The historic definition of radiology was the use of x-rays to make diagnostic images or to treat various diseases, mostly malignancies. When that described radiology, there were never enough qualified radiologists. Other physicians, dentists, podiatrists, or even chiropractors held state licenses that included their right to use x-rays for health purposes.
Radiology was recognized as a medical specialty by the American Medical Association in the 1920s and got its own certifying board in 1934. There never were enough of you to meet the growing demand for imaging. Pulmonologists, orthopedists, gastroenterologists, and many family practitioners continued their use of x-rays on their own equipment.
When the first artificial isotopes came along in the 1930s, some of the earliest enthusiasts were endocrinologists. When isotopes became available from the Atomic Energy Commission in 1946, their potential uses attracted a wide variety of bright people—including some radiologists. The same was true a couple of decades later when ultrasound made its medical debut.
I have written about the successful struggle by the American College of Radiology to get radiology defined as a medical discipline rather than a hospital service in the Medicare law in 1965. In winning that struggle, we supported all of the other physicians using x-rays, isotopes, and ultrasound, as well as radiologists. We claimed, in effect, that any imaging modality that involved penetrating forms of energy should be regarded as radiology.
We won the legislative struggle. But in the late 1950s, cardiologists began cardiac imaging, leading to a turf struggle that has not abated to this day. As part of my job for ACR, I got Medicare to pay for ultrasound as part of radiology, regardless of the credentials of medical users. Then, a vociferous group of cardiologists objected to “their” imaging being defined as radiology. Medicare flipped its description, saying that ultrasound was not radiology. That had implications for insurance coverage, as well as training, hospital privileges, and other professional issues. It took 2 years to get congressional language saying that ultrasound was indeed radiology.
With computed tomography (CT), we gained its immediate acceptance as radiology, with costs effectively limiting it to specialists. We repeated the process with magnetic resonance imaging (MRI) a decade later. By then, government planning agencies and health insurers recognized that a new imaging modality involving expensive equipment was less of a financial threat if its use could be limited to referral specialists.
Get Radiology Tree app to read full this article<
Get Radiology Tree app to read full this article<
Get Radiology Tree app to read full this article<
Get Radiology Tree app to read full this article<