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Wanting Versus Deciding: Making Good in Radiology


The will to provide legitimate make goods to help address bad situations for radiologist employers can be a key difference between staff loyalty or mutiny.

There is a cellphone game I have been playing for a few years (one might say too many). It is no big surprise that the thing’s novelty has long since worn off, but I haven’t quite gotten to the point of nixing it.

As with many other games of its kind, it is never a finished product. The developers regularly add new content, lest longer-term players like me get a sense of having seen/done everything and drift away. The new content doesn’t always work the way they think it should in terms of functioning properly or challenging/entertaining the players.

When such things go badly, sometimes the developers offer “make goods” in the game to appease the players. It is like a gift certificate from a restaurant that screwed up your dinner. It doesn’t erase the bad dining experience, but it might just salvage your impression of the place and retain you as a customer.

Make goods can be anything that is valued by the recipient. In workplaces and business venues, financial stuff predominates. “Time is money” is trite but true, and things like comp days thus came into being. With a little creativity, other options can also be thrown into the mix, but it has been my experience that a lot of folks in leadership positions don’t think outside of the time/money box when it comes to making good. Unable or unwilling to part with either, they offer some words of apology or not even that, effectively choosing not to make good.

I have been around the block a few times. Different work environments and various types of leaders (some stretching the definition of that term) have shown me many occasions in which make goods could have been applied and how successfully they were applied, if at all.

One way that make goods fall short or fail to happen entirely stems from a lack of mental commitment to enacting them. Those who have the authority to offer make goods excuse themselves with the notion that the resources for a proper make good aren’t there or cannot be spared. They rationalize that whatever harm the make good is supposed to address wasn’t all that bad, or that its damage won’t really be fixed by the make good, so why bother? Often, they get stingy, offering some tiny token that doesn’t make good at all and possibly adds insult to the original injury.

A podcaster to whom I regularly listen recently dwelled on the distinction between wanting to do something and deciding to do it. Most if not all of the make good opportunities I have seen in my radiology career (and elsewhere) rose or fell as result of the want/decide divide.

I probably won’t do justice to the podcaster here, but I will put it this way: If you want to do something, there is a good chance you won’t. Think about how many people want things that never come to pass, whether it is osing weight, making advances in a career, learning a new language, etc. A lot of those failures come about because wanting isn’t enough.

If, on the other hand, you decide to do something, you are committing yourself. You will do whatever is in your power to make it happen. It still may not happen. Circumstances might conspire against you, or you might not have what it takes to succeed, but failure won’t be the result of insufficient effort on your part. Rather, if you truly decided, no particular failure will be the end of your efforts. You will just switch tactics and keep on going until you succeed.

Every failed make good opportunity I have seen was a case of, at best, wanting to rectify situations or, much more commonly, giving lip service to such wants while privately deciding that no real make good would happen.

That empty lip service often has “tells,” weaselly wording that as much as says “We’re going to make an empty gesture towards making this up to you.” Much like when an unreliable coworker or friend tells you they will “try to” X, or “do their best” at Y, the weasel words are like a heavily hedged radiology report. Most of what is said dwells on how horribly limited the study is, and why everything from A to Z cannot be ruled out.

When making good actually happens, it is a rare breath of fresh air. We’re liable to regard its deliverers as heroes, if not saviors, because so many others would not have done the same. In a weird way, successfully making good to someone can elevate your status in their eyes far higher than if there had never actually been a misadventure to compensate.

Here is an example. I spent about seven years in my first teleradiology job, a pay-per-click affair that began with typical night shifts. About halfway through my time there, the employer began an initiative in which rads could volunteer for a lower-paying case mix in exchange for daytime hours. I eagerly signed up. Unfortunately, the company got a little ahead of itself, and I found myself staring at often empty worklists. That meant zero income, and no amount of daylight made that tenable.

Leadership was apologetic, but more importantly “took ownership” of the error and made good. They applied a stipend to my direct deposit that month, a sum that didn’t quite match what my regular monthly income would have been with a normal volume of work but more than sufficient to make my ends meet.

They could easily not have done that. They could have made the stipend a pittance, or made noise about considering it, kicking it back and forth between committees, etc., ultimately telling me that they wanted to make good but couldn’t for this excuse or that. Instead, they decided to make good, and did it without delay.

Folks who have read this blog for the long haul know that I had more than a couple of dissatisfactions with that telerad company, and this didn’t completely wipe them clean. However, it went a long way toward balancing the scales as far as I was concerned. It definitely kept me in their ranks for far longer than otherwise would have been the case.

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