This column will appear in the upcoming March print issue of Surgical Products.

It takes a certain type of person to challenge 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.

A Pioneer

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 many accomplishments.

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 innovation environment.”

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. Furthermore, any time a new and disruptive 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 that quickly.”

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.”

What's your take? E-mail me at  or respond on Twitter @MikeSchmidt_SP.

To subscribe to Surgical Products magazine, click here.