Did You Know?

Did You Know?

Number of Radiology Departments in Top U.S. Medical Schools in 1913
As ranked by the Council on Medical Education of the American Medical Association, only 4 of the top 18 U.S. medical colleges in 1913 recognized Roentgenology as a distinct "Department of Instruction": Northwestern University, Harvard University, Cornell University, and the University and Bellevue Hospital Medical College (from "Medical Colleges of the United States: Annual Presentation of Educational Data by the Council on Medical Education in J Am Med Assoc1913;61(8):569-598 and quoted in "Instruction in Roentgenology" by Adolph Henriques and Lodilla Ambrose, JAMA 1914;V.LXIII;N.8:651-653).

The Council chose the top or "A+" 18 U.S. medical colleges by . . .

rating all medical schools on a scale of 1,000 points based on 10 criteria each worth 100 points (please see criteria listed below). Class A+ colleges were those that earned an "acceptable" rating based on these 10 criteria (to read more, please access "Medical Colleges of the United States: Annual Presentation of Educational Data by the Council on Medical Education" in J Am Med Assoc 1913;61(8):598).

10 Criteria:
1. Showing of graduates before state boards and other evidences
of the training received.
2. Enforcement of a satisfactory preliminary educational requirement,
granting of advanced standing, and the character of records.
3. Character of curriculum, grading of course, length of session, and
time allowed for matriculation and supervision.
4. Medical school buildings: light, heat, ventilation, cleanliness.
5. Laboratory facilities and Instruction.
6. Dispensary facilities and Instruction.
7. Hospital facilities and Instruction, maternity work, autopsies, and specialties.
8. Faculty, number, and qualifications of trained teachers, full-time
instructors, and assistants, especially of the laboratory branches, organization, and extent of research work.
9. Extent to which the school is conducted for properly teaching
the science of medicine rather than for the profit of the faculty
directly or indirectly.
10. Possession and use made of libraries, museums, charts, and stereopticons.

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CT Scans and War

For the first time in war, CT scans are being used in autopsies according to Denise Grady of the New York Times: "Since 2004, every service man and woman killed in Iraq or Afghanistan has been given a CT scan, and since 2001, when the fighting began in Afghanistan, all have had autopsies, performed by pathologists in the Armed Forces Medical Examiner System. In previous wars, autopsies on people killed in combat were uncommon, and scans were never done." To read the full article from May 25, 2009, please access "Autopsies of War Dead Reveal Ways to Save Others" or Download file.

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Glimpse of Radiologists in 1938
(from "The Economics of the Practice of Radiology" in JAMA, V. 113, N. 10; 1939:943-948)

--The total number of radiologists in the United States had grown by 118%, increasing from 1,005 in 1931 to 2,191 in 1938.

(According to a survey of 876 radiologists in "The Economics of the Practice of Radiology":)

--The average age of the surveyed radiologists was 49 years old and the mean number of years of specialization was 18.

--In 102 hospitals, "roentgenologic interpretations" were made by someone other than the radiologist while in 1,148 hospitals, the "roentgenologic interpretations" were made "only by specialists in radiology."

--25% of the radiologists who also practiced in some other field were likely to have chosen (in order of frequency) general practice, surgery, internal medicine, or pathology.

--There were proportionately more radiologists in the Mid-Atlantic (704) and Pacific (192) sections than in the North West Central (172) and East South Central (86) states.

--Most radiologists (640 or 73%) worked part-time in one or more hospitals, and most fees for the services of radiologists were included in the hospital bills sent to patients.

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A Sketch of Early Radiologists*
The head of the Department of Roentgenology at Children's Hospital in Boston, Dr. Percy Brown, conducted a survey of all members of the American Roentgen Ray Society (ARRS) in 1910.

Of the 50% who responded, the majority received their medical degrees during the years 1896 to 1903. Many of those who received their medical degrees between 1900 to 1903 had worked with X-rays as photographers, engineers, physicists, and eletricians prior to medical school.

20% of the ARRS members surveyed limited their practice to radiology while the remaining 80% "were equally divided between general practice and some other specialty."

30% of survey participants indicated that they practiced both X-ray diagnosis and therapy while "[a]bout half worked only in diagnosis, and a significant minority (19%) specialized solely in therapy."

(The above statistics are from Radiology: An Illustrated History by Eisenberg, Ronald L.; St. Louis, MO: Mosby-Year Book, 1992: 61).

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Public Perception of Radiologists in 1956 and 2008
A 1956 survey by Eastman Kodak revealed that "[l]ess than one in four patients who had received a radiographic or fluoroscopic examination knew that there was a specialized physician--called a radiologist--who was involved in its performance or interpretation" (from "Who Are You? and Who Cares?" (Download file) by Linton, O; Academic Radiology September 2008;15(9):1212).

