Radiology in Greece has followed the rapid technological evolution experienced by other European countries, despite the financial constraints of the recent times. Social security funding is under heavy pressure and reimbursement policies are facing cutbacks. Nationally, diagnostic imaging, which includes all imaging modalities, sales and services, is worth almost 200 million euro a year in business terms.
Scans themselves are relatively inexpensive. While prices on different imaging modalities vary widely, a typical PETCT scan might cost 1,100 euros, while an MRI would cost 280 euros and a CT scan would cost 75 – 130 euros according to official reimbursement public lists. Regarding installed imaging systems, the private sector owns the majority of these. For instance, 76 percent of CT units, 84 percent of mammography units and 86 percent of MRI units are installed in private health service institutions. According to the OECD, a considerable increase in available imaging systems was noted during the last decade.
Specifically for 2005, there was an official recording of 25.8 CT units per million inhabitants (compared to 20.2 in the other OECD countries) and respectively 13.2 MRI units per million inhabitants (compared to 11 in other OECD countries). It is a fact that this number today is considerably higher. In addition, it should be mentioned that relatively recently there has been a tendency among all radiological departments in the country toward progressive digitalisation.
Hellenic Radiological Society
The Hellenic Radiological Society is the official educational and scientific association of Greek radiologists. It was founded in 1933, and its purpose is to promote and develop the highest standards of radiology, and to exchange scientific information in all fields of radiology and related sciences through education and research. The society is governed by the President, the Executive Board, and the General Assembly.
The society publishes the Hellenic radiology journal in quarterly issues covering all technical and clinical aspects of diagnostic imaging and intervention. Greece leads Europe by a wide margin in the number of doctors per capita. In addition, it should be mentioned that recently there has been a tendency among all radiological departments in the country toward progressive digitalisation.
Education of Radiologists
Radiology is the domain of board-certified doctors in Greece. Radiologists are trained for a total period of five years, which covers all sectors of imaging and interventional techniques. Training is provided by certified state and university hospitals. For the acquisition of the title of specialist, written and oral examinations are required, held by three-member state committees of evaluation after the completion of five years of training, during which a specific number of procedures and radiological examinations must be completed.
The Supreme Scientific Organisation of Greece recently recognised the subspecialties of interventional radiology and neuroradiology, which will be practiced in specialised centres. The total number of doctors in Greece is estimated at approximately 64,000. Of those, 11 percent are unemployed and 14 percent are part-timers. The total number of certified radiologists runs to 1,800, while the total number of radiologists in training is approximately 500. In Greece, radiotherapy and nuclear medicine are distinct specialties, separate from radiology.
In every radiological department of the public health system, there is a director or chairman that leads the team, a range of consultants of the various subspecialties and modalities, as well as radiologists-in-training. Radiologists serving in the public hospitals are full-time, with the right to see private patients in the hospital during afternoons. Academic, military, and radiologists appointed by insurance institutions have the right to practice private medicine. Greek radiologists have representatives among the elected members of European scientific societies, including the ESR, ESGAR, ESUR, CIRSE, MIR, the ESSR and others.
Tight Budgets Limit Imaging Growth
Diagnostic imaging is one of the stand-out success stories of modern medicine, in Greece as elsewhere. However, in recent times it is now under pressure from tight healthcare budgets and from professional competition. Imaging is one of the pillars of modern medicine, halfway between art and science and comprises two parts: the technical and the clinical; numbers and equations and evidence-based medicine.
Besides what technology tells them, radiologists must trust their eyes and rely on their visual perception, their memory and their cognitive processes. Imaging is the fastestgrowing component of physician services in Greece. The possibility for over-utilisation in imaging technology is one of the main concerns expressed in government healthcare policies and a major challenge for the future, in the costcontainment movement which must surely lead future developments in modern medicine.