fell swoop, that journalists, commercial companies, and sdentists themselves are incapable of an unbiased reporting of empirical events. Indeed, if this were true, we would be in a sad state of affairs, doomed to a condition where it would be impossible to learn from our own history. Dr Kaufman objects to the characterization of the Goodspeed and Jennings radiograph as the “first” x-ray photograph and suggests that there may be another undiscovered radiograph made at a still earlier date. I agree that many firsts are both uninteresting and unimportant. However, in my article the word first is used in its chronological sense. Dr Kaufman’s objections are inconsistent because he does not object to the article’s description of the first photograph of lightning or the first aerial photograph of Philadelphia. It appears that Dr Kaufman’s comments serve some agenda that is related only tangentially to the content of my article. Thomas L. Walden, Washington, DC
ing medication to patients during interventional procedures, with or performing procedures, and providing postprocedure care and follow-up. Her more extensive understanding of disease, patient care, and procedures makes her the perfect person to classify and schedule cases. We have had no problems or feelings of “loss of patient control.” There has been no obvious detriment to resident or fellow education; in fact, the physician’s assistant helps the staff in many practical areas of resident and fellow training. Despite the successful use of physician’s assistants in other medical specialties, these professionals are still greatly underutilized in radiology. In vascular and interventional radiology, physician’s assistants can complement a dedicated patient treatment team and offer an excellent way to increase efficiency, better utilize valuable physician time, and improve the quality of patient care. assisting
References
Jr. PhD
1.
Ellis B!. Physician’s assistants in radiology: has the time come? Radiology 1991; 180:880-881. Barth KH, Matsumoto AH. Patient care in interventional radiology: a perspective. Radiology 1991; 178:11-17. Land M, Carver D. The role of the nurse in interventional radiology. In: Kadir 5, ed. Current practice of interventional radiology. Philadelphia: Decker, 1991; 18-21. Adams P. The physician’s assistant in interventional radiology. In: Kadir 5, ed. Current practice of interventional radiology. Philadelphia: Decker, 1991; 21-23. White RIJr, Denny DF, Osterman FA, Greenwood LH, Wilkinson LA. Logistics of a university interventional radiology practice. Radiology 1989; 170:951-954.
2.
Physician’s
U
Assistants
Interventional
in Vascular
3.
and
Radiology 4.
From: Timothy C. McCowan, MD, Timothy C. Goertzen, MD, FRCPC, Robert P. Lieberman, MD, Robert F. LeVeen, MD, and Victoria A. Martin, PAC Department of Radiology, University of Nebraska Medical Center 600 South 42nd Street, Omaha, NE 68i98-i045 Editor: In the September 1991 issue of Radiology, Ellis regarding the role of the physician’s assistant tremendous
growth
of vascular
and
(1) wrote a letter in radiology. The
interventional
radiology
5.
Radiologists,
U
Clinicians,
and
Patient
Care
From:
has mandated increased participation in direct patient care and treatment by the radiologist (2). This has put a strain on the already busy interventional radiologist. Most radiology technologists do not have the training to as-
Pamela K. Woodard, MD Department of Radiology, Duke Box 3808, Durham, NC 27710
sist
Editor: Having recently finished a clinical internship, I am writing this letter 6 months or so into my radiology residency with the belief that my experience on “both sides of the fence” can provide some added insight regarding the relationship between radiologists and clinicians.
the
interventional
radiologist
with
in-depth
patient
treat-
ment. The increased role of nurses in vascular and interventional radiology has certainly improved the problem but has not entirely alleviated it (3). However, another health care professional is available to help in this area-the physician’s assistant (4,5). Physician’s assistants can be an important and productive part of a team approach to vascular and interventional radiology.
