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Even Steven


When everything works out in radiology.

You probably know one or more people who, even this long after the series has ended, cannot engage in a conversation without making at least one reference to the aging Seinfeld sitcom. Heck, you might be such a person yourself…and yes, it counts if you just think of the references but refrain from uttering them. All that means is that you’ve developed some self-control.

It’s not too hard to see why-not only was the show clever, creative, and chock full of subplots, but a big reason for its success was that so many of those plots centered on the mundane little things in life that one tends to encounter on a regular basis. Everyone could relate, sooner or later.

A theme in one episode (referenced in the title of this week’s blog) refers to the main character’s experience that, sooner or later, everything evens out for him. He loses a job, but shortly thereafter a different one falls into his lap. He’s down some money, then unexpectedly finds a similar sum in one of his pockets. Thus, when his girl dumps him, he’s got no doubt that he’ll wind up with someone else in no time.

I’ve noticed the same phenomenon in my work. In terms of productivity (number or RVU-type value of cases I get done), accuracy (QA numbers), or matters more abstract (morale/energy while on the clock, for instance, or circumstances impacting my longer term career). The key to being a calm, well-adapted Even-Steven, it seems, is recognizing the timeframe over which things can be expected to even out.

For instance, suppose I’m of the mind that a decent day of work for me is to churn out X RVUs. But, as I turn off the workstation on Monday evening, I see I only made it to .9X. Maybe, that day, I wasn’t “feeling it,” as the saying goes. Or maybe the hospitals that normally keep my worklist full were less busy than usual, and I had some empty-screen time. Perhaps I got more XRs and fewer MRs in my case mix.

I might fret about it if I’m new to my gig, and wonder if X was a realistic goal. But if I’ve been around longer, I might have seen that, yes, I often have .9X Mondays…and just as frequently 1.1X Tuesdays, even exceeding 1.2X on weekends and holidays. I might eventually notice that entire weeks, even months, have up- and downswings. (Summer versus winter, for instance.) Having such perspective, I’m less inclined to worry about smaller-scale setbacks…or to metaphorically count pre-hatched poultry when I mistake a particularly good week to be my “new normal” rather than just another fluctuation.

The longer-term stuff is harder to learn to take in stride, because I think one has to actually live through a certain number of cycles before getting comfortable that things will regress towards the mean.

For instance, the radiology job market. Being out of residency for just shy of 12.5 years, I’ve pretty much worked through the tail end of a minor boom and the vast majority of a multi-year bust. I’ll confess to some sour thoughts along the way, when hearing older-timers wax philosophical about how the pendulum swings, and predicting that good times would return-after all, they already had their good days; how could they know, and why should they care, whether us newer rads got to have some of our own?

And yet, here we are, the job market finally showing signs of renewed life. Even Steven strikes again?

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