Tag: work

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Get Back To Work Now, Will You!

work

Many of us have experienced a recent hiatus from our regular radiology activities related to decreasing imaging volumes. It has been not uncommon to work one, two, or more days less per week than before. Although you may not have wanted this pathway to less work, it has had some positive effects. We have more time at home. Many of you have restarted long begone projects unrelated to the radiology world. Others have begun to re-experience their family life after years of being pulled this way or that.

But now, if your practice or hospital is anything like mine, we have begun increasing our workload. For some, this may be a bitter pill to swallow. We have experienced a taste of an alternative life, the life we could have had if we had an alternate career, or have worked part-time. And, I have a sneaking suspicion that for some radiologists out there, this change may eventually become permanent. But, most of us want to get back into the swing of things. How can we get back to a more regular working existence in radiology after such a long break in the action? Here are some suggestions.

Remember Why You Went Into The Field

Most of us, residents and attendings alike, can think of a time that we made a finding or came up with a differential diagnosis that changed a patient’s life. Or maybe, you can remember a time when you put that stent into a patient’s leg, and the patient could walk without pain afterward. Picture how these moments felt. Think about how they had attracted you to the field of radiology.

Find Some Great Cases And Discuss With Colleagues

Maybe we are no longer on top of one another in the reading room. But, there is always room to pick up an unusual case and share it with some of your colleagues, residents, and attendings. Nothing sparks more interest in the field than a great imaging dilemma with twists and turns.

Read About Areas That Interest You

It’s not an unreasonable time to start picking up a book or two to learn a new area in radiology that you have not studied recently. Or, brush up on some other topic areas that interest you. As we start to become busier again, you will become more versatile. And, you may save time in the long run. Moreover, learning something new can rekindle your interests in radiology.

Teach Others

Although you may not have the option to do close one-on-one teaching at the same reading station nowadays, there are many opportunities to teach others. It could be remote, on the phone, or across the room. Regardless of the method, get involved. I can think of no better way of sparking interest in yourself and others.

The Hiatus Is Over. Get Back To Work!

It’s time to start up again. And, we need to get our heads back in the game. Make the most of the time you currently have. Whether it is reminiscing about our greatness, going over fascinating cases with others, learning about new areas in our field, or imparting our knowledge, we all need to latch on to those aspects of our field that we enjoy. It is mission-critical to be excited and mentally prepared to get back to a full day’s worth of work once again!

 

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Is Radiology Still A Career Or Just A Job? And What Does It Mean?

job

What exactly is a career? If you listen to the internet authority, Wikipedia, it is “an individual’s metaphorical “journey” through learning, work and other aspects of life.” And, what is the definition of a job? Again, if you listen to “all-knowing” Wikipedia, a job is an activity, often regular and often performed in exchange for payment (“for a living.”)

So, which definition does radiology meet today, a career or a mere job, a transaction made to make a simple living? Many long-standing radiologists and outsiders would say that radiology is a career. You spend countless years learning and practicing the art and science of radiology. Moreover, when you finish, you live and breathe the profession. You strive for professional excellence. More importantly, it becomes ingrained as part of your persona.

These everyday thoughts are an oversimplified answer to whether radiology is a career or a job. As such, the response has transformed itself over the past ten to 20 years.

Changes To The Equation of Job Versus Career For Radiologists

So, what has changed over the past decade or two that has morphed the answer to this question? First, the landscape of medicine has dramatically shifted. Students that formerly completed school with reasonable amounts of student loans are now graduating with hordes of debt. Additionally, external pressures from governmental bureaucracies have dramatically increased. The number of films radiologists need to read, and procedures they must perform have exponentially climbed. Some may say that the numbers have far surpassed what is safe for patients.

Finally, different demographics have joined the profession. Today, many radiologists want to practice part-time to raise a family or pursue other interests. Years ago, this type of radiologist was much less common.

Individually, each of these factors plays a role in the change. In the following few paragraphs, we will go into more detail about the reason for each.

Reasons Radiology Has Become A Job For Many

Student Debt

Let’s start by talking about the noose of enormous student debt hanging around the shoulder of new radiologists. In the past, radiology residency graduates could afford to pick and choose where and what to practice based on the merits of the post-residency job alone. No longer is that the case. Now, it becomes more important to make sure you can afford the debt service payments and the day-to-day living expenses of the region of practice. For many, finding work is about desperately needing to make ends meet. So, radiology merely becomes a means to this end.

