Patient contact in radiology

[BC7106]

MS3 here currently considering a career in radiology. The only thing that is really holding me back now is reservations about not having any patient contact. That's one of the aspects of medicine that I have really grown to love and I don't know if I'm willing to give that up.

I know that interventional radiologists get to have some exposure, but I was wondering if any radiologists out there could comment on just how much patient contact they get and if this is something that other people are dealing with. Thanks

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[doc05]

minimal patient contact is generally considered an advantage in rads.

 

[Docxter]

In my mind, the advantage of radiology is not that you get minimal patient contact. The advantage is that you can have as much or as little patient contact that you want. The range is from the interventional radiologists having clinics a couple days a week and admitting patients to some diagnostic radiologists who have chosen to have very very little patient contact. The majority lie in between these two extremes, with the patient contact often being in ultrasound, fluoroscopy procedures, mammography and discussing results with patients, and consenting and doing image guided biopsies. Yes, the majority of image-guided biopsies (e.g., thyroid, liver, breast, etc.) are done by diagnostic radiologists not interventionalists.

 

[Carb Addict]

I think it's important to remember that you still get plenty of professional contact in radiology. Many prefer the field for that very reason. It's nice to be able to discuss patients with clinicians who actually understand what you're saying and recommending, as opposed to the huge number of ignorant patients that never seem to 'get it.' You're never isolated from people (in the most general sense) in radiology.

 

[Whisker Barrel Cortex]

Yes, there is some patient contact in rads, but it is minimal compared to other specialties. If you really love direct patient care, I would think twice about rads. Unless you like the non-patient contact aspects of rads more than you like direct patient care, you could find yourself unhappy in rads residency. Although it is rare for people to leave rads residency, I do know of some that are disenchanted and miss being more involved in patient care.

 

[BenFelson]

In my mind, the advantage of radiology is not that you get minimal patient contact. The advantage is that you can have as much or as little patient contact that you want. The range is from the interventional radiologists having clinics a couple days a week and admitting patients to some diagnostic radiologists who have chosen to have very very little patient contact. The majority lie in between these two extremes, with the patient contact often being in ultrasound, fluoroscopy procedures, mammography and discussing results with patients, and consenting and doing image guided biopsies. Yes, the majority of image-guided biopsies (e.g., thyroid, liver, breast, etc.) are done by diagnostic radiologists not interventionalists.

I agree with Docxter about the advantages of Radiology. I have worked in academic centers, HMO, solo and single-specialty groups. When I did Internal Medicine, I usually saw 20 patients a day. As a radiologist at the HMO, when I did fluoro, I typically performed 30 exams from just 7am to 10am. Before every procedure I talk to the patients about their symptoms and history and I also review their old films. I communicate the results to the patient if the referring physician does not object. I have very strong relationships with the clinicians, and constantly talk to them by phone to know what they are looking for and what I had found. I also offer suggestions for any further work-up. I do feel that I have contributed positively to the patient's care; without being bogged down with volume of paperwork that the referring physician have to endure.
There are days when I read 200 exams - I talk to or examine around 50 of them, which is more patient contact than when I was in internal medicine.
The variety of pathology is is interesting and the need to keep up with new progress can be challenging and stimulating. I often see patients that I have worked on before. Although the continuity of care is limited, I don't miss getting calls from drug-seeking patients after hours

I cover four hospitals, some via teleradiology. I am usually the last physician to leave the main hospital. The clinicians can rely on my availability and no one dare talk about radiologist's banker's hours. Some do envy the rewards, which are well-earned.

 

[Docxter]

IAs a radiologist at the HMO, when I did fluoro, I typically performed 30 exams from just 7am to 10am.

Huh? Exaggeration to the extreme?

 

[Amxcvbcv]

Granted I have very limited experience, but of all the fluoroscopy procedures I have observed while volunteering, I have never seen one take less than 15-20 minutes.

Care to elaborate on how you can do 10 per hour?

 

[BenFelson]

Huh? Exaggeration to the extreme?

I wouldn't believe it myself until I had to do it. The HMO is Kelsey Sebold Clinic in Houston and our department has only 6 radiologists reading for all the facilities through out the city. The technologists are very fast and competent. Two fluoro rooms are run at the same time. They take the overhead drinking views of the esophagus. You come in the room for fluoro when the patient is already in the RAO position. The main problem is the tube heating up. So you are limited to 2 min. of fluoro per patient. You have to label the findings on the films because when the stacks come to you, you would have forgotten already. When you are done with fluoro, you still have between 5 and 10 IVPs that you have to put in a catheter and inject.
HMOs tend to cover healthy people and the results are mostly negative. You try to spend more time with the few problem cases. They also are good at providing preventive care. When I am on Mammo service I read about 150 cases per day. I only read 5-10 right now. You can't do a good job with that kind of caseload. That's why I no longer work there. The experience did make me a faster reader.
I didn't like having to work harder because the old guys goof off and because you are nice to them and don't give them a hard time, the technologists bring more films to you. I also didn't like the fact that they didn't have an MRI and patients had to jump through hoops in order to get one out of network.
http://forums.studentdoctor.net/newreply.php?do=newreply&p=2557388#
Clappy
For the med students with the sarcasm and attitude, try not to be yourself when you interview. Good luck.

 

[Amxcvbcv]

I wasn't being sarcastic. I'm just very naive and curious.

I wouldn't believe it myself until I had to do it.

Imagine that... 😛