Radiology and medicine – research or science?
very year at the ECR and other congresses, I hear what great science is presented. Frankly, though, there is very little hard science presented at such events but mostly technology and applied research, and they are primarily teaching, social, and commercial gatherings, not strictly scientific meetings.
Science, research, and technology aren't synonyms ...
and radiology isn't a science – nor is medicine.
Often there is a misunderstanding of the term "science," and this lies at the heart of the matter here.
Science is knowledge of the world of nature – the concerted human effort to understand, or to understand better, the history of the natural world and how it behaves and functions, with observable physical evidence as the basis of that understanding. It is done through observation of natural phenomena and through experimentation that tries to simulate natural processes under controlled conditions.
Research is as old as mankind: gathering of data, information, and facts.
However, contrary to the Latin word scientia, science did not originate in ancient times; it developed in its mature form only a few centuries ago. The word scientia is the root of the French or English word science, but originally scientia means knowledge: "Scientia potentia est" – "Knowledge is power" was Francis Bacon's maxim . Science and scientia were two completely different terms. The Oxford English Dictionary dates the origin of the word "scientist" to 1834.
Many historians suggest that modern science began around 1600 in the time and with the efforts of, for instance, Galileo Galilei, Johannes Kepler, and Francis Bacon. Their era punctuated the change from the scholasticism of the Middle Ages and Renaissance to science as we know it. Scholasticism largely involved deductive reasoning from principles supplied by Aristotle and the Bible.
Modern science instead involves induction from multiple observations of nature, and so works from basic observation or experiment to generalization. Francis Bacon and René Descartes helped to define science and establish the "scientific method":
"A method or procedure that consists in systematic observation, measurement, and experiment, and the formulation, testing, and modification of hypotheses."
Already in the early 19th century, the scientific disciplines were becoming well defined and increasingly separated in their methods and philosophies. Alexander von Humboldt attempted to unite all manner of natural phenomena to understand the heaven and earth, the whole universe. Few others have attempted such a grand undertaking. Throughout the 19th and 20th centuries, scientific disciplines increasingly subdivided into ever smaller and more specialized fragments.
Nowadays we distinguish the following groups of sciences:
Natural sciences, (the 'true' or 'hard' sciences) – the study of the natural world: astronomy, earth sciences, biology, chemistry, and physics,
Social sciences, (the soft sciences) – the systematic study of human behavior and society: sociology, psychology, anthropology, political sciences, and economics, and the
Humanities and Liberal Sciences, those branches of knowledge that are concerned with human thought and culture: philosophy, mathematics, history, literature, and art.
Different countries vary not only in their nationalities, their population, their cultures and attitudes, but also in their languages and in the understanding of terms and terminologies. Science or not-science is a question of academic schools and geographic regions. In contrast to the scientifique, científico, or wissenschaftlich character of the continental European academies of science, those in England and the United States were scientific in the stricter sense of the word, that is, usually limited to the natural sciences, the hard sciences, and excluding the social sciences and humanities.
Because pride and vanity, money and power – both political and individual – play a major role when it concerns science, everybody wants to be a great scientist, not only a simple researcher.
Medicine is not a science – it's sometimes described as an applied science, sometimes as an art or a craft. The medical Nobel Prize is called "The Nobel Prize in Physiology or Medicine." Physiology is considered a science.
Medicine always stood outside at the edge of science. Taking radiology as an example, Röntgen, a physicist, discovered x-rays in 1895, but he left the field in the year 1900. Lauterbur invented magnetic resonance imaging and many of its applications, but he never personally used the method in medicine. He was a chemist. Röntgen and Lauterbur developed the ideas, engineers turned them into routine technologies. Physicians – among them radiologists – use them. Using x-rays or magnetic resonance imaging doesn't turn the user into a scientist.
However, a physician can be a scientist; a scientist can also be a radiologist. Science today is becoming increasingly complex and diverse – which becomes visible in diagnostic imaging applications. Here the knowledge of physicians can be integrated into overlapping scientific disciplines. Yet, research and science are not synonyms. A phase-3 study of a drug or the addition of yet another eight channels to a CT scanner is no scientific highlight. Still, it can be solid and honest applied research. Why not be a good researcher and knowledgeable radiologist?
1. Rinck PA. Beyond the basics: Is knowledge power? Rinckside 1992; 3,2.