Automated Diagnosis: Rhetorics of Technical Change in Radiology

When new technologies are adopted into professional workplaces, the existing allotment of work tasks is often altered. How do professionals respond to such shocks? Radiology, a highly digitized, high-status medical specialty, has profoundly changed in response to the progressive digitization of its tasks. The field was first affected by the digitization of diagnostic image production, through technologies such as computerized tomography (CT). The widespread adoption of Picture Archiving and Communications Systems (PACS) digitized the diffusion of diagnostic images, allowing for rapid and remote retrieval and interpretation, but once again changing the allotment of tasks. Most recently, the structure of radiology has been challenged through the advent machine learning technology, which may digitize the interpretation of images themselves. Each successive technology has generated unanticipated consequences, opening space for challenges to radiological expertise from technologists, non-radiological clinicians, and finally, from machines themselves. How have radiologists resisted or adapted to such changes? Content analysis of a major radiological journal offers insight about both the effects of technological change and radiologists' strategies for resistance and adaptation. By analyzing the rhetorical repertoires and behavioral strategies that professionals use to respond to technical change within the workplace, we can better predict the effects of automation and design more effective responses.