Neurosurgery Vs Interventional Radiology

[managedcarefin]

I dont know if youre still considering ortho but a quick plug for lifestyle. Apart from trauma, the hours arent that bad. I met my wife during residency (shes non healthcare) and we obviously got married and started a family. All while I was in residency. I was able to moonlight, I was able to travel, I was able to see my wife most days for dinner minus trauma or some random long days (and of course call).
All of the ortho attendings I know love their job and have pretty good lifestyles. Most PP ortho have atleast 1/2 day a week of protected time to catch up on notes/clinic. Most academics have 1 day "academic" day for research or notes. As a resident you operate a lot but as an attending its not that common to operate more then 2 days a week (again outside of call stuff). PP call I've seen average around 1/6-7. Academic call is way less from what I've seen.

Good luck!

I doubt this level of open clinic days will exist once the op is an attending. Hospitals are actively trying to get rid of 1/2 day clinics etc etc.

---

Members don't see this ad.

 

[DrOrthoSpineMD]

I doubt this level of open clinic days will exist once the op is an attending. Hospitals are actively trying to get rid of 1/2 day clinics etc etc.

I already signed a contract for post fellowship and it is written in my contract.
I also know numerous attendings in PP (not hospital employed) who have this as well.

 

[AnatomyGrey12]

...aaaaaand a couple months after this heartfelt post I am back considering rads. I am all tee'd up to apply neurosurgery, but I am struggling to finally commit. I have been reading up and speaking to my mentors, and nobody has been in the position I am in: married, likely to have kids as a junior resident (can't wait much longer due to my age and wife's age), spouse also in medicine and will start residency a year behind me, and coming from a place with no home program so unlikely to control matching in my hometown with family. Either folks had a stay at home spouse or spouse with a chill job, or they had kids after or late in residency, or they were young and single during training. Never all of the above, and my mentor was telling me the people he knew who did have kids in the middle of training struggled to stay afloat and went straight to private practice when they finished, which is not what I am interested in. Training is not what it was, but it is concerning to me that I can't find anyone who had as many things to juggle as I will during residency. I love neurosurgery the most, but I don't want to burn my family and relationships down over those 7-8 years.

I've established that the CNS is my favorite. I am considering going the rads->neurorads->neurointerventional route. It gives me the freedom during residency to start my family, and I can ramp my career back up later down the pipe while still working with the diseases and treatments I am interested in.

I think what has been so agonizing is this is truly the first time in my life I have had to consider genuine compromise regarding a major life decision. Being a neurosurgeon has been my primary career goal for about 10 years, and untangling that from what I want for my life big picture is difficult.

I am a little embarrassed posting this given all my back and forth, but maybe someone later on will read this and it will help them with their own decisions.

For what it's worth one of the only neurosurgeons I know graduated residency with 4 kids. He said it sucked going through training, and wasn't for everyone, but if you and your partner are committed you can make it work.

 

[managedcarefin]

I already signed a contract for post fellowship and it is written in my contract.
I also know numerous attendings in PP (not hospital employed) who have this as well.

PP is different but I’m telling you that there’s no way that those things won’t change overtime. Hospitals are doing everything they can to squeeze more productivity out of physicians. Open half days of clinic time is incredibly expensive for a system. I’m not arguing that it’s right or wrong either just providing you facts on the future especially post COVID, when it comes to demand recapture.

 

[Dr G Oogle]

My co-resident In OBGyn was married to a Neurosurgeon, w kids and family clear across the country; 2 of my friends from school are neurosurgeons and wives are obgyn. None of them felt like they compromised all of them made it work. For sure you will be home less at least in residency, but it’s quality over quantity, you will sacrifice your own hobbies to spend time with family or do your job. Whatever you do i highly suggest you get a night nurse for when you have kids, moms and dads can always be brought in for a few months when baby is born and can stagger them so support lasts for most of first year. Try to outsource any chores you can: laundry, house cleaning, even cooking if neither one likes to do it etc so when you guys are home you’re not doing chores or bickering about who is doing more.

it is also much easier to switch out of neurosurgery than switch into it.

