A look at the future of the health care system.

Payment systems are driving many of the changes in the health care system and those payment systems will continue to change in the years ahead. Cost containment pressures have already brought physicians and administrators together in efforts to reduce length of stay and diagnostic tests. Increased competition, fiscal restraints and prescribed patient care protocols will continue to influence tomorrow's physicians. Hospitals must find increased opportunities for physician participation in continuing education, management decision making, and business ventures such as development of ambulatory care centers, preferred provider organizations (PPOs) or health maintenance organizations (HMOs). Only by working together can physicians and administrators achieve their ultimate goal of providing quality health care that is also cost effective for both the hospital and the patient.     

Dental CT imaging: a look at the jaw

The jaw comprises two complex bony structures: the mandible and maxilla. Their curved or archlike configuration makes radiographic imaging difficult. Furthermore, the superimposition of dense teeth and roots may obscure underlying tissues, and streak artifacts from dental restorations often degrade computed tomographic (CT) images. Recently, dental CT reformatting programs that use thin transverse images of the jaw to reformat multiple panoramic and cross-sectional views were developed. Since images are reformatted, streak artifacts that degrade bone visualization at direct coronal CT are projected over the crowns of the teeth, permitting optimal viewing of bone. As a result, these programs have been successfully used to evaluate implants, cysts, tumors, and surgical procedures. They have created not only a new modality for viewing the jaw but also a new partnership between dentists and radiologists. Questions that cannot be answered in the dentist's office with conventional radiographs are now answered in radiology departments with dental CT scans. The objective of this article is to trace, with a series of examples, the effect that this imaging modality has had on radiographic evaluation of the jaw and to provide the reader with knowledge that should enable him or her to become more involved in imaging of the jaw.     

Motivation: a new look at an age-old topic

Employee motivation is a shared responsibility. An employee has to have some amount of intrinsic desire to perform a task. You can't create that desire. But, you can create an environment that brings out that desire, and allows an employee to shine. Abraham Maslow developed one of the most useful of all motivation theories--the "Hierarchy of Needs"--in the 1940s, and it is still the prevailing theory today. The Needs Hierarchy begins with the basic idea that only an unfulfilled need is a motivator. Or, in plain English, people perform specific actions to meet specific personal needs. Maslow defines five levels of needs that all people experience: 1: Physiological, Food, shelter, and yes, sex. 2: Safety/Security. No personal harm and the current lifestyle is safe. 3: Social. The need for acceptance by others, for belonging, friendship and affection. 4: Self-Esteem/Ego. Recognition, status and prestige. 5: Self-Actualization. Self-fulfillment and the need for achieving one's personal best. What makes this needs theory so interesting and so useful in the workplace is the clarity with which a position in the hierarchy can be determined. The basic premise is that lower-level needs must be satisfied before moving upward to the next level. Consider your own employees and what you know about them. Look at their situations, and evaluate where they may be in the hierarchy. Remember, it's difficult to separate their personal situations from their work personas. Try using Abraham Maslow as a starting point to identify motivations of your staff.     

A look at radiologic technology education.

Radiologic technology education has been progressing for the last 80 years; however, we have seemingly reached a plateau. Educators in the profession believe there is need for a change in direction due to demands of the manpower market and outside agencies. The direction radiologic technology educators should follow has been questioned, but no definite answer has resulted. With these thoughts in mind, a decision was made at the Duke University Medical Center to survey the nation and collect data to aid its particular problem, as well as to lend educational direction.