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Radiology Swap- University Radiologist Goes To Private Practice (Part 2)

radiology swap

Today we return to Part 2 of our Radiology Swap blog. Click on Radiology Swap- Radiology Private Practitioner Goes To University (Part 1) to catch up if you missed the first part of Radiology Swap!

University Radiologist Goes To Private Practice

Day 1 Radiology Swap:

Unaccustomed to working in a private office, the University radiologist is surprised by the relatively small size of the office. The parking lot is not too full, and he can walk rapidly from his car to the office, very different from usually having to walk from the back of the parking lot—a nice perk.

Finally, entering the building, he locates his workstation and seat. As soon as he sits down at the desk with the PACS monitor, a technologist dumps a stack of papers with today’s work next to the monitors. It must be about 150 cases. Where are my resident and fellow? I need them to help me with the dictations! Oh, my God!!!! I just realized that I forgot how to use a dictaphone.

After struggling with dictations and having read maybe 10 of them, 11 AM rolls by as he teaches the technologists about the ultrasounds they show him. But, the technologists roll their eyes as they just want to get through the cases so they can go home. They sense him droning on and on! He looks at the stack of papers given in the morning. It still looks the same!

Noon: He begins to receive phone calls, not happy ones. Clinicians are asking him about the results of chest x-rays, ultrasounds, and MRIs. Unsuccessfully, he tries to soothe them and let them know he has not looked at them yet, but he will get to them! No lunch for me.

Eyes reddened, head bleary, and voice cracking, the University radiologist now realizes it is almost 5 PM. He has only finished maybe half of the stack of orders. Lots more to go. No one to talk to. I can’t leave yet to get to the family.

10 PM arrives, and he is finally finishing his last dictation of the “day.” How does the private practice radiologist do it?

Day 15 Radiology Swap:

He arrives wearily into the office, looking haggard and worn with a 15 lbs weight loss since he started the job (1 pound per day!). His temper flares every once in a while, taking out his frustrations on the constant bombardment by the technologists by making snide remarks and yelling at the staff’s mistakes. For the past 15 days, he has left the office in the dark, no earlier than 8 PM. No direct contact with interested learners or other clinical physicians. All interactions on the phone. So, this is physician burnout!

Day 30 Radiology Swap:

Assessment day for Radiology Swap!!!

Practice President: So, you have worked in our practice for the past 30 days? Let’s start with the good part: I’m glad to see that you have made it through the encounter.

Academic Radiologist: Yeah, barely. How do you guys do it?

President: We do it efficiently to make money. The more we read, the more we earn. It keeps us going. In any case, let’s continue with your review. We received many complaints from our staff that you were curt and inappropriate at times. It was like pulling teeth to get you to do fluoro cases on our patients. You kept on grumbling- “Where’s my resident?”

Academic Radiologist: I thought you would at least provide me with a physician assistant to help with daily work. I don’t usually touch patients. My residents do it for me.

President: We also received numerous complaints from our referrers that they did not receive their reports in a timely fashion. We lost some serious business this week.

Academic Radiologist: When you get 150 new studies per day, everyone has to wait!!!

President: I don’t think we would be able to keep you here because we need radiologists to keep up with the work. We don’t get paid if we don’t read the minimum volumes!

Academic Radiologist: The best part of this job was the 15 lbs weight loss! I can finally get some sleep again. His eyes begin to close, dreaming about returning to his academic position.

 

The Radiology Swap Meetup

So, the academic and private practice radiologists now seat themselves in the same room to share their experiences after having returned to their respective jobs.

Private Radiologist: How do you do your job on a daily basis without getting totally bored?

Academic Radiologist: How do you do your job without getting totally burnt out?

Private Radiologist: Let’s agree that we are not right for each other’s jobs. It would never work out for us.

Academic Radiologist: At least I can understand what you go through on a daily basis. We used to make fun of private practice radiologists. Don’t think that I will do that anymore.

Private Radiologist: Doesn’t mean that we can’t be friends. Let’s go out for drinks! I think we both earned it…

Academic: True. We both earned some stiff ones.

The radiologists leave the room and head down the street, never to look back on their former residency swap experiences again and happy to go out for some drinks…

THE END

(until next time!)

