Cleaning House

August 2, 2013

From using the term "suboptimal" to working for the TSA to comparing experiences with other rads, here's a few random radiology musings for you.

I've never gotten my mind around the concept of spring cleaning. After a winter of unkind weather, when things finally get nice and springy, the last thing I want to do is spend even more time inside making things look tidy. Still, clutter does build, and sooner or later one gets motivated - especially on an unseasonably cool and gray summer day like today.

So, I have slowly been accumulating a group of half-baked files on my computer desktop - blogs that got developed to a certain point, and then wound up in Limbo. Some were just looking for zingy closures, others barely made it past their opening lines, and to varying extents they've resisted subsequent efforts. A couple have been sitting there and smirking at me for more than a year.

I'm tired of looking at them, so I've decided to harvest a few snippets and trash (or "recycle," thanks Microsoft) the rest:

"Suboptimal" covers a broad swath of lousiness, from just inferior to what one might have liked to the worst imaginable. As a result, it rarely conveys just how bad a job was done (by whomever). Unfortunately, use of any stronger language could get you into trouble for putting negative stuff on the written record, so we're stuck with "suboptimal," which is, itself,… suboptimal.

"Clinical correlation," used in certain ways, can be a verbal flip-off to referring clinicians. Sometimes entirely intended as such by the dictating radiologist.

If radiology deteriorates to the point that I want to seek other careers without giving up on all of my acquired skills, I might inquire with the TSA. I could stare at security-checkpoint scans of people and their bags without feeling too much of a jarring transition. They don't seem anywhere near as stressed when they develop a backlog of passengers as we do when we have a backlog of STAT cases to be read. Might be nice to be unionized, too.

The mythical head-in-sand ostrich might have the right idea. We're all frantically looking for scraps of information about an endless tide of new budget-cuts and regulations - and how often does all of the worrying and scurrying pay off? When we think we've figured how something will play out, how often are we right, and/or able to do anything about it? Seems we're more often than not playing the role of Chicken Little, or maybe Cassandra.

I frequently encounter people who cannot comprehend how I live with an every-other-week nocturnal work schedule, yet operate during normal daytime hours on my off-weeks. Really, it's no different than adjusting to jet-lag. And someday, I'm going to test that by taking a trip to the far side of the world right after I finish a week of night work.

The momentary flare of frustration or anger that occurs in the middle of busy working hours when I encounter a case that was done badly, for the wrong reason, etc., is strikingly similar to the heady feeling I get in the middle of a long-distance run. In both settings, I can have a perfect vision of what I should do (to make sure the bad case never recurs, or to act on my brilliant inspiration post-run). Even just an hour or two later, when I'm no longer mentally or physically spent, about a dozen flaws with my "perfect" vision are painfully obvious.

There has to be a way for radiologists, other than one-on-one word of mouth, to compare their experiences working for local hospitals and private practices. Obstacles would include fear of libel accusations (even for reporting legitimately bad behavior of former employers; nobody wants to get dragged through legal action even if they know they'll come out on top), and false reports from individuals with axes to grind. If anybody has ideas, I hereby offer up my proposed website name: GoodRads.com.