Boris Alvarez

Boris Alvarez, project consultant, Medical Technology School, Universidad San Sebastián

Editor’s Note:  Boris Alvarez, project consultant for Medical Technology School, Universidad San Sebastián , in Santiago Chile, shared his thoughts with us on the difference between public and private healthcare, digital x-ray technology and the importance of continuing education and networking.

Q: Having lived in both the United States and Chile, can you give us a snapshot of the differences you see in planned healthcare reforms?

In my opinion, healthcare reforms in both countries address the need to achieve better access to care, especially for those more vulnerable citizens.

On one hand, the USA has been the most important country in the development of technologies for the whole world. This is increasing healthcare costs by transferring research costs to American patients. The US government expects to use strategies that reduce healthcare prices for the population with fewer alternatives to pay for it.

In contrast, the Chilean government is addressing healthcare access through a framework that allows public and private investment to give access to better technology to the people who can not afford it.

I think the biggest challenges for healthcare institutions are in their capacity to adapt to the new scenario. In the American case, institutions must be able to fit their cost structure in order to be more competitive. In the Chilean case, institutions must follow the technologic vanguard, in spite of the limitations in budget of the Chilean market.

Gary Allbutt

Gary Allbutt, visiting relief radiographer in North Dandenong, Victoria, Australia

Editor’s note:  We sat down with Gary Allbutt, who is currently a visiting relief radiographer in Cath Labs, Angiography and General Radiography, in North Dandenong, Victoria, Australia.  We asked him a few questions to get his thoughts on changes in radiology over the past 40 years, observed from his vast experience across commercial and regulatory roles as well as administration, training and other specialties.

Q:  You’ve been involved in radiology for nearly forty years. What was radiology like when you embarked in this profession 38 years ago?

I entered Radiography in  1975 as a student in the Royal Melbourne Institute of Radiography (RMIT) three year course for  “External Studies Students,” who were employed outside of metropolitan hospitals across Australia.

From day one, students undertook an apprenticeship, working side by side with experienced Radiographers, absorbing the culture and work practices.  Logbooks listed required examinations and procedures to be observed and conducted with a progression through general radiography of extremities increasing in complexity to procedures such as Angiography, in the final year.

Modalities such as CT and Ultrasound had just started to appear. Early Angiography was undertaken by “Direct Stick” in Carotids and Trans–Lumbar Aortograms. The Seldinger Technique and selective catheterisation was just emerging overseas and major metropolitan departments here inAustralia.  Manual cassette changers and rapid serial film changers acquired sequential images of the contrast bolus’ passage through the vessels.

Looking back the introduction of new technologies and techniques has been dazzling and un-abated. Take radiographic support in theatre for a hip pinning — radiographs from two mobile machines and manual film processing! The advent of Mobile Image Intensifiers made the guidance of internal fixations more accurate and reduced the patient’s time under anaesthetic.

Compound that now with the advent of hybrid theatres with systems supporting neuro surgeons, as well as vascular, orthopaedic and others. This is just one phenomenal area of growth let alone Ultrasound, 3D and Cone Beam technologies. From my early days in 1975 these developments would have been almost inconceivable.

[caption id="attachment_1462" align="alignleft" width="144" caption="Greg Freiherr, Medscape and Diagnostic Imaging Europe contributor, and consultant to the medical imaging industry."][/caption] Guest Post:  Greg Freiherr, a frequent contributor to Medscape and Diagnostic Imaging Europe, as well as a consultant to the medical imaging industry The medical community goes through