"path vs. rads

[bente]

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Path is great because it is RARE for someone to second guess your dx. Maybe a few oncs will spout immunostain gibberish, or think they can read a slide well.
But Rads constantly deal with clinicians second-guessing their film interpretations. From the neurorad to the NP/PA who can 'read' a chest 'XRAY".

 

[b&ierstiefel]

oh this thread is bound to get some attention!

 

[LADoc00]

oh this thread is bound to get some attention!

I want to marry a radiologist, so if you know a female one who is at least reasonably cute, pm me with the 411.

My plan to create path/rads hybrid babies and take over the world.

Muhahahahahahaha

 

[Mrbojangles]

That's the impression I get too. I did a month of medicine heme onc and I never saw a clinician doubt a path report. Maybe the oncology surgeons are in more of a position to challenge pathologists.

 

[yaah]

That's the impression I get too. I did a month of medicine heme onc and I never saw a clinician doubt a path report. Maybe the oncology surgeons are in more of a position to challenge pathologists.

They don't really challenge pathologists - the only time they seem to question is when they are asking about specific immunostains or margins or certain prognostic features (like extracapsular lymph node tumor extension or vascular invasion) which are often judgment calls.

 

[bente]

oh this thread is bound to get some attention!

Exactly! I was chumming for med students!!! 🙂
Good pick-up.

 

[bente]

I want to marry a radiologist, so if you know a female one who is at least reasonably cute, pm me with the 411.

My plan to create path/rads hybrid babies and take over the world.

Muhahahahahahaha

Got just the spot for ya buddy.
AFIP. You sit in on the Rad-Path class and have ~~80 women to choose from. At least half would make the cut off of 'reasonably cute'. Very few with LA enhancement though.

 

[QuietSylph]

Path is great because it is RARE for someone to second guess your dx. Maybe a few oncs will spout immunostain gibberish, or think they can read a slide well.
But Rads constantly deal with clinicians second-guessing their film interpretations. From the neurorad to the NP/PA who can 'read' a chest 'XRAY".

YES! This was so true at my institution. Clinicians were constantly second guessing the radiologists and often didn't even read the final report because they had already drawn their own conclusion. That was one of my many reasons for deciding I preferred pathology.

 

[cytoborg]

Yeah that would piss me off to no end. For a clinician to think they can make the call better than someone who trained for 4 years in nothing but rads and probably did a fellowship or two in that particular area, is absolutely ridiculous. Would drive me up the wall.

I've only seen a pathologist get questioned/dissed once (in my vast experience hence far 😉 ). He signed out some small round blue cell tumor in a kid and the peds oncologists came in a big posse to see the slides. One actually said, "What makes you qualified to make this diagnosis?" 🙄 The pathologist said with utmost professional courtesy and without a single obscene gesture, "Five years of residency, two years of fellowships, and twelve (or whatever) years of practice." 👍

 

[LADoc00]

Its not rare for people outside of path to second guess your histopath diagnosis, it simply doesnt happen. One guy tried to do it to me at a tumor board this year and I opened the floodgates to Hades on him, he stormed out and never came back to that conference again.

Went something like
Dipshiat clinician: Is that a Reed-Sternberg cell right there?
Me: Where?
DS: Here, the big one!
Me: No, thats a histocyte. (I shake my head)
DS: Are you sure?
(I whip out a sawed off pump action 12-gauge shotgun and get to work)

 

[yaah]

One of the attendings here told a story of how a group of surgeons came in to see a frozen section at the multihead scope, and the surgeon started telling all the residents and students about what they were looking at, "those are granulomas, and that's necrotizing inflammation, so our clinical suspicions were right!" Then the path attending said, "Well, I'm still looking for a granuloma. When I see one I'll let you know."

 

[deschutes]

Prof says to me with utmost calm: "What does < insert name of Young-Upstart-Nephrologist > know about FSGS? Diddly-squat, that's what."

😱

He signed out some small round blue cell tumor in a kid and the peds oncologists came in a big posse to see the slides.

One of the attendings here told a story of how a group of surgeons came in to see a frozen section...

Y'know, I never thought about this much before, but I guess this is what those floor medicine people mean by being "people persons". 🙄

Round in beeeeg group.
Rustle along in formation.
Strength in numbers.
Be part of the Teeeeeeem!

 

[yaah]

There is always a team. The nephrology people used to descend on the path department at my med school in their groups of 10 to look at urine they had spun down, because that was the only microscope with enough heads to look at it.

The problem with "teams" is that there are often 80% of the team who has no function except to follow around and maybe write something down.

 

[b&ierstiefel]

Yeah, they do always come in groups. Screw this! I'm bringing my bonkstick to residency.

"Is that a mitotic figure?"
"Oh wait, what is this I hear...the sound of wind blowing?..." *BONK!* "Oh wow, I puzzled as to where that came from."

BTW yaah, when you described that story of the surgeons...was that Dr. Knoll? I can see him trying to pull that kind of **** off.

 

[yaah]

BTW yaah, when you described that story of the surgeons...was that Dr. Knoll? I can see him trying to pull that kind of **** off.

Nah, he's an ok guy. This was a thoracic guy I think, I wasn't there. They were assuming it was sarcoid but it was just a hyperplastic lymph node.

 

[b&ierstiefel]

Nah, he's an ok guy. This was a thoracic guy I think, I wasn't there. They were assuming it was sarcoid but it was just a hyperplastic lymph node.

hehe...you haven't worked with him in the OR.

well neither did i (thank god) cuz i've heard some horror stories from more than a few people.