Category: Resident Advice

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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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How To Overcome Imposter Syndrome As A Radiologist!

imposter syndrome

It’s the beginning of the new academic year. Many of you have just started your journey in the radiology world. Others are beginning their first foray into fellowship or as an attending. In each of these situations, you will likely start to doubt yourself. In the case of a first-year resident, other physicians will ask you questions that you believe they know more about than you do. As a fellow, you are probably unfamiliar with all the subtleties in your “expertise.” And, as a new attending, it will be hard to believe that your name will go at the bottom of the report, possibly alone. How can you handle all this responsibility? Are you even worthy? In each of these situations, you are undergoing imposter syndrome. You feel like you don’t have the knowledge and confidence to play your role in the healthcare system. So, what do you do?

Solutions To Imposter Syndrome

Act The Role

Now, I don’t want you to get in trouble. Of course, don’t say things that can negatively affect patient care, especially if you don’t know a topic that can affect a patient’s morbidity or mortality. However, if a resident or attending stops by to look at a film, don’t hesitate to say yes. Go through the case. Look at the priors and the report. When you look at cases with other staff, you develop more confidence in your consulting role.

Additionally, make yourself available for all procedures. Each time you perform the subsequent barium study, PICC line, or paracentesis, your hands and brain become slightly more familiar with the technique. This process allows you to feel more comfortable in your skin. Eventually, you will feel like you know what you are doing!

Becoming good at a role involves becoming a good actor at first. Eventually, the acting job will turn into your career, assuming you put in the work. And you will feel like you know what you are doing!

Read A Lot

As you probably know, radiology involves much more reading than most other specialties. This burden is due to our overlap with many specialties and the core examination. If you are not reading, you sure will feel like an imposter. At a conference, everything sounds like mumbo jumbo chicken gumbo. With the clinicians, you will be at a loss. But that all changes once you start reading intently. I promise. Whether reading films or other complicated radiology tasks, you can answer questions and feel comfortable in your skin.

Get Involved Actively In Your Specialty

Those who know many others in their career will rarely feel like an imposter. If you know all the “muckity mucks” locally, regionally, or nationally; you will feel much more grounded and connected to the world of radiology. So consider heading out there and meeting and networking at the RSNA, AUR, ARRS, and more. (especially when the pandemic eventually subsides!) Or, get involved in your hospital administration by participating in conferences, GME, or other resident administrative roles. Each time you do so, you will feel more invested in radiology and less likely to catch imposter syndrome.

Imposter Syndrome And Radiology: You Can Overcome It!

Only a few simple steps can move you down the road from imposter to maven. Acting the role, reading, and actively getting involved in your specialty are simple ways to move in that direction. Most of us feel like an imposter from the get-go. We have never done anything quite like radiology before starting our radiology track. But you can leave that position quickly. It’s a bit of work to end imposter syndrome. So, get cracking!

 

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Disrespect From A Surgical Attending- How To Deal?

disrespect

Question About Disrespect From A Surgical Attending

The Situation

Hello, I am a radiology resident berated by a surgeon with disrespect in the reading room in front of my colleagues and attendings. An outpatient had imaging findings of small bowel obstruction. I sent a secure electronic message via EMR to the aforementioned surgical attending who ordered the CT scan, an unexpected result that could potentially affect management. I did it out of courtesy even though the hospital policy does not include this as a critical diagnosis that radiologists need to convey immediately. My radiology attending signed the report a couple of hours after I had sent the message. 

However, the surgery attending did not see the message/report until later that afternoon and started to ask me via chat if I had contacted the patient or another surgeon. As per my hospital policy, I did not do that because this is not a clinical diagnosis requiring immediate notification to the clinical team, such as a stroke or pulmonary embolism. The surgery attending took the time to come to the reading room soon after. First, he asked me if I was a resident or an attending; when I answered that I was a resident, the surgery attending started to yell at me for not reporting a critical finding directly. He made it sound like the patient was going to the OR urgently (at the conversation time).

