The patients have certainly changed over 45 years as a radiographer (and counting)

RAD Magazine must have been five years old when I qualified. I have been a diagnostic radiographer for 16,582 days as of today (April 29, 2025). To be honest, I thought it was longer; it certainly feels longer than that.

I am now semi-retired, working part-time as member of a community team of radiographers in north Liverpool. I have had the most amazing and varied career, including being a leader and manager as well as working for NHS England, and I have now come full circle doing the sort of radiography that I started out to do all those years ago: plain x-rays, primary imaging, general x-rays… whatever label you want to put on it. The bread and butter of radiography.

I was going to write about the changes I’ve witnessed over the years, but these are well known and well documented. So, having returned to clinical radiography after a couple of decades, I sat and thought about other aspects of the job, some of which have changed for the better, and others not so much.

I was relieved to see that centring points were exactly the same, thank goodness. I only had to get to grips with the digital technology, which quite frankly made my life a breeze. No more did I have to repeat an examination due to poor selection of exposure factors.

Language has changed to a point. We no longer have focus film distance – instead we have source image distance; that makes sense even to me. No films – so why is the term ‘plain film’ often still used?

We have gone from the old adage of ‘nobody ever died because of the lack of an x-ray’ to ‘nobody gets a diagnosis without having some sort of imaging’, and in so many cases every type of imaging there is, whether it is needed or not. Hence the ever increasing numbers of referrals that incessantly turn up.

Which brings me to something that has not changed or improved over the last 45 years: the quality of the referrals; Despite IR(ME)R, RCR guidelines, protocols, etc, etc, etc, they are still rubbish. Well, they are in the community and, yes, I know if they’re unjustified we cancel them but this entails having long and involved conversations telling patients that their GP or referrer has not bothered to provide us with the relevant information. I mean come on, ‘vague pain in lower leg. Nil on examination’. Oh, please.

But in my recent experience patients have changed. Many are much more knowledgeable and they come prepared. No longer do we have to spend half an hour helping elderly ladies divest themselves of their oversized corseted upholstery. Oh no, our ladies attend ready for action: sports bras and leggings are not just for the gym and not just for the super-fit. In fact, most of our patients now attend in what they believe to be suitable attire for their x-ray… some even get it right.

And so, 16,582 days after I first qualified as a radiographer, I am still here singing “breathe in… hold your breath… breathe normally now”, just as I did when I started all those years ago. And you know what? I love it. I still get the greatest satisfaction in producing great images and can be seen raising my arms in the air just like I did when Liverpool won the Premier League on Sunday.

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