Increased Bureaucracy

We all feel the weight of increased paperwork and regulations we must follow. To that end, maintenance of certification has become more stringent (although, more recently, it has been slightly letting up). Requirements for accreditation have been increasing exponentially. Also, the maze of insurance requirements to complete a study keeps rising. Moreover, these factors are the tip of the iceberg. For many radiologists, many bureaucratic factors lead them to resign themselves to practice radiology as a job.

The Work Treadmill

Nowadays, many radiologists are hostage to the ever-increasing number of studies they need to read. Public expectations for the delivery of results promptly and efficiently have climbed. Also, time to transcription has become the holy grail of the hospital administration. In these conditions, how can some radiologists perceive their work as more than just a cog in the wheel to make ends meet?

Changing Demographics

Finally, we need to also talk about why different radiologists pursue radiology. No longer do all radiologists fit the same mold. For some, their role in raising a family has become more crucial than the position that they may play in running a radiology practice. So, these radiologists merely want to fund their lifestyle and not get involved in the professional aspects of radiology.

What Does This All Mean?

Well, to start with, we know that the most consummate professionals invest heavily in their careers and see their profession as a calling. These are the incredible clinicians, the movers, and the “shakers.” Moreover, they perform groundbreaking research, make improbable diagnoses, teach their residents, and create radiology systems and businesses to promote the profession.

However, based on the new pressures on individual radiologists, we cannot expect all radiologists to see their original “calling” as a “career.” Instead, many other factors play into the equation. Student debt burdens some radiologists. Alternatively, the chains of bureaucracy and increasing workloads prevent the pursuit of their interests and infringe upon the professional lifestyle of a radiologist.

Regardless, we should not talk badly about radiologists who need to work in the profession merely as a job. Many radiologists have excellent reasons for that. Instead, we should work to fix those factors that have changed to make radiology into a job so that we can improve the quality of our profession and return it to a career for all.

 

 

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Work Expectations For New Attendings: How To Know If You Meet Them

work expectations

Every career stage has its difficulties. And you thought figuring out the ropes as a resident was difficult? Working as a new board-certified radiologist in your career of interest is no different. Just like you have in the past, you will worry about both the quality and quantity of your work. So, how do you know what you do is enough to make a good impression on your future partners and colleagues? Some would say that if you have to ask this question, you are probably not reading enough. But I think that answer is way too simplistic. Instead of relying on aphorisms, let’s go through some work expectations for completing enough studies at each early stage during the first few months and years before starting as a partner in a practice.

First Few Months Of Work Expectations

At the beginning of your first employment opportunity, most practices tend to give new employees a bit more leeway (although not all!). Rather than focusing on quantity, most practices would want you to concentrate your efforts on maintaining the quality of your work. That said, if you garner a reputation of working slowly as a slug, that is not likely to do wonders for your likelihood of becoming a partner or a long-term employee within a practice. Most practices have unstated minimum work expectations. And as a new employee, you should expect to try to take as much work as you can reasonably muster so long as you are not overdoing it and you are not sacrificing the quality of your work.

You should always try to help by taking extra cases, performing as many procedures as possible, and becoming the “invaluable go-to guy or gal.” Don’t let yourself get stuck in the mind frame of “that is not my responsibility.” Of course, if the folks that run the practice are assigning you duties that you have not trained for and cannot complete, you need to say something. But for the most part, you should welcome the additional responsibilities and expectations the owners have given you.

So, what are some signs that you are not reading enough to maintain weight and meet practice work expectations? If you notice the partners are frustrated that they have to take over much of your work because you are not working fast enough, then maybe you need to consider taking it up a notch. Fortunately, most practices, however, will give you a little bit of leeway at this point in your career.

First Few Years

After the initial probation period, you really have to consider whether you are keeping up with the appropriate amount of RVUs and meeting work expectations. No longer can you rest on your laurels because you are the new gal in town. It’s not just about quality anymore!

At this point, your colleagues expect you to pull your weight by completing your assigned lists, which is why they hired you. In addition, you should be helping out with others; if the day ends at 5 pm and you can help others complete their work after this time, by all means, go ahead. Especially when you have your sights on the partnership, you should put your best efforts forward. At most practices, your performance still counts toward your group’s chances of adding you to their fold.

