No Time for Resting on Laurels: Elliot Fishman, M.D., Named Nation’s Top Radiologist
Recognition for a job well done may be par for the course in some industries, but it’s an iffy proposition in the just-get-it-done, patient-centered world of medicine. So when such recognition does come — and when it comes very publicly and from one’s own peers — it doesn’t get much better than that.
ACR member Elliot K. Fishman, M.D., should know. In April, the 54-year-old luminary was named the “top radiologist” in the nation by Medical Imaging. The survey of some 600 radiologists assessed candidates based on their current research, patient care and outcomes, and industry interaction.
The honors didn’t stop there. The second annual “Cream of the Crop” awards chose, as the nation’s best radiology department, the Russell H. Morgan Department of Radiology and Radiological Science of the Johns Hopkins Medical Institutions — where Fishman is professor of radiology and oncology and director of diagnostic imaging and body CT.
ACR Daily News Scan recently sat down with Fishman to discuss his career highlights, which include pioneering work in 3-D medical imaging, early collaboration with the forerunner of Pixar Inc., and development of an award-winning radiology Web site (www.ctisus.com), today believed the world’s largest radiology site. These and several other initiatives clearly demonstrate that Elliot Fishman isn’t one to rest on his laurels.
Fishman says he’s honored to receive the kudos but is also circumspect. The discipline of radiology, he declares, is filled with dedicated individuals, many unsung. If recognition is due, he insists it go to the approximately 40 hardworking Hopkins radiologists who have built — and built brilliantly — on the shoulders of giants.
Fishman’s track record over the last 27 years may be replete with outstanding clinical work, education, and discovery, but he humbly deflects praise. “I really followed in the footsteps of Stanley Siegelman, M.D., one of the ‘gods’ of CT. At Hopkins, we’ve always had (and have) great people and incredible leadership. Ultimately, CT — like all cutting-edge radiology — is expensive. Hopkins has been very good about giving us the latest technology, which has helped keep us on the cutting edge.”
Fishman cites a host of motivators that drive him upward: Hopkins’ rich tradition, his department’s passion for excellence, a powerful synergy among his colleagues, and his own insatiable curiosity. And, he identifies the mysterious X factor as this: “My work is a lot of fun. But I never tell people that, or they’ll cut my salary or something!”
The Brooklyn native (and Yankees fan) arrived at Hopkins in 1980, and by the mid-1980s, began working in 3-D medical imaging. He characterizes the state of the art back then as “pretty limited.” Looking around, Fishman approached and began partnering with Pixar Image Computers (and later, with Siemens), where a cadre of elite researchers was doing seminal work on computer visualization using ultra-fast proprietary computers. Fishman’s contribution was to help Pixar adapt its massively complex technology to the medical front. Ultimately, Pixar shifted its focus away from medical computing, but its groundbreaking work opened the door for a host of scientific revolutions. In time, Pixar would enjoy tremendous commercial (and critical) success making such movies as Toy Story, Finding Nemo, and Cars.
Recalling those halcyon years of around-the-clock work, Fishman says, “The people at Pixar were the smartest people I’ve ever worked with, anywhere. I’m talking 11 over 10 — just incredibly unbelievable.” But he reserves his warmest praise for Pixar CEO (and Apple Computer founder) Steven Jobs. “He is a remarkable visionary and also one of the most charismatic people I’ve ever met.”
“One of the highlights of my career,” he continues, “was giving a named lecture at Stanford University. Steve came to my one o’clock lecture on 3-D imaging, which I’ll never forget. I figured I’d be speaking to radiologists, so even if I was wrong on some technical point, they might not know the difference. But with Steve there, I realized that if I made a mistake … ‘Oh, my God, if I say something wrong, he will definitely know.’”
Flash forward 20 years. Today from his vantage point at Johns Hopkins, Fishman is enthused about radiology’s new focus on combined anatomic and physiologic data. “I see a lot more of CT obviously being used in the operating room to guide procedures, as well as interactive surgical planning,” he says.
Looking to the future, Fishman sees low-dose CT rising in prominence. “This radiation issue really concerns everybody — it concerns me. We need to get the dose down. What I see five years from now are scanners running 10 percent of the dose — now done basically in a single heartbeat –- with a resolution of classic angiography in the 2-mm range. We’re talking about 5,000 to 10,000-slice data sets, with the information being generated in true 3-D from the start.”
Fishman’s award-winning Web site today boasts more than 100,000 images viewed by more than 50,000 medical professionals. Here, visitors find 200 podcasts and vodcasts of Johns Hopkins lectures, scanner protocols, a “quiz of the month,” information packets — even an animated “coffee break” that tests radiologists on their mastery of pop trivia. “All of it is free to users,” Fishman notes.
By working 100-hour weeks, Fishman also manages to run Hopkins’ CT CME programs. He even earmarks some of his earnings to fund his Web site’s operational costs. “I think that’s sort of our contribution to radiology worldwide,” he says.
Through it all, Fishman somehow maintains a busy clinical schedule. He is reluctant to discuss his workload, but when pressed for details, says with a hearty chuckle, “I do as much clinical work and generate as many RVs as anyone in the department and work more than half the weekends in a year.”
At a time when many radiologists express concerns about the profession’s future, Fishman is bullish. “I think there has never been a more exciting time to be a radiologist, there’s never been a time with more opportunity, there’s never been a time of more change. The opportunities for discovery and moving the field forward have never been greater. For students just leaving medical school and looking for the field that has unlimited potential, radiology offers so much. I probably work longer hours now than I ever worked, but to me, it’s my hobby.”