Surgical Attending Disrespect, Exaggeration, And Bluster

Furthermore, he was threatening me that the patient could have died due to the delay in communication. Later, I found out that the surgery attending had already spoken with the patient on the phone. The patient felt perfectly fine/refused to go to the ER and would wait until Monday to go to the clinic (documented in the EMR). Even though we caused no harm to the patient, the surgery attending was very contentious. He made a public scene and stated that I did not do enough to communicate this finding in the middle of the reading room. 

Also, if I had not messaged, the surgery attending may not have found out about the SBO until after the weekend, as the patient felt perfectly normal. The surgery attending cared more about displaying her power over a resident. Her display of power was not for resident education. Is a new SBO on an outpatient a critical enough finding to call the patient directly or attempt to reach the inpatient surgical consult within minutes? What do you think is the best course of action to combat what I perceive as bullying and disrespect? Thank you for listening to my long story.

Answer

There are two main issues in your question. First, let’s first start with the facts about small bowel obstruction. Second, I will discuss the reasons for this public display of power and disrespect and the right course of action.

A Little Bit About Small Bowel Obstructions

Small bowel obstructions without other emergent ancillary findings such as portal venous gas, pneumatosis, free air, bowel wall thickening, SMA thrombus, free fluid, or focal fluid collections are typically managed clinically and are not “emergent.” As your hospital policy dictates, this reason is why radiologists do not usually have to make a phone call to the surgeon at your institution. And, you did more than required by sending the text message. 

Additionally, if you are talking about a plain film diagnosis, these findings are even less specific. I can’t tell you how often I have seen a plain film with dilated bowel loops and air-fluid levels. Then, we get a CT scan, only to see not much happening. A CT scan is a lot more specific for the diagnosis but is by no means perfect. 

Nevertheless, in a pure small bowel obstruction without complication, our role is less diagnostic than management-related. Usually, the surgeon wants to know if it is better, worse, or unchanged. This decision tree, along with the surgeon’s clinical assessment, should factor into the equation of whether they need to pursue the case/management further. The surgeon’s responsibility is to look at the plain film or CT scan with or without the radiologist and decide if further steps are necessary. This role is regardless of however the radiologist reads the study.

More About The Surgeon And What To Do

Based on your story, I suspect that the surgeon is at fault for negligence with the patient. And, I believe that the surgeon is transferring her inadequacies onto you. In my history of dealing with surgeons, the least confident ones unnecessarily tend to take their anger out on others. Unfortunately, you were a target because you are “lower” in the hospital hierarchy. This surgeon is trying to feel better about her faults by displaying her power over you.

If this bullying recurs or you feel that it was egregious, I would refer the case to your faculty in a situation like this. It is wholly unprofessional to berate and disrespect anyone in the middle of a public forum such as a reading room. I don’t care if it is a janitor, technologist, resident, or attending.

Also, it would help if you precisely documented what happened with any other witnesses. That way, it takes the situation to a faculty level with some objective facts. The attending staff can then can decide to talk to the surgeon based on the case. Unfortunately, as a resident, you are not in a position to reprimand or talk back to the surgeon.

On the other hand, your faculty can undoubtedly do so. This way, it should not happen again. And, maybe the institution can change this surgeon’s inappropriate behavior.

I would be very interested to know what you have decided to do,

Barry Julius, MD

 

 

 

 

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Hobbies For The Radiologist: Are They Just A Fling?

hobbies

Yes, I enjoy radiology. But, a whole world of other pursuits awaits me when I finish work. I may write for this website, learn two different languages (Spanish and Hebrew), play guitar, prepare for the next gig, read about finance, or cook. These are just some of the long-term projects and hobbies that I always seem to fall back on. Yet, I understand that not everyone has the time or inclination for my daily rituals. But, maintaining at least one toe outside the field of medicine is necessary nowadays. And, it is not just about making a paper trail for applications to medical school, residency slots, and radiology jobs.

