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Approaches to Success in Radiology From a Mediocre Outfielder


Can consistent timeliness, visual effort and engaging attitude give a radiologist with so-so skills a discernible advantage?

If you have read this blog over a course of years, you might have the (correct) impression that I am fond of baseball. I am far from a loyal fan. I don’t follow any particular team. At any given point, I wouldn’t be able to tell you who is doing well. Still, if I am near a TV that’s showing a game, I will enjoy watching it.

You wouldn’t know it if you could turn back time and watch me try to play the game as a kid. I wasn’t much good swinging a bat, taking the pitcher’s mound, or manning the bases. I tended to wind up in the outfield, which is just where I liked it because I could do the least amount of damage. As long as the ball didn’t come my way, my ability, or lack thereof, was not on display.

The notion came to me pretty instinctively. If I don’t have amazing skills, I had better do the best I can with what I have got. Maybe sometimes I will make an important play, but I won’t visibly fall short from lack of effort.

That attitude wasn’t confined to my grade-school gym classes. It seemed applicable to everything. I have brought that attitude with me into my radiological career, and I think it has served me well.

I was reminded of it a couple of weeks ago, when I heard a podcaster marveling about a college basketball underdog that had triumphed over a superior team. He and/or one of the interviewed players summed things up much more tidily than I will be able to do here: If someone has better skills/tools than yours and has the advantage, your best bet is to use 100 percent of yours and hope that gets the job done.

Maybe you will exceed yourself and perform at 110 percent for a win. More likely, the other person won’t be using his or her 100 percent. They might have a less than day, or just not try so hard, and function at 80 percent, falling below your hundred.

I have written in this blog before about what a razor’s edge the spectrum of radiological performance can be. Everywhere I have worked, rads have performed with QA accuracy percentages in the mid/upper 90s. Quality assurance isn’t everything, of course, but from that perspective, the difference between any given set of rads is liable to be a couple of cases out of a hundred, if even that.

Will most observers be able to discern such a slim difference without doing a deep dive into the rads’ stats, or are they likely to just perceive some rads doing roughly similar work?

There is a third option. We humans like to compare and contrast things. If we see that skill differential can be dismissed as a “wash,” we look for other variables. Being human, rads provide plenty of opportune targets for scrutiny with their behavior. These targets that aren’t so different from what you might use to size up two different outfielders on your baseball team.

Be where you are supposed to be when you are supposed to be there. It doesn’t matter whether the outfielder had ability to catch a high-fly ball if he or she wandered away from his or her post. The thing will plunk onto the grass, and the rest of the team will rightly blame the outfielder as the other side scores.

Similarly, a rad who routinely saunters in late, takes excessive breaks, leaves early, etc. might be the smartest person in the world but while he or she is not at post, other rads are having to do his or her work. Watching this person’s cases pile up, fellow radiologists may start wondering if they will wind up getting tapped to deal with his or her backlog. Perhaps the rad in question is the only one around who can read a certain type of case, or a referrer prefers dealing with him of her. If that rad is MIA, he or she can make the whole group look bad.

Meanwhile, suppose you have a mediocre rad who can be counted on. Maybe he misses an extra 1 percent on his reads but he’s there when you (and the referrers) need him. If you have a coverage hole, this rad will fill it without a complaint. Eventually, a day comes when you will only be able to keep one of these radiologists on your team. Who would you pick?

Make a visible effort. Here comes another high fly ball, but it’s headed right between the territory of two outfielders. One of them runs full out to try and get it, diving at the last moment and sliding across the ground but ultimately failing. The other guy takes a token step or two in that direction or doesn’t even budge. Their stats are the same but who would you rather have on your team?

I probably don’t need to spell out the ways you can tell when a rad is making an effort versus not so much. If you’ve been in the field for any length of time, you already know and, really, you can probably say the same for folks in other lines of work. A little observation, and we can tell when our fellow mortals are striving or merely subsisting whether one is talking about auto mechanics, grocery store cashiers, taxi drivers, etc.

Have a good attitude. Once again, let’s envision two members of the team without a big difference in their by-the-numbers performance. The first person is a pleasure to work with, polite, patient, and maybe even fun to be around. Even when a stressful situation provokes him or her to vent some steam, it is within reason.

The second person is unpleasant, maybe even an ogre. He or she may be prone to bad moods, predisposed to complain or fling criticisms at anybody, and not above an occasional tantrum. He or she is the sort of person you see will be working nearby and immediately think to yourself: This is going to be a bad day.

Now suppose the ogre rad catches one more high fly ball than the nice rad in a typical game or reads one more case per hour. You might go home slightly earlier than you would have if the nice rad had been your teammate. On the other hand, there is a substantially greater chance each day that the ogre will pick a fight with you or stab you in the back via group politics. Which rad would be your long-term preference?

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