Noted Author Describes "A Whole New Radiology"
In the many strategic planning retreats that I have facilitated for radiology groups during the past couple of years, I have used as a basis for generating strategic and visionary thought a remarkable book whose author outlines a vision of our society's transformation—and the implications for medicine—to an age of heightened creativity and an increased reliance on right brain functions to understand and gain new respect for context. His thesis has many ramifications for radiology, especially in his delineation of the movement from mere "process" to adding value to the information that is generated. In my opinion, it is an understanding of this shift to a relationship model of interdependence between radiologist and referring physician that will ultimately determine the success or failure of tomorrow's practice. On a whim, I contacted the best-selling author of "A Whole New Mind" to see if he would agree to an interview with me to share his thoughts on this concept as a direct message to radiology practices. To my delight he agreed and in the following Q&A, Daniel Pink gives all of us in this fascinating segment of medicine a glimpse of what will be expected of us if we are to be among the leaders, and, dare I say, survivors in this new era. Question: In your book you say "This century, new technologies are proving they can replace human left brain." How important do you feel it will be for radiologists, who rely on high-technology medical equipment to generate their diagnostic data, to find new ways to add value to the resulting information that is interpreted and sent to the referring physician and patient? Pink: Obviously, it will be very important. If radiologists intend both to serve their patients and continue earning a living, they have to be something more than high-end medical Photo-mats. That means being able to detect the non-obvious elements of a scan. But it also means thinking of their role more expansively; not as a processor of data but as someone who can put the information they have in front of them into a larger context. That requires understanding the patient's story, being comfortable moving across a range of medical specialties, and developing real relationships with the referring physicians. Question: There are recent examples of diagnostic imaging studies being sent to India for interpretation by radiologists in that country, who provide the service for a fraction of the cost. What can radiologists in respective markets in the U.S. do to have their "customers" (referring physicians, payors, and patients) see them as more than merely assembly line producers of diagnostic reports? Pink: Well, they have to be something more than assembly line producers of diagnostic reports. They have to be more than vending machines for routine answers. This is true, I think, of most physicians today. As patients self-diagnose and tap the same reservoir of information available to physicians, the doctor's role is changing from omniscient purveyor of solutions to empathic advisor on options. The analytic and information-based parts of doctoring remain essential but increasingly they must be supplemented with new approaches such as empathy, narrative medicine and holistic care. Question: As you look at the future of specialty medicine, do you have any advice for those physicians who perhaps have not spent much time developing their right brain functions? Pink: The first bit of advice is to recognize that these right brain abilities are not niceties in the practice of medicine. There's a growing pile of evidence that shows that they can help lower costs and improve patient outcomes. The second bit of advice is to understand that these abilities are fundamentally human ones. Every doctor, every person, can master design, empathy, symphony, story, and the like, to some degree. It's just that these abilities haven't been in demand so they're like muscles that we haven't used and have atrophied. We simply need to work these muscles back into shape. Interestingly, I found these ideas played out in real time at the recent meeting of the radiological Society of North America (RSNA), where the "next big things" were prominently discussed within the context of the types of transformations that Pink describes. An example was the Molecular Imaging Zone, a newly segmented area with a beginning much the same as InfoRad had in the early days of imaging informatics at RSNA. The point is that by drawing attention to molecular imaging, the responsibility has been placed on radiology to be the innovators, the early adopters and the purveyors of added depth to the diagnostic information available to the medical community. The bar has been raised yet again for radiologists to be among the most knowledgeable and educated physicians of any of the many specialties, and to share that knowledge in consultative partnership with referring physicians. Another area that ties in to the theme of the new order in radiology was the message delivered by outgoing RSNA president Robert R. Hattery, MD, during the opening ceremony's annual presidential address. The timing of the message and its connectivity to the themes that are paramount to this institute made the address particularly relevant. Hattery said, "When radiologists are seen as serving themselves before the public [and here I would add customers within the definition of public], they will be considered a service commodity to be bought, sold, and traded." It is good to have such prominent allies as Daniel Pink and Hattery helping to shape a new attitude among professionals whose prominence and impact on medicine and society I passionately applaud and promote. I am in good company when I say, as I have often done in the time I have been extolling radiology's many virtues, that the most successful of tomorrow's radiologists will be those who truly find ways to add personal value to their diagnostic knowledge and the resulting information. A whole new radiology will require a whole new mind, which will require a whole new commitment.