CHICAGO — From the most powerful companies in the U.S. to Congress there is a call for ethical conduct in all branches of professional and public life — and now in the practice of medicine.

That is the clarion call by the presiding president of the Radiological Society of North American (RSNA; Oak Brook, Illinois), Bob Hattery, MD, whose opening address and the theme of this year's conference is the need to strengthen professionalism among the society's radiologist membership.

"Ethics is on the front page . . . and it needs to be," Hattery told an early morning plenary session officially kicking off the conference Sunday at cavernous McCormick Place.

"The higher calling of medicine is still there, but we cannot let it stand as an echo in a distant canyon," he said.

The cause for urgency is that there are "threats" to the fabric of medicine, which are undermining how it is being practiced today, he said. Among these: the rise of business influence and commercialization in medicine, the eroding trust of the public in both healthcare providers and the healthcare system, clinician burnout and. "sadly," he said, "lower prestige" for practitioners.

The good news, he said, is that practitioners have the freedom to determine their own destiny. "Frankly, it's up to us," asserted Hattery.

Among the professional attributes he outlined were those most commonly thought of in leaders: accountability, altruism, duty, excellence, honor and integrity. And he said that radiologists should be among the practitioners who exhibit these attributes and use them for universal causes, such as better access to care for all.

As healthcare providers, that is a privileged position, but with this privilege comes the need for "strengthening professionalism."

"Professionalism has no magic formula," he said, but rather is "at the very core of the art as well as the science of medicine."

He referred to the "Ten Commitments" published in the earlier part of this decade, in Radiology, as the guide by which radiologists should evaluate their performance.

Among those commitments is recognizing the "sacredness" of the patient-physician relationship, as well as striving to be "humble" and not being driven by ego. "Medicine can only succeed when it is wrapped up in . . . human values," Hattery said.

It is important — again the repay the debt for the privilege of practicing medicine — to "teach and mentor," he said.

Besides focusing on professionalism, the RSNA this year is giving more play to informatics.

After almost 20 years of being grouped in a special infoRAD area, this year's informatics demonstrations have been integrated with the rest of the electronic and hard-copy education exhibits and posters in a newly redesigned center."

Practicing radiologists will benefit from making good informatics choices and implementing integrated solutions through knowledge enhanced by participating in the activities in the new and friendly Lakeside Learning Center," said David Avrin, MD, PhD, professor of radiology, adjunct professor of biomedical informatics and chief of body imaging in the Department of Radiology at the University of Utah. Avrin is chair of the RSNA Radiology Informatics Committee.

"Informatics is the key to workflow, and good workflow is the key to running an efficient imaging practice," said Avrin.

David Mendelson, MD, a member of the Radiology Informatics Committee, said attendees will find that clinical informatics exhibits, when relatively mature and specific to an organ system, have been integrated into the exhibits of that organ area.

"RSNA is trying to integrate informatics as much as possible by featuring demonstrations with specific clinical applications within the relevant organ areas at the meeting," he said. "We are trying to present these technologies as part of the mainstream."

As for informatics exhibits not tied to a specific clinical area or in a more embryonic form — including trends in image processing and analysis, as well as decision support and workflow topics and new technologies in development — they are subspecialty "spokes" in the new "wheel" layout of the center. Integrating the Healthcare Enterprise (IHE) and a new National Cancer Institute showcase will occupy space on the perimeter of the center, along with classrooms for how-to workshops.

IHE is demonstrating its Cross-enterprise Document Sharing for Imaging (XDS-I) and Teaching File and Clinical Trial Export (TCE) integration profiles that offer standards-based solutions for sharing medical images and reports across care sites defined by IHE.

Developed nine years ago by RSNA and the Healthcare Information and Management Systems Society (HIMSS; Chicago), IHE seeks to improve patient care by standardizing the way health systems exchange information. Fields such as cardiology, eye care, laboratories, patient care coordination and patient care devices have joined IHE.

The IHE demonstration at RSNA 2006 is one of more than a dozen presentations, some being held at meetings of the American Academy of Ophthalmology and Society for Cardiovascular Angiography and Interventions.

Also part of the informatics demonstrations this year will be RadLex, an RSNA initiative aimed at developing a comprehensive radiology lexicon, and RSNA's Medical Image Resource Center (MIRC). The goal of MIRC is to enable the information generated by radiologists to be used for education and research.

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