An Interview with Dr. Ross Golding, founder of Reno Diagnostic Centers
On December 16, 1985, Reno Diagnostic Centers (RDC) opened their doors for the first time, and a new era of medical imaging in Nevada began. Led by Dr. Ross Golding, RDC instituted an era of higher standards for medical imaging by introducing the first MRI scanner to the state. This led to more accurate diagnostics, fewer false positives, less exploratory surgery, and greater overall health and well-being for citizens of the state. For 30 years, RDC has continued to innovate, incorporate new technology, and lead the way in providing Nevadans the highest level of diagnostic care while treating patients with the passion and commitment they deserve.
Before RDC: A Wild Imaging System in the West
It’s hard to think back to 1985. The vast, rapid, and earth-shaking technologies that have completely changed our lives were in their infancy, and some had not even been dreamed of yet. Medical imaging was still living in the past, having hardly changed since the 1970s. According to Dr. Golding, “Most people got their imaging done at hospitals. Most of the imaging involved X-rays, ultrasounds or injecting some contrast into someone. These were more invasive procedures with higher morbidity and even some mortality.” The verdict? “Woefully inadequate,” Dr. Golding says.
In an evocative description, Dr. Golding spoke of one such procedure called a myelogram, which was popular in the 1970s, 1980s, and even the 1990s. Many readers might remember the procedure—perhaps as something out of a bad dream. If the patient had a lower back problem, for example, a needle was put in his or her back to draw out cerebrospinal fluid that surrounded the spine. Then, contrast was placed in the back, and a series of X-rays followed. An update of the procedure required additional CT scans and also required the patient to spend the night in the hospital.
The myelogram procedure was painful and was known to cause severe headaches in 20% of patients. In addition, the cost of a myelogram exceeded $10,000. Compare that to a spine MRI today at RDC, which costs approximately $1,200 and is dramatically more accurate in diagnosis.
Many other imaging processes at the time were like the myelogram—crude and inefficacious, and, often, they created the problem they were trying to diagnose. But just as the technology that we see every day was starting to come into being, technology that could change the medical field—and the lives of millions of patients—was coming to Nevada.
The Birth of RDC and the Transformation of Medical Imaging in Northern Nevada
Dr. Golding and his partners opened their first center as 1985 was drawing to a close, bringing with them the technology that would change the lives of people across Nevada. With MRIs, imaging was faster, more accurate, and brought with it considerably fewer risks. Like any new era, though, RDC’s birth didn’t mark their adulthood. There was growing to do.
As in many professional fields, the medical field was slow to accept change. In the mid-1980s, X-rays and contrast shots were how imaging was done, and imaging took place in hospitals—not in outpatient centers. RDC was revolutionary, bringing new technology to sites outside hospitals. As Dr. Golding explains:
“Mostly, physicians adapted to this very slowly. We were the first MRI in the state, and there were probably fewer than 50 MRIs in the country at the time. We felt a responsibility to educate our colleagues. The first two to three years were very lean as people were slow to adapt to the new technology; and to the fact that you could get as good a diagnosis—if not, in fact, a better one—at an outpatient facility.”
That doesn’t mean RDC didn’t make a difference, right away. The procedures being offered to patients were getting less invasive, easier, and, most importantly, providing more accurate diagnoses. “We were diagnosing things that others weren’t,” Dr. Golding remembers. “We did have a huge impact on many of our patients’ lives.”
Innovation, Inspiration, and Excellence: RDC Through the Years
RDC brought the first MRI to Nevada, but that was far from their last innovation. Over the years, they have introduced many more life-changing machines to Nevada residents, including the Open MRI scanner, which helps with the claustrophobia some patients experience while in MRI machines. They brought the first Positron Emission Tomography (PET) scanner to northern Nevada, which has been crucial in diagnosing and treating cancer. One of RDC’s more important contributions has been in the field of mammography, having introduced digital mammograms nearly a decade before anyone else in northern Nevada. Just this year, RDC became the first in the area to offer 3D mammography.
However, the RDC commitment to the highest quality of care isn’t just about bringing in the newest imaging machines. Dr. Golding explains that every new technology is thoroughly tested, evaluated, and studied to ensure it brings real value and difference to people’s lives. “RDC makes sure that they aren’t just bringing new expensive technology—it has to be a true, clinically relevant innovation and bring value to our patients.”
Through the years, these innovations have made a huge difference. Radiologists, with the help of picture archiving and communication systems (PACS), look at hundreds of images, instead of four or five, which gives them much more information and the ability to make a more accurate diagnosis.
As he explains, “This improved diagnostic capability has dramatically lowered the number of invasive procedures and exploratory surgeries. Exploratory surgeries that were once routine 20 to 30 years ago are now nearly nonexistent today. Autopsies that were once routine, with the exception of forensic autopsies, are virtually a thing of the past. Imaging is often believed to raise healthcare costs, but by replacing more expensive invasive procedures, imaging provides a dramatic decrease in the cost of diagnosis and improves patient outcomes, in addition to lower rates of morbidity and mortality.
“In national surveys asking doctors what has made the most difference for families and their practice, MRIs and CTs typically are number one or two. It was an enormous change, and cannot be overestimated.”
As an example, Dr. Golding refers to his days as a medical student at Emory University, where once a week, he attended Brain-Cutting Conference in which the students dissected a brain from someone who died of a stroke, hemorrhage or tumor and examined it under a microscope. “With MRIs, today we literally see more than we did by holding the brain in our hands.”
It isn’t just about the machines, though. One thing everyone at RDC is proud of is how the RDC staff works as a team—holding each other responsible, helping each other, and knowing that there can’t be any silos. Information must be open, from schedulers to billers to the technologists who make everything happen.
In Dr. Golding’s words, “At RDC, no one is more or less important than anyone else. Any mistake made has a ripple effect, so we make sure that everyone knows the importance of every step. It is a culture of shared responsibility, and that’s how we make sure we provide the best service.”
Looking Ahead: The Future of RDC
The world is going to keep changing. Looking back 30 years ago, technology seemed closer to that of 1900 than to the technology of today. It happens that fast. RDC is prepared and excited to meet the changes that come with time’s arrow. Dr. Golding reflects that the next 30 years will be, in some ways, like the last 30. Reflecting on the past, present, and future, he says:
“The last 30 years have been hard work, like in any other business, with constant challenges. It’s been very rewarding and a lot of fun. We have an exceptional team of employees and managers. When you turn 30 as a person, you feel as Columbus might have; like you’re about to sail off the edge of the world. You don’t though—you keep sailing, and that’s what we’re going to do.
“We look forward to the next 30 years. We live in a crazy, complex world, and as healthcare is getting progressively more complex, imaging will continue to play a larger and larger role. The demand for quality, clinically relevant imaging will only increase. Our success is guaranteed by our customers, so we promise great equipment, accurate diagnosis and strive to provide it in a patient-friendly way. As we have the last 30 years, we’re going to remain lean, which gives us the ability to move quickly. In a complex world, you find success by simplifying. We’re going to continue to learn and adapt.”
It’s that spirit of learning, adaptation, and adjusting to, embracing, and creating change that has led RDC to be at the forefront of improving healthcare across northern Nevada. It’s a testament to everyone who has worked at RDC over the years that they have never stopped trying to figure out how to bring the highest-quality imaging and customer service to their patients. It’s a far different world than it was in 1985, but the values that led Dr. Golding and his partners to bring the first MRI machine to Nevada haven’t changed—and they never will.