The radiologist as clinical activist: A time to focus outward

The radiologic process, divided into eight distinct activities is examined. The first six may be considered to be those initiated by a primary physician when the possibility that an imaging procedure might be useful for evaluating of a clinical problem in his/her patient is raised. They involve the following: (1) assessment of clinical workup strategy, with particular reference to the role of specific diagnostic procedures; (2) generating a request for a procedure; (3) performance of the procedure; (4) identification of the findings; (5) interpretation; and (6) reporting of results and communication of advice. Since the last of these activities may involve a recommendation for subsequent procedures, the process may repeat in an iterative fashion. The remaining two activities which are not part of this iterative process directly, are concerned with (7) quality assurance, and (8) improvement of the process itself. The purpose in examining these activities is primarily to emphasize the extent to which the activities of the radiologist are intertwined with those of clinical colleagues and out medical care institutions. A conclusion the author seeks to reinforce from this examination is that future systems and technological developments must focus not just on avoiding isolation of radiology, but also on actively fostering its close integration with the rest of the health care establishment. The computer interface of the radiologist is discussed.