Which candidates will your practice cut during the first few years? Essentially, any partnership track employees who did not fulfill the expectations of their initial reasons for hiring. If you feel that this includes you in this category, beware!

In addition, those folks on the chopping block include employees that cannot adapt to workload changes and work expectations. Practices are not stagnant. Instead, you can’t expect to read the same amount of studies in any given year. Working conditions can become busier, or your practice may add new modalities and procedures. So, always ask if you are keeping up with their expectations even after your first few months. You are not quite at the end of the tunnel until the group has officially voted you in!

Final Thoughts On Work Expectations

Working at a job where you intend to stay for years is more of a marathon than a sprint. Therefore, your mentality needs to be one of “what can I add to the practice?” rather than “why should I do extra work?” or “it’s not my job!” If you maintain this attitude toward your work, you will not only form good employment habits, but you will also think of your role as part of a team effort, not just pulling for oneself. And in the end, that is what most partnerships expect. So, go forth and put your best foot forward. Then, you, too, will find success!

 

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Top Eight Advantages Of Living Close To Work As A Radiologist

close

Driving 50 miles to and from work or over 1.5 hours each way is undoubtedly a recipe for a problematic residency or career. (I did that for six years as an attending!) So, I recommend that you heed the following advice. Live close to the hospital and enjoy life! We will go through eight tangible benefits I have discovered now that I live close to work to support this argument. Try to do the same!

Traffic And Stress

Arriving at work after a school bus, a large white van, and a Toyota Prius cut you off during your 1.5-hour journey versus stopping at the one traffic light between my house and the hospital. Which one is more stressful? Hmmmmm… I can say that stress levels have declined by 95 percent at the beginning of the workday. Who cares if that guy in front of you cuts you off in the parking lot when you are five minutes from the hospital. You’ll still arrive on time!!!

Forgetting Things

The feeling of forgetting something important halfway through a 1.5-hour journey still sends shivers down my spine. I can still remember filling out the medical staff renewal forms due the same day, only to discover they were not in the car halfway through my trek to the hospital. If that happens now, no big deal. I just go home in the middle of the day and pick it up!

Healthier Lifestyle

All those hours on the road wreak havoc on your body. The body should not sit in a car for 3 hours a day. Fast food outlets become your friend. Fat accumulates in the wrong places. All that time that you lose, you can spend exercising or creating a healthier lifestyle for yourself.

Taking Care Of Things At Home

Occasionally, you need to drop off something at the house. Or, you may meet with a contractor to fix your ceiling leak. When you are 50 miles away, it is next to impossible. On the other hand, if you are right around the corner, you can usually stop by for a moment!

Community

Are you volunteering for the community? No problem. Want to coach a kid’s baseball team? You can manage it. Join a local symphony? It’s possible to find the time. Living close opens up many local opportunities you would never have otherwise!

Emergencies

Sometimes disaster strikes. When you live far away, it is almost impossible to help out. On the other hand, if your child injures a leg playing soccer or falls off a horse and you live right near the office or hospital, you are no more than a few minutes away. You can even pick him up and drive him to your hospital yourself!

Family Time

Want to spend quality time with the kids in the evening? You will now have the time. Think it’s essential to go on date night with your spouse? It’s possible to make plans, even during the week. Need to plan family outings- like the school picnic or that hockey game in the evening. Not a problem!

Call Issues

Have to reduce an intussception at 3 AM? At least you are around the corner. You can get in and out in minutes. And, before you know it, you are done. Need to check a scan because the internet froze? All you need to do is drive-in for a moment or two, not 1.5 hours!

Live Close To Work!

As you can see, living close to the hospital makes a world of difference. And the advantages are almost endless. So, go ahead and try to live reasonably close to your work. You can live your life the way you want while not burdened by all the time wasted in the car!

 

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Hiring Radiology Physician Extenders- Helpful for Residents?

physician extenders

Many radiology practices throughout the country are understaffed and overworked. But, it is not just the attending radiologist that can suffer the consequences of decreased time and increasing workload; it is also the radiology resident. Due to the increased burdens of radiologists, radiology residents may have reduced time to attend conferences. They may also have increased service obligations and less availability to perform procedures. Overall, the psychological stresses of residents to complete the daily work increase every year. One potential solution for the hospital-based radiology practice to improve these conditions is to hire physician extenders. So, I will briefly discuss the types of physician extenders, how programs can utilize them in practice, and finally, how residencies can use physician extenders to improve the residency program.

