Patient Contact?

[rpkall]

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Hi all,

Just wanted to ask a question; I'm a PGY1 resident in another field, thinking about switching to radiology, and I wanted to ask about this issue.

Clearly some people choose rads because of the minimal amt of patient contact; but what about the people who really do like patients and saying a few words with them every now and then as their doctor...?

Obviously IR has tons of patient contact, but in regards to diagnostic--is there room in most private practice jobs to actually meet some of your patients? for example, discuss the findings with interested patients as long as you're not going to scare them or make things more difficult for the PCP? Or is is really expected that you just stay in the dark room, and become a film reading machine for 10 hrs a day?

I've done some rotations in diagnostic, IR, and some places where they do a few biopsies a day, but in general, most of the radiologists I've worked with are less concerned about meeting the patient and focus on the technical details of the procedure only.

Are radiologists who are extroverted, generally compassionate doctor types generally happy in this field, or do they wind up becoming unhappy with the minimal patient contact/pressures to read more and more films, etc, etc. ?

Obviously you have to have some interest in radiation biology/physics and technology to like rads, which I do, so the non-patient-contact side wouldn't be painful, I'm just asking. I would ideally love to have a balance of both.

 

[goremachine]

Academic radiology has a lot more potential for patient contact than do private practice jobs since there are less time pressures, more interdisciplinary interaction, etc. IR obviously has considerable patient contact, so does peds radiology. The rest of radiology, not so much. In private practice in particular, you are expected to become a film reading machine to pull your weight so I wouldn't expect much chitchat with the patients there. I am not in practice, but that is what it seems like from what I hear. Perhaps someone else can contribute as well.

Oh, mammography also has a lot of patient contact, obviously, and it's expected and necessary. But women's imaging is not really the most thrilling field for the majority of rads.

 

[colbgw02]

Agree with above. There's more patient contact in radiology than folks think, but if you absolutely need patient contact to be happy, then private practice diagnostic radiology probably isn't for you.

 

[rpkall]

Agree with above. There's more patient contact in radiology than folks think, but if you absolutely need patient contact to be happy, then private practice diagnostic radiology probably isn't for you.

Are there some positions where there are more procedures, like you could spend half your day reading films, and the other half doing some procedures? Someone mentioned women's imaging in regards to that... But it's not really desirable for many people? Why is that, the monotony/routine of it, or is there some other more specific "rads" reason that folks don't like it? Is it really annoying to look for microcalcifications all day, maybe?

 

[Substance]

Are there some positions where there are more procedures, like you could spend half your day reading films, and the other half doing some procedures? Someone mentioned women's imaging in regards to that... But it's not really desirable for many people? Why is that, the monotony/routine of it, or is there some other more specific "rads" reason that folks don't like it? Is it really annoying to look for microcalcifications all day, maybe?

Reasons why mammo ain't so popular:

1. Very subjective: looking for little white dots amidst a swirl of patchy grey isn't very cut and dry, which leads to reason two...

2. High malpractice insurance rates: due to the subjectivity of the field, things can be missed more easily than in other parts of radiology. The vulture lawyers know this, and pounce like rabid beavers, which causes the mal premiums to increase for mammo radiologists.

3. Stress: given the above two reasons(missed BRCA/lawyers), its obvious...

 

[colbgw02]

Regarding mammo, I would also add that you're not exactly dealing with the most reasonable patients. Even if it's a young person with a relatively benign-appearing lesion, the only thing the patient thinks is, "oh my God, I might have breast cancer!" I don't have breasts, so I can't comment as to why, but I will tell you that women generally get more upset if you tell them they might have breast cancer than if you tell them they might have - oh, let's say - a hepatoma. I would imagine that there is a feminine self-image component to this phenomenon. Regardless, I've found that this leads to a fair amount of melodrama and probably also increases the likelihood that you'll get sued.