Month: June 2019

Posted on by

Job Market Is Booming: Are Fellowships Still A Necessity?

fellowships

Let me clear up the facts for all the radiology residents that are thinking about fellowships in this market:  Just like any other job market, the number of radiology attending positions available is subject to market forces. Moreover, this prolific job market will not last forever. To support these claims, in my medical career, I have seen two job cycles, trough to peak. And we are sure to see others. It’s just a matter of time.

So, how does the changing job market impact the topic for today’s blog, the necessity of fellowships? Well, I have a bit of explaining to do.

Back in the early 2000s, when I completed my residency at the last market peak, great jobs were everywhere. California, New York, and  Florida were no exceptions. The theme of the job market was: “Name your price!” And, I can distinctly remember the heated discussions in the reading room about whether fellowships are necessary.

Well, it’s happening again. All you need to do, go to the recent forums on Aunt Minnie on the topic. Or, you can stop by my residency program. You will hear a few passionate debates on the matter. (We had this discussion during noon conference a week or two ago!) Regardless, I think this is a prescient indicator of a market peak. Not that it means we will experience a sudden downturn. But, we are riding somewhere along the top of the curve.

So, what happened the last time around the market went from peak to trough? Well, if you took a poll of radiologists without a fellowship, I believe a higher percentage of these folks would have had more issues with their career than those with one. Therefore, I am going to throw a bit of proverbial cold water on those of you who are thinking about going down this non-fellowship path by telling you why.

More Likely To Have Work You Don’t Like

For better or for worse, those radiologists without a specialty tend to have less control over their domain of practice. Don’t like mammo and plain films? Well, you can’t say you are an expert in another area that you enjoy more when you are starting your career. So, guess where the practice will want to place you!

Severely Limited Job Market On The Coasts

If you want to have a better chance of securing a job in the more populated portions of the country, you will have a much better shot if you have a fellowship. I can certainly speak for my part of the country, New Jersey. It’s possible, but good luck finding a quality position without one!

Not Considered An Expert In Any Area

Now, this may or may not bother you. But, many radiologists like their colleagues and referrers to perceive them as experts in a particular area. Clinicians know individual radiologists and ask for them by name because of their fellowships. That will be less likely to be you!

Much Harder To Start A New Fellowship Once Established

Once you have already been working as a full-fledged radiologist for a while, it becomes much more traumatic to start anew as a fellow. You may have a family. Or, perhaps you have become accustomed to the lifestyle of a radiologist. It’s hard to go back and do a fellowship once you’ve started your career!

Yes, You Will Have Increased Chance Of Losing Your Job

And finally, you may not want to hear this, but as an employee of a practice, when the reimbursements turn down and the market becomes sour, who is the first to go? Well, it’s not likely to be that expert in neuroradiology who the neurosurgeons love. And, it’s not going to be the nuclear radiologist who performs complicated radiopharmaceutical treatments on the referring physician’s patients that the practice cannot replace so easily. Hmmm. Who can be ousted the most quickly without a significant impact on the business? That person is much more likely to be you!

Booming Job Market: Still Need Fellowships!

I get it. You’ve been out working for so many years. And, you’ve become impatient. Maybe, you have a family and want to earn a real living. But, in the long run, it’s not worth the additional risks that you will take by not completing the additional training. So, think again before you choose to enter the job market without a fellowship now. You may regret your big decision later in life!

 

Posted on by

What Diagnoses You Shouldn’t Miss As A Radiology Resident And Why!

diagnoses

For some of my readers, you will be beginning or are currently participating in a journey into the heart of radiology learning, the world of overnight call. And, I can think of no better way to master all the diagnoses you need to become a true radiologist. With all privileges comes significant responsibilities. And, overnights are no different.

So, how do you prepare for such a critical episode in your career so that you do not miss the basics? Well, I have just the solution for you. In addition to reading lots of cases on PACs, taking precall quizzes, and, reading books in general, you also need to triage your time appropriately to learn those topics that will become most critical to know at nighttime.

