Life in the (Radiological) Fast Lane

February 10, 2017

Choosing which radiologists to please.

I am not a fast driver. In a recent online forum thread in which participants discussed their personal all-time highest driving speeds, I found myself to be one of the pokiest, never having gone much above 80 mph. Most reported in excess of 100, though to be fair that included some who had experienced the Autobahn or Montana highways.

Still, I’ve done enough motoring to know that what might be inconsequential at low speeds-say, an unintended sudden veering of 15 degrees from your intended course-can have far greater consequences at high velocity.

From time to time, I’ve had similar thoughts regarding my work in radiology, and indeed other pursuits for which factors like productivity, efficiency, and honed skills are in play. Possibly because I’ve always had a certain “workhorse” mentality. Even back in my salaried, pre-telerad days, when my paychecks were the same no matter how many cases I read. My attitude was that there was work that I had been hired to do, and I should do as much of it as I could without sacrificing quality in the process.

When it’s a personal priority to maximize what you’re getting done, you tend to take notice of the things standing in your way. You remove what obstacles you can, and you learn workarounds for others. Some, inevitably, are beyond your control. Your choices, then, are A) Learn to live with them, knowing that you could be doing more but it’s not your fault that you aren’t, or B) Appeal to others who might have the ability to improve your circumstances.

Option B might take the form of pleading for a favor, but as often as not the obstacles to be removed (upgrading hardware or software, changing workflow algorithms, adjusting workplace policies, etc.) are there for a reason, even if the reasoning is outdated. Option B therefore generally is employed as a quasi-bargain: Remove this obstacle for me, and I will be able to provide greater productivity (or quality) for you in return.[[{"type":"media","view_mode":"media_crop","fid":"56532","attributes":{"alt":"Radiology productivity","class":"media-image media-image-right","id":"media_crop_8625353618520","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"7099","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 170px; width: 170px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"©Blue Planet Earth/","typeof":"foaf:Image"}}]]

Such requests, I’ve noticed, are too often ignored, or given diplomatic lip service and never acted upon. None too surprising, since I’ve yet to encounter a radiologist, or indeed anybody who works hard and cares about their work even harder, who doesn’t have ideas about things that could be done to improve their job-hearing them all out would be a neverending process.

Further, a fair number of those ideas, if acted upon, would be perceived as detrimental changes by other folks in the organization; what makes my life easier might make things more annoying for the rad next door. There’s also the matter of cost-benefit analysis; if instituting a change to make a radiologist happy consumes substantially more resources than will be counterbalanced by the rad’s increased productivity, it’s a net loss.

Still, I would argue that the “fast driver” rads should probably be more readily given audience and consideration in this regard. If you’ve got two rads, one churning out 200 quality reads a day and the other doing 80, and they both have ideas that will reliably improve their productivity by, say, 2%, you’re looking at a gain of four reads versus fewer than two. Similarly, a race car driver who insists on fine-tuning for his gear probably needs to be catered to a little more than someone like me, bringing my 11-year-old SUV to the mechanic and kvetching about why it doesn’t run like new.

And no, it’s not just about the numbers: Going back to an earlier point, it’s rarely possible to make everyone in your organization happy. If you absolutely have to pick whose morale will be boosted, you’ll probably want to favor the folks who you most want to keep around, the ones who are best for your operation as a whole. I used fast driving as a metaphor, but there are other virtues beyond speed/productivity to consider: Quality, versatility, availability, etc.