Ever notice how one or two studies can become the focal point of any night?. Hordes of surgeons, medical specialists, and more come down every fifteen minutes to look at or discuss the case with the radiologist. And, you become the “most popular physician in town.” Sure, it can feel good to be so popular. But, you will find many costs to the disruptive study. On a busy night, you cannot get to the next case. And, the tick-tock of the clock becomes more ominous as the weight of an ungodly list of additional studies piles up. Most critically, you become unable to read everything else. So, how do you prevent a disastrous outcome with unread studies, unhappy doctors, and a nightmarishly long shift? Here are some tips for decreasing the suffering that a disruptive study can cause.
Make Preemptive Phonecalls!
If you know that a case will be “interestingly” positive, make sure to call all the relevant parties beforehand. Although not a guarantee, this polite maneuver will often prevent a group of surgeons or ob/gynecologists from asking you about the case while you are in the middle of dictating something entirely different and complex. Plus, it will make it seem like you are on top of everything.
Don’t Be Ambiguous
Sometimes cases are like magnets to the clinicians because your dictation or what you tell them is not clear. It could be a nodule that you measured as 2 cm in the body of the report, but you stated it was 2 mm in the impression. Or, perhaps, you were not straightforward with your differential diagnosis. Ambiguous reports lead clinicians to find out what is going on by searching for you, especially while dictating something else!
Dictate The Disruptive Study As Quickly As Possible
Cases have a shelf life. If you don’t dictate them on time, the shelf life will end, and you will have a clinician coming down to review the case before you know it, interrupting the workflow for your day. So, as a rule, I try to dictate the “interesting: report as soon as possible. You significantly decrease your colleagues’ chances of stopping you in your tracks.
Tell Your Junior Resident About The Case
Sometimes you are on buddy call or have another radiologist help you out. This opportunity is perfect for teaching your junior resident and then having them go over the case with everyone else! Firstly, this will prepare the resident to learn about a radiological finding or a disease entity. But, it will also teach your junior resident how to go over cases. And the fringe benefit is that you can get the rest of your work done!
Worst Case Scenario- Batten Down The Hatches!
Sometimes the night can get extremely busy. And, you have no time to beat around the bush. As a last resort, sometimes you have to tell the doctors that you are in the middle of doing something else. And that you don’t have the time to go over the study. If you don’t have the time, it’s not cruel to delay a third interpretation of the same case. You do have other cases to read!
The Disruptive Study- Not The End Of The World!
The disruptive study is simply part of our job. Bizarre and challenging cases spark the interest of our colleagues, and they will want to address the issues with you. Nevertheless, we can mitigate the interruptions that it will cause by calling clinicians, increasing clarity, reading cases efficiently, or telling other junior radiologists about them. And worst-case scenario, you can ask them to come back when you are ready. The disruptive study can be painful. But, at least, you have some ways to decrease the potential for it to ruin your whole day!
