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Thu Jan 15 02:52:28 GMT 2009

I have never been able to 
comprehend what makes anyone do radiology in the first place... ;-)

1. the most rapidly developing?high tech specialty; i have seen more than ten new radiology specialties born in my career
2. opportunity to interact with all specialists
3. the enjoyment of discovering what is difficult to see
4. training one's eyes to see things that most cannot recognize. many doctors actually admire radiologists
5. a generally relaxed set of co-workers who are interesting, eclectic and intelligent
6. being in the action for so many different clinical problems. more than 60% of diagnoses are made by imaging
7. interacting more with physicians than with patients 
8. controlling ones hours of work (less than it used to be)
9. the aesthetic beauty of the images. 
10.?the income?

if you want to know the ten reasons why not to become a radiologist, just ask

sal

-----Original Message-----
From: Doc Holiday <drydok at hotmail.com>
To: .Trauma List <trauma-list at trauma.org>
Sent: Tue, 13 Jan 2009 1:46 pm
Subject: RE: reimaging transfer patients

From: William Bromberg (brombwi1 at memorialhealth.com)  > We routinely rescan 
patients for these reasons...

--> I think there would be little debate on whether one should re-scan patients 
if images are sub-par, unreadable, wrong format, no contrast or other 
ommissions, etc...
My comments were in reference to the original thread, on re-scanning patients 
for "cannot double dip, hence no pay, hence no read" [Joe Nemeth, Mr 
(joe.nemeth at mcgill.ca)]

> 4. The referring facility reports never come with the patient (like all rads 
reports the formal report doesn't happen for 24hrs

--> In which case I don't see a benefit for re-imaging, as you'll not get YOUR 
radiologists to report them within 24hrs if they "all" don't

> don't get me started on the fact that the radiologist can bill for picking up 
a pneumothorax 24hrs after I've already treated it

--> I promise not to get you started on this!I have never been able to 
comprehend what makes anyone do radiology in the first place...But in your 
context, I guess you could look at their "delayed reading" as you do upon a 
historian documenting the past ;-)

> I don't know what the malpractice situation is like in Oz...

--> Me neither!Methinks you confuse my "accent" as Oz, but I'm in the UK... Have 
been in South Africa and elsewhere. But not Oz...
Still I'd bet big money that their "malpractice situation" is better than in the 
USA by a very very long way (from a doctor/patient point of view, not a 
lawyer's).

> but expecting physicians to accept the liability without any reimbursement is 
not only fundamentally unfair IMO but in fact will just not happen in most 
facilities

--> I do not look at the stupidity of involving litigation in medicine any 
differently than involving profit in it. I see legal & financial as equipotent & 
equivalent sides of the same coin. I.e., in your context, I think that the ONLY 
fear here is financial - the liability worries people in terms of what it would 
cost to lose a case financially.

> Performing a "dummy scan" a
nd billing for it would be considered knowingly 
fraudulent behavior in the US and would result in fines and prison terms

--> I was not being serious, y'know...Us ozzies have a funny sense of... Wait - 
I forgot I am not Ozzie...

Still is this not funny?Say you receive PERFECTLY ADEQUATE AND READABLE 
images...But your local dark-man refuses to read them for lack of profit for 
himself...How so quickly we expect one go to court for my "fraud", but all is 
instantly "legal" if one adds some unnecessary irradiation, generating identical 
images and harming the patient... That's Kosher!

From: Gross, Ronald (Ronald.Gross at bhs.org)  > This is the way our guys handle 
these things as well. We need only give them the disc so that they can (1) load 
the images onto the PACS and (2) put in an "official" order for radiology 
re-read of outside images. When necessary, they will let us know when we need to 
re-scan or image the patient.

--> Thanks for this!I'll save myself the effort of trying to further explain the 
point, 'cause here are least two places which work "sensibly" (at least by my 
logic)!The question to all those who explain why this SHOULD NOT happen is "why 
not, if it does happen at least in these two places"?
Do their radiologists know something yours don't?Are there no lawyers where they 
are?Do their local insurers pay for stuff others don't?Do their outlying 
hospital radiology departments meet a higher standard?
Or are they simply doing what's RIGHT rather than what's PROFITABLE, without 
making excuses...

From: Fiona Wallace (tielserrath at yahoo.co.uk)  > perhaps the US system is 
different

--> ...and the Pope catholic...

> ... when you have a 3hour wait for a retrieval team to arrive, would it not be 
sensible to use that time to complete any necessary radiology, as long as it can 
be done safely?

--> "sensible"?Of course!PROFITABLE for the radiologist?
Not so much... I believe that was the original reason for the thread. Could it 
be that the originator of this thread was looking for a 
way/rule/system by which 
to CONVINCE or force his local radiologists to be "sensible", rather than 
profitable?

So... The 2-3 of you who have so far indicated that their radiologists are 
"sensible2 in this regard - could you provide any clues as to how to make other 
radiologists follow suit?
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