 

 

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Radiology Swap- Radiology Private Practitioner Goes To University (Part 1)

swap

Ever watched the show called Wife Swap? Essentially, women of two households “swap” roles and responsibilities for different families and share their experiences with the TV audience. It’s a lot of fun to watch! Like this exercise, I thought it would be fun to speculate on what would happen if you swapped a private practice and academic radiologist for a month. How would each experience the other’s world? What would be the trials and tribulations? Let’s see!!!

Radiology Swap- Private Practitioner Goes To University

Radiology Swap Day 1:

The private practice radiologist walks into his university radiology reading room for the first time. Looking around, he encounters a group of 2 medical students, one resident, and one fellow waiting for him to read out the films from yesterday evening and the morning. He thinks: Why are all these people here? Do I need four additional trainees to look at the ten cases left over? This excess is sort of ridiculous!!!

He begins to sort through the pre-dictations of the radiology resident and fellow. As the cadre of 4 trainees looks over his shoulder, he looks at the first dictation and decides to erase everything. Although he feels a little bit self-conscious from all the stares over his shoulder, he starts all over from scratch. He doesn’t like the way the resident words the dictation. It’s too freakin’ long. Rapidly, he runs through each resident and fellow’s cases, erases each, and re-dictates everything.

Only a few additional cases come through the department, and the resident/fellow handles each before looking at the images. They are tertiary referrals from another facility and are very complex, but he does not perseverate and completes the cases in 30 minutes. Staring at the clock, he begins to walk around. Well, not much going on. I’m going to grab some breakfast!!!

After grabbing breakfast for 15 minutes, he arrives back at the reading room. Two more cases show up. The residents, fellow, and student seem to wait for the radiologist expectantly. Again, he promptly erases the resident and fellow dictations and quietly reads the two cases very slowly with the team, trying to pass the time. This day is Chinese water torture! Learning to run intermittently once every few hours from his office to the reading room, the day continues, as is, until work ends at 5 PM.

Radiology Swap Day 15:

It’s the weekly admin slot. On the schedule today, the radiologist attends a tumor board with bleary eyes at 7:00 AM. Not accustomed to the so much time spent on each case, it is hard for him to stay awake. But he manages. Next, at 8 AM, he attends a meeting to discuss performance reviews for the technologist staff. For half of the conference, the attendees discuss when the next meeting will occur. Ugh!!! What a waste of time! 

He quickly dots off to read a few films to help out his colleagues instead of perching himself at his desk to write a grant. He has writer’s block. What the hell should I be writing now? I haven’t written anything but a dictation for 20 years!!! He sits and sits and finally falls asleep at his desk.

Noon arrives. Thank God it’s lunchtime. Something to do!!! He happily runs down to the cafeteria to eat. He stretches out his lunchtime meal for one hour when the next meeting starts. Quality improvement initiative is the theme of the next conference. Could they think of a more boring topic to meet about?

It’s now 3 PM. He begins to meet with the backup staff in the department to discuss increasing resident and attending research output. This group includes the research coordinator, the head of research, the research financier, and the student research liaison. A recurrent thought flashes through his mind during the entire meeting. Who pays for all these extraneous people and why? I would cut the fat here immediately if I could!!!

Radiology Swap Day 30:

Assessment day! The department chairman sits the private practitioner down to summarize the events that ensued over the past month. The conversation goes something like this:

Chairman: I am impressed that you got all the work done quickly. They can be challenging cases. Our other academic radiologist never seems to get to read all the films.

Private Radiologist: Really? He only read 20 films per day!

Chairman: However, you did not apply for one grant; you did not even start on one paper. And, the physicist caught you sleeping at several meetings. Publish or perish!

Private Radiologist: Well, it’s challenging to write anything when you haven’t written a paper for over 20 years! How do you not sleep when half your meetings are about when the next meeting will be?

Chairman: And, your student, residents, and fellow claim that you rewrite all their dictations. You then grumble how they don’t know how to dictate and forget that they are there. Teaching is an integral part of academic radiology.

Private Radiologist: I don’t understand why they have to be there. They don’t do anything but stare over my shoulder!

Chairman: Although you can make it through all the films, your academic prowess is very poor. Academic radiology is not for you.

Private Radiologist: Thank God I can return to my private practice tomorrow!

See you next week for part 2!!!