RSNA2023 Leading Through Change
Daily Bulletin

Leveraging History to Prepare for the Future

Monday, Nov. 27, 2023

By Nick Klenske

'History never repeats itself, but it does often rhyme' is a quote often credited to Mark Twain. But regardless of the saying's origin, the notion touches on the point that while we may view today's events, discoveries and circumstances as being unprecedented, upon closer examination, one will likely find that everything has some historic precedent.


Radiology is no exception.

"Whether we realize it or not, radiologists often grapple with issues that have already occurred in the past," said Howard B. Chrisman, MD, president and CEO at Northwestern Memorial HealthCare in Chicago. "While these issues may not be identical, they certainly have a rhyming nature."

Speaking during Sunday's opening session, Dr. Chrisman noted that historic parallels can provide an opportunity for radiologists to learn from the past and better prepare for future change.

"Radiology is at an inflection point as new technologies and AI in particular rapidly transform our field," he said.

While the nature of this disruption and change can be uncomfortable, radiologists must ultimately be ready to embrace it.

Evolving Is Radiology's Superpower

The good news is that, thanks to experience, radiologists are well-positioned to successfully navigate change.

"Before we were even a specialty, people who worked with X-rays were referred to as being 'irrational,' 'irritable' and 'prone to mental disturbances'," Dr. Chrisman joked. "Yet despite this start, the fact that we are all here today is proof that we've been able to persist and that we will continue to persist."

Dr. Chrisman said that the secret to radiology's staying power is its ability to evolve.

"While history shows that change is often disruptive, I believe radiologists are well-prepared thanks to our agile nature," he said.

Today's AI is Yesterday's PACS

During his presentation, Dr. Chrisman highlighted several examples of how radiologists can leverage historic parallels to think about AI and adapt to change.

One of those examples is the advent of PACS. As Dr. Chrisman said, prior to PACS, radiology was the hub of the hospital.

"I'm sure many of us remember the days when physicians brought their images to a central room to examine and discuss alongside radiologists—it was a very social process," he recalled.

But then came PACS and everything changed.

"We were essentially the first specialty to be digitized," Dr. Chrisman said.

While this change fundamentally transformed radiology, with many even predicting the practice's imminent extinction, radiologists leveraged this new technology as a means of providing even better service.

According to Dr. Chrisman, today's AI is yesterday's PACS.

"There's no shortage of people who say AI will make radiologists irrelevant, but I believe our history says otherwise," he said.

While there's no denying that AI will have a profound impact on how radiologists practice medicine, Dr. Chrisman is confident that there is no specialty more prepared to deal with change than radiology.

"Change creates a lot of emotion, but the one emotion we shouldn't have is fear," he concluded. "Just as was the case with every technology that has come along since the X-ray, AI will be another extension of our expertise—one that allows us to practice better medicine."

Access the presentation, "History Never Repeats Itself, But It Does Often Rhyme," (S6-PL01B) on demand at