Wallace Davis Buchanan

Abstract

In 1964, the ACR made a decision to fight against the proposed federal Medicare program covering radiology only in hospitals and as a hospital service rather than a medical specialty. In the view of College leaders, the future of radiology hung in the balance. If the specialty was defined as a hospital service rather than a physician discipline, the ability of radiology to attract bright young physicians would be handicapped severely. If the proposed Medicare coverage in hospitals only was adopted by private health insurance carriers, the survival of private offices was in grave doubt. And if radiology offices disappeared, much of the bargaining power radiologists had with hospitals would be gone. The chance of winning the point that radiology should be treated the same as other medical disciplines in federal legislation was slim. Most radiologists worked on hospital contracts. But for Wallace Davis Buchanan, or Buck, and his colleagues on the ACR Board of Chancellors, the effort had to be made. The college hired a lobbyist and organized its members into a vigorous campaign. Against all odds, against the opposition of the American Hospital Association and even President Lyndon Johnson, the ACR's effort succeeded. Radiology was defined as a physician service, radiologist fees were separated from hospital billing, and the ACR moved to get its members out of hospital contracts specifying collective billing. No one individual can be credited with the effort. The ACR's leader was Dr Buchanan, as chairman of the board and as president. His commitment was firm, unwavering, perceptive, and determined. The effort would be made, and resources would be committed. On his numerous trips to Washington DC, his quiet, earnest manner was convincing to members of Congress and their staffs. He was equally persuasive with radiologists, whose convictions led them to end their hospital contracts and begin billing for their own professional services. After the new law was passed, with radiology on the medical benefit side, Dr Buchanan invited Wilbur Cohen, the undersecretary of health, education, and welfare and principal architect of the Medicare program, to meet with the Board of Chancellors. Mr Cohen had favored putting radiology into hospital service. But he accepted the offer and brought with him the top members of the newly created Medicare staff. Out of that meeting came the relationship that has served the program and the specialty of radiology for more than 40 years. During his time as an ACR chancellor and officer, Dr Buchanan was in a 7-member radiology practice in South Bend, Indiana. His colleagues supported him and covered the many days he spent on ACR activities. Buck Buchanan was a native Hoosier. He took his medical degree from the University of Indiana in 1933 and did his internship at Indianapolis City Hospital. For 8 years, he had a general practice in Bremen, Indiana. In 1942, he was commissioned in the navy and assigned to a military hospital in Port Lyautey, French Morocco, where he served during most of World War II. During his navy experience, he became interested in radiology and served several months in naval hospitals in Philadelphia and Portsmouth, New Hampshire. After his discharge, he completed his residency at Northwestern University's Wesley Memorial Hospital and passed the American Board of Radiology's examination late in 1946. Then he joined the South Bend practice group. In addition to his service in the ACR, Dr Buchanan was active on the board of the St. Joseph County Hospital for Tuberculosis and Chronic Disease, the local tuberculosis association, the board of the local symphony orchestra, and the United Community Services board in South Bend. After his term as ACR president, Dr Buchanan remained active, making speeches to radiology groups, participating in a College film about radiology and Medicare, and serving as a member of the Judiciary Committee. He made a final appearance before the US House Committee on Ways and Means in 1967, when the first Medicare amendments were considered. The American Hospital Association made a last, unsuccessful effort to make radiology a hospital service in Medicare. In 1976, Dr Buchanan retired from his Indiana practice and moved to Sarasota, Florida. Retirement did not suit him, and he soon joined a smaller radiology practice in Fort Lauderdale. He practiced for another decade until failed cataract replacement surgery made it impossible for him to continue reading x-ray films. Then he returned to Sarasota, where he died in 1998. His friend and mentor, Earl E. Barth of Chicago, said of Buck Buchanan in his 1968 ACR gold medal citation, “The hour provides the man. Buck Buchanan's leadership brought radiology into its new era.” And so it did.