 

[libertyyne]

...aaaaaand a couple months after this heartfelt post I am back considering rads. I am all tee'd up to apply neurosurgery, but I am struggling to finally commit. I have been reading up and speaking to my mentors, and nobody has been in the position I am in: married, likely to have kids as a junior resident (can't wait much longer due to my age and wife's age), spouse also in medicine and will start residency a year behind me, and coming from a place with no home program so unlikely to control matching in my hometown with family. Either folks had a stay at home spouse or spouse with a chill job, or they had kids after or late in residency, or they were young and single during training. Never all of the above, and my mentor was telling me the people he knew who did have kids in the middle of training struggled to stay afloat and went straight to private practice when they finished, which is not what I am interested in. Training is not what it was, but it is concerning to me that I can't find anyone who had as many things to juggle as I will during residency. I love neurosurgery the most, but I don't want to burn my family and relationships down over those 7-8 years.

I've established that the CNS is my favorite. I am considering going the rads->neurorads->neurointerventional route. It gives me the freedom during residency to start my family, and I can ramp my career back up later down the pipe while still working with the diseases and treatments I am interested in.

I think what has been so agonizing is this is truly the first time in my life I have had to consider genuine compromise regarding a major life decision. Being a neurosurgeon has been my primary career goal for about 10 years, and untangling that from what I want for my life big picture is difficult.

I am a little embarrassed posting this given all my back and forth, but maybe someone later on will read this and it will help them with their own decisions.

It’s funny you mention this , because I have been having very similar conversations with my wife and even internally with myself. Even the idea that rads ->neuro it as it allows a more family friendly existence during residency. And the possibility of NIR and tougher lifestyle afterwards.

I have loved neurosurgery so far, some things do concern me like economic pressures for patient selection that may not be perfect. But there is pure medicine as well like when you are on 30 hour call and a patient rolls in the ED and you have to rationally think through physiology, anatomy and physics because no cookbook exists and the best evidence for anything is grade C. I am also getting better with hand skills which is also gratifying. Plus constantly being around people who are seriously smart and care about what they do is great.

I am doing rads soon, IR got canceled because of covid so lets see if I will enjoy it as much as I enjoy NSX. I absolutely love looking at neuroimaging though.

 

[7331poas]

...aaaaaand a couple months after this heartfelt post I am back considering rads. I am all tee'd up to apply neurosurgery, but I am struggling to finally commit. I have been reading up and speaking to my mentors, and nobody has been in the position I am in: married, likely to have kids as a junior resident (can't wait much longer due to my age and wife's age), spouse also in medicine and will start residency a year behind me, and coming from a place with no home program so unlikely to control matching in my hometown with family. Either folks had a stay at home spouse or spouse with a chill job, or they had kids after or late in residency, or they were young and single during training. Never all of the above, and my mentor was telling me the people he knew who did have kids in the middle of training struggled to stay afloat and went straight to private practice when they finished, which is not what I am interested in. Training is not what it was, but it is concerning to me that I can't find anyone who had as many things to juggle as I will during residency. I love neurosurgery the most, but I don't want to burn my family and relationships down over those 7-8 years.

I've established that the CNS is my favorite. I am considering going the rads->neurorads->neurointerventional route. It gives me the freedom during residency to start my family, and I can ramp my career back up later down the pipe while still working with the diseases and treatments I am interested in.

I think what has been so agonizing is this is truly the first time in my life I have had to consider genuine compromise regarding a major life decision. Being a neurosurgeon has been my primary career goal for about 10 years, and untangling that from what I want for my life big picture is difficult.

I am a little embarrassed posting this given all my back and forth, but maybe someone later on will read this and it will help them with their own decisions.

Can you do neurointervention through IR? Thought it was only through neurosurg and neuro -> stroke -> crit care. I know IR can do neuro diagnostic angios, but i didn't think they could do thrombectomy.

