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Introduction
Volume 12 No 3
I
June 2016
7
being pursued. I see this ‘big data’
related development as an opportunity
to further improve patient care,
recognising that there are significant
issues around implementation and
connectivity. As this improves it will
increase our understanding of each
patient’s clinical situation and thereby
enhance the quality of our opinion, our
recommendations and optimally guide
patient care. Setting the sizeable topic
of teleradiology aside, along with the
trend to demonstrate increased value
for patients and referrers, it seems likely
that text only reports will gradually be
superseded by multimedia enhanced
radiology reports. These combine text
and relevant images so that referrers
and patients are more easily able to
understand our findings.
At the far end of the spectrum of
developments afforded by sophisticated
algorithms, increasing computer power
and perhaps quantum computing,
the potential for machine learning
is attracting considerable attention.
Confident advocacy for the future
potential of artificial intelligence has
been present for 40 years and has been
particularly active recently. In my opinion
substantial short-term impact seems
unlikely but in the more distant future
radiologists may again need to adapt to
disruptive change and find new ways to
demonstrate the value they provide to
patients and referrers.
The Interest of Other Disciplines
One of the challenges that clinical
radiology faces is the increasing
interest by non-medical disciplines
in reading and reporting on imaging
studies and even performing image-
guided procedures. This interest
is often assisted by the limited
understanding of others who may view
image interpretation as little more
than perception of abnormalities.
It is important to remember that
clinical radiologists are highly trained
specialist doctors and unlike a number
of other non-medical disciplines, have
training in anatomy, physiology and
pathology with significant experience
in clinical medicine in addition to an
understanding of imaging techniques
and image interpretation.
It is therefore critical that we respond
to this challenge and effectively
communicate the difference between
simple perception of an abnormality and
what clinical radiologists actually do.
Specifically, when interpreting images we
integrate our image interpretation with
our knowledge of medicine, anatomy,
pathology, physiology and the clinical
context to provide an expert medical
opinion. The capacity to undertake
this process is the source of the added
value that clinical radiologists provide
when reporting imaging studies or
participating in multidisciplinary team
meetings. Importantly, such capabilities
are usually not within the scope of
those who would seek to move into our
field and this point is often not clear to
decision makers in health care.
The challenge is perhaps even
more acute where other medical
disciplines express an interest in
image interpretation or performance
of image-guided procedures. One of
the principal advantages available to
clinical radiologists is dedicated training
in the full range of imaging techniques
and well developed perceptual and
interpretive skills. In this context it is
also important that radiologists maintain
their knowledge at the forefront of
areas such as informatics, various
imaging modalities and their evolution,
contrast media and where appropriate,
devices used in interventional radiology.
To demonstrate their value, clinical
radiologists should engage positively
with other clinicians in settings such
as multidisciplinary team meetings
where the value of clinical radiology
is readily apparent. In the setting of
major interventional procedures it
is important where possible to see
patients before and after therapy and
truly act as a clinician managing care
in order to compete effectively. At the
same time we will need to respond to
another challenge and try to manage the
tension between reporting workload or
workflow pressures and the importance
of engaging with our clinical colleagues
and patients.
Current Activities and RANZCR
Advocacy
Targeted and unrelenting advocacy by
College office bearers, College staff
and active participation by its members
is vital to ensure that the interests of
members and optimal patient care are
well represented in a wide variety of
settings. In terms of current significance
and activity, the MBS Review is a worthy
example. This review is well underway
and although it will be some time before
outcomes are clear, the College, a
significant number of its senior Fellows
and the Faculty of Clinical Radiology
team, ably led by Mr Mark Nevin and
capably supported by Ms Daisy Garling,
are making very substantial efforts on
behalf of College members. At the
same time that we seek to improve the
Medicare system in a way that benefits
“I believe that focus
upon the quality of
care we provide our
patients and the value
we add to care in the
eyes of our referrers will
be the most significant
determinants of our
long-term future as
clinical radiologists”