Comments on: At The Radiologist’s Mercy

By: dr dave 26

dr dave 26 — Sun, 30 Mar 2008 05:23:47 +0000

My sympathies to you on the mess you dealt with. Agree with T Ellis probably just go through with the transfer and get 2nd read by Neurosurg and eval of the AMS. They always repeat the studies at the referral center also.I was recruited to work in an ER and later found didn’t have after hours reading period. The current docs were so proud of the fact that they had been “taught” by the radiologist to read their own CT scans at night. Hmm, I wonder why he was so kind to teach them this new skill? Sleep all night and still bill for am overreads-nice gig if you can get it. I pointed out to them that they did not want to be on the stand someday when the plaintiff attorney aks, “And Dr. ER doc where did you do your radiology training, get your board certification, etc”. Time to stroke a check… I too learned quickly to read many CTs and got pretty good at it. But as Med Director I was alarmed and pushed admin to get telerad (big capital outlay and lost revenue for hospital radiologist losing am overreads). Now we use telerad, but I still look at the scans right away. Can often pick up things for immediate dispo and not have to wait on telerad reading.

By: X-ray Rocks

X-ray Rocks — Wed, 20 Feb 2008 00:34:39 +0000

Stories like this make a person nostalgic
for the LOCAL on call Rad. of yesteryear.
Not so nostalgic about waking that Rad. up
in the middle of the night!

By: JaneMarieMD

JaneMarieMD — Fri, 11 Jan 2008 04:14:58 +0000

Shadowfax is right-it’s a good idea to look at the actual films whenever you can. Of course it isn’t realistic to look at all films, but I like to look at the ‘positive’ ones so I can learn some radiology. I have seen CTs with subdurals before, and our radiologists often put arrows on CTs to help us (poorly-paid) clinicians (doin’ the direct patient care!!) find the abnormality.

Let’s face it–uncertainty is everywhere!! Jerome Groopman stirred me to some momentary sympathy for radiologists with the chapter in his book about their errors; Eric Cassell has written the most eloquently about the seductive nature of technology–that it will remove all doubt–yet doubt and uncertainty remain.

Sigh …

Thanks for sharing the story!

By: TK

TK — Tue, 08 Jan 2008 15:03:08 +0000

I just had a similar case last night. I had JUST discharged a woman who looked like she had a negative (but traumatic) LP and a reportedly normal MRI/MRA when our neuroradiologist called to tell me the guy that read it initially had missed a subtle SAH!! He did say it could have been caused by the tap (introducing a small amt of blood into the canal) but when I called the patient back, she said she felt fine and didn’t want to come back unless she got much worse. I was like “shit, shit, shit, shit!” Fingers are crossed I don’t get a letter signed by someone…Esq!

By: T Ellis

T Ellis — Tue, 08 Jan 2008 14:50:40 +0000

Sounds like she needed a neuro consult anyway, with or without a positive scan.

By: tagaAmerica.com » At The Radiologist’s Mercy « WhiteCoat Rants

tagaAmerica.com » At The Radiologist’s Mercy « WhiteCoat Rants — Tue, 08 Jan 2008 09:00:29 +0000

[...] At The Radiologist’s Mercy « WhiteCoat Rants [...]

By: Dx:Ddx

Dx:Ddx — Tue, 08 Jan 2008 06:05:58 +0000

Ain’t it wonderful to be a doctor?
To care for patients?
God I’d hate to spend my life looking
Looking at Fourier transformations of
Radiated or magnetized
Patients when I could be
Caring for them.

Too bad they are more
Valued
than me.

By: Nurse K

Nurse K — Tue, 08 Jan 2008 04:32:49 +0000

Let’s smile, hold hands, and look on the bright side—the American taxpayers (and the patient) were saved the expense of a costly ambulance transfer.

Poor little granny sounds like she had—a concussion.

By: SeaSpray

SeaSpray — Tue, 08 Jan 2008 02:14:42 +0000

BTW…if the pt’s mental status was off a bit…do you think she was anymore confused? Or did all this happen around her and she stayed in her room the entire time oblivious to it all.

This is also a perfect example of all the “behind the scenes” WORK hospital staff does on behalf of their pts and ties them up from helping others.

By: X-Ray Geek

X-Ray Geek — Tue, 08 Jan 2008 02:11:46 +0000

You mean he didn’t finish off his report with clinical correlation recommended???? Or is symptoms persist, get a (insert favorite modality here)? Being the one that works under the rad, there are many days where I want to shake the living heck out of them and tell them to make up their freakin mind!!!

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