Patient contact in rad?

[Striker254]

Hi all,
I'm a third year med student thinking about going into radiology. I'm really drawn to the problem solving, visual nature of the work, technology and advancements being made, and the lifestyle, but a little concerned about not having the opportunity to interact with patients at all.

Does a general diagnostic radiologist get the opportunity to interact with patients throughout the day or is it pretty much just looking at pretty pictures all day? Does it differ between hospital vs private practice? I get the impression some private practice docs just read for 8+ hours a day and do like 25k reads a year but I could be wrong.

Unfortunately we get very little exposure to radiology as a specialty in school and I didn't think too much about it til it consistently matched #1 in multiple personality surveys. Any recommendations for a student who is very much a "people person" interested in going into rad?

Thanks for the advice!

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[shark2000]

A few points that may help:

1- Patient contact is very minimal other than IR and mamo. There are brief encounters with patients every day but it is next to nothing.

2- Lack of patient contact or brief patient contact is one of the best advantages of radiology. If you miss patient contact you are not radiology type.

3- If you want patient contact, IR and mammo are out there. IR is surgery type hours and lifestyle esp with new trends. Mammo has better hours, but it is not as exciting as the rest of radiology IMO.

3- Radiology is not a lifestyle specialty at all. For sure it is better than Neurosurgery or cardiology, but at least half of medical specialties have better life style at the attending level. Der, Plastics, most of surgical subspecialties, ENT, Ophtho, Urology and GI all have better hours.

4-Despite what I said, Life-style means different to many. I'd rather read 10 CTs at 10 pm than seeing 4 patients at 10 am, But again, this is personal. But generally speaking the hours of mentioned specialties are better than radiology with less weekends and after hours.

5- Even if you get exposure to radiology at your school, it is very limited and wrong. First the PP is a whole different world than Academics.
Radiology as a medical student seems very boring and as a resident is very challenging.

6- If you can not tolerate reading 100-130 studies a day, almost non-stop in a row do not do radiology. It is a typical day for most people in pp. The story is completely different in IR. And do radiology for IR only if you are surgical type and you don't mind the hours.

7- Radiology is one of the greatest fields in medicine, but for the right personality. Do it if you don't mind reading at least 100-130 studies a day (alone with nobody around) or you are surgical type and don't mind the IR hours. Otherwise, you can not have a clinic like a family doctor or a dermatologist. You can not do procedures and have good hours like Mohs surgery or Urology.

 

[shark2000]

..

 

[Striker254]

Thanks for the input so far. Any other thoughts from others? If this is the way it is it may not be for me. I'm not expecting to run a clinic, but sitting in the basement of the hospital for 8 hours reading film without interacting with others does not appeal to me. Intermittent procedures, consults from physicians, etc, could be enough to make me feel like I'm not a hamster in a wheel pumping out reports.

 

[davidjones]

Shark pretty much said it with a few exceptions.

IR is all patients all the time, but hours like surgical sub specialties and if you're in a level 1 trauma you get hours like a trauma surgeon.

In PP, especially in a small town, you can have a practice where you do diagnostic and some light IR, vascular access, drains and biopsies, LPs and joint injections. Some DR practices have a consult pager well all you do is interact with referers. But in general those kinds of practice environments are rare. I am at an academic place where DRs do biopsies and drains and some even do tumor ablation and love their job.

Mammo you get a lot of patient interactions as well as procedures and diagnostic but you're pretty much only focused on the breast. It's a really popular field for people who want pt contact and some procedures and it's pretty evenly split by gender. In many private groups even if you're the mammo guy/gal you can still do general rads. That's less likely in academics.

Peds is also another great specialty and is really the only place I see diagnostic rads practiced the way I pictured it in my head. They spend the majority of their time interacting with referring docs, do GI/GU studies. The only downside is you have to be in a Peds hospital or have a practice with a high referral
Rate for Peds. I am an IR guy but i love Peds radiologist I think they are some of the smartest and kindest docs out there.

