PERSONAL INTEGRITY AND THE STATUS QUO.

Abstract

It is the opinion of competent radiological travelers from this country and from abroad that the people of the North American continent, overall, receive the best radiological care in the world. As a consequence of the sheer weight of numbers one must take for closer observation radiology as it is practiced in the United States and Canada. This is not intended as an arrogant disparagement of our foreign colleagues. Even casual perusal of the radiologic literature in our own English language tells us that many centers elsewhere in the world offer unique and superior methods of providing particular therapeutic and diagnostic radiological services. Let me emphasize again that, overall, what we have to offer is of high quality and generously available. Personal conversation with foreign visitors allows me to state that they themselves often share in this opinion. I, for one, would like to contend that this state of affairs came about through the healthy degree of competition and balance between private practice and hospital radiology. Except for relatively minor trends, radiologists in the United States have not seen any great change in the manner of this practice in the past four decades. Recent events, occurring at a rapid rate, threaten this balanced system. While it may seem only a small squiggle on the total sociological seismograph, there has been a significant change in the manner of practice among our neighbors to the north. Time and observation of the results of this change (which seems great to us) may offer an answer as to whether it is permanent or not. This type of socioeconomic medical change, however, is not likely to be reversed. If this assumption is correct it will be too late to make amends, for the balance of competitiveness between private office and hospital radiology, the difference in private and hospital purveyance, will no longer exist. Private office practice will diminish or, as our good friends tell us, may become nonexistent. A whirlwind of forces seems to want to change this system of balanced radiological practice. Medicare and the insurance industries' desire to label radiology as a hospital service both 100m large. The first has not been established as yet; the other is being palliated by good efforts of dedicated people. As long as the private practitioner can have the help of his own specialty organization and that of all organized medicine he will, we hope, survive to offer his services to the medical public. His colleague in full-time hospital practice is having his trouble in surviving and maintaining his part in what we would like to be believed the best of all systems of radiological practice. While the hazards of legislative professional extinction and insurance company regulation may disturb him, they do not threaten his professional eradication. His perils are closer. They are his “employers” in the hospital administration itself as well as his own human frailty.