Image courtesy of Barco.
Decompressing after RSNA 2013, I took a moment to watch “Falling Down” with Michael Douglas. I always read the credits at the end of movies, mostly for the bit players. The main characters everyone knows — the Douglases and the Duvalls. I feel like the bit characters deserve some attention. There, five down from the top and two above Mr. De Fens’ mother, was a credit that shook me — Tuesday Weld as Mrs. Prendergast.
It couldn’t be, I thought. Not Tuesday Weld. Through the magic of DVR and the Yahoo images button on my laptop, I juxtaposed how I remembered Tuesday and the grotesque creature who played Mrs. Prendergast ... Tuesday Weld at age 50. OMG, I thought … and that was 20 years ago.
We have in our minds the way things were. If we liked them, they stay that way, frozen in time. Radiologists had it great when I started covering their specialty 30 RSNAs ago. They wanted a machine ... they got a machine. McCormick Place was their store window, like Macy’s at Thanksgiving. The leads that vendors took on the floor turned into new year sales like clockwork.
Now, like so many things, radiology has changed. Radiologists have a voice, but theirs is not THE voice. Decisions are made by committee with ever more weight centered in the C-suite. With this change has come a change in the motivation of radiologists and a fundamental change in the metrics of productivity.
It used to be simple — the more cases they interpreted, the more they were paid. Report turnaround, responsiveness to referring physicians, patient concerns — they were all dealt with when radiologists had the time. Now the concerns of enlightened radiologists have risen to a higher plane.
CT scans are a lot easier to read than they were a decade ago; ultrasound has gone 3- and 4-D; radiographs are digital and their imagery is even more straightforward than before. It’s gonzo radiology that the referring physician can do. Not surprisingly, many have their own X-ray and even ultrasound labs.
To make money, radiologists now must be indispensible to the medical team. If techs take the pictures, computers enhance the images and referring docs can do the reads, radiologists have to be superheroes — interpreting images faster than a speeding bullet; responding to signals projected into the cloud; beaming their findings with X-ray vision to mobile devices everywhere and anywhere.
The technology is there. It was splashed across the RSNA show floor, like the many good opportunities Tuesday Weld turned down. She turned down movies that propelled other actresses to stardom, choosing instead a raft of B movies (e.g., the 1960 classic “Sex Kittens Go to College”). She embraced a role that could not be sustained; indelibly burned it into the minds of her fans; then all but disappeared, preferring to be remembered for what she was rather than what should could have been; recalled from time to time in bit parts incongruous to the image she clung to until it was too late for her and her fans.
Sadly, Tuesday probably knew what she was doing. After refusing the title role in “Bonnie and Clyde,” she was quoted as having said: “I do not ever want to be a huge star. Do you think I want success?”
Do radiologists? Their choices will determine whether they are remembered as sex kittens of modern medicine or marquee performers.
Greg Freiherr has reported on developments in radiology since 1983. He runs the consulting service, The Freiherr Group. Read more of his views on his blog at itnonline.com.