 

[libertyyne]

Can you do neurointervention through IR? Thought it was only through neurosurg and neuro -> stroke -> crit care. I know IR can do neuro diagnostic angios, but i didn't think they could do thrombectomy.

Interventional Neuroradiology Fellowship | NYU Langone Health

NYU Grossman School of Medicine offers subspecialty training in neuroangiographic and neurointerventional procedures for adults and children. Learn More

med.nyu.edu

Neuroradiology/NIR

Its kinda been the wild wild west for NIR for a few years, but there are pathways through Neurology, Radiology and Neurosurgery.

 

[Giovanotto]

Interventional Neuroradiology Fellowship | NYU Langone Health

NYU Grossman School of Medicine offers subspecialty training in neuroangiographic and neurointerventional procedures for adults and children. Learn More

med.nyu.edu

Neuroradiology/NIR

Its kinda been the wild wild west for NIR for a few years, but there are pathways through Neurology, Radiology and Neurosurgery.

I hope we can get to a point where you can go from neuro to neuroIR without 2-3 extra years of residency. Like neuro>1 year critical care>neuroIR. The current pathway is too long. And vast majority of neuro residents see enough stroke. Not sure why that extra year of stroke is there.

 

[libertyyne]

I hope we can get to a point where you can go from neuro to neuroIR without 2-3 extra years of residency. Like neuro>1 year critical care>neuroIR. The current pathway is too long. And vast majority of neuro residents see enough stroke. Not sure why that extra year of stroke is there.

The other pathways take 7 years at minimum, I am not too torn about neuro requiring 6-7 years. I am assuming there is massive variation in Neuro icu exposure at neuro residencies considering neuro icu fellowships for neurologists are 2 years .

 

[Giovanotto]

The other pathways take 7 years at minimum, I am not too torn about neuro requiring 6-7 years. I am assuming there is massive variation in Neuro icu exposure at neuro residencies considering neuro icu fellowships for neurologists are 2 years .

Is my math off? For neuro wouldn't it be 4+1+2+(however long neuroIR is). That's what, 8-9 years?!

 

[libertyyne]

Is my math off? For neuro wouldn't it be 4+1+2+(however long neuroIR is). That's what, 8-9 years?!

4+2(ICU)+1(NIR)

But I am no expert, when i looked at these a few years ago i quickly came to the conclusion that nsx with enfolded vascular fellowship would be the most ideal path for me.

Edit: Found this

 

[Giovanotto]

If that is true, then I agree, not bad. In fact, I'm rather tempted now. Word on my street was that it required stroke+NICU fellowships.

 

[7331poas]

4+2(ICU)+1(NIR)

But I am no expert, when i looked at these a few years ago i quickly came to the conclusion that nsx with enfolded vascular fellowship would be the most ideal path for me.

Edit: Found this

Many programs are moving away from enfolded fellowships I thought.

 

[libertyyne]

Many programs are moving away from enfolded fellowships I thought.

It’s a little more complicated than that. You can still do enfolded fellowships as long as your program lets you take a chief year as year 6 .

 

[cybermed2424]

Do any of you guys have any insight on the lifestyle differences of NIR vs NSG? I’m imagining they may be more similar than different

 

[libertyyne]

Do any of you guys have any insight on the lifestyle differences of NIR vs NSG? I’m imagining they may be more similar than different

NIR is a worse lifestyle then gen neurosurgery.

 

[libertyyne]

So i have attended radiology conference for a few days, and I am not sure if this is definitive but my eyes tend to glaze over during these. I have rarely encountered this problem during NSX conference. The actual work of reading images was not too bad, except that I disliked the inefficency with which the resident was reading.

 

[Matthew9Thirtyfive]

So i have attended radiology conference for a few days, and I am not sure if this is definitive but my eyes tend to glaze over during these. I have rarely encountered this problem during NSX conference. The actual work of reading images was not too bad, except that I disliked the inefficency with which the resident was reading.

What was boring about it? Not that this is you, but when I spent time with the pathologists, I had a great time, but my eyes started to glaze over during the academic conference when they were way over my head.

