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The Sorcerer's Apprentice: How Medical Imaging Is Changing Health Care, by Bruce Hillman, Jeff Goldsmith
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Many will remember the segment of "The Sorcerer's Apprentice" in the Disney film Fantasia; it is a perfect metaphor for medical imaging as it stands today. The apprentice magician tests his nascent skills at sorcery by bringing common household items to life and putting them to work. At first, things go well, but eventually he loses control, and chaos ensues.
Medical imaging, too, could spin out of control. The benefits of imaging are undeniable. In the past thirty years, innovations like CT, MRI, and PET scanning have not only markedly reduced clinical risk for patients but have also transformed medical practice. Its costs, however, have grown explosively, to the point where imaging expenses have become a political issue. The aggressive adoption of imaging technology has raised issues about the role of inappropriate economic incentives and the role of defensive medicine in driving up medical costs.
Radiologists have utilized imaging technology to transform their practice from a pure diagnostic discipline into a curative one. Radiologists are among the most successful knowledge workers in the entire economy, leveraging digital information technology and Internet connectivity to become the first global medical discipline. Imaging is poised to make a further quantum advance - into the workings of the human cell and the molecular biology of complex disease.
Where is this remarkable technology, and the discipline which uses it, headed? How can society make the most responsible use of this powerful new tool? How will imaging and radiologists reshape medical practice? These questions will be answered by The Sorcerer's Apprentice.
- Sales Rank: #1325778 in Books
- Published on: 2010-11-01
- Original language: English
- Number of items: 1
- Dimensions: 7.20" h x .80" w x 10.00" l, 1.54 pounds
- Binding: Hardcover
- 264 pages
Review
"...provides fascinating perspectives on the major issues and opportunities to be faced now and in the futureEL.required reading for today's and tomorrow's leaders in Radiology, healthcare policy makers, and medical visionaries."
-- Paul E. Berger, MD, Founder and former CEO and Chairman of the Board, NightHawk Radiology Services
"...a brilliantly conceived piece of work...reads like a novel but covers topics of interest to the present and the future of healthcare."
--Harvey L. Neiman, MD, Executive Director, American College of Radiology
"...timely, comprehensive, insightful and critically important...the insights offered will be essential to inform health policies that promote innovation in medical imaging that could make health care both better and cheaper."
--Sean Tunis, MD, MSc, Director of the Center for Medical Technology Policy; formerly (until 2005) Chief Medical Officer, Centers for Medicare and Medicaid Services
"an extraordinary book... The Radiologist will assume the mantle of the Sorcerer, formulating accurate, evidence-based medical decisions that measure up to society's need for affordable access to valuable and beneficial imaging innovations."
--Eric Z. Silfen, MD, Executive Vice President and Chief Medical Officer of Philips Health Care
"Their wonderful book chronicles the rise of modern imaging from its ancillary roots to where it is today positioned astride the critical path of care for most diseases and conditions... a transformational story and one worth knowing."
--James Thrall, MD, Radiologist-in-Chief, Massachusetts General Hospital
"...I would recommend The Sorcerer's Apprentice to physician colleagues interested in learning more about the economic and political implications of medical decisions as well as to nonphysician friends and family members interested in learning more about medical imaging and health care reform." --JAMA
About the Author
Bruce J. Hillman, MD, is the Theodore E. Keats Professor of Radiology and Professor of Public Health Sciences, University of Virginia, and Editor-in-Chief, Journal of the American College of Radiology.
Jeff C. Goldmith, PhD, is President of Health Futures, Inc. and Associate Professor of Public Health Sciences, University of Virginia.
Most helpful customer reviews
5 of 5 people found the following review helpful.
A Must-Read for All Doctors and Patients
By L. Berlin
This 250-page book, written by two University of Virginia professors, one a radiologist-MD, and the other a public health PhD, is a virtual enclyclopedia focusing exclusively on radiology imaging. Traditional X-ray (radiography, Mammography (breast), Computed Tomography (CT), Magnetic Resonance (MRI), Positon-Emission Tomography (PET), Ultrasound (sonography), and Nuclear Medicine (radioisotope scanning) are all covered in depth. The authors begin with a detailed history of the origin and development of each one of these imaging techniques, then describe how they are performed, and for what medical conditions they are best suitable. In plain conversational and every-day language, the authors explain to patients -- current and future (almost everyone will fall into one of these categories), what they can expect, beginning with the ordering of the exam by their primary care doctor, what if any pre-test preparation the patient must undergo, how the patient is positioned during the test, and the average duration of the exam.
But, in addition to the medical aspects of medical imaging, the authors do not shy away from its political, financial, and business aspects. Such topics as self-referral by referring physicians, the value (or lack of value) of screening tests, and teleradiology are discussed. The last part of the book is devoted to a probably realistic view of what the future holds for imaging; the authors "take" us to the year 2036, and predict the type of imaging, and how it will be used to diagnose and treat disease.
Why do the authors title the book "The Sorcerer's Apprentice?" In that story, a magician's apprentice brings household items to life, and then loses control of what he has created. Will medical imaging spin out of control as well, the authors rhetorically ask? All of us -- physicians and current or potential patients alike -- can find the answer, and at the same time benefit tremendously --by reading this book.
2 of 2 people found the following review helpful.
Excellent Book
By David C. Brayton
This is an excellent book. Medical imaging is a multi-billion dollar a year industry and it provides spectacular benefits to patients. But it can be expensive and the utilization of MRI and CT scans is growing fast.
The authors comprehensively review all of the issues surrounding imaging: radiation exposure, cost, history (all the way back to the very first X-ray) and how we pay for such services.
If you are interested in healthcare systems, you really should read this book. For example, the authors state that hospitals are making more profit from imaging than from its bread-and-butter services like nursing. Another interesting fact--there are about 2 imaging procedures done each year on average in the US for each and every person (~600M studies).
This book is very up-to-date and discusses the Affordable Care Act (Obamacare). It also discusses the craze of whole body imaging of healthy patients in order to spot disease before it becomes symptomatic.
They also discuss where technology is heading and some of the color images are astounding.
I cannot however, give this five stars. The authors are a bit too biased in favor of protecting the tight control radiologists have on this market. The authors dismiss some cost control strategies as if they were trying the Cinnamon Test. Radiologists are very well paid--top five of all specialties--and they want that to remain so.
UPDATE 01MAY12 A couple of days ago I saw an article that reported that radiologist are now the highest paid specialists, beating out anesthesiologists, ob gyns and surgeons. So, I think the reason I gave it four stars is now evens more important.
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