I certainly have limited experience in the prviate wolrd, but in the four hospitals that I have worked at this has not been the case. While it is true that all of these services look at their own studies, in my experience they do not officially interpret them. Of course in the real world they may; I don't know. Reading bone CT is not difficult. Reading MR on the other hand is a whole different game. You cannot interpret or even properly protocol an MR study if you do not have an intricate working knowledge of MR physics. You have to know what sequences you need T1,T2, proton density, gradient recalled echo, fluid attenuation inversion recovery sequences, and so on , what coils to use, do you need to fat suppress the study, do you need gad etc... One can basically make any tissue or fluid look any way they want just with changing these factors. You must know what type of pathology you are looking for and modify the study to find it. It goes a little farther than CT with or without contrast.
In the last six months a few of the things that I can recall seeing that were missed initially include:
Several pneumothoraces including one tension/fractures including C-Spine, hip and pelvis (one hip that was cleared by ortho and the woman collapsed in the hospital parking lot from her subcapital fracture/a few tumors including bone, lung, and an atrial myxoma/ at least two cases of multiple pulmonary emboli detected incidentally on Chest CT done for other reasons/two cases of necrotizing fasciitis one involving the mediastinum/ and one case of a misplaced central line that was put into the subclavian artery in a relatively healthy young woman who died when the line was removed. The radiologist interpreted that film for the plaintiffs.
As you say, I doubt that those guys in Louisville need Rads help very often, but I would also bet that being the excellent clinicians that they are, they likely have most if not all of their studies read by Rads because that is what we are for.
As a radiologist, I like most others, get a little irritated when my work is not appreciated. A good radiologist is worth their weight in gold to clinicians and a bad one is essentially useless. I take a lot of pride in what I do and my absolute favorite part of the job is when I add something to the clinical picture. None the less, we are the Rodney Dangerfields of medicine; we don't get no respect.
I am sure that you do pick up most things, but as a wise clinician which I think that you are from reading your posts in the past, I am sure that you realize that a good radiologist is an expert at what he/she does. We look at studies all day every day and we see things and know to look for things that non-radiologists generally do not. We are a valuable part of a team and unfortunately all too often in medicine clinicians forget that we are all on the same team. I often find myself just as guilty as others in making smart@ss comments about some other specialty when they do something stupid; particularly on call. I am desparately trying to quit doing that. Anyhow, I guess we can agree to disagree on this point. Cheers!
