Nuclear Medicine – The Last 30 Years

Robert E. Henkin, MD, FACNP, FACR
Professor Emeritus of Radiology
Loyola University Medical Center

As I look forward to retiring from active clinical practice I reflect on the thirty years I’ve spent in nuclear medicine. Actually, closer to 35 years, but I spent thirty of those years at Loyola. I entered nuclear medicine just prior to the formation of the ABNM. Jim Quinn convinced us that there would be an American Board of Nuclear Medicine and that it was okay to be a nuclear medicine resident. He assured us that there would be jobs for us and that there would be a bright future. Strangely enough, I hear the same reservations today from the nuclear medicine residents that I heard form our group over thirty years ago. Yet we have had a successful career, a great run and a good time.

When we took the Hippocratic oath we swore among other things to render the best patient care we knew how, to do no harm, and to teach our skills to those who would follow us. There was nothing in the Hippocratic oath about relative value units, payment classifications or salary. Further, there is nothing about territorial issues, about turf battles, nor about anti-trust laws. All of those things have crept into medicine and have tended to corrupt and undermine the Hippocratic oath.

One of the most important things to keep in mind is that every day you spend as a health care professional it is your task to take care of patients. You should take care of patients the best way you know how with the best resources you have available. Your patients deserve the best you can do for them. Sometimes that involves conflict with your hospital administration or with outside parties who think they control the quality and payment system. We are the patient’s advocate. Failure to advocate for your patients is a violation of your obligation to the patient.

Nuclear medicine is unlike any other medical specialty, it is a true team approach. Our team includes basic scientists, physicians, and technologists. However, there is a member of our team that is rarely recognized. That member is industry. Nuclear medicine could not exist without its industrial partners. We may have ideas, we may have protocols, we may have patients, but only the industry can provide us with the tools to care for the patients. In no other medical specialty that I have noted does industry play has such a central and integral role. The failure to recognize the role of industry in the practice of nuclear medicine will cause progress to cease. All of the conflicts of interest not withstanding, a close alliance with industry is important for our future.

People often referred to the time that I entered Nuclear Medicine as the “Golden Age of Nuclear Medicine.” I don’t view it that way. I think we are entering the Golden Age of Nuclear Medicine now. The number of diseases we can successfully treat and impact is increasing. We have patients surviving today with various diseases who have failed forms of therapy other than nuclear medicine. We have bettered patients’ lives who were suffering in pain and in many cases they can live a normal life until their disease progresses. We have identified patients at risk of heart attack and led to interventions that both prolonged their life and improved the life they lived. In many other instances, we have discovered life-threatening infections that were not found by other modalities. Most of the things referred to above were not possible in the “Golden Age”.

People ask me then “Why are you retiring?” There is never any one single reason for a person to change the flow of their career. I am retiring from active clinical practice, not from life. Neither am I retiring from nuclear medicine. There are changes in medical practice which are in conflict with my ethical beliefs about how I can practice as a physician. Some of them have no resolution at the present time. As long as I am in clinical practice, I will be unable to deal with some of those issues. Hopefully, once I leave active clinical practice I will be able to voice some of those issues clearly and perhaps lead to some changes with regard to how we care for patients. Organized nuclear medicine is vital to the continuing growth of our specialty as well as for our education. I hope to remain active in the chapter and SNM. I look forward to seeing many of you at future meetings. I think of all you as part of our larger family of nuclear medicine.

I wish you well in all your endeavors.

Robert E. Henkin, MD, FACNP, FACR

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