Month: October 2021

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Making Silly Mistakes- Not The End Of The World!

silly mistakes

As I sit here writing late at night, my silly mistakes on radiology reports cross my mind. I can laugh about them now. But, when you first hear about them, they feel somewhat awkward. And I’m sure that you know what I mean. That prostate gland can become a uterus. Or, you pronounce a pregnancy on a patient with ascites. Maybe you say you saw a gallbladder in a patient with a prior cholecystectomy. It’s just a matter of time before it happens to you. If it doesn’t, you probably have not read enough scans! So, how can you make this experience a bit more comfortable? Here are some of my main words of advice to prevent you from being too hard on yourself.

Don’t Take Yourself Too Seriously

In the medical profession, many physicians tie their identities to perfection. Many of us encounter these physicians in medical school and our residency training. They tend to be miserable people. However, self-aware physicians will never make this mistake. We have to be able to admit that we will have our errors. And, if you do not make your identity perfect, you will look back and figure out how you made the silly errors you made. You might even laugh about them and enjoy the irony!

Realize Mistakes Will Happen

It’s not just a perfection issue. When you interpret enough films or perform more than your fair share of procedures, statistics say you will make a silly mistake. We can’t beat the numbers. And, the sooner we get through that notion, the happier we will be.

Silly Mistakes Are Learning Experiences

I found that each mistake is a learning experience, silly or not. When I think about how, when, and where I made a mistake, I understand the conditions that caused the problem. Did I go through a case too fast because it was the end of the day? Under what circumstances did I forget to look at the patient’s sex? Was I interrupted or too tired? Did I miss a finding because I neglected my search pattern, or was it a lack of knowledge in a particular area? Each of these questions allows us to delve deeper into the circumstances of an error and forces us to confront the truths so that it won’t happen again.

Silly Mistakes Can Be Teaching Tools!

Instead of covering up my silly mistakes, I use them as teaching points for others. These moments can be some of the most fun teaching tools. Moreover, they can make great stories. Who doesn’t like an excellent allegory to make that point stick? I would have been much less likely to do the same if I heard one of these ridiculous errors.

Yes, You Are Allowed To Talk About Your Silly Mistakes!

We are all human. When you dictate 10,000 reports containing 100 words, that’s a million. Just by sheer statistics alone, it’s only a matter of time before you say something ridiculous in one of those million words. So, get off your high horse and own your silly mistakes. At least make them into something useful!

 

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Making A Radiology Schedule Can Be Tough!

radiology schedule

In any stage of radiology, we all want the best schedule possible. Most of us hope for rotations where you can enjoy what you are doing, perhaps within your specialty. We desire vacation time that is fair and equal to others in a similar specialty/situation. And, you want a call that is equitable and reasonable compared to everyone else. Not all rotations fit that bill, though. Nor is it possible to accommodate everyone all the time. If you tweak one person’s schedule, you can make someone else life miserable. The balance is delicate. It’s kind of like when you give medication, and it comes with untoward side effects! So, if you are helping out with the schedule at your institution, how can you make the radiology schedule as palatable as possible for everyone? Here are some of the guidelines that work at our site.

Get The Appropriate Tools For The Radiology Schedule

Our main job is practicing as a radiologist, not as a scheduler. So, make sure that you get all the necessary tools to make your job as easy as possible. Whether it is radiology scheduling software, a business manager, or a secretary for the practice, you should have some assistance to help you along the way. Don’t try to make the schedule without these tools. It is below your pay grade!

Be Redundant

We all are human, and calamities befall all of us at one time or another. Whether it is sickness or taking care of loved ones, we have to expect that not all of us will be available on any given day. So, every practice needs a little bit of redundancy in the schedule. That way, your practice will have adequate coverage when these events happen. It is not feasible to allow just a skeleton crew to steer the ship. It can become a potential recipe for disaster if some calls out sick!

Communicate All Schedule Changes Well

In practice, this statement sounds entirely logical. But, often, lack of communication can represent the downfall of a radiology department. If you decide to change a location or rotation, you need an excellent system to communicate the change. And, preferably, you should make the change well in advance of the new schedule. Radiologists have plans too!

Make Sure There Is A Balance

If you want to stoke the anger of your colleagues, the best way to do that is to make sure that one radiologist gets the most cush rotation at the expense of everyone else. Therefore, it is critical to monitor the different calls and rotations and ensure that the numbers are as equitable as possible for each practice member. This step can be time-consuming. But, recording where each radiologist is working and how many calls they work should become a critical mission to improve the schedule.

Be Nice But Firm

You can’t always get what you want. (Just like the Rolling Stones song!) Sometimes, we need to cover rotations and calls that no one wants. And, everyone at some point will have to take one of these shifts regardless of how they feel about it. So, if you are in charge of the schedule, there are times you have to hold your ground for fairness’ sake, of course, in a friendly way. Scheduling can be a tough job!

