution should be making the patient aware of this team that is going to be taking care of them.  Our organization, the American College of Radiology, is actually actively encouraging the younger radiologists; as well as those who have been in business for a long time, to get out and make patients aware of the difference we bring to their care.  Now, it’s very easy in some areas to make that contact with patients first-hand; particularly in the area of breast imaging, where we interact with the patients on daily basis.  We interview them prior to, say, perhaps, mammography or an interventional procedure, such as a biopsy.  And, now, we’re doing more and more MR examinations of the breast.  


Those patients, we contact them, we give them their results right away.  We talk to the doctors.  We’re actively part of that patient’s care.  The same applies, also, in interventional and neuroradiology, where we’re actually performing noninvasive procedures via catheters or via instruments that we’re trained to utilize.  As radiologists, we are fully trained board certified physicians who’ve spent, actually, on average, five of six years post medical school; additional, training to gain skills that benefit the patient in an interdisciplinary team fashion.


Dr. Linda Austin:  Now, you mentioned that the second thing; the first thing being faculty, is the facilities and equipment that we have here for radiology.  Tell us about those.


Dr. Philip Costello:  Yes.  I’m very proud to be able to say that the institution, the dean, the medical school, and the hospital really backed the emphasis to improve the technology over the last three to four years.  The rapid changes in medical care have been evolving around advanced technology, which is generally noninvasive. Initial capital investments are fairly expensive.  But when you see the amount of surgical procedures being left and abandoned because of this high technology or the minimally invasive approaches we’re able to take to interventions and patient care, you will see that those technologies that we’ve invested in are paying off not only in patient comfort, but in patient outcomes and safety.


So, the technologies that we’ve put in place here are the highest levels of sophisticated CT, nuclear medicine, and MR equipment.  In ultrasound, we’re fully digital.  We have volume imaging.  In mammography, we’ve been one of the first sites in the state of South Carolina to be involved with developing digital imaging, which provides us with a high degree of accuracy for patient management.  We’ve also developed a very strong interventional program in mammography for breast biopsies and interventions.  And, also, we’ve developed MR imaging, which, again, is critical now, it appears, in defining patients at high risk for second breast carcinoma or recurrent breast carcinoma. 


All of these noninvasive imaging tests have required initial investments, and will require continued assessment for their efficacy.  But that is really a strong commitment and a way in which the MUHA (Medical University Hospital Authority) and MUSC have really been behind developing the technology required to advance patient care on the level that we feel is appropriate. 


Dr. Linda Austin:  Dr. Costello, thank you so much for talking with us.


Dr. Philip Costello:  Thank you for the opportunity.


If you have any questions about the services or programs offered at the Medical University of South Carolina, or if you’d like to schedule an appointment with one of our physicians, please call MUSC Health Connection at:  (843) 792-1414.

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