Training standards and imaging: will these have any impact on turf wars affecting radiologists?

In the current issue of the Canadian Association of Radiologist Journal (CARJ ) you will find an article on training standards for reading coronary computed tomographic (CT) angiograms. This article was prepared jointly by Canadian radiologists and Canadian cardiologists, and will be published in the journals of both specialty societies. This article represents a collaborative effort to deal with a subject that is often viewed as a potential significant turf war. Over the last 20 years, turf issues have loomed large in the radiologic world, and much concern has been expressed that other specialties are ‘‘stealing away,’’ in a piecemeal fashion, the most advanced aspects of diagnostic imaging, while neglecting to incorporate a ‘‘best use practice’’ based on a multimodal imaging approach to disease. For example, interventional radiologic procedures have been encroached on by both vascular surgeons and cardiologists, and occasionally by other specialists as well. These actions have elicited a variety of responses from radiologists that ranged all the way from complacency and/or resignation, to aggressive reactive and proactive actions. Despite the desolation, opportunities still exist to win turf back, as has been the situation with regard to CT coronary angiography. There are a variety of reasons these turf battles take place, and it would be specious to say that remuneration and income issues were not among them. Although this is obviously a concern for Canadian radiologists, it is critical that we remember that, to defend our integrity as respected physicians, in the final analysis, we must be sure that whatever we do ends up being in the best interest of the patients that we serve. It is critical that we be certain that we can provide high-quality diagnostic and interventional services to these