question for the future radiologists

[ImaMedStud]

---

Members do not see this ad.

Hey there,

I though I wanted to be a diagnostic radiologist until the primary care bug bit me in MS2, I did research in radiology and I know a few in pvt practive and have a lot of respect for the specialty. Which really pi**ed me off when I got the run around this past week.

I'm on IM at VA, admitted a dementia pt for syncope and fall from height, PE unremarkable, no witnesses to the syncopal episode, poor historian. With the blessing of the attending, I order a Head CT s contrast to r/o intracranial bleed. 3 days go by, radiology does nothing, so I call down, told to page the resident, and when I get him on the phone and explain the relavent history/findings and why imagery would shape my managment, he says no focal neural deficits, no CT, its not indicated and I should know better. Get the Sr. Res to call and she gets slapped down. Get the attending, and the team takes a trip to Radiology, theres some attending-attending chit chat and the radiology attending tries to diffuse the situation by half jokingly asking the radio res "what would you do if you're the boss"-before he can open his mouth my attending says "I'm the boss, I want the CT, why have we been waiting 3 f*&king days?" Room goes quiet, we step out but the rad res calls me back to yell at me for bringing this all the way up to the attending.

My question is, wtf do people go into radiology and not want to do their f@#kng job? I'm a med stud for christ's sake, I pay for the privilage to get **** on from the house staff to the pts, and I do what I'm asked.

 

[Uncus]

So from your single anecdotal experience you're asking why "radiologists" don't want to do their job? Your generalization makes the question flawed. If you felt the CT was so important why did you sit 3 days before calling radiology? I don't know the patient but sounds like CT wasn't indicated to begin with and you're only contributing to incresed healthcare costs by ordering unnecessary studies. Let me guess, you got the CT and it was negative.

 

[Mage]

Mental status change and fall in an elderly patient would warrant a Head CT, IMO.

 

[TheWowEffect]

If you felt the CT was so important why did you sit 3 days before calling radiology?

Exactly what I thought. If you are suspecting an intracranial bleed, you would order stat and do a proper follow up. Waiting for 3 days is gross negligence.

P.S.- I am not a radiologist.

 

[Docmike2006]

Sounds like the CT was indicated, but it makes sense that on a patient such as the one described, the medical team would stay on top of the situation and discuss the case with the radiologists. I am sure it would have worked out better for everyone.

So what did the CT report say?🙂

 

[Uncus]

Mental status change and fall in an elderly patient would warrant a Head CT, IMO.

I didn't see anything in the original post indicating mental status changes.


Indications for Computed Tomography in Patients with Minor Head Injury.

New England Journal of Medicine. 343(2):100-105, July 13, 2000.

"Our results suggest that such patients can be identified by the presence of one or more of the following seven findings: headache, vomiting, an age over 60 years, drug or alcohol intoxication, deficits in short-term memory, physical evidence of trauma above the clavicles, and seizure."


Was the patient older than 60?

 

[MD Dreams]

you're only contributing to incresed healthcare costs by ordering unnecessary studies.

I think the lawyers and the flawed US health system are to blame for this one, not the practitioner.

 

[Docmike2006]

I think the lawyers and the flawed US health system are to blame for this one, not the practitioner.

Why bash lawyers? It's the patients who hire them🙂