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Ten Things Radiologists Cannot Tell The Ordering Clinician (We Wish We Could!)

ordering clinician

As residents and radiologists, we have all experienced frustrations that we cannot verbalize to an ordering clinician for fear of retribution. Perhaps, the ordering clinician may stop referring patients to us. Or, just maybe we will get written up in the middle of the night for performing unprofessionally. That would end badly! Regardless, I have created a list of ten things that all radiologists and radiology residents wish we could tell you, the ordering clinician, but cannot quite get up the nerve to do so. So, here we go.

Examine The Patient First

How frustrating is it that patients get a hepatobiliary scan to rule out cholecystitis, only for us to discover afterward that the patient had a cholecystectomy? Or, we receive a CT scan to rule out appendicitis, only to find out there is no appendix! Come on, guys, do your due diligence, PLEASE!!!

Throw Me A Bone- Give Me Some More History

You ever heard that saying called GIGO- garbage in, garbage out? Well, that certainly applies to us! Please, no more clinical histories with abnormal clinical findings or rule out? What does that exactly mean? If you want your reports to be somewhat valuable, throw us a bone!!!

I Cannot Read Your Handwriting- Write Something Legible Next Time.

Ever consider the amount of time we waste trying to mull over what you wrote on the prescription? Precious time that we could have used to get home earlier lost! Did you write CT w/ for contrast, or does CT w/o mean without contrast? This stuff matters!!!

Get An Answering Service, Bub!

Yes, there are times that we need to contact you. One of the most frustrating things in the world is to make that phone call that your patient has a pneumothorax only to find you, the ordering clinician, are out to lunch without anyone to contact. Please, please, please. If you are not around, find us someone who is covering!!!

Don’t Kill The Messenger

Hey, guys… We are only trying. Don’t get angry with us when we are doing you a service by letting you know that patient has an unforeseen pulmonary mass. Or, maybe we want to tell you that your patient has acute appendicitis. I don’t care if you are on vacation when we get you on the phone. Please show us a little bit of respect!

Just Provide The Relevant Facts, Man, We Don’t Have All Day!!!

We, too, have studies to read and patients to see. Could you not keep us on the phone? We have to hear about all the patient’s irrelevant labs, history, and physical examination. Keep it short and sweet, folks. We have lives that we would like to lead!

Don’t Send Us Your Patients At 4:55 PM!

Why do you like to send us your patients right before we are about to leave? Well, maybe, that patient with a GI bleed that you don’t want to work up because you want to go for the day. So, you send that patient for a GI bleeding scan instead of an endoscopy that you would typically do. The patient gets extra radiation, and then you delay the final diagnosis. Is that good patient care? NO!!!

We Are Not The Hospital Dumping Ground- Take Care Of Your Patients

So, your patient is giving you anxiety because he is combative on the floor. Therefore, you send the patient out to get a test so you can get a breather. Well, if you can’t handle your patients, we certainly can’t control your patient when they need to stay still. We are not the hospital dumping ground. At the very least, give your patient a valium if you send them down to our department!

If You See Us Dictating- Don’t Interrupt Us Until We Are Done!

You wouldn’t stop a surgeon in the middle of surgery. So why the heck would you want to interrupt us in the middle of our dictation? We provide essential information to our clinicians, and studies (1) show that interruption prevents radiologists from making all of the findings. Please… Appreciate what we do!

Give Us A Chance To Look At The Films Before Coming Up With A Final Opinion

So, you came down to our department to talk to us about the study you just ordered. Maybe, it is a CT scan of the abdomen and pelvis. Or perhaps, an MRI of the knee. If you know the nuances of reading these studies and you are telling us all the findings, then why did you come down in the first place? Did you do a 4-year radiology residency already? I think not. Give us a chance to make the correct diagnosis, not the one you want to tell us!

Final Words To The Ordering Clinician

We are clinicians, too, so we appreciate some professional courtesy. Do onto others as they would do to you!

 

  1. http://www.academicradiology.org/article/S1076-6332(14)00307-9/fulltext?cc=y=