 

[libertyyne]

What was boring about it? Not that this is you, but when I spent time with the pathologists, I had a great time, but my eyes started to glaze over during the academic conference when they were way over my head.

Im not sure, i will try to pay attention next time as to the cause of my eyes glazing over. It might be part of it being above my head, but sometimes the details are glossed over and are just presented as an abnormality where i am still scratching my head as to how they reached that conclusion.

 

[7331poas]

So i have attended radiology conference for a few days, and I am not sure if this is definitive but my eyes tend to glaze over during these. I have rarely encountered this problem during NSX conference. The actual work of reading images was not too bad, except that I disliked the inefficency with which the resident was reading.

I mean, radiology is pretty difficult to understand without extensive training. I think surgery is generally pretty "exciting" no matter what the training level.

 

[Cognovi]

Im not sure, i will try to pay attention next time as to the cause of my eyes glazing over. It might be part of it being above my head, but sometimes the details are glossed over and are just presented as an abnormality where i am still scratching my head as to how they reached that conclusion.

You'll glaze over any material that is cognitive or perceptually inaccessible due to lack of prior experience or knowledge. It only starts to click as a PGY-3.

 

[slowthai]

You'll glaze over any material that is cognitive or perceptually inaccessible due to lack of prior experience or knowledge. It only starts to click as a PGY-3.

Guess it takes more of a leap of faith to commit to rads, then. It's like that for all fields, of course, but it seems to be more true for the field.

 

[efle]

Guess it takes more of a leap of faith to commit to rads, then. It's like that for all fields, of course, but it seems to be more true for the field.

I'm planning to apply Rads having had only a Pass/Fail Zoom elective so far.

Leap of faith indeed...

 

[qwerty89]

I picked rads based on the fact that patients kinda suck, nice technology, and good old fashioned process of elimination.

I have questioned going into medicine a few times but I have never questioned picking radiology.

 

[efle]

I have questioned going into medicine a few times but I have never questioned picking radiology.

I've heard this from a few radiologists now. Seems like a lot of the time Rads is the rescue option for people who realize the floors, ORs, ICUs, EDs and clinic would all be a mistake.

 

[cranialLOOP]

Exact same logic but for me the OR is the rescue option as opposed to the reading room. Something out there for everyone! (Usually )

 

[Splenda88]

I picked rads based on the fact that patients kinda suck, nice technology, and good old fashioned process of elimination.

I have questioned going into medicine a few times but I have never questioned picking radiology.

FTFY
You are a winner...

Prevent a 21 y/o from dying from a bad DKA (AG >30, BS >1400, HCO3 4)... what I got was a bite mark from him after I told him he can't leave the hospital until he is stable.

 

[qwerty89]

FTFY
You are a winner...

Prevent a 21 y/o from dying from a bad DKA (AG >30, BS >1400, HCO3 4)... what I got was a bite mark from him after I told him he can leave the hospital until he is stable.

I always have to tell people that I dont hate people. I just strongly dislike patients. There is a difference. Patients have a remarkable ability (through complaints and verbal/physical threats and lawsuits) to make your life miserable.

Want to tell a patient that abx would be inappropriate for their viral infection? lol they don't care. They paid a 20 dollar copay and expect something in return. Want to "do the right thing" and spend 15 minutes (that you dont have) to convince them. You still will likely feel forced to prescribe it otherwise risk a complaint to admin (and another dreaded meeting). Maybe you might win. Congrats! You practiced good medicine. But now the other patients are pissed that they had to wait and remember admin cares about those door to doc times...

Its similar to the power dynamic that parents can have over teachers. The saying "well I know my body" that a doc hears from a patient is the same as a teacher hearing "well MY little boy is a special boy. How dare he only get a B+" from a parent. You can fight the good fight but all you will get is frustration on the back end. Its much easier to stop caring about the practice of good medicine and just say F it. You want it. You get it. Even though we all suffer (increased medical costs leading to reimbursement cuts as a result).

A similar analogy would be any occupation that directly deals with customers in customer service. Remember now, the customer is always right! Similarly, in modern medicine the patient is always right.

