A Message from the President

Radiology 101 – Back to Basics

Dr Lance Lawler

Given the extraordinary events of the last year, one may be forgiven for pondering existential questions such as 'what are we here for?' or 'where am I going?'—I write this while waiting for a plane flight—or, more to the point of my message for this issue, 'what is the role of our medical college? It is never a waste of our precious thinking time to ask the simple questions again, to plumb the depths of our purpose and stay focused on the basics. So this is the result of my airport musings.

Our College has two main roles or responsibilities (and one which is ancillary to these). First, and most importantly, is the delivery of competent, qualified medical specialists and a mechanism for them to maintain and demonstrate their competency (both pre- and post-Fellowship).

Having FRANZCR after your name is a licence to practise clinical radiology and radiation oncology—see how far you get without one!

The second role is in setting the quality standards of practice for the safe delivery of care in our specialties.

The legal authority for these two roles is delegated from our national regulators, bodies such as the Medical Board of Australia and the Medical Council of New Zealand (MCNZ), and with it we set and uphold the educational training and rules for the profession.

Funnily enough, we do not have any power to enforce these—that must be done by the various regulators.

To ensure that our voices as experts are heard and taken notice of in this regulatory space, the College has developed a strong advocacy arm. This is the ancillary role but still a crucial one, a role which involves a lot of meetings with our stakeholders, especially in government, and a strong commitment to communication, private and public (for example, Targeting Cancer and InsideRadiology).

If we didn't do this, our voices would be drowned out by the other colleges and competing organisations.

We have other roles too, but these are the most important. Of these, the advocacy role is the most difficult to resource and manage. The end result of a successful advocacy campaign for us is to be viewed as the trusted advisor— that is, the first people asked for advice on all medical imaging and radiation oncology matters. The key word here is trust. If we were to lose this all our hard work would be undone.

This brings me to what the College is not, and my hope here is to help dispel a few misunderstandings which come up often. Here are three:

First, the College is not a trade association for private practice. It can be difficult for our members to make this distinction in the heat of discussions, but it is vital that we are seen to give principled value-based opinion that always puts the patient at the centre of our deliberations.

Second, we are not a bank to fund any and every scheme or idea a member comes up with, and our members do provide ideas, which is something to feel positive about because it demonstrates a high level of engagement. But not all ideas, even the good ones, are feasible. We are a small college, with limited funds which come mostly out of our members' pockets. We have many checks and balances in place to manage our funds. This can be a source of irritation for some but there are sensible reasons for it.

Finally, the College is not a policeman to act on allegations of poor practice. We are here primarily to assist members in their work. Yes, we may be asked by the regulators to provide a view or opinion on instances of poor care (although not very often, this is usually managed through other channels). It is only in the most difficult of cases that we may be drawn in.

We have processes to follow that our regulators oversee but, as a member-based organisation, it's our job to support our members, not cajole, threaten or bully.

Everyone has their master though, and he who pays the piper calls the tune.

My plane is now boarding . . .