Dr. Bret Wiechmann is a distinguished interventional radiologist who overcame many challenges in his early career with remarkable fortitude. Having navigated the hurdles of establishing a practice, understanding the business side of medicine, and dealing with complicated scenarios, Dr. Wiechmann now offers priceless wisdom for budding radiologists and medical practitioners. Keep reading to learn more about the trials many radiologists face post-fellowship, how to cultivate a holistic perspective toward patients, and how to maintain a curious mindset in the midst of professional obstacles.
Dr. Wiechmann, shortly after you completed your residency/fellowship training, was there a therapy area or subject matter you wish you were taught or had more experience in?
Absolutely. A subject matter that has been left out of residency and fellowship programs is the business side of medicine. This might be changing, but the vast majority of trainees are not well versed in how physicians get paid, including the work RVUs, practice expenses, malpractice insurance, etc. The path to securing fair and appropriate reimbursement for the often complicated procedures and managing challenging patients is intricate and involves many stakeholders. Coming out of training, I was blind to all that.
During my residency and fellowship at the University of Florida under Dr. Irvin Dick Hawkins and Dr. Jim Caridi, I received comprehensive training and exposure to all aspects of interventional radiology, which left me feeling competent in pretty much all areas of my field. Transitioning to private practice in Gainesville, the on-the-job training was equally helpful. It felt like an extension of my fellowship. While the endovascular treatment of peripheral arterial disease became a larger part of the practice, I was able to apply my technical skills very easily.
Many residents and fellows leave training with a sense that they aren’t fully ready for clinical practice. Do you remember a time when you felt like you weren’t ready for “prime time”? How did you overcome this?
I do recall a moment when I felt “not ready for prime time.” During my first weekend on solo call, I was consulted for a complex procedure on a patient who was the wife of the pastor from my childhood church. It was a jarring introduction to the realities of practicing in your hometown.
What’s the single most important advice you’d give to radiology residents or fellows interested in pursuing a career in vascular and interventional radiology?
Easy. Focus on holistic patient care, which can be equally important, if not more, as technical skills. The more clinically aware you are, the better you’ll appreciate the need for the services and procedures that interventional radiology offers. For example, knowledge of PAD treatment, including medical management, risk factor modification, exercise therapy, and endovascular/surgical therapy will be valuable in your practice. Competency in all these areas allows you to identify patients who will benefit most from different types of therapies and decide on the next steps if the results are less than optimal.
Dr. Bret Wiechmann is a distinguished interventional radiologist who overcame many challenges in his early career with remarkable fortitude. Having navigated the hurdles of establishing a practice, understanding the business side of medicine, and dealing with complicated scenarios, Dr. Wiechmann now offers priceless wisdom for budding radiologists and medical practitioners. Keep reading to learn more about the trials many radiologists face post-fellowship, how to cultivate a holistic perspective toward patients, and how to maintain a curious mindset in the midst of professional obstacles.
Dr. Wiechmann, shortly after you completed your residency/fellowship training, was there a therapy area or subject matter you wish you were taught or had more experience in?
Absolutely. A subject matter that has been left out of residency and fellowship programs is the business side of medicine. This might be changing, but the vast majority of trainees are not well versed in how physicians get paid, including the work RVUs, practice expenses, malpractice insurance, etc. The path to securing fair and appropriate reimbursement for the often complicated procedures and managing challenging patients is intricate and involves many stakeholders. Coming out of training, I was blind to all that.
During my residency and fellowship at the University of Florida under Dr. Irvin Dick Hawkins and Dr. Jim Caridi, I received comprehensive training and exposure to all aspects of interventional radiology, which left me feeling competent in pretty much all areas of my field. Transitioning to private practice in Gainesville, the on-the-job training was equally helpful. It felt like an extension of my fellowship. While the endovascular treatment of peripheral arterial disease became a larger part of the practice, I was able to apply my technical skills very easily.
Many residents and fellows leave training with a sense that they aren’t fully ready for clinical practice. Do you remember a time when you felt like you weren’t ready for “prime time”? How did you overcome this?