Take Suggestions For The Radiology Schedule

Making a schedule for a practice can be complicated. And, you might not have the experience to know what makes sense in all of the subspecialty departments. Therefore, a scheduler must be willing to listen to the suggestions of those folks that may know the rotations and schedule in their area the best. Without the input of others, it is unlikely that you will be able to create a reasonable plan for everyone!

Making A Fair Radiology Schedule

Scheduling is a critical part of any radiology practice. And it is not easy. Moreover, it may be impossible to satisfy everyone. But, if you have the tools you need and take into account the input of others while listening to some of my suggestions, you can make a schedule that will maximize equitability for everyone. It is possible to make a reasonable schedule for your residency or practice!

 

 

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You Will Have A Bad Radiology Day!

radiology bad day

Almost all of us start as wide-eyed, enthusiastic residents, ready to absorb nearly anything. I know I certainly did when I first started. But, eventually, at some point, all the planets will align the wrong way. Maybe you missed a finding and then dealt with an angry surgeon. Then, that same day, you had a heated argument with an OB/GYN resident who ordered an inappropriate study. Or, the chairman chews you out for not helping out one of the referring clinicians. Regardless of the number or sequence of events, you must expect some bumps in the road. As much as I like radiology, unforeseen problems will occur. So, how do you get your head back in the game after a bad radiology day like this? Here are some tips to help you proceed when you feel the radiology world is not in your favor.

Play The Long Game

I am sick of the cliche: “Residency is a marathon, not a sprint.” But, it is true. You have four years during your residency to learn and fulfill your goal of becoming a competent radiologist. A bad day here and there is not the end of the world (although it might feel like it!) For this reason, keeping your long-term goals in mind is essential to keep you on track. You can think of a bad day as a life lesson that will make you a stronger radiologist at the end of your residency.

Learn From Your Bad Radiology Day Mistakes

You may feel that miserable lump in your throat when you’ve made your mistakes. It’s never fun to miss appendicitis or have a team of surgeons berate you. But, good residents and learners will take this opportunity to self-correct and avoid making the same mistake twice. This principle is practice-based learning in a nutshell. Those who succeed at this will eventually become excellent radiologists, even if it doesn’t feel like it right now.

Maintain A Positive Attitude

Remaining positive can be a tough nut to crack in the face of stark adversity. But enthusiasm and positive attitudes do go a long way to getting you through that bad day. If you let the negative Nancy nay-sayers get to you because you are having a bad day, how can you treat the next patient well? We have to remember our goal as physicians is to help patients. A negative outlook will not allow you to fulfill your true potential.

Take A Mental Break

Sometimes, you need to give your mind and body a break. Listen to some music. Read that book that you always wanted to peruse. Every once in a while, getting your mind out of medicine is healthy. The perfect time to do so is after a bad day. Allow your mind and body to recalibrate. Human beings should not be on task 24 hours out of every day. It is healthy to take a break (contrary to the popular belief of some program directors!)

Learning From Your Bad Radiology Day

Not every day will inevitably be in your favor. The world does not work like that. But, if you play your cards right, you will come out of this day more enriched than when you started. It’s a matter of perseverance. So, remember why you are here, learn from your mistakes, maintain positivity, and give yourself a well-needed rest until you are ready to start anew. These techniques are some of the tried and true methods that will get you back into shape to practice radiology, prepared to work another day!

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Why A PACS Crash Can Be A Disaster!

pacs crash

Many of us have become numbed by the PACS crash. Yes, it can ruin our day and prevent us from completing our work. And, it can cause us to finish up work late. As well, we joke about it as just another technical glitch that we have come to expect. However, there are real-world ramifications to the PACs crash that we don’t discuss but should take a bit more seriously. For this reason, we should have vigorous backups and supports for the systems. Here are some of the potential tragic issues that patients, physicians, and radiologists can face.

Missing Findings

I don’t know about you. But, when I am in the zone, I use all my search patterns and am thorough, going through all the anatomy that I need. But, when the PACs crashes in the middle of a case, you lose track of where you were. Well, that’s when bad things happen. You lose your train of thought. Perhaps, you forget to look at the adrenal glands or the spleen. It is now that radiologists miss critical findings that can be detrimental to their patients.

Even worse, when the PACS crashes at nighttime, the ER can bombard you with loads of phone calls and prevent you from getting a wink of sleep. When you wake up the next day, you are barely awake. It’s a setup to missing even more findings!

Incomplete Information Leading To Bad Treatments

Unable to pull up priors or histories? Well, you know what they say: Garbage In. Garbage Out! That PACS crash can cause incomplete reports that won’t even answer the question that the clinician asked. This lack of information can lead to patient disasters and poor outcomes. How is the poor radiologist to know the diagnosis of the patient when there is no history anywhere?

