Debates, Dialectic, and Rhetoric

Arguing is an art and essential to the functioning of our political and legal system. Moderated debates between residents are a useful educational vehicle to teach residents health economics and health policy. Articulating the opposing arguments leads to greater mutual understanding, an appreciation of the limits of knowledge and improved advocacy.

“The test of a first rate intelligence is the ability to hold two opposed ideas in the mind at the same time, and still retain the ability to function.”

F. Scott Fitzgerald, “The Crack-up”, Esquire Magazine, February 1936

In preparing radiology residents to meet the broad challenges of the present and tomorrow it can scarcely be objected to that becoming an excellent clinical radiologist, though necessary, is not sufficient . Radiologists will have to demonstrate their value at the societal level as well as at the patient level. They may have to persuade a variety of decision-makers, the local congress member, the chief executive officer of the hospital, and the payers, to name but a few.

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Arguing

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Arguing as a vehicle of medical education

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The introduction of debates to the resident curriculum

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Format of the debate

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Topics for debate

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Role of the moderator

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Why radiology and radiologists?

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Resident debates at national meetings

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Conclusion

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References

1. Borgstede J.P.: Radiology: commodity or specialty. Radiology 2008; 247: pp. 613-616.
2. Berlin L., Hall F.M.: More mammography muddle: emotion, politics, science, costs, and polarization. Radiology 2010; 255: pp. 311-316.
3. Nelson H.D., Tyne K., Naik A., et. al.: Screening for breast cancer: an update for the US Preventive Services Task Force. Ann Intern Med 2009; 151: pp. 727-737.
4. Woolf S.H.: The 2009 breast cancer screening recommendations of the US Preventive Services Task Force. JAMA 2010; 303: pp. 162-163.
5. Kopans D.B.: The 2009 US Preventive Services Task Force Guidelines ignore important scientific evidence and should be revised or withdrawn. Radiology 2010; 256: pp. 15-20.
6. Farnsworth W.: Farnsworth’s Classical English Rhetoric.2010.David R. GodineBoston
7. www.en.wikipedia.org/wiki/Intelligence_Squared . Accessed October 10th, 2012.
8. Gadamer H.-G., Smith P.C.: Hegel’s Dialectic: Five Hermeneutical Studies.1982.Yale University PressNew Haven
9. Chen J., Krumholz H.M.: How useful is computed tomography for screening for coronary artery disease? Screening for coronary artery disease with electron beam computed tomography is not useful. Circulation 2006; 113: pp. 125-146.
10. Dworkin L.D., Jamerson K.A.: Case against angioplasty and stenting of atherosclerotic renal artery disease. Circulation 2007; 115: pp. 271-276.
11. Charon R.: Narrative medicine. A Model for empathy, reflection, profession and trust. JAMA 2001; 286: pp. 1897-1902.
12. Enkin M.W., Jadad A.R.: Using anecdotal information in evidence based healthcare: heresy or Necessity?. Ann Oncol 1998; 9: pp. 963-966.
13. Kahneman D.: Thinking, Fast and Slow.2011.Farrar, Strauss and GirouxNew York
14. Arrow K.J.: Uncertainty and the welfare economics of medical care. Am Econ Rev 1963; 53: pp. 941-973.
15. Hayek F.A.: The use of knowledge in society. Am Econ Rev 1945; 35: pp. 519-530.
16. Keynes J.M.: The pure theory of money. A reply to Dr. Hayek. Economica 1931; 34: pp. 387-397.
17. Krugman P.: How did economists get it so wrong?. New York Times, 2009;
18. National Federation of Individual Business v. Sebelius, 567 US (2012).
19. 42 USC Sec. 1395dd (1994).
20. Paulos J.A.: Mammogram math. New York Times 2009;
21. Berlin L.: The radiologist: doctor’s doctor or patient’s doctor?. AJR Am J Roentgenol 1977; 128: pp. 702.
22. Iglehart J.K.: The new era of medical imaging – progress and pitfalls. New Engl J Med 2006; 354: pp. 2822-2828.
23. Crowley P. The effects of corticosteroid administration before preterm delivery: an overview of the evidence of controlled trials.
24. Redberg R.: Coronary CT angiography for acute chest pain. New Engl J Med 2012; 367: pp. 375-376.
25. Lexa F.J.: Macroeconomics in the US: fundamentals and implications for radiologists in 2012. Appl Radiol 2012; 41: pp. 24-28.
26. McMenomy B., Zingula S., Smith K., et. al.: Introducing first-year radiology residents to the ACR at the AMCLC: the effect on future ACR and state radiologic society membership and participation. JACR 2010; 7: pp. 339-345.
27. Rove K.: The dividends of Romney’s debate victory. Wall Street Journal October 11, 2012;

Debates, Dialectic, and Rhetoric

Arguing

Arguing as a vehicle of medical education

The introduction of debates to the resident curriculum

Format of the debate

Topics for debate

Role of the moderator

Why radiology and radiologists?

Resident debates at national meetings

Conclusion

References

Further Reading

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Combined Diffusion-Weighted, Blood Oxygen Level–Dependent, and Dynamic Contrast-Enhanced MRI for Characterization and Differentiation of Renal Cell Carcinoma

Comparison of 3D Phase-Sensitive Inversion-Recovery and 2D Inversion-Recovery MRI at 3.0 T for the Assessment of Late Gadolinium Enhancement in Patients with Hypertrophic Cardiomyopathy