The TV Philosophy
I want to think that computers are a good
thing. In our world of imaging services (ah,
heck, I still want to call it radiology . . .) it
was obviously a revolutionary-evolution-ary jump in what the capability of looking
into the body was all about. My goodness,
it was all so simple then: x-ray film, film
jackets, alternators, date stampers, file
rooms, dark room techs, pass boxes, film
processors—now all near extinction.
So, with technology, imaging should
be a much more efficient, less labor intense, less complex existence, right? It
seems we have managed to make things
even more complicated than ever. I call
it the “TV Philosophy.” When my dad
bought our first black and white 15” TV
back in the 1950s, it was an incredible
feat of technology. We had eight channels to choose from. We could watch
anything we wanted, and the major
channels had all the great shows! What a
choice of programs! Plus, our high tech
motorized antenna could be adjusted to
move in whatever direction we needed to
improve our reception.
Fast forward to 2014, where I have
a 60 inch, high definition TV that is so
clear it’s like the images can jump out
at you. It’s thin, like only 3” deep. I have
hundreds of channels and programs to
choose from, it’s ridiculous. Well, no, it’s
most of the actual programming that’s ridiculous. What a selection—from judge
shows, to reality shows, to game shows, to
shopping shows, to car shows, to animal
shows, to history shows, to sports shows,
to educational shows, and on and on.
We have so many choices, it’s paralyzing.
Especially when you consider that there
are times when I can’t find anything that
I really want to watch.
So my “TV Philosophy” is about the
simplicity of the world as we once knew
it, versus the infinitesimal complexity
of our computer based world of speed,
instant knowledge, and endless choices.
Is it better? In many ways it is. Imaging
is more efficient, more diagnostically detailed, and really fast. We can take thousands of images of the body in seconds
then reformat gathered data to look at
whatever we want in any plane we want.
We can instantaneously look at comparison images that are stored at our finger
tips, automatically. We can acquire an
image and not get up from our chairs to
move that image thousands of miles in
seconds for someone in another corner
of the world to interpret and provide us
X-ray continues to be the foundational “black and white TV” with simple
variations that gave us a few alternatives
for viewing. Today, we have x-ray, CT, ultrasound, nuclear medicine, MRI, PET/
CT, CR, DR, wireless digital, PACS, and
numerous variations within these modalities. The “TV Philosophy” applies to
the wide variety of channels to choose
from, the high definition of the images
that we acquire; and the speed in which
we can acquire and manipulate information. Add to this the clinical diagnostic processes and demands of referring
and ED physicians that has changed the
methodology of evaluation. Therein lies
the issue of overutilization.
The mere mention of overutilization
prompts the more recent issue of radiation overexposure and safety. We are now
being required to monitor exposure levels and report to the government when
overexposures or incorrect patient exposures beyond accepted limits occur. The
governance of radiation exposure will
only increase. It’s like the IRS discovering a tax impropriety. They uncover a
problem and they will only dig further,
make it more complicated, and hold our
feet to the fire. You know it’s real when
equipment manufacturers and software
companies develop and feature dose reduction programs as a selling point.
So, has computerization of our imaging world made things better? In certain ways, yes, and in other ways, no. It
complicates our businesses, increases
regulatory compliances we are required
to adhere to, and overall will add new
complexities to the services we manage.
There was something really basic about
black and white TV that I loved. Fewer
choices, but we were happy with what we
had. And if the TV went out, we always
had a transistor radio to fall back on.
When our computers go down in today’s
department? Oh my . . .
Gordon Ah Tye, FAHRA is director of imaging and
radiation oncology services for Kaweah Delta Health
Care District in Visalia, CA. He holds a bachelor’s degree
in biological sciences from California State University in
Fresno. Gordon is a past president of AHRA, received the
AHRA Gold Award in 2001, and received the 2006
Minnie for Most Effective Radiology Administrator of the
year. He may be contacted at firstname.lastname@example.org.
By Gordon Ah Tye, FAHRA
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