In 1956, the marketing team from Eastman Kodak, the dominant supplier of x-ray films, approached the American College of Radiology (ACR) with the results of a survey. Less than one in four patients who had received a radiographic or fluoroscopic examination knew that there was a specialized physician—called a radiologist—who was involved in its performance or interpretation.
The ignorance of the public about the existence and function of specially trained and qualified radiologists posed a threat to the future of the discipline, the marketers suggested. Something vigorous needed to be done about this problem if radiology was to thrive and survive in coming decades. The ACR Board of Chancellors was willing to consider action, particularly when Eastman Kodak offered to provide expertise and to help organize a national public relations program.
A decade earlier, the InterSociety Committee, created by the national radiology societies, had made successful targeted efforts to avert hospital domination of the specialty. The American Medical Association had passed resolutions declaring radiology to be a medical discipline and not a technical hospital service. But the reality was that most radiologists worked in hospitals under agreements by which the hospital billed patients or the growing number of health insurance plans for the total cost of any x-ray service. The hospital charge made no mention that it covered the earnings of a physician. For radiography, patients did not see anyone professing to be a physician, much less a highly qualified specialist. For fluoroscopy, in darkened rooms, patients seldom were informed about the identity of those people shrouded in lead aprons. When patients received x-ray services in private offices, they were most commonly delivered by the physician responsible for the patient’s care and not a consultative specialist. And the x-ray cost was added to the charge for the office visit.
The Kodak initiative in 1956 involved the services of its advertising and public relations agency. The agency developed a series of press relations efforts. The ACR hired a public relations director, Hugh N. Jones, a radio newsman, and loaned his services to the American Roentgen Ray Society, the Radiological Society of North America, the American Radium Society, and the Canadian Association of Radiologists to provide press coverage for papers at their annual meetings. Five years later, Hugh Jones joined Kodak’s agency to manage its radiology efforts, and I was hired by the ACR to succeed him.
With the strong lead from the Kodak-sponsored efforts, I reached out to other suppliers for public relations help. The Dupont Company produced a 30-minute movie about radiology and paid for its distribution to thousands of audiences for more than a decade. General Electric sponsored a series of advertisements in leading American magazines. By 1968, we had more than a dozen cooperative public relations and educational programs. Each one was different from the others.
Many of our efforts were targeted to special audiences. Most of the papers at national meetings had more interest to other physicians who would refer patients for new procedures. So we worked with a growing number of magazines and newsletters directed at doctors. By 1964, when the ACR decided to fight for radiology as a medical service in the pending Medicare program legislation, most members of Congress and their staffs accepted that radiologists were specialized doctors and should be treated as such in payment programs. Another ACR effort was targeted at medical students to entice more of them into radiology and make use of the new technology made possible by image intensification and megavoltage therapy equipment.