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A Radiologist is a Physician


When you are asked for an informal medical opinion, one’s intellectual curiosity and desire to help others never fade away.

Pay the slightest bit of attention to radiology social media or more formal publications, and you will never have to wait long to encounter a writeup reminding that, yes, radiologists are physicians. Given its frequent repetition and being a statement of the obvious, I suspect pretty much nobody pays attention at this point.

Good for you on making it past the first paragraph. Either your “been there, done that” filter is lower than that of a true cynic, or you are charitable enough to stick with me.

A lot of those pieces focus on how much of the public doesn’t even realize we’re docs, and it is on us to showcase ourselves as such, lest horrible things occur.

I am focusing on another facet here. I recently had occasion to weigh in on some pharmaceutical choices for someone in my personal life. She has a complex mix of issues, and a few of her subspecialists are contemplating new meds for her, some of which are biologics. They gave her a short list to research for herself, not sure whether they knew she had a friendly doc to help her in this quest.

It’s a sure thing if you are a physician. Friends and family, sometimes even people you have barely met, will ask you for your informal medial opinion on things. They don’t even wait till you’ve completed med school, much less residency. Most docs get very accustomed to explaining how their area of expertise differs from whatever they are being asked about on a given occasion.

I am sure some leave it at that and even I have found myself completely without a clue but usually, I feel like I have at least a tidbit or two to offer. As a lot of these questioners seem to instinctively know, going through nearly a decade of medical education and postgrad training means having at least a brush with most major topics. I might know only 1 percent more about something than the general population, but that 1 percent could conceivably be of interest.

When I was asked about medications, for instance, I was pretty useful during my med school and internship years. Two semesters of pharmacology got me passingly familiar with just about every available medication. Even if I only prescribed a small fraction of that armamentarium as an intern, I didn’t magically forget the rest of it. If someone asked me whether a given antibiotic was right for an infection they had, I could reasonably weigh in on this.

Fast-forward through residency and a bunch of years of practicing radiology without even owning a prescription pad, and that knowledge gradually faded. I could still look stuff up and rapidly refamiliarize myself, if needed. Other meds turned up, but a glance at their generic names would tell me what class of drug was involved. If someone tells me he or she is on a med I never heard of but it ends in “-statin,” I don’t need to do a deep dive to know the person is being treated for cholesterol.

Eventually, however, genuinely new drugs came along, having no counterparts in my education/training experience. The biologics I referenced above are one example of this. Should I give up the ghost and say that I have no doctorly value in the situation? “Sorry, I just read scans.”

I guess I could, but that just doesn’t come naturally to me. First, someone wants a modicum of help from me, and that makes me want to provide it. Second, I have more than a little intellectual curiosity. What is this new med, surgical procedure, or whatever is being asked about? Third, as I have referenced in this week’s title, I am a physician. I never stopped being one, even if most of what I have done for the past 20 years has been interpreting imaging, a relatively small slice of the medical sphere.

That education and training I went through equipped me better than most to look up these new-to-me bits of health care. I learned a gazillion other non-radiological things before, even if most of them would ultimately have no bearing on my daily practice. I can relearn them as needed or learn new things. I can read about mechanisms of action, drug-drug interactions, adverse effects, statistics of efficacy, etc. If I shrug my shoulders and willingly carve that out of my life, it seems a monstrous waste.

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