Who needs high technology? Presidential address 1983

The strength of the Institute lies in the way in which it provides a forum in which different disciplines, including industry, can generate new ideas and discuss new developments. Two successful diagnostic meetings which occurred not very far apart were responsible for the choice of subject for this address. First, there was an excellent day organised with the Hospital Physicists' Association on digital imaging, and then, a month or two later, a stimulating evening meeting organised by the late Sir Howard Middlemiss on radiology in underdeveloped countries. At this meeting, reported in the present issue of the Journal, speakers from the World Health Organisation described a simple Basic Radiographic System capable of being used by health workers with very little training in surroundings with limited facilities. The juxtaposition of these two meetings, looking to the future in such different directions, led naturally to the questions—Who needs high technology? And how much? Where is diagnostic radiology going? Diagnostic radiologists use expensive machinery which is increasingly the target of epidemiologists, health economists and health care research workers, who see large sums of money being spent on equipment, the benefit of which to patients is by no means always obvious. It is not surprising that at a time of rapidly decreasing resources our professional judgement about the need for imaging having an increasingly large slice of the cake is rightly called into question.