Significant Loss Of Revenue For The System

If you can’t dictate, you can’t get paid. PACS crashes can lead to problems with demographics and matching patients to studies. And that’s only the beginning. Depending on the severity, it’s possible to lose tens of thousands of dollars with a long-term PACS crash. A PACS crash can cut the imaging center or hospital’s bottom line!

Angry Physicians And Patients

And then there is the ill will you build with the patients and clinicians. Who wants to return to an institution with delays and constant technical malfunctions. What’s the point when they can go to the institution down the street? It is tough to build back goodwill once it is lost.

Inability To Make Emergency Diagnoses

Hemorrhagic strokes, appendicitis, and more significant disease entities can cause morbidity and mortality. We, as radiologists, find these entities all the time. And every second counts. When you lose your PACS system, you lose those valuable seconds to save a life potentially.

Potential Legal Ramifications

Even when the system comes back up, everyone is on the hook. All the misses, delays, and anger can cause lawsuits and the potential for long hours with an attorney. Not to mention all the legal fees your practice can rack up when dealing with the misdiagnoses and angry patients you could not help because of a PACS crash.

Loss Of Confidence In The System

Finally, PACS crashes can cause lost confidence in the system. These systems can be a hospital, imaging center, or clinic. Anytime you lose information, you lose trust. These patients may never come back to your department again if the PACS system does not work. It can be a permanent loss!

A PACS Crash Can Be Devastating! 

Most tend to make fun of the ineptitudes of information technology and the folks staffing them. However, there is a real-world consequence when the PACS goes down. Patients can get hurt, and we have the potential to be at fault legally. Physicians and referrers struggle. And, the radiologists can look like fools. So, the next time your hospital looks for a PACS system, make sure to get involved and find a reliable and redundant system. The last problem we need is another PACS crash!

 

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What To Do If You Have A Blemish On Your Radiology Application!

blemish

Some of you are applying for radiology this year with a blemish. Maybe, it’s a course or two in medical school that you initially failed but later retook it and did fine. Or maybe, you had a tough time in one of your clinical rotations because of an errant resident or attending. Regardless, now is the time you need to deal with these issues. Why? Because radiology has become more competitive, many program directors toss aside many applications with a blemish since there are many without them. This problem can also be the case, even though you would be an excellent candidate for radiology. So, what can you do?

Own The Blemish

First of all, don’t disregard the facts. Own your blemish. Yes, you may get fewer interviews than others. But, if you play your cards right, you can increase your chances of acceptance at sites where you interview.

By owning the blemish, you need to have insight into what caused it in the first place and use it to make you stronger. Yes, it will affect you. But, you need to address the issue. The program director will ask you about it. So, explain in your personal statement. Show what you learned from your blemish and why it can be a strength rather than a weakness. No radiologist is perfect,  Don’t go hiding it or sweeping it under the rug. Most programs will know or find out!

Complete Radiology Research

Radiology research is the grand equalizer. It shows that you are interested in radiology even while busy with an internship or senior-level courses. And, it allows you to succeed even though other parts of your application are subpar. It is not a cure-all, but it can compensate for some faults elsewhere. Heck, a paper of yours that gets into the New England Journal of Medicine will undoubtedly elevate your application to a much higher level!

Ace Your Internship/ Senior Level Courses

This statement goes without saying. However, many applicants concentrate so much on the blemish that they don’t get the grades in their most recent courses or internship that will give them that needed boost. Don’t forget that your current courses can count just as much as the blemish. If you don’t perform well on your current rotations, all may be lost!

Do Well On Your Remaining USMLE Exams

All is not lost if you did not ace Step I or even II. Yes, it will make it a bit harder since many programs screen those exams. But, whether it is step II or III USMLE that you need to take, they can still matter a lot if you do very well, especially while you are busy with other endeavors. It shows you can handle stress well and have the potential to pass the radiology core exam.

 And remember, for those of you who have not yet graduated, USMLE step I is no longer going to be scored in the future. So, the Step I exam will become less of an issue (unless you fail, of course!)

Get To A Know A Radiology Residency Program

Finally, try to get to know the faculty in a radiology residency near you. Maybe, you are in medical school and have access to the folks in a residency program. Or you are amid an internship. In any case, attempt to get to know the staff in the local residency program. Ask to meet with the faculty or participate in projects. These connections can help get them to know you as a person and not just as an application with a blemish!

Applications With A Blemish: All Is Not Lost!

I cannot give you a money-back guarantee that you will find a spot in a residency with an application blemish, especially as radiology has become a bit more competitive. However, in most cases, all is not lost. If you own the blemish, complete research projects, do well at your current level, ace the following USMLE exams, and get familiar with a radiology residency faculty, you can surely up your chances of getting accepted!