O Fortuna

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Reflecting on 2008, I can think of a no more apt description of the year just past, than the poem O Fortuna from the early 13th century collection of Latin verse, Carmina Burana.

Admittedly, our economic woes have more to do with man's avarice than the whims of the aforementioned Fortuna, goddess of fortune in Roman mythology. Regardless, the result is the same and undoubtedly will influence how our policy makers fund and regulate the Canadian health care system in the months and even years to come.

It is not just the economy that is making news. The political climate both in Canada, with the paroguing of Parliament, and in the United States, with the election of Barack Obama, is extraordinary. Under these circumstances, the Canadian Association of Radiologists Journal (CARJ) thought it would be of interest to look at the current state of our respective health care systems. For the American perspective, I am very pleased that Dr Bruce Hillman, editor of the Journal of the American College of Radiology, has accepted the CARJ's invitation to provide his assessment (p 6).

Dr Hillman is most qualified to do so as chair and principal investigator of the American College of Radiology Imaging Network, member of the American College of Radiology (ACR) Board of Chancellors, and a Fellow of the ACR. Dr Hillman has authored or co-authored more than 145 studies appearing in every major medical publication. In addition to being the editor of the Journal of the American College of Radiology, he is a former editor-in-chief of Investigative Radiology and Academic Radiology. He is a recipient of the George C. Marshall Memorial Fund Fellowship, the John A. Hartford Foundation Fellowship, and a Pew Memorial Trust Fellowship honoree.

Dr Greg Butler, CAR representative on the ACR Board of Chancellors, previously has written on the Canadian perspective for the ACR journal. We are grateful for permission allowing the CARJ to republish an updated version so that it could reach a larger Canadian readership (p 11). He, too, is eminently qualified, having served in many Canadian and International radiology leadership positions. These include serving as an executive member of the CAR, President of the Nova Scotia Association of Radiologists, Board member of the College of Physicians and Surgeons of Nova Scotia, numerous committees of the Medical Society of Nova Scotia, Canadian Medical Association, CAR, CIRA, CRF, RSNA, and ACR. Dr Butler founded the precursor to the CAR committee on Teleradiology and PACS in 1996.

These also are exciting and challenging times for our society with the CAR having undergone significant change, which continues to evolve. In keeping with the political theme of this month's issue of the Journal, David Vickar, current President of the CAR, has written an article describing the CAR's new governance model (p 17). Many of you already know that there was not uniformity of opinion on the changes made, or even the need for them. Indeed, these changes have generated passionate, sometimes heated, but always healthy discussion. Such dialogue continues in the guest editorial by past CAR presidents, Drs Hammond, Fraser, and Lentle, on provincial representation in this new model.

Although there is much here to make us think, that is not enough. We need to be proactive and work with all levels of government through our national body the CAR and our provincial organizations to build the best health care system possible. In this quest, the CAR needs your support.

On a final note, I am sad to write I am reaching the end of my term as editor of the CARJ. In this issue you will find an advertisement calling for applicants. I strongly encourage you to consider putting your name forward, or suggesting possible candidates. It has been a remarkable and rewarding experience, one I am most fortunate to have had. But more on this in my next editorial! Until then, as always, I welcome your comments. I can be reached at coblentz@mcmaster.ca.