Next Time

June 30, 2017

In radiology, focus on this time.

It strikes me as a peculiar little phrase. A statement containing the words “next time” is almost invariably a commentary on last time. Or this time, if you’re still in the thick of things.

Usage is, of course, more likely if you’re in circumstances that tend to repeat themselves. A radiologist reading a chest x-ray, for instance, has much more potential for “next time” to play a role than someone who’s been struck by lightning (at least, one hopes)…or won the lottery.

Most often, the idea is that what has happened (or is happening) is less-than. It should not have happened, or it should have gone better. This can be on the part of an aggrieved party, such as the rad reading the CXR maybe resenting that the case shows a pneumothorax, and should have been read hours ago by a colleague who left work early or otherwise prematurely stopped reading his cases. Or it can be in response to the vexed individual, assuring him that this unhappy set of circumstances will not be allowed to happen again.

The use of “next time” as a reassurance often rings hollow, because the subtext is often “Next time, things will be fairer…but this time, you’re just going to have to live with things as they are.” For instance: An attending rad I knew during my residency had already given notice in advance of heading to another gig, and had a small amount of time left in his current post. Some aspect of his work displeased the leadership of our department, but they had no real power over him anymore. Thus, when they tried to give him a talking-to, his response (with a barely-suppressed chuckle) was, “Well, I’ll try to do better next time.”

“Next time” can also be an ultimatum. Getting back to the rad and the CXR mentioned above: He might be ticked enough that, instead of suggesting that administrative action take place so that, next time, the important pathology gets detected and communicated in a more timely fashion, he conveys that there had better not be a next time. It’s really only half an ultimatum, since he hasn’t spelled out what will happen if there does indeed turn out to be a next time: Will he quit? Refuse to sign his name to the hot potato study? Put his slacker colleague’s name in the report? If you’re not like the short-timer rad mentioned above, and you don’t have a finite interval remaining with whoever your “next time” communication is shared, it should probably be on your radar that the phrase gets weaker with each use, eventually being little more than an insult to the receiving party.

That is, unless it’s routinely followed with meaningful action. A figure of authority who says “You’re fairly warned; next time you do this, there will be consequences,” and then proceeds to mete out those consequences when the next time occurs, will be taken seriously.

More often than not, though, those who make use of “next time” aren’t so good about that part. You’ve probably seen some folks demonstrating this with, shall we say, less-than-stellar parenting. Allowing their kids to get away with bad behavior because “next time” there will be discipline for it…yet multiple next-times come and go without punishment. Guess what the kids learn? (Hint: It isn’t to be cowed by threats about next time.)

Even if “next time” is followed through without fail, it still conveys a message that probably should be avoided: Inefficiency, ineptitude, or even injustice will be accepted as a matter of routine. Those wanting satisfaction aren’t getting it, this time around. The answer to the (often implied) question of “You’re telling me next time? What about this time?” is, effectively, a lame shrug.