10 Questions with Carolyn C. Meltzer, MD

1. Please state your name, title and the organization you work for. 

Carolyn C. Meltzer, MD, FACR. I serve Emory University School of Medicine as the William P. Timmie Professor and Chair of Radiology and Imaging Sciences. I also hold secondary appointments in the departments of neurology and psychiatry and behavioral sciences.[[{"type":"media","view_mode":"media_crop","fid":"53403","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_945276674058","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"6672","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 214px; width: 170px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"Carolyn C. Meltzer, MD ","typeof":"foaf:Image"}}]]

2. How did you get where you are today?

My rather serpentine career path has been chock full of missteps, detours, and (initially) unsuspected opportunities. Most importantly, I had great mentors who generously gave back (which is one of the reasons I have grown to be passionate about mentoring and professional development). I was fortunate to receive a terrific pre- and post-graduate education at Johns Hopkins University School of Medicine before heading to the University of Pittsburgh where a new PET Research Center had just opened. A fulfilling decade there gave me the opportunity to pursue NIH-funded research with some very smart colleagues, evaluate the first combined PET-CT scanner, and eventually oversee the radiology department’s research mission as well as the neuroradiology division. While it was difficult to leave Pittsburgh, heading the call to join Emory opened up many more experiences and the privilege to lead a highly collaborative and growing department during a time of great change. 

3. Why did you choose your profession?

Initially interested in brain science, I spent time early in my career with imaging scientists. The opportunity to observe closely the first human brain PET studies of neuroreceptor systems was quite exciting for me as a first-year medial student. Once I more fully discovered the inherent innovation and power of radiology for early diagnosis of disease and supporting patient care/health, I was hooked.  My dual focus on neuroradiology and nuclear medicine allowed me to understand the value of multimodality imaging technologies to evaluate brain-behavior relationships.

4. What is your biggest day-to-day challenge? 

Ah! My biggest day-to-day challenge is keeping up with the many and rapidly changing demands of a very large clinical enterprise spread across seven hospital sites, while maintaining a balanced perspective of all of our missions. Fortunately, I have had the sense to recruit faculty and staff leaders who are uniformly smarter than I am and thus the department has greatly benefited from a strong team of proactive and well-aligned servant leaders. As our system becomes larger and more widespread, clear communication is increasingly essential to optimizing our operations.

5. What worries, if any, do you have about the future of radiology? If none, where do you think the field is going?

I am very optimistic about the future of radiology. While commoditization risk remains, this has been dissipated by our field’s continued emphasis on optimizing utilization and on fully delivering on the value of our expertise as critical members of health care coordination teams. Efforts to grow clinic-based procedural practices, to communicate directly with patients, and to offer hospitals 24×7 services are examples of value-based radiology.

6. What one thing would make your job better?

I believe I am not alone in longing for truly integrated and user-friendly information systems that will allow us to optimize our workflows, allow real-time interactive communication with collaborators and patients, and package and deliver extensive data into situation-specific knowledge. The promise of informatics is tremendous and accomplishments to date are very exciting, yet most of our health systems rely on offline cumbersome EHRs that have fallen short of our expectations.

7. What is your favorite thing about radiology?

The constant innovation in technology and approaches makes our field particularly exciting. It also is likely the reason why we tend to attract professionals who embrace positive change and constantly seek better ways to improve diagnostic accuracy, more specific approaches to treatment monitoring, and novel image-guided therapies.

8. What is your least favorite thing about radiology?

Our lack of success in attracting diversity – both women and under-represented minority candidates. For example, while women make up approximately 50% of medical students across the US, they only represent about 27% of our residents, fellows, and faculty. We must address the reasons we are not successfully accessing the broadest range of talent, a necessary component of excellence in assembling the strongest possible workforce for the future.

9. What is the field’s biggest obstacle?

The development of PACS allowed radiologists to interpret diagnostic images with greater efficiency than previously possible. Yet, an unintended consequence has been the overemphasis on rapidly interpreting large volumes of imaging studies, an activity that robs our attention from non-interpretive portions of clinical imaging. The image of the radiologist, with eyes glued to a monitor, is not the best advertisement for students considering our specialty. 

10. If you could give the radiology specialty one piece of advice, what would it be?

Embrace the future. A rapid pace of change due to health care reform, market forces, and health system consolidation can be tough to adapt to but there are many opportunities to amplify our role in patient care. Payment reform will continue to move us from a fragmented fee-for-service system, to one in which care coordination and doing the right exam at the right time will be rewarded by both improved patient outcomes and optimized financial performance.

Gains in informatics and artificial intelligence promise to streamline the radiologist workflow and perform accurate analyses of routine examinations (eg, ICU portable chest radiographs).  This will free us up to spend more time on value-added elements of patient care, innovation, and training. And, to harness all of the patient’s health information along with their imaging data to help manage long term outcomes.

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