Also for what it's worth , don't put too much weight into those surveys, I always came up with pulm/cc and I hate that stuff, neurosurgery was always number 2 and I have been called aggressive with cases and getting patients but again sort of hate the brain. The surveys are more of a personality test, maybe it's just saying you're a visual person, like to work at your own pace and have introverted tendencies. In which case there are numerous specialties you can pick from.

Check out Peds and IR though.

 

[Striker254]

That sounds a little more up my alley! What do you really consider a "small town"? Some pop. of 5,000 place in the middle of nowhere? The PP IR practice where I get to dabble in a little bit of everything sounds very appealing to me, but what is the availability of positions like that?

Anyone else with other thoughts about types of radiology positions that get good patient exposure? Hadn't thought of peds before that sounds really exciting!

 

[davidjones]

Small town like a couple of hours outside of a big city. Like Peoria or south bend outside of Chicago. Depending on what you do the job market might be different and you can find your dream job in a big city.

The job market is tight for all specialties in big cities right now, but the current docs there have to retire some time.

There are any number of practiced where you can spend a day or two doing basic procedures, most rads Don't really like them and would gladly give them away to
Someone who does, and many IRs, provided they are busy would prefer not to do LPs and drains and biopsies and focus on bigger procedures.

Spend a day or two in mammo, you might find you like it.

 

[colbgw02]

Patient contact is the most overrated concept in medicine.

If your experience is anything like mine, you've probably been brainwashed since about halfway through your pre-med curriculum into thinking that patient contact is the culmination of medicine. I completely rid myself of that delusion about 5 hours into my first day of internship. I wish I had lost it a long time before that.

Don't get me wrong, I'm not antisocial, nor do I hate seeing patients. I enjoy what little patient contact I get for the most part. But it's more in manner of "I just had a pleasant interaction with that bank teller who answered all my questions promptly and curteously" rather than the "I feel like a member of your family; please date my daughter" manner.

 

[PokerDoc]

Patient contact is the most overrated concept in medicine.

If your experience is anything like mine, you've probably been brainwashed since about halfway through your pre-med curriculum into thinking that patient contact is the culmination of medicine. I completely rid myself of that delusion about 5 hours into my first day of internship. I wish I had lost it a long time before that.

Don't get me wrong, I'm not antisocial, nor do I hate seeing patients. I enjoy what little patient contact I get for the most part. But it's more in manner of "I just had a pleasant interaction with that bank teller who answered all my questions promptly and curteously" rather than the "I feel like a member of your family; please date my daughter" manner.

This is pretty much my answer every time, because like you said, 90% of my class is deluded into thinking Radiology is somehow not really patient care.

 

[davidjones]

That sort of attitude is cool for some and usually those people decide on something like DR or pathology, personally just reading films all say outside of a context of seeing an actual person is not fun for me, but that's just me. I think the great thing about rads is you can be on either extreme or somewhere in the middle, there is no other specialty I can think off that offers that sort of flexibility.

 

[Striker254]

This has been really helpful so far. Thanks a lot and keep the input coming!

I'm really interested in IR, but a little turned off by the surgery type call schedule. I think call once a week, maybe occasionally twice is about all i'd be willing to handle for the long haul. Is this possible with IR? Family friend says he's on call q4, but he's in a DR group and one of the few IR guys.

 

[davidjones]

He might be q4 but how often does he come in?
Unless you're neuro, there are few IR emergencies that need Immediate attention. Usually the GI bleeds,traumas (rare unless you're at a level 1 center), cold legs (rare unless your group kept PAD) etc.

Even surgeons who are on call don't come in every night.

 

[officedepot]

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[shark2000]

It seems you want to justify or convince yourself to go into radiology. Probably because you've heard form others that it is a great field, pressure from classmates , ... Or the worst scenario is that you did a salary survey and find it to have high salary which may or may not be there by the time you finish.
If you don't like reading images or do not like doing image guided procedures, do not do radiology.
If you enjoy patient contact, enjoy talking with people and you will miss it, don't do radiology.
Radiology is one of the greatest field of medicine, but for the right personality.
Statements like visual nature of the field or technology is more self-serving rather than truth.
2 Main advantages of radiology are lack of patient contact and its diagnostic challenge..
Doing radiology while you like patient contact is like doing surgery while you hate procedures.

