The Pursuit of Excellence

Dr Rajiv Rattan | Dean of the Faculty of Clinical Radiology (FCR)

It is a privilege to be the Dean of FCR, among other things because of the opportunities to advance this most rewarding profession, be a voice for radiology, promote a culture of excellence and foster the next generation of radiologists.

Radiologists are integral to the practice of modern medicine, involved in 85 per cent of patient journeys in any part of the Australian and New Zealand healthcare system, akin to the rest of the world. As we all know, the answer to the diagnostic conundrum often comes from us.

We are at the forefront of an ever-evolving healthcare landscape of rapid technological innovations that have enabled the proliferation of, and increased access to, general and sub-specialised radiology services.

The standard of radiology in Australia and New Zealand in general is excellent. At the same time the expectations from our patients and referring colleagues are very high as well.

If we are to constantly evolve and elevate our profession, we have to be prepared, as individuals, to keep increasing our knowledge, renewing our passion, and updating our skills. We need to stay engaged with our referring colleagues to understand how best we can help them; and to do all that in an inclusive and collaborative culture where innovation and excellence can thrive.

Our profession is only as strong as the individuals within it, the relationships we develop with colleagues, workplaces and our patients, and the kindness, civility and respect we show each other.

If you think about it, cultivating excellence is an intrinsically moral matter, where our individual values, integrity and professionalism are reflected in our practice, clinical competency and interactions, and which together, can enhance the standing of radiology, maintain its relevance and ensure its longevity.

We are privileged to have multiple touch points within the healthcare system and interact with a number of specialties. This also means that we need to understand the nuances and specific requirements of each speciality. It is imperative to be able to speak their language and provide a skilled service which enables our referrers to provide optimal patient care. Whereas the resourcing and funding allocations to radiology may be relatively limited, the pursuit of excellence is unlimited.

The realities of practice

The realities of contemporary radiology practice—with its increasing productivity demands and expectations of workplaces, referrers and patients, turf erosion—ultimately risk commodifying radiology, undermining the professional stature and perceived value of radiologists.

In settings where studies are entirely interpreted off-site, the potential arises for radiology to devolve from a well-respected medical profession into a perceived technological commodity, where only cost distinguishes value among products or services.

While technology has accelerated faster processing, transfer and communication enabling greater productivity and output, it has simultaneously created stressors as examinations become more data intensive and demands for rapid turnaround intensify.

We are all familiar with the inherent tension between providing accurate and carefully reviewed reports, essential for patient care, and the ‘vicious cycle’ that can occur with long reporting lists, constant interruptions and distractions, that impede report turnaround and create frustrations that hamper efficiency and effectiveness.

The interplay of these factors provides both challenges and opportunities for us as individual clinicians and for the profession itself.

Against this backdrop, what does excellence mean?

While we can never ignore the imperatives of efficiency, outputs and financial performance, it is in the relationships we have with patients, referrers and our allied health colleagues that we can embody excellence and reinforce the value and impact of radiology on therapeutic decisions and patient outcomes. The currency of health care is trust! The trust that our patients and referrers place in us.

The ask is not just being excellent, but being consistently excellent.

Although it may sound somewhat trite, excellence is present when we can take genuine pride in our work and experience the deep fulfilment that comes from making a real difference in the lives of others. Be it the quality of our scans and reports or the skill with we which we accomplish our interventional procedures, or the effective communication of results. We are making a real difference. And in our training departments, across the two nations, this is what our trainees should be learning along with core radiology skills. We are the doctors’ doctors!

When we come ‘out of the dark room’ to the actual point of care, provide excellent images and clinically relevant results, at a time when it really matters, we become more visible to, and demonstrably embedded in, the patient journey.

This is the space in which we can add value beyond image interpretation, reclaim and promote opportunities for patient contact, and provide clinical expertise and specialist advice to referring colleagues on how best to use imaging in the care of patients. This is also how, slowly but surely, we can keep creating awareness of the critical role, we as radiologists play in health care. No advocacy can be stronger than this.

I encourage members to utilise Inside Radiology (www.insideradiology.com.au), a valuable resource which provides up-to-date information to health consumers and health professionals on clinical radiology tests, procedures and interventions. The members can lean on the College for lifelong learning and upskilling via webinars, structured courses, the ASM and some amazing educational content put together by experts.

The pursuit of excellence, adding value and commitment to doing our jobs well, with every patient, every time, will ensure our relevance and enhance the longevity of our profession— and will reward us with fulfillment and satisfaction.

The abaton at the Temple of Asclepius (Epidaurus) where the sick awaited the visitations of the healing gods