Sunday, December 28, 2008

A Day In The Life Of A Radiologist

Radiologists are often seen as being a relatively easy specialty within medicine. This cannot be further from the truth. While certainly less demanding than other fields like surgery, radiologists remain very active during the day. Here is one radiologist's experience:

Dr. Michael arrives in his office just before 8:00 a.m. and tries to set it up for the coming onslaught. He sets his stereo to soothing classical music and turns down the overhead lights. On this day, he is able to snatch five minutes of set-up time. During this brief break, he thinks back to medical school, all the hours studying, preparing for USMLE Step 1, writing notes, being at the bottom of the totem pole.  But then the action starts. The phone rings—one of the receptionists is sending Dr. King down to the office. He wants to go over some films. Dr. Michael barely has time to look at today's schedule, which has him assigned to fluoroscopy-upper GIs and barium enemas, basically.

No sooner is he able to figure out his assignment, then one of the "fluoro" x ray technicians, Bernadette, comes into his office to cheerfully announce that the first UGI series is ready. Just then, Dr. King rolls in, so Michael tells Bernadette to hang on for a few minutes so that he can go over films with Dr. King. Fortunately, on this day, the findings on the films are found and explained quickly by Dr. Michael; while Dr. King explains the clinical circumstances and they compare notes.

Dr. Michael would love to chat with Dr. King about this, that, and another thing, but right now he has a patient and tech waiting for him in a fluoro room, so he must cut this social encounter short. These interactions with the clinical staff, a mixture of professional and nonprofessional, are a very important part of Dr. Michael's workday and important for the patient too. When a clinician and radiologist exchange medical information, the patient surely benefits. But Bernadette and the patient are still waiting.

It's just 8:15 when Dr. Michael walks into the fluoro room to do his first case. He introduces himself, induces the patient to drink barium, and takes a number of x-rays. This patient wants to know what is going on before she leaves. Dr. Michael is happy that patients are actually becoming enlightened consumers, asking questions about diabetes care, diabetes supplies, and even diabetes treatment options. He even shows the patient her esophagus on the fluoroscopy screen to which she exclaims "Gross!" That terminates the tutorial. Finished with the case, Michael goes back to his office to check if the emergency films have been read yet. In an acute care hospital, chest x-rays on certain inpatients are frequently obtained more than once a day. These patients are often very sick, and they are often awakened at first light for a daily chest x-ray; those films need to be read.

For more of Dr. Michael's story, check out the Radiology Channel (http://www.radiologychannel.net/insideradiology/radday.shtml)

Clearly, a radiology job is not sedentary, so you can forget those compression socks! Lower extremity edema is one thing a radiologist certainly does not have to worry about. A radiologist is active and dynamic, making important decisions throughout the day, affecting patient care in a myriad of ways. To be a good radiologist, you must be able to process large amounts of information, think on your feet, make decisions quickly yet accurately, and be able to communicate your decisions to other members of the patient care team. In many cases, the decisions made by a radiologist have far-ranging impacts on the care of a patient. Any good radiologist should always strive for excellence, given how important their role is.