Tag: career advice

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How To Pull Your Weight As A Radiologist!

pull your weight

You may not know it, but hiring a lazy radiologist is one of the biggest disasters a practice can encounter. Practices spend much time and money getting their new employees up to speed. The last thing you want to be is to have to pull your weight in addition to someone else. And you want to avoid being seen as one of these lackadaisical radiologists. Why? First of all, your job can be in jeopardy. Even worse, you will lead an unsatisfying work life fraught with the anger of your co-workers. And you will most likely miss out on the perks of becoming a senior practice member. So, how do you avoid this reputation and pull your weight? Here are some tips for holding your own!

Don’t Cherry Pick

If you want to anger your colleagues and establish a lazy reputation, this is the best way. It doesn’t take long for others to realize that you are taking all the easy-peasy cases and leaving all the tough ones out there for others to suffer.

Follow Through On Your Word

Imagine working with someone who says they will help with an overflow of cases and then decides to pack it in when the clock strikes 5 PM. Or, how would it feel to trade worksites with someone else only to have that person not show up as they said? These workers leave a bad taste in everyone’s mouth. Just follow through on your word!

Take That One Extra Case At The End Of The Day To Pull Your Weight

I’ve written about this before (click the link above!). But, it is true that if you help by taking that one extra case at the end of the day, it can make all the difference for the rest of your colleagues. As opposed to establishing a bad reputation, this kind-hearted technique will put you in everyone’s good graces!

Pull Your Weight By Dictating Leftovers

Most practices have a list of cases that can go untouched for what seems like eons. These may be cases with QA issues, incomplete imaging, or other miscellaneous issues. If you take charge of some of these cases that everyone else ignores, the practice will deem you a hero. Who wants to avoid working with a radiologist who takes charge of the worklist?

Don’t Argue Over Minutia: Who Should Do This Or That?

Yes. Every practice has rules of etiquette that dictate who should read what and when. But, in some cases, the boundaries are crossed. Don’t be that radiologist who refuses to help because the technologist completed the case after your shift time ends by thirty seconds. Just read the study!

Don’t Let Cases Bleed Over To The Next Shift- Pre-dictate!

In some cases, they need to wait for the subsequent radiologist on shift, but many don’t. Be cautious about not pre-dictating studies that you know will have to return for delays, such as questionable diverticulitis. You don’t want the work from your shift to bleed into the next. It shows respect to your colleagues that you are willing to do the work!

Pull Your Weight!

It’s sometimes easy to let things slide when you are tired and want to go home. But others have to complete any work that you still need to complete. So, as a young radiologist, don’t garner the reputation of laziness. Heed some of the recommendations above, and you will become a well-appreciated member of a radiology team!

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What Electives Are The Most Marketable?

marketable

Question About The Most Marketable Electives

Hello Dr. Julius,

I’m having difficulty deciding what electives to do during my last year of radiology residency. I will be doing a fellowship in body imaging, and I’m considering finding a job in a private practice (outpatient, ER, private hospital). I have a total of six electives. I thought of three neuro, two MSK, and one mammo versus three MSK, two Neuro, and one mammo. What would you recommend? What would make me more marketable?

I appreciate your help.

Thanks a lot for all the info you’ve provided us!

 

Answer

 

Your marketability will depend on multiple factors. But, the specific number of each of the rotations you provided is not so critical. More importantly, you should feel comfortable in whatever areas you want to practice when you finish your residency program outside of your fellowship.

For example, you may have done a lot of mammo before coming to fellowship. So, in that case, I would opt to do that elective less. Or, if you are weaker in MSK and are interested in practicing in that area as a radiologist, go for it. Each elective you choose should help you when you leave the academic world and start a real-world radiology job. And, if you want to be more creative, you can check out my previous blog on creating electives as a senior!

Let your experiences and desires to practice different subspecialties dictate which ones you should choose as an elective. At most job interviews, they are usually not going to delve into the details of how many rotations you have done. But they might ask you about mini-fellowships (since they are all the rage!). And they are surely going to ask you what you feel comfortable reading!