I do recall a moment when I felt “not ready for prime time.” During my first weekend on solo call, I was consulted for a complex procedure on a patient who was the wife of the pastor from my childhood church. It was a jarring introduction to the realities of practicing in your hometown.
What’s the single most important advice you’d give to radiology residents or fellows interested in pursuing a career in vascular and interventional radiology?
Easy. Focus on holistic patient care, which can be equally important, if not more, as technical skills. The more clinically aware you are, the better you’ll appreciate the need for the services and procedures that interventional radiology offers. For example, knowledge of PAD treatment, including medical management, risk factor modification, exercise therapy, and endovascular/surgical therapy will be valuable in your practice. Competency in all these areas allows you to identify patients who will benefit most from different types of therapies and decide on the next steps if the results are less than optimal.
Dr. Bret Wiechmann is a distinguished interventional radiologist who overcame many challenges in his early career with remarkable fortitude. Having navigated the hurdles of establishing a practice, understanding the business side of medicine, and dealing with complicated scenarios, Dr. Wiechmann now offers priceless wisdom for budding radiologists and medical practitioners. Keep reading to learn more about the trials many radiologists face post-fellowship, how to cultivate a holistic perspective toward patients, and how to maintain a curious mindset in the midst of professional obstacles.
Dr. Wiechmann, shortly after you completed your residency/fellowship training, was there a therapy area or subject matter you wish you were taught or had more experience in?
Absolutely. A subject matter that has been left out of residency and fellowship programs is the business side of medicine. This might be changing, but the vast majority of trainees are not well versed in how physicians get paid, including the work RVUs, practice expenses, malpractice insurance, etc. The path to securing fair and appropriate reimbursement for the often complicated procedures and managing challenging patients is intricate and involves many stakeholders. Coming out of training, I was blind to all that.
During my residency and fellowship at the University of Florida under Dr. Irvin Dick Hawkins and Dr. Jim Caridi, I received comprehensive training and exposure to all aspects of interventional radiology, which left me feeling competent in pretty much all areas of my field. Transitioning to private practice in Gainesville, the on-the-job training was equally helpful. It felt like an extension of my fellowship. While the endovascular treatment of peripheral arterial disease became a larger part of the practice, I was able to apply my technical skills very easily.
Many residents and fellows leave training with a sense that they aren’t fully ready for clinical practice. Do you remember a time when you felt like you weren’t ready for “prime time”? How did you overcome this?
I do recall a moment when I felt “not ready for prime time.” During my first weekend on solo call, I was consulted for a complex procedure on a patient who was the wife of the pastor from my childhood church. It was a jarring introduction to the realities of practicing in your hometown.
What’s the single most important advice you’d give to radiology residents or fellows interested in pursuing a career in vascular and interventional radiology?
Easy. Focus on holistic patient care, which can be equally important, if not more, as technical skills. The more clinically aware you are, the better you’ll appreciate the need for the services and procedures that interventional radiology offers. For example, knowledge of PAD treatment, including medical management, risk factor modification, exercise therapy, and endovascular/surgical therapy will be valuable in your practice. Competency in all these areas allows you to identify patients who will benefit most from different types of therapies and decide on the next steps if the results are less than optimal.
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World's Brightest Physicians
Delivered straight to your inbox. Completely free. No spam.
Fun, Insightful Interviews with the
World's Brightest Physicians
Delivered straight to your inbox. Completely free. No spam.
Dr. Wiechmann, as a vascular and interventional radiologist, what are 2-3 business concepts or skills that you wish you knew when you first completed your fellowship?
1. It’s crucial to understand how physicians are compensated to avoid exploitation because you might be taken advantage of unless you “speak the language” as medicine becomes more corporate.
2. If you work in a hospital setting, know how to advocate for your own value to your partners and to hospital administration.
3. Building your practice takes time and effort. Unlike diagnostic radiology, patients don’t just magically appear on your doorstep in interventional radiology. A practice-building mindset is necessary to stay competitive.
