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Does Increased Comfort Enhance Productivity in Radiology?


A comfortable environment for reading CTs, MRIs and X-rays may be conducive to less interruptions and longer intervals at radiology workstations.

Health care is a “back in my day” field. Put together elder statesmen physicians and fresh-out-of-training newcomers, and it is a minor miracle if the senior rads don’t wind up telling the newbies about how much has changed since times of yore.

Stereotypically, the conveyed message is that young’uns don’t know how good they have it. They’ve been coddled and/or improperly prepped. You know, the “I walked 20 miles in the snow to and from my hospital, uphill both ways” kind of stuff.

Sometimes, the old-timers are more charitable, instead speaking favorably about how conditions have improved. I gravitate more to that way of thinking, in part because positivity gets a better response than being Dr. Negative. I would also rather dwell on how nicely my profession is treating me now than grump about dissatisfactions from 20 years in the past.

I don’t think it’s controversial to say that most of us do our work much more comfortably now than in yesteryear. I am not even talking about telerad versus on-site work. That is apples and oranges. Comparing working conditions at my training hospitals against even my first couple of post-fellowship jobs, well, there really is no fair comparison.

Technological improvements factor into the equation. A lot of added comfort came from replacing alternators and film-jackets with computerized systems. If you have never gotten a “paper cut” from the edge of a film or had to sit and wait for folks to come repair a jammed alternator, you might not fully appreciate this. A lot of the factors in (dis)comfort, however, had nothing to do with function.

Take, for instance, “rounds” in clinical services. When I did my internship, and for that matter during latter years of med school, it was a given that one rounded with one’s team — often more than once a day — entirely on foot. Wearing dress shoes, one was expected to stand in hospital hallways, slowly moving from room to room, for however long it took to discuss every single patient being covered and for the attending to expound upon any academic topics that came to mind. If you thought sitting now and then, or using more comfortable footwear might be reasonable, that was your weakness.

Times change and eventually folks rise through the ranks who are able/willing to question, even change the status quo. Why are we standing uncomfortably throughout rounds? Can’t we sit around a table for most of the talking, and only get up when it is time to actually see the patients? Or “I’m the attending now, and we’re using these comfy things called chairs.”

One comfortable change begets another. Folks’ eyes are opened to the notion that, if there is nothing gained by an uncomfortable situation, there might be nothing lost by adding comfort to it. Perhaps there will even be improvements beyond the comfort itself.

My radiological journey moved from wooden or folding metal chairs in the reading room to cushioned affairs, then seats with wheels, armrests, and various adjustable things like height and reclinability. There were hiccups along the way, like an old, overdue for replacement chair with half-gone cushioning, no longer able to roll in a straight line (fobbed on whoever was lowest ranked in the room).

We also shifted from group reading rooms to individual affairs. Both my residency and fellowship hospitals were works in progress in this regard. Neuro might have single reader rooms, whereas body imaging would host two or three attendings and their respective house staff. After training, I never again saw two rads have to simultaneously work in the same room.

Anybody who’s gone from having a roommate to not (for instance, between first and second years of college) knows the innumerable added comforts of having one’s own space. You stop having to dictate in a hushed voice, and no longer have to worry about someone else talking into their dictaphone or otherwise interrupting your work. It also becomes a non-event that they will bring in some rancid-smelling lunch (and you can bring your own without fear of disgusting anybody else).

Even simple things like climate control trend toward comfort. Working in hospitals, I had to abide by whatever conditions the facilities set. Some reading rooms were frigid while others were uncomfortably warm. Fast forward to individual offices in a private practice, and you might just have your own thermostat although that can be abused if the device controls more than one room. I recall one individual who saw nothing wrong with cranking down the thermostat for everyone else while keeping a space heater under her desk.

As I mentioned above, working via telerad brings comfort to a whole new level. No longer leaving your home (or perhaps your vacation-like second home), you don’t need to endure unpleasant weather or traffic for a commute. Dressing up to look professional ceases to be necessary. You can wear your comfiest PJs. Plus, since it’s your house, you can indulge in whatever high-end chair you like rather than begging some boss for permission to replace the torture rack you have endured for the past several years.

It is easy for onlookers to sneer at this trend towards comfort. Look at that prima donna rad insisting on having this particular headset and that fancy pants sitting/standing desk. How is he any different from a computer-gaming nebbish in his parents’ basement?

Such naysaying loses sight of the functional value of comfort. Yes, it’s nice but a lot of the time, it incrementally adds capability. If I have the headset that I know works best for me, for instance, I might produce slightly more accurate, higher quality reports. Perhaps I will average an extra RVU or three per day. Further, if my setup keeps me comfy at my station for longer intervals, and I less frequently feel the need to get up, stretch, walk around, etc., it helps me keep pace with the ever-increasing demands of the radiological system in which I work.

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