Tag: burnout

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Top Ten Signs It’s Time For A Radiologist To Retire!

retire

I’m sure many of you have encountered radiologists who should have retired years ago but are still hanging around. Maybe they are burnt out. Or, perhaps, life has thrown them a few curveballs. Here are some of the top ten reasons why you know it’s time for your fellow radiologist to retire!

One Extra Case Sets Them Off

You probably know one or two radiologists like this. If anyone asks them to help with another case, they will lay it thick on you. Perhaps, they will yell and kick, or they will say they need to get home and can’t afford the time it takes to complete it!

They Can Only See Films From One Eye In A Certain Position

Some radiologists will do almost anything not to go to the doctor. They hang around longer than necessary in practice. I have known a few that would practice with ailments for which I am not sure they can compensate. For many of these radiologists, it may be time to pack your bags!

Spend More Time Napping During The Day Than Reading Cases

In the past, I used to know a radiologist or two who would spend a few hours in their office while everyone else was working hard. Some residents saw them getting shut-eye while everyone else struggled to keep up with the work. If you get to this point, maybe you should be getting up late every day at home without having to read films!

New Ailment Every Day

I’m sure you have heard of a radiologist who always seems to get sick. One day a heart condition, the next day, a limp, and the next day a raging cough. Some folks are too frail to make it to work. If that is you, it may be time for you to nurse yourself back to health and take some time off. It will do you some good.

Yells At The Medical Students Upon Arrival

Poor students. The wrath of some attendings manifests itself on the underlings that come in to visit. They are angry at the world and take it out on the learner. No, it isn’t right. But, it does happen. These folks need some time off to think about their behavior!

They Are Reading 400 Cases Per Day

Most practices have one radiologist that reads too much to be safe. If you are reading four hundred or more cases per day, I feel you are missing a lot of critical findings. Think again if that is what you want or if it’s simply time to slow down.

Flagged Cases So That A Particular Radiologist Will Not Read!

If you have your name tagged on one too many cases, it may be that another one of the radiologists is not allowed to read this referrer’s studies. Or, some physicians whisper about another radiologist and don’t want this person reading the cases. Either way, it’s not a good sign. It likely means that this radiologist is not doing his job well. This radiologist may want to give up and stay home.

Their Cases Always Seem To Make To Morbidity And Mortality Conference

Ever notice that the same radiologist’s cases make it to morbidity and mortality conferences? Well, perhaps, it is for a good reason. All their misses contribute to the holistic lousy patient care. Be on the lookout if this radiologist is in your department!

No One Can Speak To Them Anymore Or Ask Questions

Some radiologists stay away from this one colleague. Unlike most colleagues you can bounce ideas off of, they can’t ask any questions of this person for fear of yelling and negativity. You probably have someone like this in your practice. There is a good chance that it is time for this radiologist to retire!

Always Complaining That They Should Retire

Everyone knows of a radiologist that constantly talks about retiring. They say it in myriad ways, and it becomes a real bear to hear. “I can’t stand work it’s time to retire,” “I can’t take it any more and it is time to go” are the statements they make all the time. Well, do it already!

Reasons It’s Time For Radiologist To Retire

No one can work forever. But, I think that these reasons to retire soon do justice to those folks that should pack it in sooner rather than later!

 

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Do Radiology Resident Retreats Really Work?

resident retreats

Flashback to 2001 or 2002: Our program director at Brown announces that we are going to meet in the fancy dining room in the new wing of our hospital for a resident retreat. One or two days later, we all had a free meal and shared war stories from the hospital with the guidance of our faculty.

Today: I can vaguely remember only the stuffed chicken from this first “retreat.” And, I can barely remember the war stories. Sure, it was nice getting a break from the regular rig-a-ma-roll of hospital activities. But, did it reduce resident burnout and exhaustion? Moreover, did it create a lasting memorable experience that changed me?

Well, the recent article in the Radiology Business Journal claims that resident retreats may directly reduce burnout. And, this conclusion was explicitly based on another piece which issued questionnaires to residents.  (You can click on it at Current Problems in Diagnostic Radiology here).