Therefore, today, I will give you a simplified series of lists of what diagnoses you should not miss and why by dividing the most important types of cases into three main categories: those diagnoses that will kill the patient, common diseases, and entities that will make you look silly if you make/miss them. If only I had a few lists like these when I started — just something to simplify what you need to know for your first forays on call. Well, now, you do. Try to review them before you start. So, let’s begin!

Killer Diagnoses/Findings

Vascular

Aortic Rupture
Aortic Dissection (Type A)
Active Extravasation From Vascular Organ Issue (Arterial Blush)
Portal/Splenic/Renal Venous Thrombosis/Thrombotic Arteries

Abdominal

Pneumatosis/Free Air/Portal Venous Gas/Extraluminal Contrast/Perforation
Shock Bowel
Bowel Obstructions/Volvulus/Bowel Ischemia
Peritonitis

Thoracic

Pulmonary Embolus (V/Q scans and CT scans)
Pneumothorax/Pneumomediastinum (Esophageal injury)

Brain

Large Bleeds Of All Kinds (Subarachnoid, Epidural, Subdural)
Anoxic Brain Injury
Large Acute Brain Infarcts

Gynecology

Ectopic Pregnancy Rupture

 

Common Important Diagnoses

Gastrointestinal

Appendicitis
Diverticulitis
Infectious/Inflammatory Colitis
GI Bleeds
Abscesses
Pancreatitis
Organ Lacerations
Intussception
Pyloric Stenosis
Cholecystitis/Gallstones
Biliary Leaks/Bilomas
Seromas/Lymphangiomas/Hematomas
Organ Trauma/Lacerations (Depends on whether you work at a level one institution)
Free Fluid

Genitourinary

Urinary Tract Stones Of All Ilks (Obstructive/Nonobstructive)
Hydronephrosis
Pyelonephritis/Renal Abscesses
Cystitis
Prostatitis
Ovarian Cysts/Dermoids/Tubo-ovarian Abscess
Ectopic Pregnancy
Early Pregnancy
Fetal Demise
Retained Fetal Products/Endometritis

Neuro

Masses
Encephalitis
Berry Aneurysms
Small Bleeds/Infarcts
Meningitis
Multiple Sclerosis/Demyelinating Disease/Optic Neuritis

Thoracic

Pneumonia
Pericardial effusions
Pleural Effusions
Empyema/hemothorax
Pulmonary Nodules

MSK

Fractures Of All SortsOsseous Avascular Necrosis
Osteomyelitis
Soft Tissue Injuries Of The Knee And Shoulder (ACL, rotator cuff tendon, etc.)
Cord Compressions/Disk Herniations

Oncology

Cancers/Metastases/Adenopathy

Head/Neck

Tonsillar abscesses
Acute Sinus Disease
Parotitis
Sialoliths

Miscellaneous

Foreign Bodies From All Ends (Esophageal, Rectal, Soft Tissue, Etc.)

 

 

Silly Entities Not To Make/Miss

Prostates in Females (Post Hysterectomy Changes Can Sometimes Look Like Prostate Glands)
Uteri in Males (Big Prostates Can Look Like Globular Uteri)
Penile Prosthetic Devices (Reserves Can Look Like A Urinoma)
Normal Studies (The Majority of Cases!)

 

By the way, if you are interested in going through call cases like these and more, take a look at the three quizzes (10 cases each) that I have given to previous residents before starting the overnight call.  See if you are ready!

Click here to get access to the precall quizzes for $9.99!!!

 

Posted on by

The One Phrase You Should Ask For In All Your Letters Of Recommendation

letters of recommendation

ERAS season has recently begun. And, with applications to radiology residency and fellowships on the system now available, medical students and residents are scurrying about trying to find letters of recommendation from their faculty and mentors. On that note, if you are applying now, I would advise you to read one of my previous blogs (Cracking The Radiology Residency Application Code).  Previously, I have mentioned that references are one of the less significant discriminators in getting an interview for radiology. However, that statement only applies to decent letters of recommendation. It does not mean that you should find the wrong ones.  That can become a disaster. Remember. Program directors have so many excellent applications from which to choose. So, one lousy recommendation can lead yours into the DNR (Do Not Rank) pile. In the case of a horrible reference, it becomes a great discriminator!

