The Radiologist’s Chair: The Key to Being an Efficient Reader

Radiologists and cockatoos may share a habit of inefficiency.

I bought a cockatoo a number of years ago under the impression that they were smart, for a bird, and could learn to talk. I’m the kind of person that reads the instructions so I bought a book on cockatoos to learn how to care for it. One of the facts concerning cockatoos that made a lasting impression on me was the statement that “they are inefficient eaters.” That turned out to be an understatement. I am pretty sure the concept of “food fight” originated with this species. If they get even a fourth of what they are fed past their beak into their digestive tract, it would be a miracle. The rest goes flying everywhere.

What does this have to do with radiology? As a keen observer of my fellow radiologists over the last three decades, I have decided that, like the feeding habits of cockatoos, some radiologists are inefficient readers. In the halcyon days of increasing revenues this was less noticeable and less bothersome. Now with a frenetic work pace and declining reimbursements, many radiologists are looking over their shoulders or checking the statistics on PACS to see if their buddy in the next foxhole is carrying his or her share of the load.

The concept of basing pay on productivity is being discussed more frequently, I’m sure mostly by the folks who believe they are working harder than anyone else. This is a tough sell in our Three Musketeer radiology culture but it is gaining traction for the same reason that groups are putting off hiring - to maintain their incomes as long as they can.

There are many different personalities in radiology and each of these personalities directly affects the work habits of the individual radiologist. On one extreme is the omniscient, cerebrally enhanced type that vaporizes study lists without any apparent effort. They are clearly efficient readers and the envy of their peers. Then at the opposite extreme are the ones with an apparent allergy to whatever material their chair is made from. Included in these are the storytellers, schmoozers, wanderers and flirts. There are those who will declare war on a particular issue regarding image quality or other technical or procedural problem and wage battle for a period of time while not getting any work done. There are the administrative types, the teachers, the day traders, the vacation and meal planners and the online shoppers. I have even known some radiologists who seem to wait until after the workday has nominally ended to do their work, apparently, because there are less distractions.

I have a nephew in the Air Force who explained that the other services call them the “Chair” Force because most of their work is done seated in a chair of some type. Radiology is the “Chair” force of medical specialties. The key to getting work done in radiology is “chair” time. Being an efficient reader in radiology is less about being omniscient and lightning fast than it is about being consistently seated in front of your workstation pecking away at your work list with your beak. This is definitely not a universal trait amongst radiologists.

By the way, the cockatoo never learned to speak. There were only blood-curdling shrieks, which is exactly how I feel many days.