So,  based on some of the “data,” as well as my experience, I figured I would attempt to tease out whether resident retreats do mitigate resident fatigue. And, we will look into whether this article is anything more than clickbait. Also, is the resident retreat is just another way to get around the real issues that cause residents to be miserable during their residency without directly addressing them? We don’t want to give this article and the Brigham program (as much as I like it) an easy pass!

The Main Conclusion Of The Study: Improved Camaraderie

Yes, many residents bog themselves down in residency and lose the bigger picture. And a day or two of a retreat can reset your general mindset and outlook. However, giving residents an open-ended questionnaire and expecting the answers to reveal some long term decrease in burnout is a big leap of faith. I mean, sure, you will get positive opinions expressed because it is a day off from work. Who doesn’t want a day off to relieve the mundane parts of your job? I would be happy to answer any question positively after a day or two off with a full belly and a few good conversations with my colleagues.  So, I’m not sure if this format truly addresses whether the resident program is mitigating burnout. Sounds nice in theory, though!

What Is Causing Burnout- Does The Retreat Solve That?

Well, take a look at another article from the Radiology Business Journal. You will see a whole list of factors that cause resident burnout. In fact, they list the following: “counterproductive administrative tasks such as procedure logs and training modules, continuous and long clinical shifts, demanding call schedules, technical issues and lack of feedback and social interactions.” And, of course (based on my current resident experiences), I would like to add student loans/high debt to the equation.

So, what exactly does this retreat address then? Merely just one of the myriad factors that cause burnout- lack of social interactions. Is this enough to tip the overall ship to reduce burnout significantly? I’m not so sure about that. And does it deflect from solving most of the other real issues that cause exhaustion in a radiology residency program? Probably! If you think about it, of all the causes of burnout, this residency neglected all the others in the spirit of making the residents temporarily happy by having a day or two of social interaction.

Bottom Line About Resident Retreats

It’s good PR to create a retreat to provide the residents with an opportunity to fraternize with their colleagues. And it’s certainly nice to have some time to commiserate with your brethren. However, it takes more than one resident retreat with a few fleeting smiles to relieve the myriad causes of resident burnout. Based on this method of data collection, the numerous sources of burnout, and my own retreat experiences, the study conclusions overly simplify the real causes and solutions for treating resident burnout. Although it sounds nice in theory, and may temporarily increase residency morale, a solitary retreat is not the answer!

 

 

 

 

 

 

 

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What Is Your Work Limit? Find It Before You Get Your Next Job!

work limit

I’ve written before about RVUs and how much work is too much for a radiologist. But, let’s talk about how to figure your work limit before getting into RVU numbers. And that begins right where many of you are now, in radiology residency. Don’t just assume that you will start your first radiology job and you will comfortably work your tail off to make a gazillion dollars per year for the rest of your life. It’s not sustainable. Trust me. You will never be more miserable in your life.

So, how much can you do without going batty? Well, I am going to be a little bit formulaic and give you some ideas on how to figure that out now. Don’t make the wrong decision and work for that next burnout factory!

Do Some Thought Experiments To Determine Your Work Limit

Let’s Say You Could Do Your Favorite Specialty All The Time

Let’s begin by creating an ideal job for yourself where you could do just the right amount of work. For those of you who only want to practice within a specific subspecialty like mammography, this answer should be simple. How many of these studies can you realistically read in any given day without tiring yourself out? Is it twenty, forty, a hundred, or more? The number may not be entirely exact. But, it’s an excellent starting point when you begin to look.

Start thinking in this way because, for some lucky individuals, you can pick the number of studies you want to read in your desired subspecialty. Especially in this market, you can find many lifestyle jobs in the market. Who knows, maybe you can find one of them?

Let’s Say You Could Do Some of Your Favorite Specialty Some Of The Time

For many of you out there, you want to do some work within your area of expertise. But, you would also like to practice in other subspecialties as well. So, say you opt for 25% of the work in your area of fellowship training. And, maybe, the other 75 percent you will dedicate to outside your primary discipline. In this situation, think about which areas within radiology you would like to practice outside your subspecialty. And then, come up with a particular quantity of studies that you can comfortably read in a day.

Why is it more critical to figure out the number of studies you can read outside your primary area of expertise? Well, you want to figure out the most you can bear to do in specialties that you are the slowest. And, for most, that number relies on work they are willing to perform outside of their fellowship training.