In the
physician’s assistant program at the University of NeMedical Center, 2 years of undergraduate study with a focus on the sciences are required. Once accepted into the program, the student undergoes 2 more years of education. The 1st year in the program is didactic and includes courses in anatomy, biochemistry, immunology, pharmacology, and internal medicine. The 2nd year is composed of 13 months of cmical training with an emphasis on family practice. Physician’s assistants are licensed by the state of Nebraska to
braska
work with a primary
supervising
physician
and,
as needed,
with other “backup” physicians. With proper certification, physician’s assistants can perform some specific duties (eg, perform biopsies, suturing, and arterial punctures, and order medication) under supervision of a physician but without the necessity of the physician being actually present. Training, licensing, and acceptable activities of physician’s assistants may vary from state to state and should be investigated by any institution or group wishing to employ a physician’s assistant. Our department has employed a physician’s assistant for 3 years. During that time, she has worked exclusively with the section of vascular and interventional radiology. Because of her level of training and her ability to act autonomously, she helps in patient treatment, including such diverse activities as explaining procedures to patients and obtaining consent, contributing to preoperative assessment, monitoring and administer-
582
Radiology
#{149}
As
radiologists,
we
are
University
physicians,
and,
Medical
rightly,
Center
we
are
both-
ered when some imply that we are merely sophisticated technicians. We resist the “us” and “them” mentality, yet, perhaps subtly, we promote it. Some of these feelings may arise because we are in different specialties. Surgeons have more exposure to other surgeons, and radiologists, likewise, work with other radiologists. We have all experienced the colleagueship or bonding among individuals who work together. The key phrase, however, is work together, and it sometimes appears that neither radiologists
nor
clinicians
realize
that
the
ultimate
objective
working together with the common goal of patient ologists can do several things to foster both a good with the clinician and good patient care. 1. Examine
the
an emergency gists
do
not
patient.
room visit
the
Although
setting, floor
radiologists
often
it is my experience or
the
intensive
care
that unit
is
care. Radirelationship do this radiolo-
in
often
enough. Periodically examining the patient whose images you read every day not only provides the radiologist with additional clinical information, but also fosters relationships with clinicians. As an intern in medicine, I was impressed with radiologists who made this effort, and as a radiologist, I have been met with nothing but appreciation for doing the same. Besides showing that radiologists own stethoscopes, time spent on the floor or in the unit gives the radiologist an opportunity to discuss patient care with the ward team and to provide guidance to the young clinician who may be overwhelmed by the myriad of available radiologic studies.
August
1992
ing medication to patients during interventional procedures, with or performing procedures, and providing postprocedure care and follow-up. Her more extensive understanding of disease, patient care, and procedures makes her the perfect person to classify and schedule cases. We have had no problems or feelings of “loss of patient control.” There has been no obvious detriment to resident or fellow education; in fact, the physician’s assistant helps the staff in many practical areas of resident and fellow training. Despite the successful use of physician’s assistants in other medical specialties, these professionals are still greatly underutilized in radiology. In vascular and interventional radiology, physician’s assistants can complement a dedicated patient treatment team and offer an excellent way to increase efficiency, better utilize valuable physician time, and improve the quality of patient care. assisting
References
Jr. PhD
1.
Ellis B!. Physician’s assistants in radiology: has the time come? Radiology 1991; 180:880-881. Barth KH, Matsumoto AH. Patient care in interventional radiology: a perspective. Radiology 1991; 178:11-17. Land M, Carver D. The role of the nurse in interventional radiology. In: Kadir 5, ed. Current practice of interventional radiology. Philadelphia: Decker, 1991; 18-21. Adams P. The physician’s assistant in interventional radiology. In: Kadir 5, ed. Current practice of interventional radiology. Philadelphia: Decker, 1991; 21-23. White RIJr, Denny DF, Osterman FA, Greenwood LH, Wilkinson LA. Logistics of a university interventional radiology practice. Radiology 1989; 170:951-954.
2.
Physician’s
U
Assistants
Interventional
in Vascular
3.
and
Radiology 4.
