Want Efficiency and Productivity? Start with Familiarity

January 31, 2019
Eric Postal, MD

If you’re new to a job, don’t expect efficiency right away.

As I’ve referenced from time to time in this column, I’m no ivory-tower academic. Nor am I a brilliant super-sub-specialist, the go-to guy for interpreting a particular little niche of radiology studies. When it comes to reading exams, I’m good at keeping my nose to the grindstone and taking an oversized chunk out of the worklist without sacrificing quality. In other words, being productive.

I’ve also previously referenced how that played out in my last two jobs-in a small outpatient imaging-center and then in a much larger telerad situation. In the small outpatient setting, it was possible, though uncommon, to have everything read and literally nothing left to do. A particularly busy day for me might have meant 80-plus reads.

Related article: How to streamline radiology workflow

Moving to teleradiology saw my daily number quickly move to 100, and eventually 2-3 times that-an empty worklist became a vanishingly-rare thing since there were a gazillion facilities feeding work to the practice. A bunch of efficiencies made my productivity-jump possible, described in previous columns: a superior infrastructure for the telerad group, better tools, none of the routine interruptions that had plagued me when I was an on-site rad, etc.

It can be a heady experience, seeing that you’re reading that much more than you used to. Especially when you still know on-site rads who ask how much you’re reading in telerad and then marvel at the answer as if you’re some kind of superhero.

So in pursuit of my new gig, it only made sense for me to cite the sort of productivity I’d come to expect of myself-along with a caveat that such productivity was with the aid of those efficiencies I’d come to leverage and rely upon. After all, it wouldn’t do to make grand promises to a new employer, then enter their fold and produce half of what I’d said I could.

That said, most reasonable employers will make allowances for a newbie, no matter how capable, to learn the ropes of the employer’s system. Indeed, I was advised that I should start off by paying no attention to the productivity-tracking mechanism used by my new gig.

Easier said than done. Priding myself on being an industrious sort, and a fast learner, I was dismayed at just how much of my vaunted productivity failed to evince itself during my first couple of days. The main issue was those ropes mentioned above; I of course had zero familiarity with the new-to-me system.

All of it-the software, the workflow, the layout. Even some of the hardware. Learning where to look for things like the clinical history, contrast, or radionuclide dosage, reports from prior studies. How to rewindow images, take measurements, etc. Even to remember where the buttons were to sign my completed reports. And working against me were the strongly-ingrained habits I had built up over the 7 years in my previous gig. Heck, a couple of weeks later, I still occasionally try to use voice-commands from my old system.

Happily, developing familiarity with such frequently-used things is pretty rapid. After all, if you read multiple dozens of cases each day, that means multiple dozens of times you are training yourself for such mundane things as knowing where the “sign” button is, or how to adapt your search-pattern so it dovetails with the structured report-templates that differ from the ones your previous job used.

So the learning-curve is nice and steep at first. I think my productivity for Day 2 was probably double that of Day 1. Maybe I gained another 25-33% on Day 3. A couple weeks later, I’m still seeing steady gains, but things have leveled off a lot. I’ll probably soon get to a point where I plateau from a day-to-day perspective, but there will still be an improving trend on a weekly or monthly scale.

Related article: 7 Reasons Rads Burn Out-And How to Cope

Once attained, familiarity is not a static thing. I occasionally learned interesting wrinkles of the system at my previous gigs even years into them-sometimes with a sense of wow, how did I not know this by now?

There’s also the matter of changes in policies and procedures which intermittently impact the familiarity of even the most seasoned folks in the ranks: CMS has a new rule that everyone needs to learn to follow, for instance, or a big referrer wants reports rendered differently. Even a superb new software upgrade is going to feel unfamiliar for a while, no matter how much everyone agrees that it’s a vast improvement.

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