A brief economic history of radiology.

The authors present a historical review of radiology reimbursement, including the effects of health care legislation and court decisions. The political leadership of the American College of Radiology is detailed. Changes in the delivery of health care will alter the practice of medicine.

Radiology and the courts: the first 100 years.

The authors examine the impact of legal decisions over the past 100 years on the practice of radiology. Eleven cases are reviewed that have national implications for radiology. Five themes emerged. (a) Radiology is a medical service, to be billed as such, rather than a hospital service. (b) Physicians and their organizations are subject to federal antitrust laws and regulations. (c) Applicability of state regulations to radiology practices depends on legislative intent and actual circumstances. (d) Hospitals and physician groups are entitled to make exclusive contracts for valid business purposes. Radiologists losing such contracts are entitled to due process before being deprived of staff privileges. (e) Physicians practicing in managed care plans remain liable for untoward patient results of adherence to plan protocols even if conformity to those protocols is a requirement for participation. As the practice of medicine becomes more complex, radiologists face additional legal challenges fashioned for a business environment.

Compensation of radiologists.

The compensation of radiologists for professional services to patients has shifted in the past half century from a strong reliance on hospital billing and payment to a pattern of financial independence of radiology groups. The laws and regulations creating the Medicare program were instrumental in spurring the transition for many. With the advent of managed care programs, employer self-insurance for health costs and pending state and federal health reform efforts, radiology compensation patterns are likely to undergo further changes to make them compatible with new payment mechanisms.

Dr Henry Garland: the man, the myth, the legend, and the legacy. Garland Lecture from the 1991 California Radiological Society meeting.

In a century of American radiology, a relatively small number of radiologists have emerged as unquestioned leaders of the specialty. One of those was L. Henry Garland, late of San Francisco, whose multifaceted accomplishments and vigorous personality made him a significant contributor to advances in radiology during 3 decades. The Garland family has endowed an annual lecture at the meeting of the California Radiological Society. This essay is taken from the 1991 lecture, which was an assessment of Garland's significance.