At least in Rads I am insulated from the direct patient BS. A fat stack of studies to read on call is miles better. The worst part of call isnt the volume of cases (although it sucks somewhat) its the phone calls, protocolling and other random BS. Reading cases is the best/easiest part of my day.

 

[NeuResurgens]

I always have to tell people that I dont hate people. I just strongly dislike patients. There is a difference. Patients have a remarkable ability (through complaints and verbal/physical threats and lawsuits) to make your life miserable.

Want to tell a patient that abx would be inappropriate for their viral infection? lol they don't care. They paid a 20 dollar copay and expect something in return. Want to "do the right thing" and spend 15 minutes (that you dont have) to convince them. You still will likely feel forced to prescribe it otherwise risk a complaint to admin (and another dreaded meeting). Maybe you might win. Congrats! You practiced good medicine. But now the other patients are pissed that they had to wait and remember admin cares about those door to doc times...

Its similar to the power dynamic that parents can have over teachers. The saying "well I know my body" that a doc hears from a patient is the same as a teacher hearing "well MY little boy is a special boy. How dare he only get a B+" from a parent. You can fight the good fight but all you will get is frustration on the back end. Its much easier to stop caring about the practice of good medicine and just say F it. You want it. You get it. Even though we all suffer (increased medical costs leading to reimbursement cuts as a result).

A similar analogy would be any occupation that directly deals with customers in customer service. Remember now, the customer is always right! Similarly, in modern medicine the patient is always right.

At least in Rads I am insulated from the direct patient BS. A fat stack of studies to read on call is miles better. The worst part of call isnt the volume of cases (although it sucks somewhat) its the phone calls, protocolling and other random BS. Reading cases is the best/easiest part of my day.

I truly believe that the "customer is always right" mentality has led to a lot more societal damage than people realize, largely by enabling the entitlement mentality and the absolute nastiness people display when that isn't fulfilled. Good customer service is great but problems occur when that attitude generalizes to areas where the "always right" statement is demonstrably false.

 

[qwerty89]

As a side note. I think the combination of the patient/customer is always right mentality combined with a govt single payer healthcare system would be a complete disaster. I don't think the average patient fully understands what "free" will actually mean. Wait times would definitely go up and all the outrage will be at the feet of clinicians who will have to get used to getting yelled at. And unlike working at the VA or PCMH or watever this time around there will be no escape.

All these other countries with single payers have a patient population that by and large understands that they will have to wait a bit for non-emergent care and that their knee pain doesn't warrant an automatic MRI.

Good luck getting Americans to accept that.

Karen demands an MRI and god dammit she needs it NOW!

 

[libertyyne]

Can we keep this thread on topic , I’m not here to hear peoples thoughts on universal healthcare and what or what not the american people will accept.

 

[libertyyne]

I understand that the general public sucks, I worked a retail job during college. However I find that the amount of interaction surgeons have with patients to be acceptable since you tend to have focused rounds and office visits, rarely have to deal with social issues regarding dispo. Sometimes the lows can be bad like getting sued, but the highs of having a thankful patient after a successful operation are also high. Even as a student i have witnessed some of these interactions and find them to be satisfying. I literally saw a grown man cry tears of joy post op because of pain relief, or a man who suffered a terrible complication thank the team for removing a tumor. I dont think i have ever seen this form of relationship between any other physican and their patients. The patients tend to perk up and have what appear to be deep bonds to their surgeons even though the surgeons barely spend any time in the room.
I figure no one ever calls their radiologist to thank them for a post op scan, or reading a scan in general. I am not yet sure if I absolutely need that relationship with my patients though.

