As radiologists, we speak with ornery physicians, upset patients, uninformed technologists, and headstrong nurses on the phone. Daily, the phone calls we take are not all peaches and cream. Sometimes these phone calls can get the best of us. So, I thought this would be an educational opportunity for those just beginning their residency or considering a career as a radiologist to understand what goes on in daily practice. Here is a list of some of the most distasteful and frustrating phone calls you may encounter when working as a radiologist. It’s part of our life. Expect the worst but hope for the best!!!
Missing The Diagnosis
You’ve been going through films and feel like you are accomplishing significant work today. For the 3rd time today, you hear the phone ring loudly. As you pick up this phone call after a decent day… WHAM… everything changes, your heart sinks. That patient with pancreatitis has pyelonephritis, and you can hear the physician’s upset but pleasant tone. Can things get worse?
Any Call For Barium Study After 12 AM
Your eyes are watery, and you are barely staying awake in the reading room. Suddenly, the phone rings. “We need a barium swallow to look for a stuck chicken bone in my patient’s throat.” Now I’m never going to get any shuteye. Ugh, the pain won’t stop!
Bad Timing
You have a patient with unsuspected metastases on a thoracic spine MRI, and you attempt to reach out to the physician who ordered the study. “Hi. Is this Dr.______?” Next thing you know, he starts yelling at you, “How dare you to call me while I am at my father’s funeral!!!” He bluntly hangs up the phone. So much for good physician communication!
Contrast Stupidity
You arrive at your workstation and receive a requisition for an abdomen and pelvic CT scan with contrast for a patient with symptoms of flank pain and urinary tract stones. So, you call up the physician and tell her, “I think that you made a mistake with the order. You meant without contrast, right?” The next thing you know, she is arguing with you how contrast studies are better for patients to diagnose an obstructive stone. The conversation goes on for what seems like hours. It’s like talking to a piece of cheese. Oh, My God!!!!
Fellow Physician With Positive Findings
A physician friend comes down from his department and asks you to give him a call when you get a chance to look at his chest x-ray. He has a mild cough. So you oblige and say, “OK.” Ten minutes later… You look at his film, and he has sclerotic bone lesions and pulmonary nodules everywhere. Looks like mets. Gulp. You pick up the phone, not quite sure what to say. Finally, your voice cracks, “Can you come down here. I need to speak to you in person.” Poor guy. How am I going to break the news to him?
Misplaced Anger
As part of your typical protocol, you call in the results of a normal V/Q scan. Suddenly you hear a booming voice on the other end, “HOW DARE YOU CALL ME FOR A NORMAL STUDY DURING REGULAR BUSINESS HOURS!!!!!!!!” You hear a loud click. So much for congeniality…
Demand For Incorrect Protocols
You are going through a knee MRI and notice that the tech did not include the coronal images even though they are essential to evaluate the collateral ligaments. So, you call the technologist to determine why the MRI does not include the appropriate imaging after the patient recently had a motor vehicle accident. The technologist says smugly, “Oh, we didn’t need these images because the clinician said they don’t need the coronal images.” What?
Clinicians That Expect You To Make Their Clinical Decisions
On the queue, a film pops up, and you look at the images. At the left base, overlying the cardiac silhouette, there is an airspace opacity obscuring the diaphragm. So, you decide to call the Emergency Department, and you get through to the Nurse Practitioner. You tell her, “The patient has a left lower lobe pneumonia.” Surprisingly, she asks you, “How do I treat this patient? What kind of antibiotics should I administer?” Listen, buddy- this is above my pay grade. That’s your job!!!
Request For Stats But No One Is Home
At the outpatient center, you see an abdominal and pelvic CT scan with a prescription that says STAT, needs a prompt phone call to the doctor. So, you look at the study at 4 PM and find mild diverticulitis of the sigmoid colon. So, you call the number and receive a message prompt; please dial _______ number to get through to the doctor. Next, you call the number and talk to the secretary. She casually says, “The doctor is not around and there is no one covering.” But, you respond, “But it says STAT!”. She then retorts, “But no one his here.” The phone hangs up abruptly with deafening silence…
The Need To Call The Patient Directly
The patient has abdominal free air on a random CT scan of the chest for pneumonia. So, you call the clinician for the 3rd time after leaving multiple messages with the answering service. No response. The only next available option is to contact the patient directly to come into the emergency room to get checked out. So, you find the number and speak to the husband of the patient, who is 90 years old. He says, “What are you talking about? You need to call my doctor. I don’t understand why my wife has to go to the emergency room.” You spend about 45 minutes on the phone trying to convince him to get her wife to the hospital because you can’t get through to the doctor. Finally, you get the husband to take her wife to the emergency room. Fifteen minutes later, after this long-winded conversation, you get a phone call from the patient’s doctor. What a waste of time!
Phone Calls Can Be Painful!
Although many phone calls are positive and rewarding, these are just some of the phone calls that will frustrate you as a radiologist. So be prepared to have some pretty painful phone conversations with your fellow clinicians, colleagues, and friends. It’s part of the job!!!
