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History, humor guide Channin
Future practice will be totally different: this is not your father's radiology

By John C. Hayes

Dr. David Channin teaches and practices at a focal point in radiology history. The son of a pulmonologist who at one time practiced in a home-based office and a teacher and social worker who left Romania as a girl just before World War II, Channin has observed firsthand many of the computing and technology forces that have shaped the modern world and its medical landscape.

The impact of those changes is not lost on Channin, who, besides being a frequent speaker on topics involving radiology and computers, is also an amateur student of radiology history.

"In my opinion, we are entering the third age of radiology, the information age," he said. "The first was the age of discovery, from 1895 to WWII. The second was the age of the modality, from WWII to Y2K. The third age will focus on making use of the information we generate."

This viewpoint is interesting in and of itself, but also for what it says about Channin, who has combined a boyhood interest in computers with studies in medicine, specifically radiology. Today he is an assistant professor of radiology and chief of imaging informatics at Northwestern University.

At one time Channin was so focused on computing that he worked as a programmer and considered pursuing a doctoral degree in the subject. But he instead decided that he needed "domain" knowledge that would provide substance and direction to his computer interests. That domain turned out to be radiology, which Channin pursued in medical school at the University of Paris and Penn State University, graduating in 1992, and in a five-year residency at Penn State.

Channin joined the Northwestern faculty in 1997 and lives in the Chicago area with his wife, whom he met two days after he arrived in France, and their two children.

The combination of computers and radiology seems to have suited him. Channin is frequently asked to speak at CME courses and conferences on a variety of subjects involving radiology and computers.

Channin is noted for attacking all these subjects with boundless energy and a pronounced sense of humor. He invariably opens his presentations with a quip or a joke, and at the Society for Computer Applications in Radiology meeting in May, he demonstrated his talent as a stand-up comic. Channin, a member of the RSNA's Electronic Communication Committee, was planted in a panel discussion of the notoriously dry Integrating the Healthcare Enterprise project. According to one account, he stole the show with a variety of accents, sound effects, and a wicked parody of radiologists' clinical and administrative colleagues.

Behind the humor, though, there is a serious vein and some strong views about radiology and its place in the medical world.

Channin tends to think of himself as a researcher, an interest he credits to his father, who spent a decade in cardiopulmonary research before starting a private practice. This, along with the influence of his educator-mother, seems to have pushed him toward an academic career.

"They gave me the drive to do interesting things, to explore, to use my imagination, and to think about the future," he said. "That's what I try to do in research."

Another important influence was the French radiologist Dr. Maurice Laval-Jeantet, who told Channin that the best research is practical, not theoretical, because it has an immediate impact on people.

Channin took that advice to heart and today exhibits a strong preference for practical research over the more purely scientific work of forming a hypothesis and testing it. This gives him a realistic perspective on what research will be of value to time-pressed radiologists.

"If I say to a radiologist, ‘I've got this great, super workstation for you to use, just come on over and use it for an hour,' they'll say, ‘Are you crazy? I can't come over there; I've got to get the work done,'" Channin said.

Ideally, a radiologist should be able to take a 10-minute break from reading images and have the ability, without leaving the workstation, to review research cases, evaluate workstation tools, read journal articles, or even make management decisions.

Implicit in Channin's approach and sensibility is a strong service orientation. He believes, for example, that the goal of radiology is to reduce uncertainty for the referring clinician. The role of radiology informatics, in turn, is to reduce uncertainty for the radiologist.

Channin sees his own job as facilitating radiologists' ability to interpret images and to communicate that knowledge to other physicians.

"We are really just at the beginning of giving radiologists the tools they need to become more efficient," he said. "Better information systems will allow the radiologists to communicate more effectively with colleagues. You always hear jokes about the favorite plant of the radiologist being the hedge. Now, with things like CAD and other analytical tools, the radiologist is going to be more confident. Information systems will provide feedback directly to the radiologist about his or her performance."

In addition to being a researcher, Channin also sees himself as a teacher, both in the traditional sense as an assistant professor and in a larger sense as someone who imparts knowledge to subsequent generations to assure continued progress in a field.

"In every generation in radiology, as in any profession, you explore what you can and then share that knowledge and wisdom with the next generation. I am trying to acquire knowledge and wisdom so that in 10 or 15 years I can pass it on to the next generation in radiology computing," Channin said. "I try to instill my values and principles, as others in healthcare have for me. The patient comes first."

Where then does Channin see radiology informatics heading five years from now?

"Right now, workstations and information systems are getting a little better every year. In five years, I'd like radiologists, technologists, and administrators to walk into a department and think, ‘My God, this is totally different. This is not your father's radiology.'"