Tag: generation

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What Was Radiology Life Like Without PACS?

without pacs

I may be dating myself, but I am the last generation that did a radiology residency without PACS. Yes. I lived and breathed the pre PACs era. Some of it was pretty good. And, other parts of it, not so much.

Nevertheless, radiology was very different before hospitals started to add these systems to their networks. So, what are some of the most significant changes I have seen throughout my career when I compare the two eras? What was life like before the advent of PACS? Let’s go through some of the most critical differences in radiology.

Many More Films Got Lost Without PACS

On any given night, you would expect a good percentage of cases to remain in absentia without a dictation. Unsurprisingly, the orthopedic surgery residents would stealthily slip into the reading room when the radiology resident stepped out. And this person would steal the films so that the surgeons could use them for orthopedic surgeries at nighttime. Or, the alternators (the old defunct machines that you might see in the back of a reading room somewhere nowadays) would suck up several films, and they would get lost in the device or even shredded to pieces. Many cases would simply no longer be available for dication either for a delayed period or never. Film loss was just a fact of life. Nowadays, it is only the rare irretrievable case that you will need some help with from the IT folks.

Saw A Lot More Clinicians

Today, our reading rooms fill up with primarily residents and a smattering/skeleton crew of a couple of attendings. Back in the day, the reading room was hustling and bustling. Surgeons, Ob-Gyns, and more would regularly show up to look at their cases with you because they couldn’t look at them themselves on a PACS system. You got to know each clinician by name and personality. It was more than just a tryst in the reading room. Of course, that came with the upside of meeting great physicians and the downside of discovering a few jerks here and there. Nevertheless, the reading was much less of a lonely place. And, you would learn about the final disposition of cases more often because we kept in close contact with our physician brethren.

Had To Produce Your Films For Case Conferences

Have any of you ever encountered a dark room? Back in the day, it was a regular event for radiologists. We would have to develop our copies to present for case conferences. It was a big deal and somewhat time-consuming. But, we all got to know this haven of darkness every so often. It was much more intricate than just downloading a case on PACS or snapping a picture on an iPhone for a presentation on a Powerpoint. These technologies were available but still uncommonly used at the end of the pre-PACS era. It was a pain in the-you-know-what!

Priors Were Less Common

Getting priors was a real pain in the neck back then. We would somehow have to go down to the file room and retrieve them. Therefore, we would dictate many more cases without them because they could be hard to come by. So, you could imagine we lost some specificity and sensitivity in these dictations. And, then, when you did retrieve the priors, you would receive these enormous folders where you had to find suitable films. You would be lucky if you didn’t get a paper cut in the process. (They were much more prevalent back then and hurt like hell!)

Less Windows Available Without PACS

Nowadays, we click a button and re-window a case. Back then, you couldn’t look at the bones if you didn’t have the bone windows on film. So, the techs would print fewer windows to save on film. Often, if the reason for the study had nothing to do with the window, you would not have them available to read. I’m sure we missed tons of osseous lesions!

Keep Lists Of Results On Overnight Cases

Instead of having a PACS system to look cases up, we would have to keep a running tab of the patient studies we read, especially on CT rotation. Clinicians would come down and check out the results on the list and chat with the resident. Every room would have a list of cases from the previous night. Eventually, they would make their way onto the Radiology Information System. But until then, the responsibility was ours to keep tabs on everything in the reading room.

Working From Home, Ha!

And finally, working from home was a figment of one’s imagination. We needed to perform all reads and procedures in-house. Imagine being unable to take off to let the Verizon folks fix something in the house. That was our world. We lived and breathed the hospital in those days!

Radiology Life Without PACS

We lived in a different world back then. Radiology lifestyle and culture have changed dramatically over the years since hospitals have installed PACS. Yes, we had more contact with other physicians, but it came at the expense of many problems. Nevertheless, although mostly better today, some good did happen before hospitals introduced PACS to our world. Would I want to go back to those times? Probably not. But they were a great experience that new radiologists cannot imagine today!

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Most Common Stereotypical Generation Radiologist Differences

generation

 

Millennial
Generation X
Baby Boomer

 

 

 

 

 

 

Although not every radiologist fits the particular stereotype for their generation, some generational stereotypes ring true. On the whole, the baby boomers, Generation X, and Millennials perform better and worse in some parts of the radiology workforce and have their own particular needs. When you work with these individuals, it is vital to keep this in mind. Sometimes, we need to change the way we operate to accommodate these differences. So, today I would like to go through some areas where radiologist generations differ, arranged by different topics. I hope you enjoy it!

PACS And Social Media

Baby Boomers: These folks tend to be less comfortable with PACS system changes. So, beware of the PACS upgrade! It can wreak havoc on their lives. Social media can be somewhat foreign to these radiologists. Many of these radiologists do not have Facebook, Linkedin, or Instagram accounts. So, sending out messages via these media may be a waste of your time.

Generation X: For these radiologists, PACS utility issues tend to be a mixed bag. Some of the less tech-savvy radiologists fall into a similar category as a Baby Boomer. Others are more adept with PACS systems. On the other hand, social media outlets are generally much more native to the Generation X radiologist with broader and more frequent use. Although not all of these radiologists use social media, you will be more likely to find these folks more comfortable.