So, what is it about hobbies and long-term projects that enhance my radiology career? Well, there are a whole host of benefits that come with other endeavors that I enjoy. These include looking at radiology with a fresh eye, reminding me that there is more to life than medicine, finding new friends with differing interests, keeping my brain active/enhancing my energy, and enabling me to transition to a post radiology world. And, these passions may also apply to you as well. Let’s explore some of these reasons to establish a hobby now!

Looking At Your Daily Work With A Different Perspective

Hobbies can allow you to look at the world from a different perspective. For example, instead of dreading waiting for a translator to help translate a Spanish-speaking patient, as a time sink, I look forward to interacting with patients who speak Spanish. It is a way for me to get to learn their culture and get more Spanish practice. Or, as if I am working at home, having a guitar on hand as I’m reading some film enables me to play a little bit while I take a short break. All these different hobbies allow me to look at work from a different perspective.

Hobbies Remind You There Is More To Life Than Medicine

As much as I enjoy radiology and medicine, most of us need time apart from the field so that we can go back to it with a fresh eye. Working on outside projects enables you to accomplish just that. It could be a musical ensemble or a trip to a third-world country. Whatever the case may be, you enhance your enthusiasm for your career when you return to work.

Enlarging Your Familiar Circle

Pursuing hobbies outside the field of medicine can allow the added benefit of meeting other people that think and operate differently from yourself. It is a way to expand your inner circle and make new friends. It’s effortless to stagnate and drift inward as a radiologist, especially for those radiologists that tend not to see as many patients. Hobbies can keep you socially active and engaged.

Keeping Your Brain Active

Radiology can indeed be an intellectual pursuit. But, focusing on anything too much can cause a lack of stimulation. When you branch outside of radiology and medicine, it can keep you more excited about learning and reading. And, this is not just about your hobby, but rather anything else that you pursue, including radiology!

Allows You To Eventually Transition To A Semi-Retirement Or Retirement That You Enjoy

This concept may seem a long way off. But, hobbies you establish today will allow you to do other things the day you decide to partially or entirely retire. Few radiologists can work forever (although I do know a few!) Nevertheless, starting some hobby that you love today is more than a fling. It can become a lifelong mission that you can look forward to in your later days.

Hobbies- More Than Just A Fling!

You may think that hobbies should be the last item on your mind when your days are so busy as a trainee. But, starting a hobby now or continuing with projects from your past should become mission-critical. The best radiologists are happy outside the field the medicine as well. So, don’t forget to pursue other hobbies and projects that you enjoy. It will enhance your career and make you more excited about the day-to-day work!

 

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How To Prevent Home PACS Systems From Causing Chaos

chaos

We all have different ways in which we like to work. Some folks find that clutter and chaos foster creativity. And others can’t stand the slightest mess in front of them (or behind them!) I am in the first camp. I find clutter a bit cozy, allowing me to feel comfortable sitting down and starting to write. It is almost like a stimulant. But, this layout does not work for everyone. So, figuring out where to put a bulky PACS system in your office is no small task. Your well-being depends on it.

Integrating our newfound large multi-monitor computers into the overall theme of our office caused chaos. For those of us with other family members in the same workspace, these systems can interfere with the room, taking over large swaths of workspace real estate and increasing the appearance of clutter even more. So, how do you ensure the PACS does not dominate the room? And how can finding a space for it allow the rest of the family to coexist peacefully? Based on my experience, here are some tips to avoid family disputes over losing working real estate to a PACS.

Get A New Connection For A Better Workspace

Sometimes, the internet connection can limit the options for arranging a workspace. I prefer a direct hookup of the PACS system to the ethernet rather than a wireless connection. The information just gets sent to the computer that much quicker. If you don’t have the correct arrangement of hookups in the office, you may be unable to place the PACS in the right spot. Well, there is a quick fix for that. Just get a new connection and put it wherever you want!

Put The System In An Unused Space Within The Office

Only some offices have a ton of space. But, occasionally, a room may have an underutilized unique niche where that PACS system can go. It could cover up a blemish in the room or, even better, make it look more like an office. Go ahead and fill that spot with the computer system. See how it fits. It may make the office space feel like a great workspace.