A 2008 national survey by the American College of Radiology (ACR) entitled "The Face of Radiology" revealed that Americans are still "split down the middle" regarding "whether a radiologist is a person who interprets or a person who administers the scan." During four focus groups in Miami, Florida, and Burlington, Vermont, adults age 35 and older had "general attitudes towards radiologists and radiology" that were "positive" and that reflected "the notion that the radiologist is a trained professional," though respondents were "split as to whether a radiologist is a licensed physician or a technician" (Download file).

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On March 1, 2009, Drs. Glazer and Beaulieu were quoted in an article from the New York Times entitled "Good or Useless, Medical Scans Cost the Same," regarding the varying quality of imaging scans. To view the article, please click here or Download file. The article also appears in the Pittsburgh Post-Gazette.

Did You Know?

RADIOLOGICAL FEES IN 1910*

Sinus Examination: $25 to $50
Location of Foreign Bodies in the Eye: $25 to $50
Examination of Teeth: $10 to $75
Diagnosis of Renal and Vesical Calculi and Gallstones: $50 to $200
Chest Examination: $25 to $100
Shoulder Examination: $25 to $50
Elbow Examination: $15 to $50
Hand and Wrist Examination: $15 to $50
Foot and Ankle Examination: $15 to $50
Leg and Knee Examination: $25 to $75
Stomach and Bowel Examination: $75 to $200
Hip and Pelvis Examination: $50 to $100

(*The above statistics are for examinations and work done "inside the laboratory of the operator"; for work done outside the laboratory, "add 50 to 500 percent more." All statistics are from the ARRS Committee on Fee-Table [sic] published in "Minutes of the ARRS Meeting" from the Americal Quarterly of Roentgenology (1910;3:80) and quoted in "Radiology--Then and Now," by NJ Nazinitsky and BM Gold from the American Journal of Radiology (1988;151:251)).

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The Department of Radiology is home to three National Institutes of Health (NIH) Centers of Excellence:

The National Center for Advanced Magnetic Resonance Technology (CAMRT);

The In Vivo Cellular and Molecular Imaging Center at Stanford (ICMIC); and

The Center for Cancer Nanotechnology and Excellence Focused on Therapy Response (CCNE-TR).

Did You Know?

AVERAGE COST OF RADIOLOGIC EQUIPMENT MAINTENANCE
AT 57 U.S. HOSPITALS IN 1910

Interest on cost of equipment ($1,102.63=the average in 57 hospitals) at 6%...........................................................$66.15
Depreciation per year, at 12%..................................$132.31
Insurance at approx. $1,000 valuation...........................$17.70
Repairs and improvements, per year.............................$100.00
Electricity, per year (light and power).........................$25.00
Tubes, per year.................................................$75.00
Cost of 2194 plates, all sizes, estimated at 35 cents..........$767.90
Cost of developers at 5 cents per plate........................$109.70
Total cost, per hospital for one year,.......................$1,293.76

(from "X-Ray Work in Radiology" by Stevens, R.; The American Quarterly of Roentgenology 1910;2:107-109).

Did You Know?

In the years following the 1895 discovery of the X-ray when radiology was beginning to develop as a specialty, some radiologists charged less for a negative result than a positive one. In 1896, radiologist Dr. William James Morton at New York City Hospital wrote the following after examining a patient referred to him for a possible kidney stone: "Like all physicians' services a negative result is harder to charge for than a positive one." Because he did not find a kidney stone, Dr. Morton reduced his fee by $25 (Technology in the Hospital by Howell, J; Baltimore, Maryland: John Hopkins University Press, 1995: 128).

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The cardiovascular imaging group pioneered the noninvasive imaging of the heart and blood vessels in the body. Studies that once required catheterization can now be conducted noninvasively.

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Stanford physicist Fernando Sanford may have discovered the X-ray prior to German physicist Wilhelm Roentgen, who was credited with its discovery in 1895. In an 1894 article entitled "Some Experiments in Electric Photography" published in the Physical Review (V. 11; No. 4), Dr. Sanford described an experiment from 1891 in which he developed "a negative image upon a piece of bromide paper" as well as his method for photographing a coin. He described this later experiment in more detail in an article published in the San Francisco Chronicle on December 31, 1893, entitled "Without Lens or Light." For more information, please see the Stanford Alumni Review from October 1948, pages 10-11, and May 1949, pages 14-15.

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The functional MRI group is developing strategies to help people mitigate pain, depression, addiction, and impulse control. These MRI techniques provide real-time feedback of the brain during an exam.

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Stanford Radiology has one of the largest 3D medical imaging laboratories in the U.S. and averages 900 exams per month. The lab converts CT and MRI scan information to a 3D format to improve diagnosis and treatment planning.

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Stanford interventional radiologists were the first in the Bay Area to perform radioembolization of liver malignancies.

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The Stanford Breast Imaging Program has been instrumental in making new MRI techniques available to at-risk patients far in advance of commercial availability.

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Stanford Radiologists are developing computer models to improve the understanding of cancer activity.