While I am not native to San Antonio, my family moved here when my dad got transferred to Kelly AFB in 1972. I graduated from MacArthur High School; class of 1977.
I am a member of South Texas Radiology Group (STRG) one of the premier radiology groups in Texas; with approximately 70 board certified and subspecialty trained radiologists serving the patients in San Antonio, Texas, and the surrounding area. Our outpatient company is called STRIC (South Texas Radiology Imaging Company). The radiologists in STRG and STRIC are the same.
I am an interventional radiologist. We use high-tech imaging (ultrasound, CT, X-ray) to guide procedures that are performed through tiny nicks in your skin...we are the cutting edge of medicine, without the cutting!
I learned the basics of interventional radiology during my residency at Baylor and refined those skills during my fellowship at Massachusetts General Hospital in Boston. After that fellowship I joined the faculty of Baylor College of Medicine and M.D. Anderson Cancer Center in Houston, TX. Tumor embolization was one of our specialty services at M.D. Anderson, where the concept originated over 50 years ago.
STRG recruited me back to San Antonio in January 1999. We performed the first UFE in San Antonio in April, 1999.
I am active with my specialty's national society, the Society of Interventional Radiology, as well as several other local, state, and national societies including the Bexar County Medical Society, the Texas Radiological Society, the Texas Medical Association, the American Roentgen Ray Society, the Radiological Society of North America, and the American Medical Society.
In March of 2012 I was inducted as a Fellow in the American College of Radiology and in March of 2020 I became a Fellow of the Society of Interventional Radiology (hence the initials FSIR and FACR at the end of my name), honors bestowed on less than 10% of radiologists in the United States. My peers have selected me for inclusion in Best Doctors in America from 2011-2022.
I am a member of South Texas Radiology Group (STRG) one of the premier radiology groups in Texas; with approximately 70 board certified and subspecialty trained radiologists serving the patients in San Antonio, Texas, and the surrounding area. Our outpatient company is called STRIC (South Texas Radiology Imaging Company). The radiologists in STRG and STRIC are the same.
I am an interventional radiologist. We use high-tech imaging (ultrasound, CT, X-ray) to guide procedures that are performed through tiny nicks in your skin...we are the cutting edge of medicine, without the cutting!
I learned the basics of interventional radiology during my residency at Baylor and refined those skills during my fellowship at Massachusetts General Hospital in Boston. After that fellowship I joined the faculty of Baylor College of Medicine and M.D. Anderson Cancer Center in Houston, TX. Tumor embolization was one of our specialty services at M.D. Anderson, where the concept originated over 50 years ago.
STRG recruited me back to San Antonio in January 1999. We performed the first UFE in San Antonio in April, 1999.
I am active with my specialty's national society, the Society of Interventional Radiology, as well as several other local, state, and national societies including the Bexar County Medical Society, the Texas Radiological Society, the Texas Medical Association, the American Roentgen Ray Society, the Radiological Society of North America, and the American Medical Society.
In March of 2012 I was inducted as a Fellow in the American College of Radiology and in March of 2020 I became a Fellow of the Society of Interventional Radiology (hence the initials FSIR and FACR at the end of my name), honors bestowed on less than 10% of radiologists in the United States. My peers have selected me for inclusion in Best Doctors in America from 2011-2022.
Apart from my busy practice I love spending time with my wife, Azreena B Thomas, MD, and my girls Jenna and Alyssa. Mrs. Dr. Thomas is a Neurologist specializing in epilepsy here in San Antonio. We met in medical school and got married just before graduating. I am an Eagle Scout and remain active with the Alamo Area Council, serving on the Executive Board since 2018.
As you can tell I also like discussing the UFE procedure. If you are in a group that is interested in me giving a presentation on the subject, please send me an email.
Professional Experience
Chief of Staff, Methodist Hospital San Antonio, TX 1/1/2008 - 1/1/2009
Quality Improvement Chair, Methodist Hospital System San Antonio, TX1/1/14 - 12/31/15
Medical Director, IRC San Antonio, TX 3/5/05 - 12/31/10
South Texas Radiology Group San Antonio, TX1/4/99 - present
M.D. Anderson Cancer Center Houston, TX8/11/97 - 12/31/98
Baylor College of Medicine Houston, TX7/1/94 - 8/10/97
Education
Vascular & Interventional Fellowship Harvard Medical School, Massachusetts General Hospital, Boston, MA 7/1/93 - 6/30/94
Radiology Residency Baylor College of Medicine, Houston, TX 7/1/89 - 6/30/93
Medical School University of Texas Medical School at Houston, TX 7/1/84 - 5/27/88
Master of Science Texas A&M University, Dept. of Nuclear Engineering 1/1/82 - 6/1/84
Bachelor of Science Texas A&M University, Dept. of Biology 9/1/77 - 12/15/81
High School Douglas MacArthur High School, San Antonio 9/1/74 - 5/15/77
Boad Certification
Interventional/Diagnostic Radiology recertification 2020
Interventional/Diagnostic Radiology 1997
Diagnostic Radiology 1993
Most medical specialties focus on one body part or disease (a Cardiologist deals with the organ the heart, an Oncologist deals with the disease cancer), but in Interventional Radiology we apply our techniques to all diseases in all parts of the body.
