Put it on Autopilot: Your Minimal Effort Guide to Radiological Greatness

Radiology social media can be a great place for problem solving. Thirty years ago, if you were looking for advice, your sources were pretty much limited to other members of your rad group. If you had put effort into networking, you might have had a few extra contacts to call and, if your timing was fortunate, there might be an upcoming conference for you to attend with more peers.

Now you just fire up whatever device you have handy, make a few keystrokes, and voila! You have got all the input you could ever want and then some. Meanwhile, a bunch of silent observers who might someday experience your troubles are forewarned or just sit back and feel grateful not to be so beset.

I contribute my two cents when they seem worthy. In the fullness of time, I have noticed a common theme among them: putting things on autopilot.

That might sound counterintuitive. Often, that expression means relegating something to a position of low importance, giving it no real conscious attention or much effort. We might accuse someone doing a less than job of operating on autopilot.

My usage of the term takes a step away from that. I am referring to setting up systems in which your desired outcomes can result from what people or circumstances would do by virtue of least-resistance pathways.

Nature provides some good examples of this. Take hunger and thirst for example. We would get in trouble if we didn’t properly nourish and hydrate ourselves, so we have these nifty physiological mechanisms to make us seek out and ingest food and water. With these mechanisms in place, we don’t need some caretaker following us around to say that it is lunchtime, or to keep eating/drinking on a written list of chores we need to get done.

A lot of rads (and groups thereof) don’t take advantage of the autopilot approach as much as they might. To be fair, some problems don’t have a 100 percent autopilot solution, but some are a lot closer to this ideal than others. The further away from auto your strategy for something is, the more you are counting on people to be where they are supposed to be and do what they are supposed to do. That introduces a lot of opportunities for failure.

Let us take a common problem: Getting all the diagnostic imaging cases read. If you just assume that all rads know the group survives by interpreting cases and everyone should do their part, this might not happen. People might slack off, declare a workday over and leave, etc. Next thing you know, there is a backlog of cases and referrers are constantly phoning. My first job out of fellowship routinely had bins full of cases over a week old.

You might try giving the team pep talks and sending out memos. Maybe you target your less productive people for individual pressure or assign office staff to help you flog the team. All of this is effort-intensive, however, and the only extra motivation it gives to the rads who need to do their work is that they will be hassled less if they perform.

On the other hand, if they are feeling motivated in ways that matter, it becomes a path of less resistance for them to get the work done. Suppose after clearing out the backlog, the group institutes a new rule: The workday doesn’t end until all cases that were completed by a specified time have been read.

Now, you have got a pseudo-autopilot working on your side. Rads presumably want to get done and go home at some point. At any time during the workday when they might otherwise slack off, they might think, “Hey, if I let cases build up now, I will be stuck here later on.”

There is a similar pseudo-autopilot: Productivity incentives. That week-plus backlog job I mentioned above was a flat salary situation. It didn’t matter if you read more cases than everyone else in the joint, or if you were dead last. Your paycheck didn’t reflect a thing. They also didn’t do bonuses, or raises that took individual performance into account.

Suppose an outfit like that announces that a certain percentage of compensation will go from immutable salaries to a proportional amount for whatever work one has personally done. Now if I slack off, I know that will hurt my bottom line. If I hustle and read extra cases, I will fatten my wallet. The typical person’s motivation to earn more becomes another mini-autopilot that will help the group keep up.

Such pseudo- and mini-autopilots are helpful and can be created any time you come up with a more efficient, harmonious way of everyone pulling in the same direction. Where are the full-fledged autopilots though?

Chances are that you are already using a bunch of them. Switching to voice-recognition software from human transcriptionists was, for most of us, an oldie but goodie. More current examples would include AI tools, or at least the ones that are more ready for “prime time” and help more than they hurt. Any “set it and forget it” technology (aside from software updates and periodic reassessments of what is working) is an autopilot.

The autopilot strategy works at the individual level too. You can set them for yourself. Again, you probably already do. Chances are you have some sort of alarm to wake you up at whatever time you want to start your day. If you are doing MOC, you probably have weekly reminders from the ABR when “self-assessment” questions are ready for you.

Good habits are your mini-autopilots. If you make it your standard practice to look up things you don’t know as you go through your workday, your knowledge base grows a lot more reliably (and steadily) than if you just count on reading journals and doing CME now and then. Apps like StatDx and Orbit even let you accrue CME credits while you are doing these on-the-spot lookups.