 

[MossPoh]

I made my final decision to go into it after realizing how drained I am after any wards/clinic thing. Reading, writing and studying all day don't really phase me, but when I get back from a day of outpatient clinic, I feel emotionally exhausted.

Just as was mentioned above, I do not hate patients or patient contact. I simply prefer focused interactions peppered throughout the day or week. Some people feel energized by talking with people all day and there is definitely nothing wrong with that, but I find myself cherishing the moments where I can go by myself and think through complex problems and organize my thoughts in a concise and informative manner.

 

[Striker254]

Part of what you said is true shark. I do feel like I'm partly trying to convince myself about it, but only because I knew very little about the field in general until 2 weeks ago when I started digging into it because of a personality survey that I (and my wife too, separately) took, both of which times it ranked Radiology #1. So, in general, I'm trying to learn more about the field so that my knowledge of the field is not based on uninformed presuppositions.

The stereotype I held was that radiologists had great visual diagnostic challenges, the field was one of the few that will continue to change greatly over the course of ones career due to advancements in technology, they had a relatively good lifestyle, and that their pay was good too, but that they were typically stuck in the basement of hospitals for 8-10 hours a day with very little patient or human interaction.

All of those things sound great, except for the last part. I could not stand sitting in a dark room for 8-10 hours a day for the rest of my life reading images without talking to people. End of story. I'm somewhat of an introvert, and could tolerate that for a while, but at the end of the day I need some kind of interpersonal interaction throughout the day. Whether it be from patients, physicians, techs, etc, I just know that I'd go crazy if I were essentially left by myself to think for the rest of my career.

So with that said, I'm not trying to convince myself to go into radiology, but rather learn which parts of the stereotypes are unavoidably true, and which parts can be modified based on personal preference regarding work environment, desired level of interpersonal interaction, procedures, hours, etc.

I hope that helps you understand a little more about where I'm coming from. That change any of your advice?

 

[billclinton]

Part of what you said is true shark. I do feel like I'm partly trying to convince myself about it, but only because I knew very little about the field in general until 2 weeks ago when I started digging into it because of a personality survey that I (and my wife too, separately) took, both of which times it ranked Radiology #1. So, in general, I'm trying to learn more about the field so that my knowledge of the field is not based on uninformed presuppositions.

The stereotype I held was that radiologists had great visual diagnostic challenges, the field was one of the few that will continue to change greatly over the course of ones career due to advancements in technology, they had a relatively good lifestyle, and that their pay was good too, but that they were typically stuck in the basement of hospitals for 8-10 hours a day with very little patient or human interaction.

All of those things sound great, except for the last part. I could not stand sitting in a dark room for 8-10 hours a day for the rest of my life reading images without talking to people. End of story. I'm somewhat of an introvert, and could tolerate that for a while, but at the end of the day I need some kind of interpersonal interaction throughout the day. Whether it be from patients, physicians, techs, etc, I just know that I'd go crazy if I were essentially left by myself to think for the rest of my career.

So with that said, I'm not trying to convince myself to go into radiology, but rather learn which parts of the stereotypes are unavoidably true, and which parts can be modified based on personal preference regarding work environment, desired level of interpersonal interaction, procedures, hours, etc.

I hope that helps you understand a little more about where I'm coming from. That change any of your advice?

but talking to patients all day is monkey work. most people dont realize this until some time later in residency after its too late. but this is why midlevels will take over... the mundane work is not sitting in the basement constantly using your brain, reading studies- its in talking to all the patients. you must first realize you are a monkey who loves **** talking to dirty patients again and again about the same old ****., following the same alogorithm, ordering same old tests, and calling consults and hoping some one elses figures out the prblem... or are you the type of person 2ho lik3s to solve puZzles

 

[3abkrino]

If your concern is interpersonal interaction in general, I think you shouldn't worry. The Patient contact is minimal but you will have alot of contact with your Rads colleagues, Techs, Fellows and residents from other specialties.

I am a 1st year radiology resident in Egypt, so may be what I said doesn't apply in the US. Hope you the best in your career.