Build A New Enclosure Within The Room For The PACS System

You may have the room for the PACS at other times, but you may need the appropriate spot to place it. To ensure that you can have the space you desire, you need a bit of creativity to reshape the room, add a desk, or build some cabinets around it. Either hire the carpenter to create what you want or do the woodwork yourself. Either way, a new enclosure may be all you need to make the workspace of your dreams.

Divide The Room

You may have no other option but to divide the room into two. One person wants their workspace without interruption, and the other can’t stand that eyesore called a PACS system. If you have the space to divide the room into two, go for it!

Find Another Room Altogether To Prevent Chaos

OK. Only some people have space in the house to create another office dedicated to a PACS system. But, sometimes, finding that extra room is the only solution. You can’t put an entire PACS system on top of another family member’s workspace. It’s a great way to create a battle royale!

Removing The Chaos Of A New PACS!

For many folks, a bulky PACS system is a necessary evil. It is an eyesore. Yet, it is what allows us to improve our radiology work-life balance. Before plunking it down somewhere random in a room, consider making it more appetizing for everyone. Whether it takes making a new connection, finding a new niche, building a spot for the PACS, dividing the room entirely, or moving somewhere out of the space completely, making space work for everyone is critical. Placing the PACS in the right spot should be more than an afterthought! 

 

 

 

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Don’t Hesitate To Call Your Colleagues!

call your colleagues

One of the most challenging parts of becoming a radiologist is developing an awareness of when you don’t know something. Of course, when you discover what you are missing, you can look for information on the web to fill in some gaps. But, just as important, it is also critical to know when you need more than your research. Many times, experience alone can teach you the correct diagnosis or management. As a radiologist, I don’t hesitate to pick up the phone if I doubt that I can get the information myself. I call the expert in the subspecialty. So, what are some benefits when you reach out to your colleagues? Well, here are some of the advantages that I have encountered.

Experience Trumps Books Sometimes

Most books only give you some information on how to make a diagnosis. Sometimes, only a vast breadth of experience can help solve some cases. And, if you don’t know, what are the chances you can make that diagnosis? Much less, of course. So, finding someone who can confidently read that temporal bone study can make all the difference in diagnosing a rare congenital disorder. Doing the research yourself is different.

Subtle Management Issues Are Not Easy To Find Online

Many times, you can figure out the patient’s diagnosis, but you can’t find any resources to tell you what to do next. Again, managing a patient’s condition can sometimes only be appropriately triaged when you have made the diagnosis before. So, why not pick up the phone and find the expert who has managed this patient many times? Get it right the first time!

Call Your Colleagues To Increase Confidence In Your Dictations

Other times, you have all the necessary information to make the appropriate recommendations. But what you need is confidence in your report. And it reflects in your dictation. When you speak to an expert colleague, you can confidently diagnose and confirm the next steps. Why not be sure of what you should do next?

Better For Your Learning

When I hear information from someone else, I retain the knowledge more than by looking up a fact in a book or online. Your colleagues will often relay the information on the phone more excitingly so that you can remember the case for a long time. They may give you other examples of similar patients or situations. Or, they lace the information with a good joke! Regardless, sometimes, hearing input from others is the best way to learn.

More Time Efficient To Call Your Colleagues

You can sit around researching information forever or ask someone who has trained for years in the subspecialty and knows a lot. Which one will save you more time? That phone call to your colleague can save valuable minutes of your time and energy. We only have so many hours in a day!

You Will Begin To Get Consults From Others As Well

One of the most exciting parts of becoming a radiologist is getting interesting consults from others. When you ask questions of others, you are also more likely to get consults from your colleagues. They will feel comfortable enough to reach out to you when you have a patient in your subspecialty when they don’t know how to proceed. It’s good to feel needed in your practice!

Don’t Hesitate To Call Your Colleagues!

When you call your colleagues about something you don’t know, you gain experience that you don’t have, learn esoteric management skills, increase confidence, educate yourself, improve time management, and gain the trust of others. So, why not pick up the phone and call your colleague? It is an essential ingredient for excellent patient care!

