"We have a few things to learn from Captain Kirk about being bold explorers and pursuing radiology's version of 'new civilizations,' " he said. "We're in the midst of tremendous change and complexity in healthcare, but the need for imaging services is only going to increase as the population ages."
Part of this new exploration must include a shift from an expert-centered culture to a team-centered one, said Dr. Darrell Kirch, president and CEO of the Association of American Medical Colleges (AAMC), in a special lecture that followed Arenson's address. And academic radiology can lead the way.
"As we work to integrate the entire continuum of care, the goal for radiology will be to figure out at what points imaging is used and to make it effective and efficient," Kirch said.
What does "going boldly" mean for radiology? It means persevering as the delivery of healthcare becomes increasingly complex, and as factors such as the aging of the global population pressure physicians to do more with less, Arenson said.
"There's never been a more exciting era for radiology, with the new and growing demand for personalized, evidence-based medicine and integrated healthcare delivery," he said. "But there are also higher expectations from government and payors to curb spending, as well as a tidal wave of chronic disease that comes with an aging population."
Technology is radiology's area of expertise, and the field has made key contributions over the past decades, not the least of which is the development of PACS and RIS. Radiology's future will involve further use of metabolic and molecular imaging; using high-intensity focused ultrasound to treat a variety of diseases; developing steerable catheters under MR guidance; and even wearable devices and hyperfast, quantum computers that will process images in the blink of an eye, Arenson said.
"Today's innovators are critical to our field, and they will move us in new directions," he said. "In a few years, the technology we'll be using will make what we have now pale in comparison."
A perfect storm
Radiology's technological innovation will play out amidst a complex amalgam of factors, from a coming physician shortage and increasing numbers of insured patients to healthcare payment reform and tighter research funding, Kirch said in a lecture titled "Radiology, Medicine, and Healthcare: Will Inaction or Innovation Determine Our Future?"
"There's a great transformation going on in healthcare around the world, and we need to take steps to prepare for this change," he said.
Academic centers can lead the effort, according to Kirch -- in part because they provide 23% of all clinical care and 37% of charity care, despite comprising only 5% of U.S. hospitals. These centers and their associated teaching hospitals have developed special expertise, and they have been able to generate positive margins for patient care and then reinvest in innovation, according to Kirch.
"Academic centers are indispensable, and as such can't afford complacency," he said. "Although we're in a tough situation, academic medical centers are in a critical position to lead our health systems to a better place."
So how can academic radiology offer leadership in healthcare reform? Kirch offered seven suggestions:
Developing and integrating new technology must be done in the context of this new culture of the practice of medicine, he concluded.
"Somehow we need to figure out how to maintain that ethical connection to our patients, even if there's an iPad in the physician's lap and there are 20 specialists involved," he said. "That's our task as we move forward."