The radiologist--some of his problems.

Abstract

The high position of radiology among medical specialties is something of which we in the field can be justifiably proud; that position, however, is not entirely an enviable one. The growth and development of the science, so familiar to all of you, have been nothing short of phenomenal, yet with that growth has come an ever-increasing complexity of the many problems confronting those of us who have chosen this as our life's work. The mechanical and technical difficulties of the early days have long since ceased to cause much serious concern. The attempts of lay laboratories to practise medicine through radiology have been fairly well overcome, although still somewhat of a problem in some centers; and protection against the hazards of the rays, once an enigma, is now a procedure of accepted routine. Today's radiologic problems are of a different nature and spring both from within and without the specialty. Intraradiologic problems that plague us have as a common denominator the variance in the economic and social structures within which radiology is practised. These are private office practice, practice limited to hospitals, clinic group practice, combinations of these, and complete occupation in the educational field. We find it vexatious at times to reconcile the divergent individual attitudes produced by these differing professional environments. This is the main circumstance that calls for mental adjustments within the radiologic family circle. Just as every family has its differences that necessitate give and take, so does radiology. We need not, however, apologize to any group for our conduct in reconciling these differences. The family has remained intact, preserved by our intellectual comradeship, our devotion to our professional purpose—better radiology for all—and our recognition of the primary ethic : “Do unto others as you would have others do unto you.” It would be pleasant to be able to render the same sort of report on our problems that arise outside the specialty. That is not possible at this time. Perhaps I should have used the singular and said “problem” rather than “problems.” For, though it appears in many guises, our fundamental problem is the attempt on the part of some hospitals, aided and abetted to an extent by certain hospital groups, to control the practice of radiology by treating it as a hospital rather than a medical service. This is aggravated by the provisions of certain Blue Cross contracts which guarantee in the name of cooperating hospitals to provide radiologic service, rather than offering an indemnification. Parenthetically, this aggravation will remain with us until Blue Shield plans more universally include adequate radiologic service. We may take comfort in one fact. While at first glance our problem seems unique, it is but an extension of the over-all problem facing the entire medical profession—the escape from outside domination. Note that I say “domination” and not interest, co-operation, or even influence.