In any event, as always, I want to distill the essentials of applying in the world of radiology into a few simplistic nuggets. Therefore, I am going to let you in on a little secret about what you should be looking for in a recommendation writer not only to avoid this situation but instead, I want to make your recommendation into the reason you may have success getting into your program of choice.

So, here it is, a simple phrase strategically placed within the recommendation, preferably at the end. And it is this, “Your name is the type of student that we want to take at our radiology residency program.” As an application reviewer, that phrase gives me more confidence about an applicant than any other.  If your mentor wants to take you into his program, especially another program director, then why wouldn’t I? So, how do you get that person to write that into your recommendation? I will give you some simple instructions on how to do so to achieve the results you want.

Perform Well On Rotations With Potential Reference Writers

OK. Performing well on rotation may seem obvious. But, on occasion, some residents will ask attendings to write a recommendation when their performance was marginal. Why does this happen? Well, usually, the resident feels more comfortable with obtaining this written reference due to the mentor’s easy-going personality. Don’t let that fool you! When a mentor has many other applicants to write for, your recommendation will not be of the same quality as his favorites!

Befriend Your Mentors

For many medical students, befriending your mentor is a tall order. Often, he may be twice or even three times your age. Or, your interests may significantly differ. However, make that attempt to get to know that person well before asking for a recommendation. Then, when you finally request one from this person, he will feel much more comfortable with writing one. I can’t tell you how many times a medical student or resident will come up to me and ask me for a recommendation when we have barely spoken. It reflects in the written letter!

Tell Them What To Write!

Lastly, this step can be the most critical. At this point, you know your mentor well, feel comfortable with her as a reference, and you know she feels the same about you. And, she is more than likely willing to help you out in any way she can. But, many reference writers do not know what program directors are looking for in a recommendation. So, it is your job to help them out. Ask them if they can slip the key phrase into their letter- “I want you in my program.” (Of course not that verbiage exactly but you get the point!)

Even better, some writers will ask you to make a version of the reference letter. Guess what, slip that phrase or something similar into the end. It has the potential to make your application stand out from the pile!

Capturing The Magic Phrase On Your Letters Of Recommendation

Now you know precisely how to proceed to get the best possible recommendation from your mentors to help you get into the spot you want. It does take a bit of work, forethought, and, most importantly, personal interaction. So, make sure to ask mentors on rotations where you have performed well. And, only request them from those that know you well enough to write you one. Only then will you be able to obtain a recommendation with the phrase that will significantly increase your chances of admission!

Posted on by

Full-Time Practicing Primary Care Physician: How Do I Get A Radiology Residency Slot?

primary care

Question:

 

Hi.
I am a physician in a primary care specialty looking to go back to residency, specifically in radiology. I have been in practice for ten years and have realized that I do not want to practice primary care for the rest of my life. Have you had a resident in a similar situation? What factors do I need to consider? How does Medicare funding for residency come into play?

Thank you so much for your blog and the book. I realize this is a rather late stage to make a change, and I would appreciate your input.

 

Answer:

So, this is the deal: I would love to have physicians that have previously trained in other specialties. They make the best radiologists because they understand the clinical implications of diagnostic imaging. Some of my best radiologist mentors had completed another specialty first.