Types of Physician Extenders

Multiple excellent articles describe the roles of physician extenders. Some of these articles include an Applied Radiology summary called Physician Extenders: Which one is right for you?. Another one is an ACR article called Registered Radiology Assistant/Radiologist Practitioner Assistant. And, then there is a sirweb report called: Position Statement: The Role of Physician Assistants in Interventional Radiology. I highly recommend reading these articles to get the nitty-gritty details of each type of radiology physician extender.

But to summarize, I am going to list the different types and describe each briefly. These include Physician Assistants, Nurse Practitioners, Radiology Practitioner Assistants, and Registered Radiology Assistants. According to the sirweb article, only Physician Assistants and Nurse Practitioners can “order tests, write prescriptions, make diagnoses, and get reimbursed for services performed.” On the other hand, all of these physician extenders, including the Radiology Practitioner Assistants and Registered Radiology Assistants, can perform procedures. So, for a practice that needs more than just procedural help, Radiology Practitioner Assistants and Registered Radiology Assistants may not fit the bill.

How Programs Utilize The Physician Extender?

As I have perused the literature and forums on this topic, I have found that the responsibilities of the Physician Extender to be pretty varied. (1) Most commonly, they tend to work with interventional radiology and help to perform procedures such as Paracentesis, Thoracentesis, and Catheter Placements. But, they can involve themselves in more complex procedures such as Nephrostomy tube placements.

In addition to procedures in many practices, they also take responsibility for preliminarily approving patients for cases, taking patient histories, and getting consents for procedures. And Nurse Practitioners and Physician Assistants can write orders before and after cases. Also, they can create preliminary dictations. In some academic practices, they can even help out with data collection in research studies. So, their practice responsibilities can be beneficial to many different types of educational environments.

Are Physician Extenders Helpful For Residencies?

Do not fear radiology residents. Physician extenders are not here to take over the world!!! For most radiology residencies, the ability of the physician extender to perform such varied work allows the radiology resident and staff to focus on other more critical needed learning issues. These physician extenders are independent but not independent enough to run a department for themselves, so they will never take over the radiologist’s job.

What Can They Do?

At the same time, imagine you are responsible for getting consent during the daytime for all the PICC lines, and for the first time, the practice has introduced a physician extender. Now you can share in the responsibility of obtaining consents. They can write notes on the floors and talk to family members. These activities will allow you and your attendings to concentrate on some of the more advanced work in the department.

In addition, some physician extenders have lots of procedure experience and are excellent teachers. You may have a physician extender who can teach you how to do a PICC line or Portacath when the attending is not directly available. Or, the physician extender can perform procedures such as paracenteses and allow the attending and the resident to take care of other more complicated cases simultaneously.

My Experiences

Although I am not an interventional radiologist, my experiences with physician extenders have also been highly positive. When I was a resident, the practice hired a nurse practitioner, and he helped organize what we called “tube rounds.” It was a time in the morning when we would decide if we needed to pull catheter tubes, keep them in, or recommend other interventions. I learned a lot from both the physician running the “tube rounds” and the nurse practitioner who became adept at taking great clinical histories and understood the patients he followed very well. He also became friendly with many of the clinicians, such as the surgeons and GI doctors. It was a net positive for the medical team and my learning experience. Also, I’m sure he brought in more business for the hospital as well.

Physician Extenders Can Be A Radiologist’s And Residency Program’s Best Friend

In today’s demanding environment, a physician extender can be the right fit for an academic department. The ability of the extender to do procedures, teach, and consult can be a significant benefit for the busy attendings on staff and the residents in the department. Not only can it increase department productivity, but it can significantly increase the morale of the attendings and residents alike. It is a decision that programs and hospitals need to weigh carefully. But for many departments and residency programs, the physician extender brings significant long-term benefits.

(1) J Allied Health. 2015 Winter;44(4):219-24. Radiology Physician Extenders: A Literature Review of the History and Current Roles of Physician Extenders in Medical Imaging.

Sanders VL1, Flanagan J.