Earlier in life, John N. Meadors, MD, an interventional radiologist with Radiology Associates, P.A., (RAPA) in Little Rock, thought that he wanted to be a cardiovascular surgeon.

“I never considered radiology when in medical school at Little Rock,” Meadors said. “I considered sitting in a dark room and looking at x-rays to be the most boring thing in medicine. But when I accepted a surgery residency at the University of Tennessee (UT) Medical Center, Knoxville, I was able to work firsthand with radiology residents.”

In addition to seeing what their lives were like, he also got an inkling at the time that some of the minimally invasive procedures being developed required radiological more than surgical skills.

“I could see some of the most fun and easiest things to do in vascular surgery were not going to be performed as open surgery,” Meadors said. “I had always liked stereos, high definition television and other technology. The world of radiology is technology driven. Everyone could see computers making tremendous leaps and bounds including allowing us to see inside the body.”

Meadors knew by the second year of his residency that he wanted to switch to radiology.

“Radiology is the central fulcrum along which all complex patient care turns,” Meadors said. “It is exciting being in the central nexus and being able to participate in care on that side of things. I really love radiology. I get to dive into that world, see the insides of people’s body’s, and see not just anatomy, but physiology. Also, the successful surgeons I knew had 12-hour days. As a surgery resident, I felt like I was taking care of strangers and their families more than my family. Radiology is a little more suited to lifestyle management than other areas.”

When interviewed for this article, Meadors was working the night shift.

“Our group covers 16 or 17 hospitals in the state,” Meadors said. “We don’t outsource our night coverage. So we have CAT scans and ultrasounds coming in all night long. It is crazy the number of people who come in at 3 a.m. to the emergency room for a problem they have had for three weeks.”

Meadors grew up in Little Rock, and attended Southern Methodist University in Dallas, initially intending to become a lawyer. He earned his undergrad degree in political science, but soon realized that taking care of people appealed to him more than the business world.

After graduating from medical school at the University of Arkansas for Medical Sciences in Little Rock and completing three years of a surgery residency at UT–Knoxville, he stayed there for another residency in diagnostic radiology. That was followed by a fellowship in angiography/interventional radiology at the University of Texas Medical Branch in Galveston, Tex., in 1995 and 1996.

Meadors got his “dream job” when he came back to Little Rock and joined RAPA.

He finds that not just the general public, but also some physicians don’t really understand what interventional radiologists do, which is use minimally invasive image-guided diagnosis and treatment for diseases.

“Even to a lot of my colleagues in medicine, interventional radiology is a black box,” he said. “No one knows what we do. I tell people we are like the Special Forces with very specialized jobs. For example, if a kidney stone is blocking the ureter, if the urologist can’t get the stone out, or you have a tumor-blocked ureter, we almost always can. The same thing is true for blockage in bile ducts. If the gastroenterologist can’t get it, then they come to us.

“All stents placed in coronary arteries are done by cardiologists. But peripheral vascular interventions are performed by multiple specialties. I work with many of these specialists and have several of them who refer patients to me when they attempt to do an intervention and are unsuccessful. We are sort of the doctor’s doctor. If they have complex problems, they come to us. Almost every procedure that we do, we perform less expensively and with more efficiency and less risk to patients as compared to traditional open procedures.”

Some advances in the field include minimally-invasive radiofrequency and now the newer technology of microwave ablation of lung tumors. Both involve putting a needle in tumors.

“They work on different principals,” he said. “Radiofrequency was never as efficient with generating heat, so you have to move it and reposition the needle several times. Now with microwave ablation, it is so much more efficient. I can perform one single needle placement microwave, and I’m done. I don’t have to go through multiple needle placements and ablations.”  

Angiography is particularly helpful for things like a bleeding colon, which is common in seniors. In the past, the only options were surgery or putting a gastroenterology scope in the colon, both almost universally with high complication rates or low rates of success.

“Often, I can get to the individual artery and stop the bleeding,” he said. “The technology has been around for 15 years, but it has been refined so much. One of the most exciting things about interventional radiology is that the technology is getting better and better.”

There are also new minimally invasive techniques to treat aortic aneurisms and aortic dissections such as putting in endovascular devices that reline the aorta. Patients are going home the next day after the procedure feeling good, where before it required hospitalization for a week or two and a two- to three-month recovery.

“As technology develops, we will be able to treat more patients with these minimally procedures,” Meadors said.

Other specialties have begun adopting a lot of the techniques developed by interventional radiologists.

“There was a period of time 15 years ago when there were turf wars, but medicine has matured beyond that,” he said. “Some of my most enjoyable work now is working with cardiologists, cardiovascular surgeons and neurosurgeons. We all work together and the ultimate winner is the patient. And, it is fun when it is a team effort.”

Meadors said there aren’t enough gastroenterologists in the U.S. to perform all the colonoscopies needed in the U.S. That has led to consideration of CT colonography.

“Studies show that, in some cases, it can be even better than colonoscopy,” he said. “I don’t think I can say it is better or worse, but it is a screening tool for colon cancer. Most Americans don’t take time out for a colonoscopy and by the time cancer causes symptoms, it is basically too late.”

Meadors said physicians talking to patients about the value of cancer screenings such as mammography and colonoscopies should make a plea to seniors to take the time for screening not just for themselves, but their family.

“Make sure you are going to be there to watch your grandchildren grow up,” he said.

Meadors and his wife, Amber, have four children and a son-in-law ranging in age from 16 to 28, and two grandchildren. His hobbies including jogging, snow skiing, golf, and reading.

“I enjoy sitting outside reading books or magazines and drinking coffee. I love to read books, both fiction and non-fiction, and periodicals, typically home design, men’s magazines and sports magazines,” he said.