However (and this is a big caveat), it does become more challenging to obtain a slot because of the Medicare funding situation. Once you have graduated from a U.S. residency and start to practice medicine, Medicare does not fund the additional years of training.
But all is not lost. If I were you, this is what I would do. Some residencies throughout the country have their spots funded by private sources in addition to Medicare. For instance, I know in New Jersey that University Radiology Group supports several residency slots privately for the Robert Wood Johnson program. These are the slots that you would need to find. You may want to try calling the departments up individually to find out if they would take a previously trained physician. Otherwise, you will potentially waste your time and money applying to places that would not enroll you regardless of how excellent your application.
And finally (and perhaps most critically), you need to be ready to go through the mental and financial hardships of repeating another residency. Depending on your family situation, you need to make sure that all members are “on board” with the change. It’s certainly not an easy four years. But, I can tell you that going into radiology was one of the best decisions I have ever made!
Good luck with the decision process,
Barry Julius, MD
Posted on by

New Radiologist Wanting Locum Work? Think Twice!

locum

Have you ever thought about living in different places for a little a bit at a time? Maybe you have always wanted to do some traveling before starting to work? Of course, it sounds exciting to go from Honolulu for six months and then onto Dayton for the next six. Indeed, I thought about the locum lifestyle when I first started.

But, are you missing out on by taking this route instead of the established full-time job career path? Potentially. As much as the ability to travel for your job may entice you, think twice before embarking down this infrequently traveled road as a new radiologist. Let me give you some good reasons for turning this opportunity down.

Pigeon Holed/Loss of Skills

Do you want your new practice to call you that temporary plain film reader gal? Unfortunately, this sort of attitude prevails among many groups. And, imaging groups tend to place you in a particular role based on the desperate needs of the practice. So, if you sign up for XYZ, the group may utilize you in Y capacity. Over the years, this is a surefire way to lose your skills in other areas that you trained for in residency.

Will The Good Times Last?

What do you think happens when the bottom drops out of the radiology job market? Perhaps, imaging reimbursements drop precipitously. Or, suddenly, the stock market crashes and older radiologists stay in the field. And, yes, unfavorable radiology job markets like this have happened in two separate cycles since I started medical school.

In these situations, what happens first? Well, the excess fat gets cut. And, what exactly is the excess fat? It tends to be the locums’ jobs! When you start, you certainly don’t want to be in that first wave of job cuts. It becomes challenging to recover.

Locums Looked Upon Unfavorably

At many practices, the question that arises when they consider a new locum radiologist is: WHY ARE YOU A LOCUM RADIOLOGIST? From my experience, many radiologists believe (rightfully or wrongfully so) that locums radiologists have a defect. Perhaps, they read to slow and cannot hold a job. Or, maybe, the individual cannot get along with others and drifts from job to job. So, if you have a track record of only holding locum work, you have painted a particular picture of yourself that may not be attractive if you ever want to find a longer-term career!

Never Quite Maximize Efficiency

When you drift from place to place, you never get to learn all the systems in place to maximize your output. PACs machines, paperwork, clinician demands, and technology continually change. And, they differ from one practice to another. By definition, you remain less efficient and slower just because you do not have the long-term knowledge you need to keep up with your colleagues at a job using the same technology for the past ten odd years!

Difficult To Establish Long Term Relationships

What do I value most from my current job? I treasure the relationships that I have made with my colleagues, residents, and fellow clinicians. How do you create and maintain these relationships as a locum? Well, it can become very challenging at the very least. You are new the kid on the block and will remain that way until your short term tenure as a locum radiologist ends.

Locum Work: A Dangerous Road To Travel

Now, locums can be an excellent opportunity for specific individuals. If you have a family and want to fill in some time with some extra hours, it can make some sense. Or, maybe you want to retire soon and desire some additional inconsistent or occasional work. Finally, perhaps, you are independently wealthy, and a full-time career does not matter for you. But, for the typical fresh graduate with a lot of debt and wanting to begin a new locum path, you will encounter many obstacles that can affect your future career and growth. So, think twice if you choose to become a locum radiologist when you start. It may become one of your biggest regrets!

 

Posted on by

What Are The Best Resources For Learning Ultrasound?

learning ultrasound

Question:

Hi! I was wondering what source you would recommend as the best to teach ultrasound to radiology residents?
Thank you!!