 

I hope this helps,

Barry Julius, MD

 

 

 

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New Radiologist? Don’t Go Over the Head of Your Boss!

your boss

For many of you, working as a radiologist will be your first full-time job. You are finally going to enter the real world. And, if you have not worked outside the world of training and education, you may be in for a few surprises. First of all, most practices’ mission is very different from your residencies, medical schools, and universities. Your boss will no longer be a teaching physician. Instead of educating students, your first position’s goal is most likely good patient care and earning a living.

Additionally, some of the rules and regulations you will need to follow along the way are also not the same. And many of these rules are unwritten. One of the biggest faux pas of new radiologists is going straight to the top without consulting your boss in the chain of command. Of course, sometimes, there are extenuating circumstances. But, for the most part, it does not serve your needs. Let’s go through some of the reasons why!

Hard Feelings

First and foremost, most bosses don’t like it when a senior manager tells them what to do when they could have managed the situation by themselves. Say, for instance, you decided to go directly to your chairman instead of the chief of nuclear medicine to tell her about an unruly technologist that yells at patients. And then the chairman decides to deal with the issue. Well, you are leaving the chief of nuclear medicine out of the equation. How do you think your boss would feel if the chairperson decides on the matter without consulting your boss. Or if she consults with your boss without you involved. Either way, you may cause a bit of bad blood in the department. That is poor communication!

People At The Top Often Don’t Have Time For All The Details

As y0u go higher up the chain of command, many leaders have much less time to deal with the day-to-day clinical work. Many chairpersons deal more with hiring and firing, salaries and negotiations, and budgetary issues rather than taking care of the daily needs in your ultrasound section. And, they have meetings and work that takes them away from your world. Why would you ask someone with less time to help you? The best person to ask if you are having an issue with an ultrasound machine is more likely to get an answer with the chief of ultrasound instead of a radiology chairman! Moreover, your direct boss usually has more time to deal with the situation.

Your Boss Knows More About Your Position

Your direct boss knows much more about what you do than the hospital president or the CEO of your private practice. Going directly to that person in charge will much more likely give you the answers you need than someone dealing with the business’s general issues. It’s always best to go to the source that knows what you do.

Builds A Better Relationship With Your Boss

Finally, you want to get to know your boss better? Well, the best way to do so is to communicate with him. Asking your senior questions when issues arise shows that you trust their opinions and feel like they are a valuable part of the team. What is a better way to build good relationships in your department?

Don’t Go Straight To The Top Unless Necessary!

There is a chain of command for a reason. Breaking it can cause undo hard feelings, give you the wrong answers, and prevent you from building better relationships within your department. So, think twice if you need a problem that you need to solve by going too far above the chain of command unless necessary. The outcomes may not be what you desire!

 

 

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Top Ten Reasons To Work As A Rural Radiologist (From A Suburbanite!)

rural radiologist

Go onto any radiology forum, and you will hear a perpetual argument about who has it better, an urban or rural radiologist. So, let’s nip this in the bud once and for all. Let’s give a top ten list as to why you should look for a career as a rural radiologist (coming from a suburban radiologist, of course!)

Top Ten Reasons To Practice As A Rural Radiologist!

Better Pay

This one is the most obvious, but it is true. Check out any of the want ads, and you will see sky-high salaries enticing you to drop on by. Typically, they may not say the name of the town. Why? because they know that you have never heard of it! How can this happen? Well, they need to incentivize you, the radiologist, to want to come there. So, why not take advantage of it? Make those big bucks!

Cheaper Cost Of Living

Not only do you have the advantage of extra pay, but your cost of living can be more than 50 percent or even 75 percent less than living in a city. Think about a three-bedroom apartment in New York or San Francisco for umpteen million dollars. What would that cost in a rural area? A few hundred thousand dollars at best. Think about all that cash you can save with that huge salary that you have.

Less Daily Pressure

More than the money, this one attracts me the most. The lifestyle of the inhabitants of the rural world tends to be less pressured. Less screaming and arguing. More space away from others to prevent kerfuffles. Why not work and live in such an environment?

