Objectives in Radiology

Abstract

Radiology, the newest member of the medical family, is still experiencing the growing pains incidental to reaching a useful maturity. Most of us have watched its development from the time of the old static machine, which, if it was capable of impressing faintly the bones of the hand on a photographic plate, was considered a wonderful thing. With the development of increased power through the use of larger induction coils and the introduction of the transformer carne the realization, and sadly so, to many of the pioneers, that somehow these rays had a decided effect on tissue cells. This, in turn, led to further study to determine to what extent these rays might be used to affect tissue cells deliberately, particularly in the various malignant diseases. The introduction of the Coolidge tube and further refinements in apparatus, such as the movable grid, double intensifying screens, and films of greater speed, led finally to diagnostic endeavor to interpret pathology in the soft tissues as presented by the use of contrast media of various kinds for outlining the gastro-intestinal tract; visualizing the gall bladder, the kidney pelvis, ureters, and bladder, and tracing the outlines of cavities and sinuses. All of this within a period of three and a half decades! Is it any wonder that the application of radiology should to-day find itself in a more or less chaotic situation? On the one hand we have the few sincere men striving to place radiology where it belongs; on the other we have the multitude trying to make interest charges on equipment sold to them by enterprising salesmen. In the first instance the object is humanitarian and scientific, in the second, purely economic. What is the greatest objective in radiology? Service. Service to hospitals, service to their staffs, and, most important of all, intelligent service to the patient, who, in this case, is the ultimate consumer. The patient is entitled to the best service and opinion possible at all times and I am happy to say that, for the most part, he is getting them, else applied radiology would soon pass into disrepute. The larger hospitals throughout the country, practically without exception, employ full-time directors for their X-ray departments. But what about the bulwark of the Nation's health defense, the hundreds of smaller hospitals that cannot afford to employ full-time directors? We cannot expect a small hospital to operate its X-ray department at a financial loss, neither should any hospital expect income from its X-ray department to offset losses from elsewhere within the institution. The reputation for thoroughness which a hospital might acquire through an efficient X-ray department, and the additional number of patients who might, for that reason, use the hospital should be a full reward.