Millennials: On the whole, these radiologists cope well with PACS updates and changes as long as the network runs correctly. Their technology knowledge enables these individuals to learn quickly and grasp the most efficient ways to learn PACS. Social media is not just a tool for many of these individuals; it can be a way of life. Their online persona can become just as important as their offline interactions. They tend to engross themselves in the online world.

Barium Work/General X-rays

Baby Boomers: This group of individuals has, by far, the most expansive repertoire of experiences with both barium work and plain films. Since it was the mainstay of radiology initially, they often pick things up that their more junior colleagues will miss. They can work wonders with barium and grasp the nuances of a good barium examination.

Generation X: They can read plain films rather adeptly and efficiently. Although not as seasoned as a Baby Boomer, they can read an x-ray reasonably well and are comfortable with most barium work. During residency, they have had lots of experience with films and barium slinging.

Millennials: Since they spend a lot more time with CT and MRI than plain film work during the residency, overall, they are less comfortable with plain film interpretation. As residents, hardcore barium studies experience such as barium enemas can be minimal. So, the performance and interpretation of these studies can be a bit more challenging.

MRI

Baby Boomers: It is much less likely for the Baby Boomer to feel comfortable in this modality since they may have completed MRI training after their residency. Most Baby Boomers will avoid MRI if possible.

Generation X: Plus or minus. Depending on the experiences during residency, some feel very comfortable with general MRI work and others less so.

Millennials: Most Millenials are comfortable with all MRI since it has become “bread and butter” radiology, just as standard as all the other modalities out there. I would certainly put a lot of faith in their excellent reads!

Vacation Time

Baby Boomers: This generation believes in the adage “live to work.” Overall, they tend to take less vacation than given (although they get more vacation time than the rest of the generations!)

Generation X: They have a similar work ethic to the Baby Boomers than Millenials, although they can straddle both sides. Vacation time is essential, and they fully take advantage of their time off the job.

Millennials: Everyone needs to work around the Millennials’ schedule. Their motto is “work to live, not live to work.” They like flexibility in their schedule and will do whatever they can to get to the lifestyle they want. Every day a practice gives vacation time, these radiologists will take the day. They do not spare a moment that they can use to bolster their lifestyle.

Money

Baby Boomers: For the most part, these radiologists sit on a large nest egg, having worked through radiology during its most lucrative years. Debt load tends to be nonexistent. They have the most flexibility and can leave the workforce whenever they want. Many of these radiologists perform their job solely for the “love.”

Generation X: Most of these radiologists have paid off their debts and have done relatively well in their specialty. Money is still important to these folks because they still do not have enough to retire. But, they have good jobs and will do well overall since they have been working during the “good years.”

Millennials: Severe student debt weighs down these radiologists and can limit their opportunities to places and jobs that this generation does not want. It almost runs counter to their ideal lifestyle philosophy. These radiologists also started to work in the field during lean radiology years and are more likely to have had less opportunity to make money. Hence, there is some bitterness when it comes to discussing the topic of money!

Interpersonal Relationships

Baby Boomers: Overall, this group develops solid interpersonal relationships with their colleagues and staff. They never had the opportunity to rely on social media or other forms of technological communication, so they deal well with others. In addition, they have the least need for external approval.

Generation X: These radiologists probably have more in common with the Baby Boomers than the Millenials since they grew up in a world without social media. They were allowed to fail just like the Baby Boomers but were more protected than them. But, they do develop strong interpersonal relationships with their colleagues.

Millennials: Since many of these folks were not allowed to fail growing up, they need to be outwardly appreciated by their colleagues much more than the other generation. They spend a lot of time on their mobile devices, garnering relationships with others. Since online life can be just as important as their offline persona, some can seem outwardly unfriendly because of the time they spend on their devices.

Teaching Expectations:

Baby Boomers: They love a great lecturer and taking cases. However, after completing a teaching episode, the Baby Boomer will research and read the topic to reinforce learning. Overall, the Baby Boomer does not care about electronic media, but some will use it. Old-fashioned books instead of ebooks work better for the Baby Boomer.

Generation X: The typical generation Xer fits somewhere between the Baby Boomer and the Millenial. They will do their research and not expect the lecturer to tell them everything they need to know but understand the practicalities of ebooks and electronic resources.

Millennials: They traditionally have been spoon-fed information in lectures. And, they expect everything to be spelled out for them when others teach them. Overall, they expect the teacher to know everything about a topic and point them toward all the resources they need to read. Most Millennials use ebooks exclusively and will utilize electronic media to reinforce all learning.

Summary

I repeat, “These stereotypes certainly do not apply to all radiologists out there!” However, I think there is an overall tendency for individuals of each generation to fit some of the stereotypes. Knowing the strengths and weaknesses of each generation allows us to schedule accordingly, allocate appropriate resources, and understand what each generation needs. For instance, since the Millennial tends to have a higher debt load, allow for more moonlighting opportunities or extra work. Or, make sure to incorporate additional training with new electronic PACS system upgrades for the Baby Boomer. Bottom line- it pays to understand each generation!!!

 

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