Nov. 19, 2005, 11:42 a.m.

Crisis in Radiologic Practice

It has come to my attention that some physicians and surgeons (non-radiologists) are doing ultrasonography on their respective clinics, thereby impinging on the field of Radiology. What will a surgeon feel if he encounters a man doing operations when he's not a surgeon? One reason why people specialize is to provide the best for the patients. That demands time in doing the procedure. If an internist or surgeon does the ultrasound, then less time is spent on the patients. As a corollary to this, in order to spend time on the patient, the ultrasound time is cut. Such practice has led to very horrible and embarrassing diagnoses. One radiology colleague of mine in a region of the country southeast of Manila has some horror stories to tell. Several patients are crying to her, very much afraid of what their doctor diagnosed them with. One 15-year old certifiable virgin was diagnosed with bilateral ruptured ectopic pregnancies, and he sounded very serious. My colleague performed an ultrasound on her and she was perfectly normal! What if that teenaged patient was operated on? The Hippocratic oath said to "never do harm to anyone". Our former professor at the University of the Philippines, a pioneer of ultrasound, was pissed off! Horrible! Another ultrasonographer in the region always reports cleft lip in his fetal procedures, ending up normal upon review! Where are they being trained?

What can the Philippine College of Radiology (PCR) or perhaps the Philippine Medical Association (PMA) or even the Medical Board do? A thorough investigation is needed. Non-radiologist practicing Radiology is very unfortunate. Why don't they study the field formally for at least one year in a PCR-accredited institution, and they cannot practice until they passed the examinations first. Another passage in the oath said, "I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners (specialists in this art)." Impinging on other fields of medicine is not healthy. The effects are not apparent yet, but just wait for some years.

Medicine is a vocation, not a job or business where you get rich. Money may come, but that's only secondary. As a final note, we as legitimate Radiologists should become experts in our field, and really become the consultants of the consultants. If we do our part the best that we can do, people will choose us, and keep coming back. Primum non nocere!