Tag: psychology

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Partnership Track Behavior: A Primer

partnership track

Congratulations! You’ve nabbed the job you have always wanted. And your employer has placed you on a partnership track. But, you know that not all who started on the partnership track made it to the Promised Land. To prevent yourself from becoming the next casualty, you’ll do almost anything to ensure that one day you will become a partner with all its benefits. So, how can you entice your employers over the next two, three, or four or more years to take you into their fold? Having experienced the process and worked for many years as a partner in private practice, let me give you some basic tenets you need to follow.

Make Small Pleasant Waves, Not Large Ones

Let me tell you a little obvious secret. As much as the practice owners say they will treat you the same as other partners, please don’t believe a word they say. Until the day that you become a partner, any current partner can use any irritation or error against you. Worst case scenario, the upset partner can delay your partnership indefinitely!

So, my advice to you is: don’t rock the boat. Do what you must, but don’t push your views on others. Sure, consider changing a knee MRI protocol with the blessing of all the other MR readers in the department. But, don’t overhaul all the protocols on the magnet without their consent. Talk to the CT scan representative but don’t volunteer to become the promoter of the CT scan manufacturer without notifying the chairman. And so on. I think you get the picture.

Complete All Your Assigned Work And Some

Want to impress your fellow practice partners? Of course, you need to complete all of your work. But even more importantly, when you finish everything, help out your fellow radiologists. Over time your extra effort will get noticed. It certainly can’t hurt to have rave reviews from your cohorts when the time comes for them to vote you in as an equal shareholder. Who doesn’t want a fellow partner that always wants to take on additional responsibilities?

Pace Yourself

Many former employees never made it to partner: What do they have in common? Either they made too many mistakes because they read films too fast. Or, they become so worried that they will miss essential findings that they take forever to read and dictate the studies. Especially at the beginning, you don’t want the partners to categorize you as either of those sorts of radiologists. So, take your time. But remember, you don’t have all the time in the world!

Avoid Saying Anything Bad About A Partner

This advice seems obvious but is a common reason for ending a partnership track or, even worse, your employment! Never. Never utter a bad word about your superiors to anyone else. Trust me. Trash talking about your colleagues is a cardinal error that will bite you when you least expect it. Indeed, that partner you were talking about will not want to hear that he is lazy when the time arrives to decide on your future!

Don’t Complain Unless It’s Unavoidable

OK. Maybe, that PACS system keeps malfunctioning. Or that technologist always to forgets to put the measurement of the spleen on the worksheet. Try to deal with these minor situations yourself before running them by the partners. No one likes a constant complainer. And, who wants to make that person your fellow partner? Indeed, not your employers!

Volunteer For Practice Building

You are taking on a partnership track for a reason. Of course, you expect to play a role in not just the daily reading of films and performing procedures. Instead, you desire to involve yourself in the other facets of the business. In that vein, nothing looks better than taking on Grand Rounds talk that no one else can or wants to do. Or volunteer for the hospital credentialing committee. Perhaps, you should become the point man for the CT lung screenings in your community.

Practices usually do notice these additional activities. But most importantly, the partners appreciate the extra effort when the time comes to vote on your final disposition.

The Psychology Of The Partnership Track

Like any other path that you have undertaken in your career, you have to first start at the bottom. Beginning a partnership track is no different. So, put your tools to the grindstone and prepare to work hard for the time you are on a partnership track (and hopefully beyond!). Only then can you increase your chances of reaching your final goal of reaping a partner’s added rewards, prestige, and respect!

 

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Addressing Referrer Psychology In The Radiology Report

psychology

What are the most important differences between most resident and attending reports? Residents’ dictations tend to be one size fits all. On the other hand, the attending will usually look at the referrer’s name and specialty before starting with a dictation. Then, he integrates referrer psychology into the report. And finally, seasoned attendings will approach a dictation as a solution to the specific clinician’s problem.

Why is it important to address these differences? The primary reason for radiology’s existence is to provide solutions for our fellow physicians to come back for more. So, we must satisfy our referrers’ needs in our reports before anything else. And therefore, we need to individualize these solutions in every dictation we complete. For today, I aim to teach how residents and even junior radiologists can change their “one size fits all” reports into a report with a laser-like focus that answers the referrers’ questions. Let’s do just that!

Addressing Pertinent Positives And Negatives

Take a look at a great radiologist’s dictation. If the patient has a history of an abdominal aortic aneurysm, you will see statements about dissection, rupture, mural thickening, or ulceration. Or, if the patient has prostate cancer, the dictation will detail the sclerotic osseous lesions, iliac and inguinal nodes, liver lesions, the prostatic bed, and pulmonary nodules. You are much less likely to observe these relevant findings in the resident’s dictation. It is more likely to be a bland checklist. Addressing the pertinent information goes a long way to addressing the psychology of the ordering clinician.

Keep In Mind What The Referrer Wants To Know

Typically, the first paragraph of the findings should answer the clinician’s question. Logically, this makes sense. The clinician most likely analyzes only the first part of the findings and impression, if any. In addition, make sure to start with those items that contain the most critical information—then run down the findings in order of importance. For the clinician reading the report, the priority order clarifies what is most important. Dissimilar to the typical resident dictation, its goal remains clear, to answer the clinician’s question appropriately.

Give Some Leeway To The Referring Clinician

A clinician does not like to be hemmed in by the requirements of the report. So, make sure to give the clinician that leeway. Do not lock in on one diagnosis, forcing her to pursue that avenue. What do I mean by that? I will give you two examples.

First, give all the relevant likely diagnoses. If you start talking about something in-depth that is unlikely to be the cause of the patient’s illness, in essence, you may force the hand of the clinician to pursue the wrong diagnosis to the cost of poor patient care and expense to the system.

Second, you can legally bind the clinician to perform an unneeded procedure if you recommend a biopsy without an alternative. If for some reason, something goes awry and the doctor does not pursue that avenue, legal consequences can follow. So, be careful what you say!

Don’t Leave The Referrer Hanging

I like to call this waffling. Instead of giving many differentials, make sure to come down on those most likely to be the diagnosis. Always attempt to attach probabilities to the different possibilities. This process makes it much easier for the physician to provide appropriate testing and quality care.

Ask For More History

You may think the clinician will get annoyed if you ask him for more information. But, it is usually the opposite psychology. It shows you are taking the initiative. And, you are more likely to create a relevant report that will be helpful to the patient and the clinician. Rarely does a good history ruin a report!

Communicate The Results More Effectively

After you complete the report, check it over multiple times. Few things bother the referrer more than reports with incomplete, unintelligible sentences. Perhaps unwillingly, you leave out the word “no” somewhere in your dictation. Believe it or not, this can be crucial to the clinician’s treatment plan. Most of the time, the unnecessary phone calls I receive are for the occasional grammatical or incidental mistake in the dictation. It happens to everyone. But, try to minimize this effect by checking your work!

Summary On Addressing Referrer Psychology

To create a sound report that helps the clinician, you need to get into the mind of the ordering doctor. So, think like a clinician. Put all the relevant information into the dictation without the fluff, always keep in mind the goal of the ordering doctor, make sure to give some leeway to the physician, get an appropriate history, and make sure you look over your report so that it makes sense. Not only will the referrer appreciate your dictations more, but your patients will receive better care too!