The Good Bits of Radiology

April 12, 2013

In radiology, it’s easy to feel frequently worried, depressed or enraged. But then there are the isles of sanity in my career that really provide good vibes.

What with all of the headwinds facing radiologists and physicians in general, one can develop a sort of tunnel vision for stuff that makes us various shades of unhappy, from worried to depressed to enraged.

Especially in the past few years, when most of the “good news” we receive seems to be revelations of how previous bad tidings are being delayed or at least reduced in severity (for instance, a looming 30 percent reimbursement cut is put off for a few weeks).

Perhaps it’s the onset of spring, with longer daylight hours or slightly nicer weather, but I was thinking about some of the elements of my career that continue to provide genuine good vibes. They don’t tend to happen on an hourly basis, or even necessarily once per day. Still, enough of them exist to stand out, like little isles of sanity if not bliss, from the morass:

Making that crucial, yet unexpected, diagnosis. Of course, it’s even nicer when reaching the clinician isn’t like pulling teeth, and/or he expresses appreciation if not admiration for the good catch. As opposed to the surgeon from the other night, who cursed and hung up on me.

Meeting or exceeding goals. If, for whatever reason, you’ve determined that reading ten cases per hour is a good pace for you, noticing that you’re on your 35th case at the three-hour mark can give a little thrill. Seeing that your peer-review stats place your performance in the top percentiles of your group, even if you hate the whole QA process, is a welcome external validation, no matter how self-assured you may have been otherwise.

Being Solomon. There’s a thorny issue in your group, and you’re the one who comes up with the solution - or at least, a major piece of it. Maybe you’re just happy that another solution, one which rebounded to your detriment, was avoided. Maybe it’s that others are seeing you have more to contribute than churning through cases. Maybe you just like solving puzzles.

Consulting. This goes both ways; of course, it’s great to have the answers when someone brings you a case they’re finding difficult. I also find it engaging when I am asking, say, a neuroradiologist for his thoughts about a baffler which is on my plate, and I can offer my tentative differential to him rather than just saying, “Duh, what the hell am I looking at here?” I frequently end such interactions with an open invitation to bring body-imaging queries to me. Collegial bonds are thus forged and strengthened.

Improving processes. Something in the routine way of doing things has been on your nerves for awhile - a departmental protocol, some aspect of the paperwork, etc. It slows you down, or you can see a way it will eventually cause problems, and you finally manage to get it tweaked to the point where things run more smoothly. Bonus points if other folks notice.

“I can do that.” That CT-perfusion case that nobody else can read? You got it covered. A clinician wants to go over a case that somebody else on your team read, but your colleague can’t be reached? You take the call and settle the issue. A pediatric hip ultrasound? No problem; you just studied up on those and can handle them, too. It’s not that you don’t acknowledge your limits - but to you, they’re surmountable (and enjoyable) challenges.