 

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Virtual Radiology Conferences: Are They Worth It?

virtual conferences

Nowadays, when you look online for your favorite conferences, most of them have still not returned to the live format. For me, it is RSNA, AUR, and SNMMI. (of which I believe RSNA will be going live later this year). And this goes for most radiology and radiology subspecialty conferences. So, what have we lost by going to the virtual meeting format? And, why have I not signed up for virtual radiology conferences this year (I also have a sneaking suspicion that many of you are in the same boat!) We will embark on all these issues and more as we delve into the frailties of the virtual conference.

Hard To Concentrate At Home On a Computer – Kids, Dogs, etc.

I don’t know about you, but home is a different environment compared to a conference. Many of us have constant interruptions from all sorts of creatures, kids, relatives, love ones, and more. It is challenging to listen to a conference when the dog is barking and the kids need dinner. Virtual radiology conferences provide an escape from the daily trials and tribulations of home and allow you to learn without interruptions!

No Meetings With Colleagues Over Lunch/Dinner

At conferences, I often learn more from my colleagues than I do from the speakers themselves. Going to events, dinners, and scheduled meetings allows you to learn about other radiologists’ practices and issues throughout the country. These meetings are where I often find out about what is going on in other residencies or the radiology business world. And, many times, I will try to apply it to our own. Going to virtual conferences does not allow you to have these experiences without a significant challenge!

Loss Of Esprit De Corps

Then, of course, something about attending a meeting and being in the same boat as the other hundreds or thousands of attendees rejuvenates my excitement for all the new possibilities in the world of radiology. Knowing that you are there and not alone makes you feel like part of a large team. Listening to miscellaneous lectures anonymously on the computer does not have the same effect, even though many others are also attending!

Can’t Check Out The New Wares

It’s hard to get a feel for the latest and greatest equipment when you cannot see the demos, play with the software, and check out the sizes and shapes of the new PET-CTs, MRI, etc. Going to conferences allows you to talk to the vendors and get an idea of what to push your hospital to purchase. It’s kind of hard to do all this from home.

Opportunity For Side Vacations Gone

Ever thought about bringing your whole family to check out the scenery while you are at a conference? Or have a desire to take a few hours or a day off to check out the local sightseeing and food? It’s kind of challenging to do that from home. One of the reasons to go to a conference is to experience something new. Traveling allows you to do all that.

Virtual Radiology Conferences: It’s Just Not The Same!

For me, virtual radiology conferences are a no-go. All the interruptions, lack of interpersonal connections, loss of the ability to check out all the new gadgets, and the lack of ability to explore the area do not make these semblances of conferences worth my while. Until we return to a fully open live conference format again, I’d instead just get my CMEs the old-fashioned way: at home!

 

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Reasons To Check In With Faculty Early In The Morning!

check in

Radiology residency programs differ widely in the independence that they allow their residents. Some let their residents do most procedures almost entirely by themselves. And others are more stingy with giving permission. Regardless of your situation, however, it is critical to check in with your scheduled cases before the day begins with your attending as a young learning physician. These include rotations, especially fluoroscopy and interventional radiology. And it’s not just to say hi! It is excellent for education and patient care. Let me give you multiple reasons why.

Getting A Good History- Filling In The Gaps

Sometimes residents either do not know the right questions to ask. Or other times, radiologists may have discussed the case with the ordering physician already. Each of these different circumstances provides information that the resident does not already have. These critical facts can change the direction of the case. For instance, if you already know that a patient is here for dysphagia, you would perform an esophagram that would critically analyze the upper esophagus instead of mainly the stomach or duodenum. Why not check in with your attending to confirm what is going on?

Increase Learning

By going over the schedule with your faculty in the morning, attendings will most likely discuss the disease entity that you will need to know. All this discussion is the best way to reinforce what you have already learned. Even better, it is a great way to introduce you to new topics and issues you may face when performing the case. And, it’s an easier way to learn what you may need to know for the boards.

