Are you a DNR or clinging to every last breath? The biomedical world is at a crossroads again. This time, will we have the courage to cross? Biomed has been my passion and pain for 23 years, and at times I have been totally discouraged by our lack of action.

The biomed universe for an American used to be restricted to the United States. With the Internet, we are now linked to the world. John Sandham from the U.K. wrote to the BiomedTalk listserv seeking information. It was a simple question, yet it awoke my passion.

John asked: “Does anyone think we (in-house EBME departments) are under threat of extinction (being taken over by large medical companies with a vested interest.) How do we ensure our survival? Is there really anything to be concerned about?”

My reply: “Yes, there is much to be concerned about. But it is not all bad. It is just different.”

Let me share a little background information. I have been in the industry for 23 years. I started out as a technician in a one-person shop — in the old days we called them shops. Now they are departments, labs or some other name that does not conjure up visions of a grease monkey. I worked my way up to management and now I am in the process of working my way down from management. I have been an in-house employee, an ISO and worked for manufacturers.

I have seen a lot and asked a lot over 23 years, yet it seems as if we are stuck. The same questions continue to be asked over and over. For example: are we “Biomedical Engineering” or “Clinical Engineering”? What is the point of certification? Where are we going?

Does this remind you of the movie Ground Hog Day?

“Where are we going?” To our final resting-place if we do not change. Of the four hospitals I worked in, three no longer have an in-house biomedical program. They are run by a large equipment manufacturer.

Biomed will always be around. But — and this is a big but — will it be what you know today? Only in university and teaching hospitals, because rapid change isn’t supported by the academic DNA. The rest of us need to morph into something our hospitals can use, such as helping administration understand cryptic technology proposals, with all their mumbo-jumbo, buzzwords, and double-talk.

Evolution takes too long! Metamorphosis is in a blink of an eye, and that’s important for in-house biomeds, because Mr. ISO and Mr. OEM are coming to take your comfy in-house department away.

Does that make Mr. ISO or Mr. OEM evil? Heck no! They offer a lot of opportunities for in-house technicians who want to keep doing the same job. They typically offer continuing education, management training, service schools, regional meetings to share information, factory training on their products, advancement opportunities, relocation opportunities, maybe even better pay. Different paycheck, but the same job with more opportunities. That’s a win in my view.

On the other hand, if you want to remain part of your hospital, your department must morph into Technology Management. My definition of Technology Management? A strategic focal point for the collection, dissemination and processing of essential decision-making information covering all technologies. This requires the rebirth of the Chief Technology Officer. Not some retitled information technology executive, but a real, independent chief who will cut the mumbo-jumbo and help guide the institution through its technology decisions.

I have rarely seen anyone in biomed pile on the BS and attempt to dazzle administration with mumbo-jumbo. We pride ourselves on our willingness to “cut to the chase.”

Do I have all of the answers? No. I may not have any of the answers. However, I think it is time to hold a summit on the fate of biomedical engineering. We need a unified mission and an organization that represents us, since previous attempts to represent the average in-house perspective — by AAMI, ASHE, ACCE and others — have fallen short. If we are to survive and move off the endangered species list, we must act.

Are you ready to act? Then e-mail me at DennisLibrandi@prodigy.net.