We initiated a program to treat women with symptomatic fibroids in early 1999 so we are highly experienced in performing UFE. I have personally treated over a thousand women in those 24 years. I perform many types of procedures for a variety of disorders for both men and women; UFE is of particular interest to me as it is so effective; just about the best therapy we have for any disease.
UFE is also known as UAE (Uterine Artery Embolization...the exact same procedure as UFE).
UFE is not an experimental procedure. Based on Level A evidence (the best evidence in medicine) the American Congress of OB/GYN recognizes UFE as a "safe and effective option for women who wish to retain their uteri."
While most gynecologists in the San Antonio area understand the opinion of their national professional society, there are many of the mindset that hysterectomy is still the best treatment. You should know that doctors are under no legal obligation to mention what they consider competitive procedures like UFE to you as an alternative. Unless YOU ask about UFE, your gynecologist might never bring it up.
If your doctor tells you that UFE is unsafe or a bad idea for you or that it doesn't work very well, ask him/her for specific reasons why and then let me review those issues with you. I would love it if you asked him/her why they think it is unsafe while his/her professional society ACOG states it has been proven to be safe!
Hysterectomy is a great surgical solution, but it is a radical step when your only problem is fibroids. Yet the most common reason for a hysterectomy in the U.S. is fibroids.
I will now rant about this a bit more:
Here is an excerpt from an article in the Wall Street Journal from way back in 2004:
"My gynecologist didn't say a word about UFE," says Collette Styles,...she got on the Internet and learned about UFE. "I didn't want anybody cutting on me. I didn't want anybody removing my uterus," she says. After undergoing UFE in January, she left the hospital the same day, sporting a Band Aid. She returned to work as a flight attendant one week later, free of fibroid troubles, she says. A hysterectomy could have grounded her for as long as eight weeks. "
Now let's fast forward to 2023: More hysterectomies are now being performed than ever before, thanks in large part to the surgical robot. "Robotic Hysterectomy" is the name of this surgery. You might also hear it call the De Vinci robot. An article in the Journal of the American Medical Association in 2013 reported that robotic hysterectomy for benign problems like fibroids is no safer than other less invasive hysterectomies but costs a lot more. On average the cost went up 33% from $6700 to $8900, a $2,200 increase in cost for no gain in patient safety.
There are surgeries that are much safer when done with the robot; it is a great advance for surgery. But for a hysterectomy done for fibroids? Nope. Just as safe the way it was done for years without the robot. Why would your gynecologist recommend the use of the robot for your surgery? Good question. Using the robot, the surgeon gets to sit during the procedure rather than stand. And there is no chance that the surgeon will get stuck with a needle or other instrument while at the robot, safely away from you. The most obvious reasons, then, are to increase the comfort and safety of the gynecologist. But you pay for it.
OK, end of rant.
I do admit that, even though published data do not show it, I see fewer complications after hysterectomy than I used to see; I don't know if that is an effect of the robots or just general improvement in surgical techniques.
I will now rant about this a bit more:
Here is an excerpt from an article in the Wall Street Journal from way back in 2004:
"My gynecologist didn't say a word about UFE," says Collette Styles,...she got on the Internet and learned about UFE. "I didn't want anybody cutting on me. I didn't want anybody removing my uterus," she says. After undergoing UFE in January, she left the hospital the same day, sporting a Band Aid. She returned to work as a flight attendant one week later, free of fibroid troubles, she says. A hysterectomy could have grounded her for as long as eight weeks. "
Now let's fast forward to 2023: More hysterectomies are now being performed than ever before, thanks in large part to the surgical robot. "Robotic Hysterectomy" is the name of this surgery. You might also hear it call the De Vinci robot. An article in the Journal of the American Medical Association in 2013 reported that robotic hysterectomy for benign problems like fibroids is no safer than other less invasive hysterectomies but costs a lot more. On average the cost went up 33% from $6700 to $8900, a $2,200 increase in cost for no gain in patient safety.
There are surgeries that are much safer when done with the robot; it is a great advance for surgery. But for a hysterectomy done for fibroids? Nope. Just as safe the way it was done for years without the robot. Why would your gynecologist recommend the use of the robot for your surgery? Good question. Using the robot, the surgeon gets to sit during the procedure rather than stand. And there is no chance that the surgeon will get stuck with a needle or other instrument while at the robot, safely away from you. The most obvious reasons, then, are to increase the comfort and safety of the gynecologist. But you pay for it.
OK, end of rant.
I do admit that, even though published data do not show it, I see fewer complications after hysterectomy than I used to see; I don't know if that is an effect of the robots or just general improvement in surgical techniques.