Radiologists treating nuclear medicine like a poor stepchild is nothing new

July 1, 2005

I read with interest your editorial in the May Diagnostic Imaging ("Funding cuts imperil nuclear medicine's innovative tradition," page 7). I cannot agree more. What we are seeing is not the death knell of nuclear medicine but the consequence of what has been done by physicians themselves. Forever, nuclear medicine has been treated as the poor stepchild of radiology. Until recently, about 80% of nuclear medicine was controlled by part-time radiologists who usually assigned a GED tech to do the nuclear medicine. The physician just countersigned whatever the tech diagnosed. This still left 20%, and since neither discipline controlled the patient flow, nuclear medicine doctors were able to fend for themselves.

I read with interest your editorial in the May Diagnostic Imaging ("Funding cuts imperil nuclear medicine's innovative tradition," page 7). I cannot agree more. What we are seeing is not the death knell of nuclear medicine but the consequence of what has been done by physicians themselves. Forever, nuclear medicine has been treated as the poor stepchild of radiology. Until recently, about 80% of nuclear medicine was controlled by part-time radiologists who usually assigned a GED tech to do the nuclear medicine. The physician just countersigned whatever the tech diagnosed. This still left 20%, and since neither discipline controlled the patient flow, nuclear medicine doctors were able to fend for themselves.

Radiology should have embraced nuclear medicine, but short-sightedness on both sides prevented this. As a result, nonimaging physicians, such as cardiologists, have latched onto the fact that full-time practitioners were not needed, and if a radiologist can countersign a tech's report, why can't they?

Now even the 20% market share that nuclear medicine physicians had is gone. There are no jobs for nuclear medicine physicians. Recently, a large medical group contacted me to set up a nuclear medicine lab. But before I could even interview for the position, I was notified that they had decided to hire a cardiologist who, they stated, could also do nuclear. Most physicians do not know the difference between a board-certified nuclear medicine physician and a GED tech. And they really do not care.

Unfortunately, what has happened to nuclear medicine, which was aided by the radiology community, may be a forecast of what is to come for all of radiology. If it is perceived that only the images are important and that any physician can overread for the tech, the future is not bright. In order to stop what has happened to nuclear medicine and potentially all of radiology, jobs must be created for full-time nuclear medicine physicians. If that requires additional specialized training, I am sure nuclear physicians would do it. Without such identity, nuclear medicine as a discipline will be lost.

-Maynard Freeman, M.D.

Texas Molecular Imaging Consultants, Houston, TX