In this thought experiment, I would recommend to base this number on your experience on call at nighttime or moonlighting. And then, take that number and apply it to your next job.

Imagine What It Would Be Like On A Day Of Your Worst Nightmares

And then finally, imagine what it would be like to have to practice on a day where your worst nightmares come true. Maybe, you hate reading triple-phase CT scans for pancreatic masses (probably one of my least favorite!) Well, pick a day where you have a ton of them. How much would it take to make you want to abandon ship? Well, you need to figure that number out. Why? Because Murphy’s Law says it will happen and likely more than once. Unless you make sure that you find a practice that will guarantee that you will not get a day like that, you will experience it.  So, figure out what this number would be.

Take A Test Drive Right Now- Apply The Ideal To Reality!

Now that you have some ideas about the numbers of studies that you would like to complete, you are now ready to confirm it all with real-world experience. How can you do that as a resident or fellow? Well, pick a day at your site. And then, go through the number of cases in your specialties of choice that you decided you can complete in any given day. Try it several times to confirm that this is a number that you can handle.

Of course, later on in your career, you will pick up speed and read more studies quicker. But, at least by giving it a trial run right now, it will provide you with a general idea of what your work limit might be. Well, how did it feel? Did it match with your thought experiments? If it doesn’t, and you feel like you should be reading more or less, rinse, wash, and repeat. Readjust the number depending on your experiences. There is no better time than the present to figure it all out!

Finding Your Work Limit The Right Way!

At this point, you have a realistic idea of the number of studies that you can handle. And you can apply it to your next job search. So, when you interview, ask questions about the numbers of cases that you are expected to read.  Does it match up with what you have calculated would work for you?  If it does, keep it in mind as a potential candidate for your next job.

Burnout is a hot topic these days with many job prospects expecting way too much from their applicants. If you want to prevent it from happening to you, be deliberate when you look for your next job. And, utilize these recommendations for helping you to vet the practices you seek. Being methodical and intentional about figuring how many cases you can comfortably and safely read now can be critical to your future career happiness and success!

 

 

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What Is The Best Specialty For A Lazy Radiologist?

lazy radiologist

Question:

Hi,
Which is the radiology subspecialty with the best lifestyle and shortest/least taxing work hours? And how about lifestyle in body imaging?

From,

The lazy radiologist .

Answer:

I love the question. Why? Because it reflects the purpose of my website: To get answers that no one else will give you!

In any case, as you may know, if you want to make good money, radiology is no longer a lifestyle specialty. Imaging volumes are up, and very few imaging centers will hire someone that cannot keep up with the work. And, if you are the owner of a practice, you will undoubtedly need to work hard. But, if you are willing to take lower pay and not work as an owner, then numerous lifestyle opportunities abound. Of course, you can always decide to work part-time three days a week and have a great lifestyle as a lazy radiologist! Most specialties will allow you to work part-time depending on the practice where you choose to look.

OK. So, let’s say that you are interested in working full time and want a relative lifestyle subspecialty. My recommendation to you would be to find something in the outpatient imaging sector. Typically, hospitals and urgent care centers that need radiologists to work on call will be significantly busier and will require you to work on off hours. And, being busy disrupts the whole lazy radiologist lifestyle thing!

Then, what are some of those specialties that are more conducive to outpatient imaging? My first thought would be breast imaging. First of all, you will find very few breast emergencies and call scenarios for a breast imager. Unfortunately, the daily volume of work can be difficult if you want to make a significant amount of dough. But, at least you may not have to take call!

What else? Teleradiology gigs will allow you to work on your own time when you want. Some of them have “dayhawk” needs. In this situation, you can have the ultimate flexibility if you decide upon this field. But, then again some teleradiology firms want night workers. That may not fit the bill for what you want so don’t choose that pathway if so! 

Also, MSK imaging is not a bad choice for lifestyle-oriented radiologists. MR MSK imaging tends to be an outpatient phenomenon. And, you can find some outpatient centers willing to take on an MSK radiologist.

Body imaging would not be my first thought as a lifestyle specialty because most practices have expectations for you to read lots of studies and to do lots of procedures. Also, most practices will expect you to take call. However, certain workplaces do allow for a better lifestyle than others. You can find them if you look although they may not be lifestyle-oriented in the most “desirable” cities. (That’s just the way it is!)