Appreciative Patients

In rural communities, you tend to have patients that appreciate your work. Why? Well, they can’t simply go to the imaging center down the block. There isn’t any! Your word is valuable, and you are an integral part of the community. It’s just part of the package of rural America.

Cleaner Living – Nice Smell

You know that sweet smell of nature when you leave to go on a trip to the country. Well, if you work at a rural site, you can have that all the time. You don’t smell the exhaust pipes of tons of cars. Nor do you smell rotting garbage on the streets. You just have the crisp, clean air of nature.

Rural Radiologist: One With Nature

Like going for brisk walks with your dog? Or, you enjoy hiking on mountainous nature trails? Maybe, you want to go swimming in a lake? All you have to do is walk out your door, and it’s available. Not a bad gig for the nature-loving radiologist!

No Traffic

Imagine leaving your doorstep and driving to the hospital with no more than a few other cars driving on the road? That is a pipe dream for a city radiologist. But, it is the real world for the rural one. Get to work fast and without the hassle of not knowing exactly when you will arrive.

Larger Spaces/Newer Hospitals

Rural hospitals tend to be more open and modern. Why? Most were not built at the beginning of the 20th century. Therefore, you’ll find open floor plans for interventional suites and widely spaced modern reading rooms. These are features of most rural hospital centers.

Lower Decibel Levels-Better Health

When you step outside, you don’t hear the honks of cars or the screams of fighting neighbors. Instead, you hear the rustle of the leaves or the chirping of the birds outside. Furthermore, you don’t live in an area with as many pollutants in the air and water. It’s a setup for a healthier lifestyle.

A Rural Radiologist Can Do Everything

Finally, because you don’t have tons of competition in the neighborhood, you can do almost any type of procedure that interests you. You won’t be butting heads with the cardiologist who wants to take all the Cardiac MRIs or the vascular surgeon with all the peripheral vascular patients for angiography/peripheral vessel disease. The world is your oyster!

The Life Of A Rural Radiologist- Not So Bad!

So, there you have it. Here’s a top ten list for why to choose rural radiology from a local suburbanite. Take it or leave it. But, there are lots of advantages to rural life!

 

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Pros And Cons Of Emergency Radiology!

emergency radiology

Question About Emergency Radiology:

 

Hi Dr. Julius. I have recently developed an interest in trauma radiology. I like it because I would get to work from anywhere. And, I don’t have to deal with patients and people in general, aka no tumor boards (I’m an introvert). Moreover, I read somewhere that there is a significant demand for fellowship-trained emergency radiologists. The salary is on par with other specialties, although I don’t understand how they can track RVUs for an emergency radiologist. I was wondering if you can discuss the CONS of the job. I know it is a one-week night float system with two weeks off (which I love). The night shifts are long, from 10 to 12-hour shifts. Maybe malpractice is higher? But I am not able to think of any other CONS. My ideal job would be a private practice in a suburban area (not in a big city). Would you recommend doing a dedicated emergency radiology fellowship or instead do an MSK/Neuro fellowship focused on emergency? The residency I am in gives an EXCELLENT exposure to body trauma causes.

Kind regards.

Answer:

So, what do I think about emergency/trauma radiology? Well, to start, let’s first say that the job can vary widely from one worksite to another. If you are doing teleradiology ER work, that is very different from an in-house radiologist. To say that it is an excellent job for an introvert also depends on what your job entails. I know some trauma radiology jobs that need extroverts to present cases to the emergency department, highlight their research, or examine patients!.

Night Work

Night shifts can be a bummer for some folks. (I found it a little quiet and depressing during my residency) For others, it can be the ultimate in convenience (imagine being able to go shopping at 11 AM when no one is there!). 

My Take On Emergency Radiology

Although what floats your boat can differ widely between you and me, I never really had a craving for trauma type cases. I found them a bit more repetitive than cancer or a rare disease. But, I came from a level one trauma center during my residency, so I had extensive exposure to the trauma experience (perhaps too much!)

