10 Questions with Allen D. Elster, MD

January 28, 2016

For this “10 Questions” series, we spoke with Allen D. Elster, MD, about his work and the future of radiology.

Our "10 Questions" series asks the same questions to a diverse group of professionals in the imaging community.

Here, we profiled Allen D. Elster, MD.

1. Please state your name, title and the organization you work for.  

Thanks for starting with an easy one. I am Allen D. Elster, MD, and professor of radiology and chair emeritus at the Wake Forest School of Medicine in Winston-Salem, NC.

2. How did you get where you are today?

I ended up at Wake Forest because after residency in Houston, my mentor and former RSNA President, Tom Harle, told me I should go work for his friend and Wake Forest Radiology Chair (also a former RSNA President), Doug Maynard. Both men helped me and advised me along the way, together with Chief of Neuroradiology, Dixon Moody. So I owe much to these three giants of radiology who were in many ways father figures to me. My wife and I loved Winston-Salem, so I spent my entire career here, working my way up through the ranks, eventually becoming professor and chair myself.[[{"type":"media","view_mode":"media_crop","fid":"45353","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_6121614897996","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"5183","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 232px; width: 200px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"Allen D. Elster, MD","typeof":"foaf:Image"}}]]

3. Why did you choose your profession?

I was one of those mathematics “whiz kids” in school, doing calculus at a young age, etc., so my strengths were always in the sciences. My first degrees were in Biomedical and Electrical Engineering, to which I later added Neurophysiology and Medicine. I actually began postgraduate training as a resident in surgery at Harvard. During that time, a relatively new technology was just starting to be developed – MRI. It seemed to me in 1980 this technology just might turn into something (!), so I after 3 years of surgery, changed fields and started over as a resident in radiology. Part of success in life is knowing “which horse to ride”, and I think I got on the right one.

As a result of this background and training, the major focus of my professional life has been developing and testing MR techniques. As I now enter the final phase of my career, I hope my enduring contribution will be my free educational website, MRIquestions.com. I encourage all DI readers to take a look at this and join the 600,000+ others who have now used it to help understand the technical underpinnings of MRI.

4. What is your biggest day-to-day challenge?  

After a decade as radiology chair, I stepped down about four years ago to return to full-time clinical practice and teaching. I found that being an administrator for so long had left me a little “out of shape.” I wasn’t quite ready for reading such a very large volume of complex studies on our neuroradiology service, and found I hadn’t quite kept up with all the clinical advances and imaging findings for new diseases elucidated during the 2000-2010 decade. I’ve finally caught up now (for the most part), but am still a little “out of breath” on some days.

5. What worries, if any, do you have about the future of radiology? If none, where do you think the field is going?

I actually don’t have any (or at least not many). The field is going to continue to evolve and the radiology department of the future may not look anything like that of today, but there will be increasing need for people who have a dedicated focus on imaging and imaging science.

The ultimate long-term threat is that supercomputers will ultimately be programmed and learn to interpret imaging studies better than human radiologists. So the radiologists of the future need to focus on more than just reading films.

6. What one thing would make your job better?

All radiology practices could become better and more efficient if we were able to develop the use of radiology assistants and other non-MD support personnel to handle the many interruptions that still occur daily – phone calls about tangential medical or technical issues, communication of non-routine findings, etc. Although we have these people and systems in place, they could always be better utilized.

7. What is your favorite thing about radiology?

That the technology continues to evolve and doesn’t seem to be slowing down. As a former electrical engineer, I am definitely in the field for the “big toys,” and they keep getting better and better.

8. What is your least favorite thing about radiology?

That everyone is now working at such a fast pace and the cases are getting so complex that it’s simply not as much fun as it used to be. I’m really tired at the end of the day. Less time is available to talk, teach, and interact with the residents and fellows than there used to be.

9. What is the field’s biggest obstacle?

That both radiology training and practice are focused too much just on reading imaging studies or doing procedures. We constantly run the risk of becoming a trade (albeit a skilled trade, like carpenters or plumbers) rather than a profession. We must keep up with advances in the basic sciences, in addition to medical physics to survive.

10. If you could give the radiology specialty one piece of advice, what would it be?

Remember that you began your medical career as a physician, not a radiologist. As such you share the common thread with all other specialties of being a doctor first. Don’t approach the world with the perception that other specialists are constantly trying to “take your turf.” There is plenty of imaging to go around for everyone and new avenues are constantly being developed. So don’t look at imaging as a “fixed-size pie” with an “us” vs “them” mentality. Radiology and other specialties will all grow and intertwine in the future, and it will be good.

Is there someone in the imaging community that you want to hear from? E-mail us their name and we'll ask them 10 questions.

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