The Future of Radiology

Abstract

The practitioner of medical radiology is so submerged in his work that he scarcely realizes the amazing history of the specialty, its present relations to other fields of medicine, or its probable future. It may be of benefit to step aside for a moment and view radiology from without, detachedly and impersonally, seeking especially to discover its defects and to suggest measures of improvement. As for its history, suffice to say, as has often been pointed out, that within less than three decades, radiant energy has become a sixth sense in the diagnosis of disease and a powerful agent in its treatment. There is no need to exaggerate the value of radiology to medicine. Its rapid growth to the high place it has attained has been along the lines of least resistance, natural and undirected. That method of increment and refinement will, perhaps, also determine largely its future. Nevertheless, radiology has now matured sufficiently to develop a degree of self-consciousness and self-determination. It is timely, then, to take an inventory of our present status, of the conditions that surround us, and of those that are not beneficial in the art of medicine. Having thus taken stock, we shall be better prepared to direct the course of radiology along more rational lines, or at least to exercise some control of its destiny. After even the most casual survey, certain defects in the present system of applying the specialty are apparent. Among them are the eccentric status of radiology as a specialty, its unsatisfactory inter-relations with other branches of medicine, the faulty co-operation among radiologists and the incoordination of research. In continental Europe, radiology is merely a feature of clinical diagnosis and treatment. The leading radiologists there are also experienced clinicians, and the clinical and radiologic viewpoints are never dissociated. In America, radiology is both more strongly differentiated from and more thoroughly entangled with other branches of medicine. At first view its status seems quite anomalous. It is practiced as an independent specialty, and as an adjunct to other specialties or to general diagnosis. It is practiced with various degrees of proficiency by ripe scholars in medicine, by novices, technicians, nurses and office assistants. In view of these facts it is not surprising that, until recently, the American Medical Association has not deemed radiology worthy of separate recognition. Radiologists have consistently objected to the haphazard work of inadequately trained physicians and laymen. Their objections have often been misconstrued as arising from personal and pecuniary motives, but, as a sober matter of fact, the conscientious radiologist has thought more of his art than of himself. Knowing that its efficient application requires thorough training, he has felt strongly that incompetent workers tended to degrade radiology, and to impair its usefulness.