Check-In For The Collaboration

Working with your attendings allows you to get to know them better. A team-based approach is usually better than going at it alone. Teamwork usually leads to a better relationship over the year. Who knows? Maybe, you will eventually ask this faculty member for a recommendation!

Attending May Not Realize Case Is On The Worklist

Sometimes cases can get lost, even on PACS systems nowadays. Accession numbers and MRI numbers can be incorrect. Or, the tech can batch a case on the wrong worklist accidentally. By going over the morning case, your attending now knows what she can expect on the wordlist during the day. And, if it is not there (for whatever reason), either you or your faculty can look into it. It is one surefire way to make sure that the case does not slip through the cracks!

Performing Studies The Way The Faculty Likes It

Every faculty member likes cases done in different ways. Some may want a few extra views of the stomach on an upper GI series. Others expect a thorough workup of the esophagus. Regardless, you will now precisely know precisely what you should do before even starting the case. All this diligence prevents the attending from bringing the case back and ensuring that you perform it appropriately. In the end, it is your attending’s name on the report and takes full responsibility for everything you do!

Check-In With Your Faculty First Thing In The Morning

It is more than just lip service to check in with your attending in the morning. Checking in serves many practical purposes, including getting better and more valid information, learning about diseases, preventing cases from falling through the cracks, and ensuring you complete the procedure correctly. So, pick up the phone or stop by your attending’s office. And let your faculty know what is on the schedule before starting. It is an excellent way to augment learning and improve patient care!

 

 

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Should You Take A Phone Call From A Physician Outside Your Residency System?

phone call

Picture this scenario. It is 2 a.m., and you get a phone call from a doctor at an outside hospital not associated with your residency. The doctor asks about a patient previously admitted under one of the radiology faculty at your institution. This faculty member also has privileges at another site, but your residency program is not affiliated with this other imaging center. He prompts you to try to contact the faculty member to do the procedure at the other hospital. If you comply with the phone call demands, it will take time away from reading cases while you take call. What do you do?

Many of you may have encountered a situation such as this one. And, you might think there is a simple answer. Of course, you should help out a fellow clinician in need, right? But, in fact, many issues should come into play before making this final decision. So, let’s go through these factors and come up with a balanced answer to this question. Let’s tackle this problem from three different angles: patient care, the hospital/residency perspective, and the financial/legal perspective. Then, we will come up with a final conclusion on how to deal with this scenario.

The Patient Care Perspective

From a patient care perspective, as long as you can verify that the physician calling is truly a physician, helping out a fellow clinician could potentially benefit the patient the clinician is calling about. However, while trying to get in touch with your radiologist, you are distracted from the work you have at hand. You may be delaying all the CT scans, ultrasounds, and more that need to get read at nighttime. So, in terms of patient care, answering the phone call may at best be a wash in terms of fulfilling your duties.

The Hospital/Residency Perspective

On the other hand, you are also providing a service to an outside doctor, not in your job description. You are supposed to be taking care of patients at your institution, not other sites. Moreover, the hospital and the federal government pays you to take care of patients at this site. Answering the phone call for the convenience of an outside attending is outside your job purview.

Additionally, from the residency perspective, taking extraneous phone calls is not helping you in your training. Nor does this phone call count as service duty. Therefore, taking this phone and performing this service runs counter to what you should be doing at nighttime.

The Financial/Legal Perspective

Your malpractice insurance does not cover you if you are taking care of patients outside the institution. Let’s say you can’t get in touch with the faculty member to take care of this patient. But, you have promised to get in touch with him. Now, in a sense, you are taking responsibility for a case outside your institution. You have some obligation toward the doctor that called, the patient that needs care, and the faculty member that you need to call. If something goes wrong with these entities’ connections, the law can hold you partially liable theoretically. And, the residency does not insure you for that!

What To Do With The Outside Phone Call?

You have one reason to respond to this outside physician’s request (“to be helpful”), and you have multiple additional patient care, residency, and financial/legal reasons not to get involved. So, what is the best course of action? Based on these reasons, you need to make it the hospital’s responsibility to get the doctor’s information. Refer the doctor to the operator or the help desk!

