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How To Deal With The Negligent Technologist

negligent technologist

Just like not all physicians make caring clinicians, not all technologists fulfill their obligations to the patient. And unfortunately, at some point in your career, you will likely encounter one of these medical team members. Perhaps, the negligent technologist always leaves at 4:00 PM regardless of whether they are evaluating a patient for a STAT study, like a pelvic ultrasound for a ruptured ectopic. Or, maybe, they see an MRI sequence with many artifacts and decide to do nothing about it. One of these situations will likely occur as a resident or attending. Therefore, it is essential to know what to do. To clarify the rules of the road, I will divide the blog into the four strategies outlined below.

Don’t Beat Around The Bush (Be Direct)

Open communication is one of the essential ingredients to prevent recurrent episodes of negligence. If you discover an issue, why wait to address it when it is no longer fresh in anyone’s mind? Maybe, the tech was not passive-aggressive when he made the error in judgment. Instead, perhaps, he did not realize that neglecting to correct the MAs for body weight would cause a problem with the film. You must talk directly with him to find out. Sometimes confronting the issue head solves the problem permanently. Of course, that does not always happen, which brings us to the next heading!

Talk To Your Program Director

Regrettably, you still have not solved the problem by directly talking with the technologist. So, who better to discuss the issue with than the program director? Perhaps, she can guide you to what you should do next. Or even better, maybe, she can take care of the entire situation for you. Many times this simple action will solve the problem.

Document, Document, Document

Rarely talking to the technologist or the program director does not solve the problem. So, what to do next? Well, if you find that the offenses are recurrent, you must document each of the episodes. Only when you have objective data can you use it to change the situation, primarily as a resident. Why? For the most part, the technologist has likely been working for many more years than you at the institution. Therefore, the technologist’s word will often carry more weight than yours.

Why else is the technologist in a better position than the radiology resident? The institution has more to lose when a negligent technologist leaves instead of a resident because it is more costly. So, you will need to keep a written or electronic log. And be specific. Accurately state what happened, how it occurred, and when it transpired. Make sure that you can confirm the information as quickly as possible.

Discuss With Administration

OK. Direct communication has not worked to change the behavior. Nor was the episode a “one-off” event. So, what do you do next? If you need the behavior to cease, discussing the matter with the administration is imperative. Each hospital may have a different administration member to help with this. Typically, it may be a hospital liaison/radiology manager or the DIO (head of GME).

And what can they do with the documentation that you provide? It can serve as a basis to change the offending behavior of the technologist. Also, the hospital can use it to help decide whether to remediate, train, or fire. Whatever the case, when things become that dangerous, you need to address the event to the “higher-ups.”

Dealing With The Negligent Technologist

Often, the most challenging part of playing the role of the resident is not the technical work. Instead, the hard part usually comes down to how you negotiate with other human beings. So, follow the strategies that I have provided. First, communicate directly. Then, talk to your program directors. And finally, rarely, if all else fails, document everything yourself and speak with the hospital administration. These strategies are a logical approach to dealing with the negligent technologist.

Moreover, it should work to remedy most problems. Most importantly, however, you should never neglect to deal with a negligent technologist. Remember, you took the Hippocratic oath. Patient care comes first!

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The Sharp Breast Ultrasound Technologist: The Key To A Well Run Practice!

technologist

In a thriving radiology practice, all technologists contribute to the functioning of the whole. However, one sort of technologist, in particular, can tip the balance between a smoothly run practice and disaster. Which one would that be? Well, if you read the title, you would know immediately!

Why does a breast ultrasound technologist wield so much power over a successful radiology practice? Unlike other technologists, I came up with three reasons why we rely on them so much. First, these technologists are the most “independent” of all other technologists. Second, they require a good eye, more so than other technologists. And finally, they must have excellent hand-eye coordination. We will examine all three characteristics and what happens when your practice uses a suboptimal technologist.

Independence

Sure, most technologists have some autonomy. I mean, CT techs must set the parameters for the scans independently. And mammography techs must ensure they perform all the QI before beginning a study. But breast ultrasound technologists are unique in this regard. When breast sonographers leave the room to create their images, you cannot check the quality of their work directly. What do I mean by that? Sure, there are required images. However, the ultrasonographer can choose to show you whatever they deem crucial. Alternatively, this same tech can leave out what they think is “unnecessary.”

I can’t think of any other technologists with such independence of action. You can almost always check the work of a CT, mammography, MRI, or fluoro technologist. The body part is complete, or it isn’t. The breast tissue is all on the film, or it’s not. On the other hand, with ultrasound techs, you can never know if they have completed what they were supposed to. You must rely on their word and their word alone.

What happens when the ultrasound technologist does not act independently? These technologists come reeling in and out of the reading room incessantly, asking questions and interrupting the day’s workflow. Furthermore, the radiologist’s stomach churns when unsure if the technologist knows the morphology and location of what they are searching for. That means they must check and recheck everything the breast ultrasound technologist completes. It wastes so much time that the radiologist cannot attend to his other duties.

The “Good Eye”

Radiologists rely on the ability of breast ultrasound technologists to pinpoint a specific lesion on mammography. Or, they need to find the proverbial needle in a haystack on screening ultrasound. In other words, they must keep constant awareness of their search. In addition, they need to identify the shapes and abnormalities they see on the mammogram. This task becomes challenging when you have a 350-pound patient with a large amount of breast tissue! A “good eye” varies widely among technologists, similar to radiologists. But, good technologists will reliably find what is needed and discard the impertinent findings in the breast.

I can’t tell you how often a technologist without a “good eye” will search and search for something, only to have you, the radiologist, come in and find the lesion first. Imagine the hours over a lifetime that a radiologist must waste to compensate for the ultrasound technologist without a “good eye”!

Hand-eye Coordination

Finally, an ultrasound technologist’s ability to scan patients relies upon a baseline level of coordination. This baseline becomes vital for two main reasons. First, the ultrasound technologist needs to find and rediscover a lesion. For instance, some lesions are tiny or roll off the transducer very easily. Good ultrasound technologists need a steady hand to create images of these abnormalities.

Furthermore, breast ultrasound technologists, in particular, play an essential role in performing procedures to assist radiologists with cyst aspirations and biopsies. They need to be able to keep the transducer on a specific plane at the time of a biopsy.

Frustrating is the singular word for performing procedures with a breast ultrasound technologist with two left hands! Imaging studies and techniques can take triple the amount of time with a technologist with poor coordination. That does not include contamination of the sterile field!

The Sharp Breast Ultrasound Technologist- The Key To A Well-Run Practice

As you can see, a breast ultrasound technologist is much more than just another member of the imaging center team. Without a quality breast ultrasound technologist, the center becomes much less efficient and can fall apart at the seams. If you find a great one, this team member becomes the glue holding the imaging center together. Keep the tech even if at a higher-than-average cost. Why? Because the costs to a practice pale compared to the damage if they leave!