From: Timothy C. McCowan, MD, Timothy C. Goertzen, MD, FRCPC, Robert P. Lieberman, MD, Robert F. LeVeen, MD, and Victoria A. Martin, PAC Department of Radiology, University of Nebraska Medical Center 600 South 42nd Street, Omaha, NE 68i98-i045 Editor: In the September 1991 issue of Radiology, Ellis regarding the role of the physician’s assistant tremendous
growth
of vascular
and
(1) wrote a letter in radiology. The
interventional
radiology
5.
Radiologists,
U
Clinicians,
and
Patient
Care
From:
has mandated increased participation in direct patient care and treatment by the radiologist (2). This has put a strain on the already busy interventional radiologist. Most radiology technologists do not have the training to as-
Pamela K. Woodard, MD Department of Radiology, Duke Box 3808, Durham, NC 27710
sist
Editor: Having recently finished a clinical internship, I am writing this letter 6 months or so into my radiology residency with the belief that my experience on “both sides of the fence” can provide some added insight regarding the relationship between radiologists and clinicians.
the
interventional
radiologist
with
in-depth
patient
treat-
ment. The increased role of nurses in vascular and interventional radiology has certainly improved the problem but has not entirely alleviated it (3). However, another health care professional is available to help in this area-the physician’s assistant (4,5). Physician’s assistants can be an important and productive part of a team approach to vascular and interventional radiology.
In the
physician’s assistant program at the University of NeMedical Center, 2 years of undergraduate study with a focus on the sciences are required. Once accepted into the program, the student undergoes 2 more years of education. The 1st year in the program is didactic and includes courses in anatomy, biochemistry, immunology, pharmacology, and internal medicine. The 2nd year is composed of 13 months of cmical training with an emphasis on family practice. Physician’s assistants are licensed by the state of Nebraska to
braska
work with a primary
supervising
physician
and,
as needed,
with other “backup” physicians. With proper certification, physician’s assistants can perform some specific duties (eg, perform biopsies, suturing, and arterial punctures, and order medication) under supervision of a physician but without the necessity of the physician being actually present. Training, licensing, and acceptable activities of physician’s assistants may vary from state to state and should be investigated by any institution or group wishing to employ a physician’s assistant. Our department has employed a physician’s assistant for 3 years. During that time, she has worked exclusively with the section of vascular and interventional radiology. Because of her level of training and her ability to act autonomously, she helps in patient treatment, including such diverse activities as explaining procedures to patients and obtaining consent, contributing to preoperative assessment, monitoring and administer-
582
Radiology
#{149}
As
radiologists,
we
are
University
physicians,
and,
Medical
rightly,
Center
we
are
both-
ered when some imply that we are merely sophisticated technicians. We resist the “us” and “them” mentality, yet, perhaps subtly, we promote it. Some of these feelings may arise because we are in different specialties. Surgeons have more exposure to other surgeons, and radiologists, likewise, work with other radiologists. We have all experienced the colleagueship or bonding among individuals who work together. The key phrase, however, is work together, and it sometimes appears that neither radiologists
nor
clinicians
realize
that
the
ultimate
objective
working together with the common goal of patient ologists can do several things to foster both a good with the clinician and good patient care. 1. Examine
the
an emergency gists
do
not
patient.
room visit
the
Although
setting, floor
radiologists
often
it is my experience or
the
intensive
care
that unit
is
care. Radirelationship do this radiolo-
in
often
enough. Periodically examining the patient whose images you read every day not only provides the radiologist with additional clinical information, but also fosters relationships with clinicians. As an intern in medicine, I was impressed with radiologists who made this effort, and as a radiologist, I have been met with nothing but appreciation for doing the same. Besides showing that radiologists own stethoscopes, time spent on the floor or in the unit gives the radiologist an opportunity to discuss patient care with the ward team and to provide guidance to the young clinician who may be overwhelmed by the myriad of available radiologic studies.
August
1992