Answer About Learning Ultrasound:

So, I did a little bit of “market research” for you. And, I asked a few of my best radiology residents what they preferred to read to learn ultrasound. I did this because the best ways to learn regularly change. So, this is what they told me.
When they first started, they used the Ultrasound Requisites to get a solid background on the topic. Afterward, they would use what they would like to call the big blue book- “Rumack”  (Diagnostic Ultrasound) to look up additional information about any specific case. Most importantly, however, each of the residents said it was most critical to go inside the room to scan at the beginning to experience how they get the pictures and to understand the basic ultrasound anatomy. And, I have to agree with this method for learning ultrasound. I utilized a similar approach and it worked for me.
One of my great radiology mentors always said the following: “Ultrasound is not a spectator sport.” That was one of my favorite phrases. And, I continue to tell the same to my residents. You need to go into the rooms at the beginning and learn how it all works to get to know the world of ultrasound. Otherwise, all you will see are a bunch of disconnected grainy pictures!
Let me know if you have any other questions!
Barry Julius, MD
(All links are to books are at Amazon where I am an affiliate)
Posted on by

Can You Pass The 2019 Precall Quiz?

precall quiz

Once again this year, I am presenting 10 cases from our precall quiz. These cases will help to determine if you are ready for taking call at your institution. Each of these is the sort of the case you will likely encounter on call at some point. Sixty-five percent is passing. Partial credit is possible. Make sure to write down the answers on a sheet of paper and cross-reference them with the answers provided on the bottom of the page. See if you will be competent to take overnights or if you need to study a bit more before you are ready!

By the way, if you think you can score better the next time or if you want some more practice, check out the previous years’ precall quizzes. The links to the 2018 and 2017 quizzes are right below. Good luck with the exam!

2018 precall quiz

2017 precall quiz

 

Case 1:

 

 

Case 2:

 

Case 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case 3:

What is the possible diagnosis?

How would you manage this case at nighttime?

 

Case 4:


Case 5:

Case 6:

 

 

Case 7:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case 8:

 

Case 9:

What is the diagnosis?

What else would be of help to increase the specificity of the study?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case 10:

 

 

Answers to Cases:

  1. Right-sided ileocolic intussusception
  2. Right perihilar mass with pneumothorax
  3. Possible diagnosis: fetal demise with conflicting images in M-mode, How to manage: scan yourself in real time with M-mode or cine
  4. portal venous gas, bowel pneumatosis, SMA thrombosis- call surgeons
  5. Proximal transverse colonic apple core lesion, suspicious for primary colonic neoplasm
  6. Normal CT brain
  7. Hill-Sachs deformity with a loose body (greater tuberosity overlying the glenohumeral joint)
  8. Mets with multiple levels of cord compression. Abnormal signal within the cord, suggesting ischemia.
  9. Findings suspicious for PE (High probability study- old verbiage), What would increase specificity? A prior V/Q SPECT
  10. Left distal ureteral stone with left-sided hydronephrosis and hydroureter and adjacent inflammatory change, porcelain gallbladder (increased risk for carcinoma)
Posted on by

Why Do Radiologists Overall Have A High Net Worth?

high net worth

As some of you know, income is merely a snapshot of the overall financial health of the profession. On any given year, that can change on a dime. Procedure reimbursement can change. Codes can vary. And, professional or technical fees rarely stay the same.

However, most financial surveys report on physician income, ostensibly the real marker of physician economic well-being. But, what is the one long term indicator of a medical specialty’s financial health? Well, it’s going to be a long term indicator of physician savings, their net worth!

More to the point, each year, Medscape publishes the physician debt and wealth report. And, this information is more telling about the long-term state of our profession than any other survey out there. Therefore, I look at these statistics very carefully to see how we compare to everyone else out there in the medical world.

And, this year I found something interesting. On one of the last Medscape survey slides (#23 to be exact), our specialty has the highest percentage of physicians with a net worth over 2 million, tied with a few other specialties (plastic surgery and orthopedics). At the same time, we have the lowest percentage of physicians with a net worth under 500,000 dollars (slide #22). However, we are not quite at the top for the proportion of physicians over 5 million dollars (slide #4). And, on another presentation on physician income on the 2019 Medscape Physician Compensation Report, we are only tied for 5th highest mean income.

