Presidential Address

Abstract

That this is a changing world is a trite saying. Anthime Corbon said many years ago, “Everything is susceptible to change, everything has changed in the past, everything will be changed in the future! Nothing is permanent in history but the element of change itself!” When we look back fifty years—as some of us cana—one seems to get the effect not only of change but change at an increased pace—a pace that of late has seemed to accelerate so that we wonder if we are not being left behind. Nothing seems to have escaped. Even the foundations of the practice of our own profession are being attacked. Our own specialty, being about the newest in medicine, should be expected to escape if any department of medicine would. However, almost the reverse seems to be true, and we appear to be the target for more radical adjustment than almost any other branch. But possibly this is because, being new, we have, like Topsy, “just growed,” without any very definite plan. This growth has been so rapid and unexpected that the science of radiology has outstripped in growth its art and practice. There was no niche in medical practice provided for radiology, and, therefore, no recognized or established place for radiologists; we have just grown into one. Now it is evident that the place we have made for ourselves, and that was to some extent made for us, is not a final one and there is need for much adjusting in order that our relations with the rest of medicine may be equitable and harmonious; and that we may proceed without friction and attain our greatest usefulness. Therefore, it seems we must set our house in order and lay out some definite, logical plan and procedure for development—if we can, one that will be accepted not only by us but by others and insure us a proper and a deserved place in the group of medical specialties. There seem to be several problems to consider: cost, quantity, quality, and distribution of medical service and, incidentally, of radiological service. Of late there has been much talk of this, it being a favored saying, especially among those who wish to criticize the medical profession, that there are two types of patients who get the best of medical care—the very rich, who can afford what they want, and the very poor, who are looked ,after in our large institutions, where all necessary things are provided for them. And that leaves the poor devils in between who have small incomes, served very poorly on account of their inability to hire doctors. Now, things may be different in California, and the doctors there may be much more generous and philanthropically inclined than elsewhere, but I do not believe they are. I have practised medicine for some forty years in California, and with very few exceptions I have never seen a legitimately sick person who could not get a doctor because he had no money.