In a perfect world, we can help out everyone. But, there are costs and benefits to everything we do. Sometimes, initially, the seemingly most logical and straightforward answers are not the best!

 

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Top Ten Reasons To Be An Urban Radiologist! (From A Suburbanite!)

urban radiologist

Last week I gave you all a top ten list for becoming a rural radiologist. But, I have received a few complaints from my urban colleagues that believe they have been shortchanged. Despite all the advantages of rural radiology, there are still some significant advantages for urban radiologists. Today, to be evenhanded and in honor of the city life, here are the top ten reasons to migrate to the city as an urban radiologist!

Concentration Of Specialized Radiologists In One Place

Where else can you find a subspecialist that specializes in neuro intervention of vascular malformations as well as a Xofigo center of excellence? Unlikely that you will find this in the middle of rural Nebraska. But, in a big city, you can find a subspecialist in almost anything. And, you can become that specialist because of the high concentration of patients in one place!

High Quality Of The Urban Radiologist

That is not to say that rural radiologists are bad, but it does take a lot to survive in the city. And finding that job usually requires some high falootin’ credentials. It would help if you had the right hybrid of certificates and connections. So, you do find a large proportion of overachieving physicians in the city. It even goes the same for radiologists!

More Cross-Pollination With The Urban Radiologist

What happens when you gather a bevy of doctors in one place? Well, you get to hear the war stories in other departments. And you are more likely to discuss other physician areas of interest. Of course, this discussion will often lead to distinct outcomes, whether creating research or treating patients differently. For instance, you have an all-star thyroid pathologist on the premises, so you are more likely going to do lots of thyroid biopsies, more so than other institutions. Cross-pollenation changes the dynamic.

Convenience

Where else can you walk a few hundred feet away from your site of work or residence and go to a supermarket, drug store, and dog training facility? I certainly can’t think of any. There’s no need to maintain a car or means of transportation. It’s all at your fingertips by walking or public transit.

Easier For The Urban Radiologist To Get A Date

Maybe you are single and looking? When you out in the middle of rural Idaho, you might have a more challenging time finding a significant other. And many young radiologists are still single. So, think about that urban job. You are more likely to find like-minded folks and, of course, get hitched!

Larger Diversity Of Patients

Are you looking to become more culturally aware? Well, look no further than the city. You will see all types of folks and have the opportunity to communicate and learn from them. It just doesn’t happen to the same extent out in the hinterlands. It’s only one of those advantages of city life.

Greater Swath Of Pathology

Along with the more significant cultural diversity comes an increased variety of pathology unique to every culture and country worldwide. You will find all sorts of weird and bizarre diseases in the middle of a city you won’t find elsewhere. These can include all kinds of genetic and environmental pathology. Want to swing for fences with differential diagnoses with zebras? Go practice in the city!

Cultural Opportunities

Do you like the opera or want to see a heavy metal rock concert? Maybe you want to check out the local happenings at the new dinosaur exhibit? There is no better place for this than a large city. You will never get the same opportunities out in the country.

Lots Of Shopping

Folks come all over the world to shop at select stores in large cities. And, you can find goods and services that you would seldom find anywhere else. It may be a market for ancient lamps or a store for hand-hewn mannequins. You can find it all, and it may only be a few footsteps from your urban job!

Restaurants/Food

For the eclectic culinary lover of a radiologist, there is no better place to try out the flavors of the world. Olive Gardens and Chili’s (as much as I like them) don’t always do the trick. Sometimes you want to eat out or pick up food from a culinary king. And, even better, when you step out of your imaging center to go to pick it up next door!

Being An Urban Radiologist- Not So Bad!

Yes, rural radiology does have its advantage when it comes to the cost of living and pay. But life is not all about money. You miss out on a whole world of opportunities when you live outside the city in rural America. So, if you like culture, entertainment, and convenience, consider a life in the city as an urban radiologist. You won’t regret it!