So why is it that we do not have the highest income but yet we have a higher percentage of physicians with a net worth of over 2 million dollars? Moreover, why do we have a lower portion of radiologists with a net worth of greater than 5 million dollars than many other specialties?  Let’s dig further into the weeds.

Radiologists Are Not Show-Offs

You probably know a few radiologists that drive their 100,000 dollar Tesla and live in a castle. However, overall, radiologists are not ones to take all the credit. And, from my experience, most are more humble, similar to how we need to work within our profession.  And, this personality trait more typically describes their more simple spending patterns.

What do you do if you don’t spend much on things to display to the world? You save or at least get rid of debt!

Many Years Of Good Fortune

For years, radiologists have been blessed with more and more new procedures and technology. And, each year, private insurers and the government continues to reimburse reasonably well. This pattern has become long standing for years and years. Regular salaries mean more saved wealth!

Additionally, even in the leaner times, newer radiologists could command a higher salary than most other professions out there. So, even recent grads will tend to have lower debt loads and higher net worth than other specialists.

Skewed Age Of The Measured Population

Elsewhere in the survey, you will note that the older the physician, the more net worth saved. And, the population of radiologists slightly skews to older age compared to some of the other professions. We can still work into our 70s, 8os, and even 90s (if we are lucky!) All we need is a set of glasses and some insurance credentialing, and we are good to go! Therefore, savings can take the same overall weighting as well.

We Do Not Have As Many Income Extremes

What exactly explains why radiologists less commonly have a net worth over 5,000,000 dollars compared to some of our other subspecialty brethren? At least, this is my explanation. We can’t sell eyeglasses in our offices (as some ophthalmologists do) and engage in businesses that involve patient purchases. And, we need to take all sorts of insurance to make ends meet. (Many physicians in other specialties have concierge practices that don’t!) So, as a whole, we tend not to have some of the upper extremes of income that other medical specialties can provide. Therefore, most of us do not accumulate the more substantial assets (over 5 million dollars) that other specialties more often do.

Radiologists And High Net Worth

So, these are my explanations for the overall state of financial affairs for the average radiologist in the community. Remember. Not all of us adhere to these rules. You will undoubtedly find impoverished debt-ridden radiologists as well as radiologists who live more similarly to Jeff Bezos than the typical physician. But, based on being in the trenches, these overall patterns seem to explain the survey results. Shoot me an email or message if you think differently!

 

Posted on by

Breast Versus IR- The Ultimate Choice

breast versus ir

Question About Breast Versus IR:

 

Hi Dr. Julius,

I am a PGY4 resident and currently ranking my fellowship programs. Right now, I am still debating between an IR and Breast imaging fellowship. I am an active person who likes to deal with patients (within limits) and do procedures. Also, I am a family guy who likes to spend time with family and travel together besides social activities. I love IR, and I see myself in IR, but everyone is warning me of the stressful lifestyle and crazy calls. I know it depends on the practice that I will join. But, sometimes I think about it differently. I mean why I would spend two years in IR fellowship (Non-ESIR) to perform mostly central lines and biopsies. Plus, people tell me that IR will become routine, and I will lose the exciting part and left with the scraps.

On the opposite side, breast imaging is a good lifestyle. I will see patients (I enjoy seeing patients) and perform procedures. Also, I am willing to do 50% breast and 50% general radiology after fellowship if I complete a breast fellowship. I don’t want to regret not going to IR. Should I risk it better than regretting it? I have to submit my ROL by the end of this month; I appreciate your help.