In your experience, how important is networking for a newly-minted fellow, and can you share 2-3 tips on how to build relationships within the broader vascular community?
Networking is critically important at the beginning of your career, especially if you’re moving to a new area after your fellowship. It demands patience, persistence, and getting to know the lay of the land per se. Having senior partners introduce you to other individuals in the vascular arena can be valuable so that they can recognize you and get to know you and your abilities. Attending vascular QA meetings and discussing your cases can help establish your presence. It’s also important to involve other vascular specialists in your patient cases to show your commitment to advancing vascular care collaboratively.
How would you recommend a fellow get involved with clinical trials and/or establish collaborative research with other specialists?
If you have experience in clinical trials and have the support and infrastructure, you should share that experience with other partners and interested parties. Getting involved in clinical trials or collaborative research can be challenging if you don’t have access to clinical research staff. However, once you have a patient base, you can demonstrate your capability to l enroll patients in trials you may have at your site of service, and that can potentially lead you to investigative roles.
So-called “turf wars” are inevitable in almost any workplace setting, including healthcare. How do you approach this challenge and what’s your advice for graduating residents and fellows?
Regarding turf wars, avoid acting as if you “own” patients or procedures as no one has exclusive rights over a particular specialty or procedure The best way to navigate this situation is to be well-trained. Build your own referral patterns, do quality work, and maintain good communication with referring physicians. It does take time and effort but it’s possible.
What are some red flags to consider when looking at a practice? How important is it to not be afraid to negotiate all the tangibles (eg, starting salary, vacation time, etc) as well as intangibles (eg, job perks) upfront versus after your first year in practice?
A clear red flag when assessing a practice is a history of not promoting junior associates to full partnerships. The reputation of these types of groups is typically well-known. Always be mindful of this no-win situation. During the hiring process, whether the candidate or the hiring group holds the upper hand often hinges on market fluctuations and supply-demand dynamics. When it comes to “negotiating intangibles”, it can be very tricky. Ask for too much, and you risk turning off potential employers; ask too little, and you may breed personal resentment. Bottom line: don’t oversell or undersell yourself.
Throughout your educational journey in medical school, residency, and fellowship, who were your biggest mentors, and what key learnings did you gain from them? How should residents and fellows go about finding and maintaining mentor relationships?
Undoubtedly, the greatest influence on my career was Dr. James G. Caridi, the director of the IR fellowship at the University of Florida. Jim was an exceptional teacher. He used to let us learn through our struggles before offering help. He taught us how important it is to look at the patient as a whole human being, how to become better at problem-solving and troubleshooting, and how to bail yourself out of a jam. All the while keeping it incredibly fun and with an unmatched sense of humor. It may sound cliché, but there truly will never be anyone like Jim Caridi.
When it comes to personal finance, what do you wish you knew coming out of your fellowship?
I wish I had a basic understanding of investment strategies upon completing my fellowship. Discussions often center around long-term financial planning, which of course is important, but understanding early and mid-career strategies is equally important as they pave the way for long-term stability.
Which mobile app are you addicted to — personally and professionally?
ESPN College Football.
If you had to choose three songs to play on repeat during an interventional procedure, what would they be?
The Spirit of Radio – Rush
Eminence Front – The Who
Keep Talking – Pink Floyd
If you could reach every single radiology resident or fellow with one message, what would it be?
To all radiology residents or fellows: Dedicate yourself to learning as much as possible both during your training and throughout your practice. Practice development is about gaining experience, celebrating success, and learning from your failures. Nobody can tweet their way to becoming an expert; it literally takes years to establish a practice and build a reputation that hopefully endures.
Dr. Wiechmann, as a vascular and interventional radiologist, what are 2-3 business concepts or skills that you wish you knew when you first completed your fellowship?
1. It’s crucial to understand how physicians are compensated to avoid exploitation because you might be taken advantage of unless you “speak the language” as medicine becomes more corporate.
2. If you work in a hospital setting, know how to advocate for your own value to your partners and to hospital administration.