Fellowships For Emergency Radiology

Regarding what to study to become an emergency radiologist, I would consider the MSK/Neuro route. Why? Because it gives you a bit more flexibility when you go out and find a job. You can become an emergency radiologist with those specialties under your belt. But, you can do other work in general radiology and some subspecialty work as well. From my experience, trauma radiology is more comfortable to practice, and almost anyone can do it. On the other hand, Neuro and MSK work is a bit more subspecialized, so I like that option as a fellowship a little bit better. (unless you want to do academic ER radiology as a career choice.)

 

Those are some of my random musings about emergency radiology!

 

Regards,

Barry Julius, MD

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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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Radiology Fellowship Interviews: What’s The Difference?

radiology fellowship interviews

Question About Radiology Fellowship Interviews:

Hi Dr. Julius,

Thanks so much for the great piece about writing a fellowship personal statement. I recently went through the process myself and can appreciate the truth behind the points you stated.

As a follow-up, do you have any tips when preparing for the fellowship interview, after being shortlisted?

Thanks once again for all the high-quality posts. 🙂

Yours sincerely,
A Concerned Fellowship Applicant

Answer:

 

Thanks for the excellent question. It turns out that I have never delved into the differences between residency and fellowship interviews. And, there are a few significant differences between the two that I should mention. So, I thought that in addition to answering your question, it would make an excellent post.

To begin with, I highly recommend that you take a look at my original posts on residency interviews called How Important Is The Interview, Really? and Ten Ways To Sabotage Your Radiology Residency Interview. These rules still apply. And, once you have gone through some of this essential advice, take a look at some of the other specifics below about what you should look out for on your fellowship interview trail.

Radiology Fellowship Interviews: What’s The Diffference?

First of all, you will notice that different from a residency interview, most fellowship interviews tend to be more intimate. Most of the time you will be the only candidate at the site at this time. So, you will get to know the few interviewers much better than on a typical residency interview day because you will no longer be just another one of ten candidates. In that sense, it will often be a bit less nerve-racking. However, the general rules for interviewing still apply!

Next, the interviewer will expect you to have a background and a specific interest in the fellowship field of choice. So, you cannot have makeshift answers to why you are choosing to train in the field of radiology in general. Instead, you need to get down to brass tacks and come up with specific reasons for choosing this area of specialty.

Moreover, you will need to know more about the individual program to which you are applying. It is not enough to say that this will be a well-rounded program for your radiology training. No. You need to say why this particular fellowship would be an excellent fit for you. So, you should verse yourself in the specific equipment and unique training that this program has.

Also, make sure that you can talk about specific areas of research that may interest you. Fellowships, more so than residencies, tend to expect that you will perform research. So, talk intelligently about some projects that might interest you in this specific facility.

Other than that, it comes down to the same rules for interviewing in general. Be enthusiastic, conversational, well-dressed and groomed, etc.

So there you have it: some additional rules of the road for the residency interview. Let me know how it all goes.

Regards,

Barry Julius, MD

 

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Informatics Vs IR: Should I Enter Digital Heaven Or Perform Manual Labor?

informatics

Question About Informatics Versus IR:

 

Dear Dr. Julius

Thank you for this amazing blog; there are many useful topics that we don’t cover during our training. As I am finishing my second year of radiology, now is the time to choose the fellowship. I will be happy to hear your opinion as I am debating between two pathways.
I am making some bullet points for each as pro and cons.

1. IR
• ( + )Higher salary, further as it becomes more competitive, I can imagine that it will become more exclusive and the pay will keep rising.
• ( + )Now, with the introduction of the direct IR residency path, it might be the last time to join, and I should seize this opportunity.
• ( + )With all the hypes of artificial intelligence taking over diagnostic in a decade, this seems to be the long term responsible choice.
• ( – )I like from time to time interventions, but I hardly see myself enjoying it for life, especially considering overnight calls when I have a family.

2- Informatics and diagnostics-

• ( + )I am personally fascinated with all the current potential of informatics. Maybe naively thinking that we are still very early in the artificial phase of our profession, I could enjoy diagnostic, perhaps enjoy the creativity phase of this upcoming technology, and maybe also become a leader in this field.
• ( – ) Diagnostic salary will probably decrease in contrast to IR, and there is a chance in a decade that I might be obsolete
• ( – ) 2 years fellowship without any short term financial benefits
The rational choice will probably be to go to IR, but I feel that I should take a chance with informatics,
I will be happy to hear your opinion.