Thanks

Breast Versus IR

 

Answer:

What you do in IR depends upon where you decide to practice. If you choose the option of working in a highly academic large center that is on the cutting edge, you can be performing many other procedures other than central lines and biopsies. But, of course, you might sacrifice salary if you have a lot of debt. (not all the time but most).
And for the most part, if you are doing IR, you will have more weekends and nights. It is true that you will not be able to leave the department as smoothly during the daytime to take care of issues at home. Albeit, you may get more vacation overall to compensate for the extra time on call. When you are working in IR, you will generally work on your feet a lot for long hours.
On the other hand, breast radiology does allow you to work fewer weekends and nights as well as being able to occasionally escape to do other things during the day if you are reading screeners. And, you can perform procedures (even cutting edge procedures depending on the institution) But, in general, as breast radiologist, the procedures that you complete will be less involved. In both career paths, however, you will get to work directly with patients (and be a real doctor!)
So that is my little summary for you. There is a sort of lifestyle/procedure decision that you will need to make. What I’ve discovered over the years: no field is going to meet every one of your criteria. Those folks that are the happiest can decide which track to choose based on their life priorities.
Hope that helps,
Barry Julius, MD
Posted on by

Why Standards Of Care Are Important To Fight For!

standards of care

I don’t know if you have noticed, but you have probably heard the term standard of care bandied about a bit during your residency program at some point.  But, first of all, what does the standard of care mean? Well, according to MedicineNet, it is “A diagnostic and treatment process that a clinician should follow for a certain type of patient, illness, or clinical circumstance.”

However, not all standards are the same. Some measures are national standards, and others are merely within one’s department or practice. But, why is it so important to all physicians, and more importantly, specifically for radiologists? And, what happens if we all don’t meet the “standard of care”? Well, the result may not be so beneficial for you or your practice. Consequently, standards of care are of critical relevance to our world. And, that’s the topic for today!

Legal Reasons To Follow National And State Standards Of Care

OK. Let’s first start with the bugaboo. If a practice or its members are not following the best national/state standards of care, they are prime candidates for a lawsuit. To that end, one of the three pillars of a successful malpractice lawsuit is not meeting the standard of care, So, that alone should make you quake in your pants if you do not abide by these norms.

Importance of Individual Practice Standards

Well, it’s not only about the legal issues when you do not follow national and state standards. Additional trouble can ensue if you do not apply standards within your group. What do I mean by that? Well, not all practices follow the same rules because norms throughout the country and state can differ widely. Let me give an example.

If you decided to look up the requirements for how to determine which patients are appropriate candidates for a hysterosalpingogram (a test to check the anatomy of the uterus and fallopian tubes), the information is all over the map. At best, the data about how you should decide which patients should get the test is scattered and based on differing experiences. Some groups advise that you should perform the procedure between 6-10 days after a menstrual period without additional testing. Others recommend that patients should also have a urine B-HCG level before considering the patient for the test.

In either case, each practice standard is theoretically acceptable. However, if each member of radiology practice uses different criteria for deciding upon when to perform the procedure, what happens? The secretaries become confused about how and when to schedule the examination. And, the technologist or nurses can easily forget what each radiologist requires before the exam. It becomes a mess of confusion. So, practices need standards to prevent these inefficiencies.

Moreover, god forbid if somehow, a patient discovered that they were pregnant before the test, and one radiologist did not test the patient with a B-HCG level (unlike all the others in the practice), then that radiologist did not meet the standard of care for the practice. Theoretically, that could also open up the radiologist to additional legal actions.

Standards Of Care From The Patient Side

Finally, from the patient point of view, nowadays patients can look up information about best practices and procedures online before deciding to get a test. If your group does not meet these standards, and the patient becomes aware of a subsequent complication related to not meeting these norms, at best, the patient may never return. And, at worst, your practice becomes at increased risk of receiving legal action.

Fight For Group Standards Of Care!

As you can see, we all need to be on the same page in any radiology group. Changing practice standards to vary from national and state norms can lead to disaster for the group and the individual radiologist. Moreover, creating specific practice standards within a group can be critical to maintaining efficiency and reducing confusion among the staff. So, think twice if you decide to be OK with not meeting standards in your practice, it may be your future career at stake!