Type:
Audit/Professional Issues
Keywords:
Professional issues, Audit and standards
Authors:
A. Mahajan; Mumbai/IN
DOI:
10.1594/ecr2010/C-3252
Results
There has been a slow but steady decline in the number of barium studies performed in the India during the past 15 years.
The major decline seen was in enema studies and meal studies. Surprisingly there was a slight increase in the number of swallow studies.
The reason is variety of factors, including the ever-increasing accessibility of endoscopy and sophisticated cross-sectional imaging modalities such as CT and MRI.
The dedicated small bowel follow-through has been replaced to a lesser degree by abdominal CT and, more recently, by CT and MR enterography and capsule endoscopy. Finally, the double-contrast barium enema has increasingly been discarded in favor of colonoscopy, abdominal CT, and, most recently, CT colonography for lower GI symptoms and colon cancer screening.
The decreased number of barium studies performed in the india has contributed to a vicious cycle in which GI fluoroscopic procedures are adversely affected. As radiologists perform fewer barium studies, it has become increasingly difficult for them to maintain the fluoroscopic skills required for high-quality studies. It also has become increasingly difficult to train radiology residents, as there is no substitute for experience and performing a large volume of studies when learning these procedures.
The decline of barium radiology has had other ominous repercussions for training radiology residents the art of GI fluoroscopy. In many if not most residency programs, there no longer is any one individual with the interest and expertise needed to oversee the GI fluoroscopy service and to take responsibility for teaching residents the nuances of barium radiology.
The lack of interest in or enthusiasm for GI fluoroscopy by teaching faculty in training programs has also resulted in a lack of role models who might instill in trainees a genuine passion for this technology.