It takes a certain type of person to chal- lenge the status quo. It takes a truly exceptional person to make the status
quo a thing of the past.
Dr. Charles Dotter was blessed with
both keen intelligence and a tremendous
innovative spirit. His work, which includes
performing the first percutaneous transluminal angioplasty 50 years ago this year, transformed the field of medicine. The effects are
still felt by physicians and patients today.
“His work laid the foundation for all of
the continuing evolutionary – and sometimes revolutionary – work with imaging
guided minimally-invasive procedures that
improve patient care,” says Dr. Scott C. Goodwin, president of the Society of Interventional Radiology.
Dr. Dotter’s contributions to the field of medicine are both numerous and
significant. The development of the double-lumen
balloon catheter, the safety
guidewire, arterial stenting,
and thrombolysis, says Dr.
Goodwin, are just a few notable examples of Dr. Dotter’s
To fully understand Dr. Dotter’s impact, one must recall that he lived
and worked in an era of surgery where the terms “invasive procedure” and
“open procedure” were more or less synonymous with one another. In
the decades to follow the 1960s, Dr. Dotter’s work allowed for minimally-invasive interventional radiology treatments to overtake open surgery as
a preferred method of treatment for many disease conditions – minimally
invasive techniques are now used by many different medical specialties.
Since then, the minimally-invasive approach has had a tremendous impact
on the safety and efficacy of various surgical procedures.
“If you look at the entire history of interventional radiology, it all
started with Dotter,” says Dr. Goodwin, Hasso Brothers’ Professor and
chair of radiological services at the University of California Irvine (UCI)
School of Medicine. From conducting the first angioplasty to developing catheters out of Teflon tubing, Dr. Dotter consistently worked
to transform the practice of medicine. His accomplishments speak to
his legacy as the father of interventional radiology, but it is Dr. Dotter’s
dogged pursuit of all things “new” and “better” that speaks to his legacy
as an example for the healthcare professionals of today.
Modern Innovation In Medicine
Interventional radiology is one of the most dynamic medical fields;
interventional radiologists adapt a technique proven to work for one
problem and find a way to apply it to another. Opportunities are seized
and challenges are overcome once innovative ideas are developed into
products and solutions. Dr. Goodwin says he believes the number of
individuals generating ideas is larger than ever before in the history of
medicine. However, he notes, it is more difficult to seize viable opportunities and overcome difficult challenges in product development than it
was during Dr. Dotter’s day.
“It simply takes a lot more time and a lot more funding to follow all
the rules that are required to investigate something and bring it to the
marketplace,” says Dr. Goodwin.
“There’s also a lot of pressure on corporations to be profitable in the
relatively short term,” he continues. “You see downward pressure on big
investments and research and development for long-term projects, not
only in interventional radiology and medicine, but in the overall innova-
The healthcare industry is heavily regulated, much more so than
it was during in the mid-to-late 1960s. This has been a significant –
though not insurmountable
– hurdle to innovation. Further-
more, any time a new and dis-
ruptive product is introduced,
there is almost always some
resistance to it.
“If something new comes
along, you’ve got the early
adopter group,” says Dr. Goodwin. “They jump on board right away.
Then you’ve got those individuals who join gradually and late adopters. I would say overall, and perhaps more in the United States than in
Europe or other parts of the world, medicine as a whole does not move
Efforts Over Achievements
Efforts to innovate can be quite challenging in the modern healthcare industry landscape. They take time. They require patience. More
than anything else, forward-thinking individuals need to recognize their
efforts to innovate may result in failure. But the potential to improve
healthcare and potentially save lives is more than worth the risk.
It has been five decades since Dr. Dotter performed the first percutaneous transluminal angioplasty, and quite a bit has changed in healthcare over the course of those 50 years. That is due to the successes and
contributions of innovators like Dr. Dotter, but also due to the passion
of countless, less heralded innovators who – like him – never stopped
striving to develop all things “new” and “better.”
Efforts to innovate can be quite challenging
in the modern healthcare industry landscape.
They take time. They require patience.
They could fail.