As things stand, it’s not in my game plan to cease practicing radiology at any point. I haven’t, for instance, bothered crunching the numbers and determining an age at which I will be feasibly able to cease working. Although, if I were of a mind to live a Spartan life, I could probably do that now.
The fact is that I like the radiological work that I do, and don’t want to stop. It keeps me intellectually engaged on multiple levels, accomplishes some worthwhile things for other folks, and gives more than a little structure to my life. I’m not saying I’d sit miserable and idle without it—Lord knows there are a gazillion other things I never seem to have time for—but I do think it would be a net loss to set aside.
Having said that (any Curb Your Enthusiasm fans in the readership to get the reference?), it is far from unusual for me to countenance a departure from the field. And I’m not just talking about the occasional “what if I won the lottery?” fantasy. So what, if anything, makes me imagine turning off my workstation for the final time? Or might, eventually, make me do it?
In short: All of the nonsense. The hassles, the stuff in-between, the annoyances that get in the way of me doing my personal best as a diagnostic radiologist…and especially the aggravations that just keep on darkening my metaphorical door, despite every effort (my own, and others’) to diminish or eliminate them.
Those having kept an eye on this column long enough surely know some of the factors which vex me most frequently:
• Voice recognition software that never gets any better.
• Referring clinicians who can’t be bothered to give a decent patient history (or who are prevented from doing so by software that was forced on them by administrators or regulators).
• Imaging protocols with which I disagree, but am not allowed to change…and then, having my nose rubbed in them by receiving such studies to read multiple times per day.
• Nonsensical policies (oft enacted to appease VIP-status referrers) which everyone doing the rad work agrees are rubbish…but to be disobeyed at dire personal consequence.
Mandated structured reporting, or other external impositions on how I see fit to render my professional opinion of studies given to me to interpret…especially from non-radiologists who have never read such studies themselves.
Yes, of course no job is perfect, there are two sides to every coin, and one can play devil’s advocate for most or all of these examples. It does not change the “death by a thousand cuts” impact of such influences as referenced above.
Depending on my mood when I contemplate them, I tend to think of them in one of two ways:
• A metaphorical checking account of satisfaction, where the positive and negative aspects of one’s career are constantly engaging in an ebb and flow. There might be short-term deficits or surpluses, but over the longer haul it’s possible, if not probable, that the good will sufficiently counterbalance the bad.
• An analog of the “hits” theory of oncology (the Knudson hypothesis, for those interested), in which the unpleasant stuff gradually accumulates over a course of years, and cannot be negated. Eventually, some threshold is reached to result in badness (an “I’ve had enough of this” epiphany regarding one’s career, as opposed to carcinogenesis).
Whichever is more accurate, and it might vary with the individual, it seems obvious that diminishing the number and frequency of pesky vexations should result in longer and happier careers. And, since we keep on hearing about how there is to be an ever-increasing need for radiologists as well as docs in general, presumably we want as many of our rads to remain in the workforce for as long as they can.
I wonder how frequently the folks in high administrative or regulatory positions (the ones who have the means to improve these “quality of life” issues…or at least refrain from inflicting more of them) think about this.
So, if I ever retire, I hope it’s for the right reasons. Perhaps personal, such as having squirreled away enough dough and having other interests I’d like to pursue full time. Or maybe professional, such as reaching a point where I determine that I can’t properly cut the diagnostic mustard anymore such as from loss of sight or mental sharpness.
I just hope I don’t eventually find myself deciding: Gosh, I’d sure like to keep on doing this great stuff, but all of the baggage that comes with it has gotten to be too much.