“Bring me men”

I was fortunate (or unfortunate, definitely a matter of perspective) enough to be admitted to the United States Air Force Academy upon completion of my high school education as one of the appointees of Senator Robert Byrd of the great state of West Virginia. I was not destined to complete my education there—for multifactorial reasons, as with most major decisions in life. I didn’t like the planned medical career path, didn’t like being told how to fold my underwear, etc. I gained much from that experience, however. The discipline to maintain one’s sanity under duress, modest organizational skills, interpersonal skills, and many other gems came to me from that experience. The current state of our specialty in terms of manpower has brought me back to a favorite memory of that time. The inclined rampart from the terrazzo to the parade grounds was emblazoned with the insignia “Bring Me Men”—a borrowed section from a Sam Foss poem that goes on to call for “men with empires in their purpose, and new eras in their brains.” Not just men, obviously, but women too.

Academic radiology is hurting. Recruiting is next to impossible, chair positions are unfilled, staffs are shrinking, and the remaining staffs are working harder and harder, hoping for a break in the clouds. My colleagues and friends in private practices relate similar stories, although their recruiting has been somewhat more successful. Why, they’ve even taken a few of the academicians. From the outset, academic practices have lost the “battle” with private practices over salaries. We offer less vacation time. We usually don’t have the flexibility of a large private practice, dedicated as we are to total subspecialization. I don’t need to distill out the differences in the practices; it is all too obvious to every one of us, academic or private. It’s not why we’re different that is important. Both wings of our specialty want to survive, even flourish. At this point in our history, we must reflect on our needs.

What academic radiology needs at this critical juncture is an influx of academicians dedicated to the new era; an era of careful and appropriate utilization of a scarcity of both medical resources and of physicians to interpret them. Maybe we don’t need business people per se, but as a minimum we need business-savvy people. Healthcare dollars are short—we can all agree on that. They must be spent (please note I didn’t say rationed) carefully. We don’t have the time, money, or manpower to waste on inappropriate studies.

Academic radiology needs radiologists to ensure the future of our specialty through careful utilization studies; through well-designed and carefully thought-out cost-effectiveness studies; and through the understanding, at the outset, that new techniques and equipment must not only be accurate, effective, and indicated, but must also contribute to patients’ quality of life. These new studies or procedures must justify their costs. Finally, these radiologists must be able to communicate their findings effectively not only to the medical community and their trainees, but also to society as a whole.

Bring me these men and women. We can arrange an interview next week. We offer a competitive salary and benefits package.

Nothing less than the survival of our specialty itself depends on it.