Frederick Kelcz, MD, PhD, FACR is set to retire in August, leaving behind an impressive legacy. Dr. Kelcz played a pivotal role in establishing magnetic resonance imaging (MRI) as a clinical screening tool and was among the first wave of physicians to advocate for MRI screening for breast cancer.
In answering the following questions, Dr. Kelcz shared reflections on his career as well as advice for young radiologists.
Why did you decide to pursue a career in radiology? Was there a specific moment that sparked your interest?
I was always a “technical” kind of guy; probably because my father worked as a biomedical technician and, off hours, as a television repairman (in times past when you could actually fix a TV in a shop). I became a medical physicist here at UW, under Professor Charles Mistretta and, after working four years as a physicist at Columbia Presbyterian (NYC), decided I wanted to become more involved in the medicine side of things where I could better appreciate WHY certain imaging devices were needed and how they interacted with the patients’ overall care.
What initially drew you to UW–Madison?
Madison had a great reputation in physics, which is why I first came here, then, as a radiologist, I recalled the strength of medical physics here in Madison, and so decided to come back to enjoy the area and the work.
What are some of the significant changes you’ve seen in radiology during your career?
When I started here as a fellow, we were still using film that had to be mounted on alternators the evening before. Then, if you needed a comparison film from 10 years prior, it was an immense, and painful task, to find that film.
I was also witness to an unappreciated advance in CT technology – in my first few years here, scanning of large patients meant doing only part of the body, waiting for the tube to cool, then continuing the scan. Our 3D CT reconstructions were very crude and are currently spectacular.
Finally, MRI, when I came was really in its infancy. I recall giving talks on liver MRI where I meekly had to suggest an MRI over a CT in the appropriate patient – no more. The program has been very successful.
Looking back at your career, what are some of your proudest moments?
I fostered growth of MRI in the abdomen and pelvis and initiated the breast MRI clinical and research program. After a poor initial reception of breast MRI by entrenched breast surgeons, I approached women’s groups, and the media, to finally convince patients to ask for MRI. Today, breast MRI is of great significance in screening high risk patients and in treatment planning.
I also fostered growth of the prostate MRI program and, after many talks with the Department of Urology, finally convinced them to purchase and utilize MR/Ultrasound fusion biopsy rather than depending on random biopsy for diagnosis. This resulted in doubling the positive results during prostate biopsy – makes sense, of course, when you know what is abnormal, you use imaging to obtain tissue from that area.
When I started at the UW, radiology imaging orders did not contain useful information to plan and to interpret studies – the argument was that the clinicians did not want to “bias us” in our interpretation. With the help of UW quality assurance, we distributed our arguments for providing clinically relevant information in all radiology imaging orders. We thought this would be an “easy ask” – but it was not…it took three years before UW finally accepted this approach.
What are some of your fondest memories of working at UW?
Living in Madison allows me to live close to and walk to work, a pleasant way to unwind after the workday. At work, clinical colleagues in abdominal and breast imaging have always supported each other, making for a great place to work. Living in Madison is pretty hassle free.
I recall, as a NYC-bred young man and a new physics graduate student, stepping off the airport shuttle, looking around and saying to myself, “I’m going to live here for 5 – 6 years?” But then I got into all the activities Madison offered and decided to make my life here. My wife, Sheryl, and I still very much enjoy the NYC life, but only to visit, taking advantage of the frequent direct flights, then flying back to the comfortable Madison lifestyle.
What are you looking forward to in your retirement?
It will be nice to get up in the morning and change to different leisure time activities. One big advantage of retirement is not being assigned to a schedule that requires a three-month forward-looking commitment. Furthermore, there will be no immense list of emails to attend to and no bureaucratic hurdles to get through. In retirement, if we read of some activity out of Madison, we can just get up the next day and hop in the car or get on that plane – freedom! Sheryl and I do enjoy traveling and adding spontaneity to that activity is something we really look forward to.
What advice would you give to young radiologists?
You are entering a very dynamic and exciting field – however, you should remain aware of how radiology interacts with the rest of medicine. I would encourage making sure you “have a seat at the table,” as the Broadway show proclaims, so that patients are served in the best possible fashion. Having decisions on inclusion or exclusion of imaging, as part of medical decision making, being made by panels of non-radiologists may focus solely on economics, rather than effective patient care.
I would also maintain a healthy skepticism when reading clinical papers – medical students are taught to follow “evidence based” medicine, but I have seen so many treatment or imaging approaches changed after years of use, because someone kept that skepticism and performed new studies that revealed weaknesses of prior decisions.
Is there anything else you’d like to share?
I want to thank all the faculty and staff for their support during my time here – it was a great experience, and, as we plan to stay right here in Madison, I am sure that I will be seeing some of you in future years.