Answer:

Once again, some great questions. I love my audience!!!!
 
Anyway, to answer your specific questions, I am going first to give you my general gestalt about the two fields. Then, I will go through your sentiments for each bullet point (some of which are correct but others are a little off the mark)

 

My Opinions About IR:

 

 

So, when it comes to IR, it is the type of field where you need to invest your life toward that end fully. What do I mean by that? It has more “surgical subspecialty like” qualities than the rest of radiology. If you decide you don’t like to do PICCs and Ports or you determine later on that you are not interested in seeing patients, it can become challenging to extricate yourself from the specialty. And, as you mentioned, it can be hard on the family, not necessarily because of less vacation time (usually interventionalists get more), but instead, you can expect to leave earlier and come home later on a typical workday. Additionally, you may be taking overnight call a bit more often than other areas of radiology. 
 
Furthermore, especially in the beginning, if you decide you want to learn more about informatics independently while doing IR, it will be more challenging to make the time to do so. You need to establish yourself in the Interventional first to become the “go-to” person in the field. That said, anything is possible if you put in the time. It’s just a matter of how much time you want to spend with a family versus work. On the other hand, if you were to decide on another field in radiology, it would be a bit easier to learn more about informatics on top of your regular diagnostic radiology career.

 

My Opinions About Informatics:

 

In terms of informatics, I would recommend you first have some idea about what you might want to pursue within the field before you begin down that rabbit hole. The career options vary more widely than any other subspecialty in radiology. Do you wish eventually to become a CIO of a practice or hospital? Or, maybe you want to become an entrepreneur or work for a private company? Perhaps, you want to be the key “tech” guy within the practice that can fix the PACs systems? I would say before thinking about the specialty as a whole; I would first target a specific area so that you can hone in precisely what you would want from the informatics training before you start. It would be best if you had an idea about what you want before you begin or else the training you receive in informatics may not be as helpful for your career. 
 
As much as I love the specialty of informatics as a career choice, this specialty seems to me to be more like an MBA. It gives you the tools to help you in your career. But, if you don’t know what you are doing, it’s just another title!

 

Addressing The Bullet Points:

 

 
Now for the answers to the bullet points:

 

IR

 

1. IR usually has a higher salary because they work more time, not because they make more per unit worked. The reimbursement for IR procedures is overall worse than many other subspecialties in radiology. Salary is a function of supply and demand. As more people enter the field, you increase the supply and decrease prices.
2. I agree that doing the direct pathway now would save you an extra year of training if you decided to go that route. However, it is more important that you like what you do. So, that would not be my first consideration.
3.  I don’t see AI taking over any subspecialty within radiology during your or my career lifetime. AI is just as likely to take over interventional as any other subspecialty in the field. (you can refer to some of the prior blogs on the topic- especially the one from the RSNA last year)
4. The most valid consideration that you mentioned is the time issue/overnight calls. I agree with that sentiment entirely
 

 

Informatics/diagnostics

 

1. Interest in the field is the most important factor for deciding on a career path. If you enjoy what you do within a radiology subspecialty, you will be successful regardless of the field. Fascination and curiosity are great reasons to enter a field. (especially when you can get paid well for it!)
2. I don’t believe that you will become obsolete in any area within radiology as long as you keep up with the changes. Moreover, it is hard to predict where the salaries will be decreasing the most within radiology. Don’t be so sure that a salary for an interventionalist will be higher in the future than someone who is involved in informatics. It all depends on what you do.
3. From what I have read, you can do a one or two-year fellowship in informatics or any variation in between. Moreover, you can certainly moonlight during the time that you are completing the fellowship to increase your salary for the year or two that you are there.
 
So, there you go. My final summary:  I believe that for interventional radiology, you have to be “all-in.” It needs to be a calling more than any other area in radiology or else you will regret choosing the field. And yes, informatics is only as good as how you choose to use it. Have an idea of precisely what you want before you pick that route.
 
Hope this long-winded summary helps!
Barry Julius, MD
 
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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
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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!