 

[ineedhelpplse]

I understand that the general public sucks, I worked a retail job during college. However I find that the amount of interaction surgeons have with patients to be acceptable since you tend to have focused rounds and office visits, rarely have to deal with social issues regarding dispo. Sometimes the lows can be bad like getting sued, but the highs of having a thankful patient after a successful operation are also high. Even as a student i have witnessed some of these interactions and find them to be satisfying. I literally saw a grown man cry tears of joy post op because of pain relief, or a man who suffered a terrible complication thank the team for removing a tumor. I dont think i have ever seen this form of relationship between any other physican and their patients. The patients tend to perk up and have what appear to be deep bonds to their surgeons even though the surgeons barely spend any time in the room.
I figure no one ever calls their radiologist to thank them for a post op scan, or reading a scan in general. I am not yet sure if I absolutely need that relationship with my patients though.

Sounds like you want to be a neurosurgeon and you'll be bitter and have regrets doing rads. Honestly, it's not that big a deal between the specialties just pick one being either a neurosurgeon or radiologist won't be the thing that makes you happen; they all have good/bad tradeoffs in the long run. If you really hate one of them, switch to something else. It's like 6 months since you started this thread make a decision

 

[Dr G Oogle]

I’m a surgeon and agree with what you say in general, but you can have a huge impact in rads. When I did my peds rads rotation the neuroradiologists always brought patients and families back to the reading room to review scans with them. The doc doing the fluoro person gave out his cell to patient families and knew everything about the kids who had to come by multiple times; obviously peds IR had a big impact as well but much more than what is typically seen with regular IR. I have seared in my memory a family coming in to the neuroIR control room with a 5 year old kid and a baby; they named the baby after the the neuro-rad IR who did a procedure on the older kid. Granted this was at a “top 3” children’s hospital but I imagine a good radiologist can have meaningful interactions with patients anywhere not just at premier institutions.

specifically for radiology I recommend people go into it because they love radiology not because they dislike some other component of clinical medicine or dislike patient interactions; if it is the former you’ll be very content if the latter you’re bound to be disappointed.

Same with neuroIR; it is a poor substitute for NSGY much like gen IR is a poor substitute for vascular surgery. Not because they are worse or somehow inferior, they just won’t scratch that itch and it will be a lingering feeling

 

[cybermed2424]

Make any decisions?

 

[libertyyne]

Nsx.

 

[slowthai]

Nsx.

Man, this year's gonna be crazy. Got any aways lined up? Or at least a home sub-i?

 

[NeuResurgens]

Man, this year's gonna be crazy. Got any aways lined up? Or at least a home sub-i?

Aways cancelled universally for nsgy this year. They're encouraging everyone to do two home SubIs

 

[libertyyne]

Man, this year's gonna be crazy. Got any aways lined up? Or at least a home sub-i?

Finishing up two home sub Is . Did a week of IR and a month of rads . If I don’t match nsx I will just soap into surgery prelim and do diagnostic rads .

 

[efle]

Finishing up two home sub Is . Did a week of IR and a month of rads . If I don’t match nsx I will just soap into surgery prelim and do diagnostic rads .

Did you find rads underwhelming or just couldn't bring yourself to leave neurosurg behind? I'm in my rads month as well but I've been finding it way more stimulating than I expected

 

[libertyyne]

Did you find rads underwhelming or just couldn't bring yourself to leave neurosurg behind? I'm in my rads month as well but I've been finding it way more stimulating than I expected

I actually really liked rads. In rads the pacing wasn’t fast enough for me , I constantly hand the urge to see the exam dictate and move on to clear the list . IR was a little underwhelming not because of the technology Or the skill, but rather the magnitude of non emergent procedures like tace or prostate ablation. I always had the urge to stick a percutaneous needle to get the case moving faster.
the amount of patient interaction in nsx is ideal. I see you, I do an exam , I act on that exam.
Body IR was good, wouldn’t mind that pace.
I also am now convinced that AI will not make rads obsolete in my lifetime .

 

[Angus Avagadro]

I actually really liked rads. In rads the pacing wasn’t fast enough for me , I constantly hand the urge to see the exam dictate and move on to clear the list . IR was a little underwhelming not because of the technology Or the skill, but rather the magnitude of non emergent procedures like tace or prostate ablation. I always had the urge to stick a percutaneous needle to get the case moving faster.
the amount of patient interaction in nsx is ideal. I see you, I do an exam , I act on that exam.
Body IR was good, wouldn’t mind that pace.
I also am now convinced that AI will not make rads obsolete in my lifetime .

