Lessons Learned From Radiology

March 31, 2014

Some advice to my fellow members of the radiology field, young and old.

I have learned a few things from my 30 year career in radiology-some useful, some not. Here is a partial list:

• Respect your elders: When I started my first private practice job, I was convinced I was the most up-to-date, smartest person on the medical staff of the hospital that was so fortunate to have me. Unfortunately, this hubris predictably rubbed quite a few members of the medical staff the wrong way. While dictating treatment recommendations may have been perfectly acceptable during my fellowship, referring physicians in private practice were generally irritated.

• Leave your ego at the door: In radiology, we have to deal with all types and temperaments in the medical spectrum. Ultimately, as a radiologist the only thing that preserves your job is the perception and goodwill of the medical staff and administration.

• Anger only hurts you: How many times have you raged against the stupidity and unfairness of someone or some situation, especially on-call? The only thing worse than being called out in the middle of the night for something that seems unnecessary is lying wide awake seething with anger for the rest of your night on-call.

• The “ball cap” sign: Patients wearing a ball cap and boots with their patient gown for a fluoroscopy study are almost always unable to follow your instructions. This has been an observation of mine over the years that has really seemed to hold up. In fact, I toyed with the idea of awarding a special ball cap to hatless, instruction-resistant patients. Perhaps one with a spinning propeller.

• Feeling like you don’t know enough is normal: You will never know all there is to know and all you can do is your best and hope that it is good enough. Everyone makes mistakes; learn from them.

• Do what is ordered: Unless it is harmful to a patient, it is almost always better to do what the referring physician asks rather than argue with them. It is definitely quicker. A colleague from West Virginia put it most elegantly, “Don’t get in a pissing contest with a skunk, you will only come out stinking.”

• CT scans can be fun: For instance, the more anterior, coronal, facial CT reconstructions frequently look a lot like Homer Simpson and inside every morbidly obese patient is a normal-sized person.

• Treat others the way you want to be treated: Don’t forget that despite your most desperate wishes, the universe doesn’t revolve around you and your bad day does not automatically make it a National Day of Mourning.  Smile frequently, even when you don’t feel like it. It takes fewer muscles and may be just what the people around you need.

• Say as little as possible at meetings: As another West Virginia colleague explained many years ago, if you keep your mouth shut in meetings, everyone will assume that you are smart. Once you open your mouth, they will learn the truth.

• Clearing a room full of doctors quickly: I have discovered that there are at least two ways for me to clear a room full of doctors: yell “Fire!” at the top of my lungs, or tell them in a normal tone of voice that I am a financial advisor and I would like to help them.

• When in doubt, do what is right for the patient: While this is not always the easy thing to do, at least you can live with yourself and sleep at night. Of all the things I have learned, this is the most important.

These are a few of the lessons I have learned. How about you?