Most other subspecialties also involve significant amounts of work and time. But, as you get on in years, you may also have more flexibility in choosing a more lifestyle-oriented pathway as well. For instance, many interventionalists become diagnostic rads and so and so forth. So, there is no reason why you can’t choose to change your “lifestyle” pathway along the way.

Finally, remember. To be good at anything takes a lot of work. So, you may need to sacrifice being a real expert for lifestyle. That’s just the way it is!

Hope that helps a bit,

Barry Julius, MD

 

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Vacation During Residency: Not Just A Luxury!

vacation

Have you ever worked in a typical business office setting (like the world of Dilbert(1)!)? Typically, you will see young professionals, some working but others wasting time. They make time to text, check out the internet, meet at the water cooler, or make sure to make time to go out to lunch together. If they forget something or make a mistake, perhaps an order gets delayed. No big deal…

Fortunately or unfortunately (depending on your perspective!), these experiences are foreign to radiology trainees and radiologists. We tend not to have much time for inconsequential social activities in our world. Most days, we spend reading films or performing procedures with real consequences. If we miss a pneumothorax, a patient can die. If we embolize the wrong artery, we can cause a stroke. So, we relegate ourselves to taking everything seriously. And rightfully so. But, all this takes a toll over time.

Have you ever heard the phrase: all work and no play makes Jack a dull boy? (According to Wikipedia(2), it comes from 1659!) Well, this phrase applies just as much to the radiology resident. In fact, with all this talk of burnout, each resident should follow this ancient bit of wisdom. Every person (even radiology residents!) needs some time to play. So, all this banter brings me to today’s blog topic: why vacation should be mandatory for every radiology resident.

Gaining New Perspectives

Often, residents get so caught up in worrying about studying, reading, and taking tests that they forget to appreciate the other important facets of life. Sometimes, you need to step back from the daily grind and spend time with friends/family, by yourself, or accomplish something different. Whether you take a trip to an exotic locale or stay in the comfort of your own home and get some more sleep, a vacation gives you that extra time to accomplish different activities from the usual. What better way to gain a more positive perspective on your work and life?

Improving Concentration And Energy

I don’t know about you. But, after a week or two off, when I return to work, I usually return with renewed vigor. It’s a wonder what an extra little bit of sleep or change of pace can do. And I am not the only one who says so. Study after study (2) has shown that vacation improves productivity when you return. So, don’t feel guilty you are not learning enough. Take that vacation and enjoy!

Remembering What’s Most Important

Yes, the radiology work and studying we do is critical. However, as the old bit of wisdom goes, what do people remember the most at the end of life? It’s not that they wished they could spend an extra day completing an assignment at work. Instead, it tends to be the time that you spent away with your loved ones or friends or the good times you had on vacation. So, don’t fret and take that little extra time off!

Incorporating Different Ideas To Improve Residency Experience

Finally, when you vacation, you see new places, complete projects, or think about life differently. The best ideas often come when you are not at your primary work home. (For me, that’s at 2 AM when I write these articles!) Maybe, you scuba dived in Bora Bora, completed an archeological dig, took the time to finish that extra gardening, or spent more time perusing in bed. Often, you can incorporate these “extraneous” activities into improving the residency experience for yourself when you return.

Vacation And The Radiology Resident

Vacation is not a luxury. Instead, residents especially need to consider vacation as a requirement to recharge and unwind. So, fly far away or stay home. It doesn’t matter. Just take that vacation, and your work life will improve when you return. Let others worry about work when you are on away!

(1) www.dilbert.com

(2) https://en.wikipedia.org/wiki/All_work_and_no_play_makes_Jack_a_dull_boy

 

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Physician Burn Out- Is An Inadequate Medical Education System The Fundamental Cause?

We read article after article about the complete dissatisfaction of physicians throughout the United States and how it affects patient care.  Since it makes a good story to cover the woes of physicians, the general press seems to covers this topic as dogma. But it is not just the general news. Even Medscape, one of my favorite radiology news/blog sites, has multiple articles and surveys on this topic.

Many different reasons are espoused for the cause of physician burnout. But, I believe there is one major factor that is not addressed. It all has to do with our medical school system and how the system is not made for the student/trainee but rather to support the folks running the schools.

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