Re: MDs and radiological sciences

["ruth_weiner" <ruth_weiner@email.msn.com>]

Knowing the difference between alpha, beta and gamma radiation hardly
qualifies as sophisticated physics.  It seems to me that any doctor who
orders an x-ray, should know more or less how x-rays are produced and
qualitatively what they do to biological tissue -- they've got to know
something about dose!  And by the way, good doctors usually do know.

Ruth Weiner
ruth_weiner@msn.com
-----Original Message-----
From: Gibbs, S Julian <s.julian.gibbs@vanderbilt.edu>
To: Multiple recipients of list <radsafe@romulus.ehs.uiuc.edu>
Date: Sunday, July 23, 2000 12:51 PM
Subject: MDs and radiological sciences


>Having taught medical students for more than a quarter
>century, I think I may be entitled to enter some comments.
>Are HPs aware that medical education encompasses
>essentially all of modern biology, most of chemistry, a big
>chunk of physics, plus a number of lesser subjects.  It is
>simply not possible to provide expertise in depth in the
>whole gamut.  Enter specialty training, where the breadth
>is greatly diminished but depth is increased.  I teach
>radiobiology to our residents now in specialty training for
>diagnostic radiology.  Some years ago, I had the equivalent
>of a one semester hour course to cover this--modest but
>adequate.  Now, with the advent of more clinical
>procedures (magnetic resonance, computed tomography,
>ultrasound, positron emission tomography, interventional
>angiography, etc.) I have only 5 lecture hours.  I
>understand that this is probably typical of other radiology
>residency programs.
>Most diagnostic imaging procedures deliver very small
>radiation doses to patients.  The upper limit is of the
>order of 10 mGy, for some CT, angiography, etc.  In my
>teaching I try to point out that there is now disagreement
>among competent scientists as to the presence and/or extent
>of risk from these procedures.  We conclude that if there
>is a risk, it must be vanishingly small, and never
>sufficient to warrant cancellation of a medically justified
>procedure.
>Some interventional procedures deliver larger doses.
>Epilation, erythema, and even moist desquamation are not
>unknown.  These involve doses of the order of a few Gy, and
>harmful sequellae might be expected.  However, these
>procedures are generally livesaving and may eliminate
>extensive surgery, the risk of which may be much greater.
>
>I think that the best we can hope for is some in-depth
>knowledge among radiologists but less in other physicians.
>I try to emphasize to my radiology students (and to other
>medical students in my infrequent contacts with them) that
>when faced with a radiation exposure problem they should
>not rely on their memory, but rather should contact their
>friendly academic medical center for current information.
>
>Finally, I wonder why HPs do not relegate these issues to
>radiobiologists, who are really the competent ones to
>evaluate available data.  I know that when I (as a
>radiobiologist) dabble in physics I can easily
>misunderstand some of the sophisticated issues.  My
>physicist friends tell me they experience the same when
>they get into modern biology.
>
>***********************************************************
>S. Julian Gibbs, DDS, PhD               Voice: 615-322-1477
>Professor, Emeritus                       FAX: 615-322-1474
>Dept. of Radiology & Radiological Sciences
>Vanderbilt University Medical Center
>209 Oxford House
>Nashville TN 37232-4245        Email:j.gibbs@vanderbilt.edu
>***********************************************************
>"Under democracy each party always devotes its chief energies
>to trying to prove that the other party is unfit to
>rule -- and both commonly succeed, and are right."
>                -- H. L. Mencken (1880-1956)
>
>
>
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