When starting as either a resident or beginning attending, commonly, radiologists worry about whether they are reading quickly enough to meet the demands of the residency or practice. Sometimes, we self impose this construct of the “truth” about our speed. And, other times the fear may be legitimate. In either case, how can you achieve the point at which you are interpreting cases fast enough to feel like you are producing quality dictations without fumbling too much (everyone misses something no matter how quickly you read!) at a reasonable speed? Well, that is my goal for today!
Read Lots Of Cases
First and foremost, I have never found a substitute for reading tons of cases. When you have seen the same finding for the seven thousand three hundred and forty-sixth time, it will stick. Eventually, as you read it so many times, it becomes part of your autonomic system. It becomes so entirely reflexive that it never quite makes it into your consciousness (which will slow things down!).
Create A Master Checklist
Every great radiologist creates a master checklist. It may get to the point that you subconsciously check everything because you have done it so many times. But, it is still there. If you continue to use the same checklist, time after time, it will become second nature. One day, you will make all the findings and won’t even remember that you have one!
Sometimes, you have to shut the door and focus on the work ahead. Don’t allow your chatty colleagues to stop you from doing your work. If they need to talk to you and you are in the middle of a study, have them wait until you are done. A few seconds of delay can significantly backtrack the progress you have made on your report!
Use Templates Well
Templates can become a major time saver if used properly. If you are dictating a CT scan, having the technique section automated will save you countless hours throughout your career. But be wary. Make sure to take items out that do not apply to your current case!
Use Your Residents Wisely (If an attending)
If you are fortunate to work for a practice with a residency program, you need to make sure to utilize the residents to your advantage. What do I mean by that? Well, they usually have better access to histories than you do (as long as the resident is good!). So, make sure to copy and paste these into your report. On the other hand, if your resident makes lots of typographical errors, you would want to make sure to redo your own report so that it comes out readable! How you go about utilizing the reports varies on a case by case basis. But, using your resident appropriate can save loads of time!
Listen To Your Attending (If a resident)
Say you are on at nighttime and your attending likes a report a certain way (i.e the impression before the findings), make sure to create reports the way she likes it. Or, if you are sitting next to your attending and he tells you to dictate a case an include a statement about the kidneys, remember to do so. You don’t want to have the report bounce back to you!
Don’t Perseverate On The Small Stuff
We can obsess over liver and renal cysts, pulmonary granulomas, and ovarian follicles. Or, we can learn to minimize the verbiage that we use to describe these findings. At some point, when you get too busy, you have to remember to include only what is truly important. Don’t go crazy with the minutia!
Limit Your Differential
Almost every finding can theoretically have 10 differentials. But, what is really going on in the case? In the real world, you only have time to discuss those differentials that are really likely or dangerous. You don’t have time to discuss the unlikely zebras!
Knowledge Is Speed
Believe it or not, reading lots of radiology books augments your speed. Why? Just because it tends to boost the confidence of the reader. The more you know, the less you perseverate and the quicker you become. Thems are the rules!
Don’t Be Too Speedy!
And finally, a word to the wise. After all this talk about increasing speed, don’t forget that sometimes you need to slow down. Missing findings is bad for patient care, increases the likelihood of lawsuits and will ruin your reputation. Therefore, there is a point of no return. So, back it up a bit, will you?