At a Glance
- Title: Associate Professor
- Fellowships: The Children’s Hospital of Philadelphia, Pediatric Radiology and Pediatric Emergency Medicine
- Residencies: Christiana Hospital, Diagnostic Radiology; The A.I. duPont Hospital for Children, Pediatrics
- Medical Degree: Thomas Jefferson Medical College
Board-certified in four specialties, Reza Daugherty, MD, FAAP, was appointed chief of pediatric medical imaging at UVA in July 2018. In just one year, he has made a significant impact within the Division of Pediatric Radiology, working to expand the number of services and the locations these services are provided, introducing new technology and imaging protocols, as well as teaching and mentoring aspiring providers.
For the latter, Daugherty recently received the Dr. Paul Dee Teacher of the Year Award for Radiology, an award bestowed by radiology residents. “It was really great to come here as a new person and just be welcomed and accepted so quickly,” says Daugherty. “It meant a lot that the residents recognized my extra effort beyond my very heavy clinical load and showed their appreciation.”
Q&A with Dr. Daugherty
You were in practice as a pediatric emergency medicine physician for many years. Why did you decide to pursue additional training in pediatric radiology?
When I was an ER doctor, I really enjoyed diagnostic dilemmas, being given complex problems and trying to solve them. Almost always, radiology played some part — often a large part — in that process. It is a very cerebral subset of medicine. All of medicine is intellectually stimulating, obviously, but radiology is a lot of problem solving. I enjoy implementing new technology and determining how to use these new technologies to take better care of our patients. I always loved taking care of children. I’ve always been drawn to care for those who can’t always help themselves. That’s why I stayed in pediatrics. It just made sense.
I think all of those years of pediatric ER experience made me a much better radiologist. Rather than sitting in a room, often isolated from my patients, looking at images, I am able to understand what families are going through and make their experience a little better when they come see me. When I provide a report or talk to the family or referring physician about the patient, I can do it from a somewhat different viewpoint having stood in those shoes for many years.
How has the field of pediatric radiology changed in recent years?
Radiology in general is one of the most rapidly evolving subspecialties simply because we’re so heavily dependent on technology. And as technology progresses, our ability to make new and more accurate diagnoses improves. In pediatrics, our ability to do things faster, less painfully and less invasively is especially beneficial. This is one of my major areas of interest.
Which new technologies are you most excited about?
My focus now is on contrast ultrasound. It’s been used in Europe for decades, but was only approved for use in children in the U.S. in 2014. It can replace a lot of [studies] that we were using CT and MRI for. It’s sometimes used for adult patients who can’t get contrast because they’re at risk for renal failure or because they have indwelling hardware that prevents them from going into the MRI scanner. Although kids can have renal failure and implanted devices, that’s not the biggest consideration for my patient population.
For kids, the huge advantage is no radiation. Kids are especially susceptible to complications related to radiation exposure, so this eliminates that concern. There is less discomfort because it’s much faster. MRI scans can be long and you have to hold very still. Obviously for our littlest patients, that’s not possible; but even for school age or pre-adolescent kids that can be difficult to be perfectly still for sometimes up to 45 minutes. It’s a very small space, so it’s very intimidating and generally it’s not a positive experience for kids. But with ultrasound, the child doesn’t need to stay all that still and so there is rarely a need for sedation. The caregiver can hold the child in his or her lap or lie down next to their child. If the child wants to play with a toy or a tablet then they can do that too. There are just so many benefits to using ultrasound; it’s very exciting. So my focus is determining what we’re doing with other modalities now that we could do just as well or better with ultrasound.
How is this technology being applied currently?
The procedure we’re performing the most right now is CeVUS [contrast enhanced voiding urosonography] for children with vesicoureteral reflux. Traditionally, we used fluoroscopy in children to assess reflux, which meant the child was exposed to continuous radiation and parents did not have easy access to them in order to comfort the child. The child had to lie on a large metal table and a huge machine would come over on top of them, which could be very intimidating. Now we can just use a “magic wand” — an ultrasound probe — that goes over the bladder and the child can lie in their parent’s lap.
We’re doing around 15 to 20 CeVUS per month right now. It’s replaced fluoroscopy almost entirely. We’re one of a small number of nationally recognized children’s hospitals doing this procedure. We’re hoping to expand its use – there are so many other things we can use contrast ultrasound for.
What would you say are some of your greatest accomplishments thus far in your role as chief of pediatric medical imaging?
Since I’ve been here, one of the biggest things I’ve done is try to build the division of pediatric radiology. We are actively recruiting pediatric radiologists so we can expand our services, both the number of services we provide and places we provide them. I have revamped many protocols we use for different imaging studies to make them more patient friendly, faster or to improve diagnostic accuracy. One of my major roles has been in education. I give many lectures, not only to our own radiology residents, but I give a lot of talks for the general pediatric residents, for subspecialty pediatric fellows and some regional and national talks.
What types of patients do you see?
One of the things that is unique with pediatric radiology is that we have an extremely broad spectrum of patients we see. Other subspecialties in radiology tend to be more narrowly focused. In pediatrics, we are more generalists. We cover multiple organ systems and modalities, just in kids. Anything from neurologic injuries in the neonate to bone tumors in a teen, GI issues, renal issues or congenital heart — almost anything that affects the child that needs imaging comes to us because kids really aren’t just little adults. They don’t have the same physiology or the same disease processes. They have very unique diagnoses.
Another thing that is unique for us is that we don’t just have one patient. It’s not just the baby or child I need to care for. We’ve got a whole family to consider. I need to consider how to interact with them to provide a service that’s not just good for the child, but also what’s best for the whole family. Children and their families often have different needs than an adult might, so we try to tailor the way we do things. We try to provide family-centered care, not just patient-centered.
What is your approach to collaborating with referring providers?
Traditionally in the past, there has too often been an unfortunate ‘wall’ between radiologists and clinicians. They would order a study, it would go into sort of a black box and a report would get sent out to them. In pediatrics in general, and in my division in particular, we really want to break down that wall. All UVA pediatric radiologists are here as consultants to help the referring clinicians in any way we can, including before a study gets performed. If they have questions about what’s the right study to do, how to do it, when to do it or any other considerations, we’re more than happy to act as consultants and talk to them. Once the study has been done, we’re happy to discuss results with them. If they get a report and have questions, we’re happy to sit with them in person or on the phone or whatever mechanism they want to use to talk to us. They should use us as clinical colleagues and not just a black box where orders go in and results come out.
On a personal note, you and your family are very involved in animal rights. Can you tell us more about why that cause is so important to you?
I became a vegetarian about 20 years ago. One day I just realized: why do we treat these creatures — a cow or a pig -— any differently than a dog or a cat? They need our help just like kids do. So I started off with something as simple as being a vegetarian. I was busy working hard and training so I gave a little money – that was easy enough to do. But over the years, [my wife and I] have tried to donate our time too. My wife volunteers for CASPCA, the Charlottesville SPCA, several times a week. We rescue dogs and help with placements. We do what we can when we can. My wife became a vegetarian 12 years ago and we have 5-year-old twins who are being raised as vegetarians. It goes back to that mentality, that desire to take care of those who are helpless or can’t help themselves.
To refer a patient to UVA Children’s, call 800.552.3723.