3. Building your practice takes time and effort. Unlike diagnostic radiology, patients don’t just magically appear on your doorstep in interventional radiology. A practice-building mindset is necessary to stay competitive.
In your experience, how important is networking for a newly-minted fellow, and can you share 2-3 tips on how to build relationships within the broader vascular community?
Networking is critically important at the beginning of your career, especially if you’re moving to a new area after your fellowship. It demands patience, persistence, and getting to know the lay of the land per se. Having senior partners introduce you to other individuals in the vascular arena can be valuable so that they can recognize you and get to know you and your abilities. Attending vascular QA meetings and discussing your cases can help establish your presence. It’s also important to involve other vascular specialists in your patient cases to show your commitment to advancing vascular care collaboratively.
How would you recommend a fellow get involved with clinical trials and/or establish collaborative research with other specialists?
If you have experience in clinical trials and have the support and infrastructure, you should share that experience with other partners and interested parties. Getting involved in clinical trials or collaborative research can be challenging if you don’t have access to clinical research staff. However, once you have a patient base, you can demonstrate your capability to l enroll patients in trials you may have at your site of service, and that can potentially lead you to investigative roles.
So-called “turf wars” are inevitable in almost any workplace setting, including healthcare. How do you approach this challenge and what’s your advice for graduating residents and fellows?
Regarding turf wars, avoid acting as if you “own” patients or procedures as no one has exclusive rights over a particular specialty or procedure The best way to navigate this situation is to be well-trained. Build your own referral patterns, do quality work, and maintain good communication with referring physicians. It does take time and effort but it’s possible.
What are some red flags to consider when looking at a practice? How important is it to not be afraid to negotiate all the tangibles (eg, starting salary, vacation time, etc) as well as intangibles (eg, job perks) upfront versus after your first year in practice?
A clear red flag when assessing a practice is a history of not promoting junior associates to full partnerships. The reputation of these types of groups is typically well-known. Always be mindful of this no-win situation. During the hiring process, whether the candidate or the hiring group holds the upper hand often hinges on market fluctuations and supply-demand dynamics. When it comes to “negotiating intangibles”, it can be very tricky. Ask for too much, and you risk turning off potential employers; ask too little, and you may breed personal resentment. Bottom line: don’t oversell or undersell yourself.
Throughout your educational journey in medical school, residency, and fellowship, who were your biggest mentors, and what key learnings did you gain from them? How should residents and fellows go about finding and maintaining mentor relationships?
Undoubtedly, the greatest influence on my career was Dr. James G. Caridi, the director of the IR fellowship at the University of Florida. Jim was an exceptional teacher. He used to let us learn through our struggles before offering help. He taught us how important it is to look at the patient as a whole human being, how to become better at problem-solving and troubleshooting, and how to bail yourself out of a jam. All the while keeping it incredibly fun and with an unmatched sense of humor. It may sound cliché, but there truly will never be anyone like Jim Caridi.
When it comes to personal finance, what do you wish you knew coming out of your fellowship?
I wish I had a basic understanding of investment strategies upon completing my fellowship. Discussions often center around long-term financial planning, which of course is important, but understanding early and mid-career strategies is equally important as they pave the way for long-term stability.
Which mobile app are you addicted to — personally and professionally?
ESPN College Football.
If you had to choose three songs to play on repeat during an interventional procedure, what would they be?
The Spirit of Radio – Rush
Eminence Front – The Who
Keep Talking – Pink Floyd
If you could reach every single radiology resident or fellow with one message, what would it be?
To all radiology residents or fellows: Dedicate yourself to learning as much as possible both during your training and throughout your practice. Practice development is about gaining experience, celebrating success, and learning from your failures. Nobody can tweet their way to becoming an expert; it literally takes years to establish a practice and build a reputation that hopefully endures.
Dr. Wiechmann, as a vascular and interventional radiologist, what are 2-3 business concepts or skills that you wish you knew when you first completed your fellowship?
