Standards can hang you

Monday the convention seemed like old times. Apparently, most U.S. radiologists waited until Sunday to come to the meeting, as I saw far more recognizable faces the second day. I guess they like leftover turkey more than I do.

We were only outnumbered about 25 to one. This is truly an international collection.

I listened to an interesting discussion of the American College of Radiology's guidelines for practice. The mammography lexicon and standards were particularly hot. I always thought it makes sense to have a standard language. The problem is lawyers.

Lawyer: "I see you discovered a 2-mm nodule in Mrs. Lowly Victim's breast on a screening mammo".

Me: "Yes."

Lawyer: "And by the time she had special views, saw a surgeon, and had it excised, it had swelled to nearly twice that size."

Me: "Yes, I believe it was just under 4 mm when they took it out."

Lawyer: "So, if you had not ignored the national standards for your profession, if you did not send out reports your own Professional College would say are bad, if you had not called this terrible lesion a 'nodule' instead of a 'mass,' poor Mrs. Victim might have been rid of this rapidly growing tumor sooner. Tell me, Doctor, should we assume you ignore all the standards of your profession, since you clearly ignored these?"

Me: quiet babbling and drooling.

Standards and guidelines are a good thing, but they are clearly a two-edged sword.

I also attended several sessions of a case-based course on neuroradiology. I got six hours of CME, which is more than I usually get the entire time I'm at this meeting. The course and the format were excellent, but it cost me a day of roaming around in the technical and scientific exhibits.

I wish I could figure out how to do more of what is available every day without staying at McCormick Place any later. Of course, I have the same problem at home.