IDK. I can't see as a student you would be bored with the pace of cases unless you were at a university where the neuro radiologist is navel gazing over 50 lumbar spines a day. Most private practice radiologists read 100 to 150 cases a day. And thats not just your subspecialty. Just trying to add some perspective. Good luck and best wishes!

 

[libertyyne]

IDK. I can't see as a student you would be bored with the pace of cases unless you were at a university where the neuro radiologist is navel gazing over 50 lumbar spines a day. Most private practice radiologists read 100 to 150 cases a day. And thats not just your subspecialty. Just trying to add some perspective. Good luck and best wishes!

yeah the residents were reading 10-20 cross sectionals per day.

 

[libertyyne]

You’re a non trad with children and you love being in the hospital? Hmm

And you are a psychiatry resident that doesn’t understand that different people have different things that drive them or differing preferences . Hmm.

 

[WedgeDawg]

Nsx.

 

[Cognovi]

yeah the residents were reading 10-20 cross sectionals per day.

When I as a resident read with a medical student shadowing, I found myself going faster because I subconsciously feared they would find the pace slow. This thread validates my fears. I appreciated this extra push to go faster, since outside the call setting, my program is relatively self-paced and so I had the time to navel gaze.

 

[zero0]

I always have to tell people that I dont hate people. I just strongly dislike patients. There is a difference. Patients have a remarkable ability (through complaints and verbal/physical threats and lawsuits) to make your life miserable.

Want to tell a patient that abx would be inappropriate for their viral infection? lol they don't care. They paid a 20 dollar copay and expect something in return. Want to "do the right thing" and spend 15 minutes (that you dont have) to convince them. You still will likely feel forced to prescribe it otherwise risk a complaint to admin (and another dreaded meeting). Maybe you might win. Congrats! You practiced good medicine. But now the other patients are pissed that they had to wait and remember admin cares about those door to doc times...

Its similar to the power dynamic that parents can have over teachers. The saying "well I know my body" that a doc hears from a patient is the same as a teacher hearing "well MY little boy is a special boy. How dare he only get a B+" from a parent. You can fight the good fight but all you will get is frustration on the back end. Its much easier to stop caring about the practice of good medicine and just say F it. You want it. You get it. Even though we all suffer (increased medical costs leading to reimbursement cuts as a result).

A similar analogy would be any occupation that directly deals with customers in customer service. Remember now, the customer is always right! Similarly, in modern medicine the patient is always right.

At least in Rads I am insulated from the direct patient BS. A fat stack of studies to read on call is miles better. The worst part of call isnt the volume of cases (although it sucks somewhat) its the phone calls, protocolling and other random BS. Reading cases is the best/easiest part of my day.

Less than 2 months into intern year and I feel this. I'm realizing the most draining part of my day is putting up with other people's crap, whether it's patients, nurses, admin, midlevels, etc. Counting the days till I get to the reading room. Would be perfectly content to spend the rest of my days there.

 

[libertyyne]

When I as a resident read with a medical student shadowing, I found myself going faster because I subconsciously feared they would find the pace slow. This thread validates my fears. I appreciated this extra push to go faster, since outside the call setting, my program is relatively self-paced and so I had the time to navel gaze.

Something else you might consider is for students interested and if you have the time , ask them to faux read . It really opened my eyes to the complexity of reading and how enjoyable it could be , or when you show the students stuff from your teaching file don’t tell them what it is and let them scroll. Heck even getting pumped about anatomy was fun. Thanks for being a good teacher .

 

[efle]

Something else you might consider is for students interested and if you have the time , ask them to faux read . It really opened my eyes to the complexity of reading and how enjoyable it could be , or when you show the students stuff from your teaching file don’t tell them what it is and let them scroll. Heck even getting pumped about anatomy was fun. Thanks for being a good teacher .

Cannot wait for your PGY2 switch to rads, my dude