1. It’s crucial to understand how physicians are compensated to avoid exploitation because you might be taken advantage of unless you “speak the language” as medicine becomes more corporate.
2. If you work in a hospital setting, know how to advocate for your own value to your partners and to hospital administration.
3. Building your practice takes time and effort. Unlike diagnostic radiology, patients don’t just magically appear on your doorstep in interventional radiology. A practice-building mindset is necessary to stay competitive.
In your experience, how important is networking for a newly-minted fellow, and can you share 2-3 tips on how to build relationships within the broader vascular community?
Networking is critically important at the beginning of your career, especially if you’re moving to a new area after your fellowship. It demands patience, persistence, and getting to know the lay of the land per se. Having senior partners introduce you to other individuals in the vascular arena can be valuable so that they can recognize you and get to know you and your abilities. Attending vascular QA meetings and discussing your cases can help establish your presence. It’s also important to involve other vascular specialists in your patient cases to show your commitment to advancing vascular care collaboratively.
How would you recommend a fellow get involved with clinical trials and/or establish collaborative research with other specialists?
If you have experience in clinical trials and have the support and infrastructure, you should share that experience with other partners and interested parties. Getting involved in clinical trials or collaborative research can be challenging if you don’t have access to clinical research staff. However, once you have a patient base, you can demonstrate your capability to l enroll patients in trials you may have at your site of service, and that can potentially lead you to investigative roles.
So-called “turf wars” are inevitable in almost any workplace setting, including healthcare. How do you approach this challenge and what’s your advice for graduating residents and fellows?
Regarding turf wars, avoid acting as if you “own” patients or procedures as no one has exclusive rights over a particular specialty or procedure The best way to navigate this situation is to be well-trained. Build your own referral patterns, do quality work, and maintain good communication with referring physicians. It does take time and effort but it’s possible.
What are some red flags to consider when looking at a practice? How important is it to not be afraid to negotiate all the tangibles (eg, starting salary, vacation time, etc) as well as intangibles (eg, job perks) upfront versus after your first year in practice?
A clear red flag when assessing a practice is a history of not promoting junior associates to full partnerships. The reputation of these types of groups is typically well-known. Always be mindful of this no-win situation. During the hiring process, whether the candidate or the hiring group holds the upper hand often hinges on market fluctuations and supply-demand dynamics. When it comes to “negotiating intangibles”, it can be very tricky. Ask for too much, and you risk turning off potential employers; ask too little, and you may breed personal resentment. Bottom line: don’t oversell or undersell yourself.
Throughout your educational journey in medical school, residency, and fellowship, who were your biggest mentors, and what key learnings did you gain from them? How should residents and fellows go about finding and maintaining mentor relationships?
Undoubtedly, the greatest influence on my career was Dr. James G. Caridi, the director of the IR fellowship at the University of Florida. Jim was an exceptional teacher. He used to let us learn through our struggles before offering help. He taught us how important it is to look at the patient as a whole human being, how to become better at problem-solving and troubleshooting, and how to bail yourself out of a jam. All the while keeping it incredibly fun and with an unmatched sense of humor. It may sound cliché, but there truly will never be anyone like Jim Caridi.
When it comes to personal finance, what do you wish you knew coming out of your fellowship?
I wish I had a basic understanding of investment strategies upon completing my fellowship. Discussions often center around long-term financial planning, which of course is important, but understanding early and mid-career strategies is equally important as they pave the way for long-term stability.
Which mobile app are you addicted to — personally and professionally?
ESPN College Football.
If you had to choose three songs to play on repeat during an interventional procedure, what would they be?
The Spirit of Radio – Rush
Eminence Front – The Who
Keep Talking – Pink Floyd
If you could reach every single radiology resident or fellow with one message, what would it be?
To all radiology residents or fellows: Dedicate yourself to learning as much as possible both during your training and throughout your practice. Practice development is about gaining experience, celebrating success, and learning from your failures. Nobody can tweet their way to becoming an expert; it literally takes years to establish a practice and build a reputation that hopefully endures.
