questions for residents/attendings/anyone who knows

[redbow]

Hi All,
I've done a few radiology electives and have seen a variety of imaging studies and learned about reading them. However, could you please provide some information on other things a radiologist does? For example, I saw my preceptor protocoling studies once and I'm not quite sure what that entails. I know that when I am on another service and I call the radiology dept for a study I just give them some patient history and a req form. But what are their steps from receiving my request to getting the study done and read? I just want to know some behind the scenes details about a radiologist's job that I didn't see on my electives. As well, I never had the opportunity to do call on my electives. What is that like? What does one consider in triaging studies? And is it the radiologist's choice on whether a study gets done? If you could remember some of your challenges as a resident on call that would be helpful.
Thanks,
Redbow

---

Members don't see this ad.

 

[kingalls]

Just a resident here, but hopefully I can be a little help. Radiology, at it's heart, relies on our ability to discern one anatomic structure from another. Basically, protocolling involves taking a look at the requested exam, and making sure that it's a) safe for the patient and b) the best reasonable way to answer the desired clinical question. A lot of this has to do with scanning parameters, whether or not to use contrast, etc.

Radiology is a consult service. At my institution at least, while you CAN fight unnecessary studies, most of the time it's far easier to go along with the request. The exceptions, of course, are studies with unnecessary risk to the patient and the truly nonsensical, like the stat hip US on a newborn we just got a request for. Hope that helps, and happy to answer any further questions if I can.

 

[colbgw02]

Radiology is a consult service. At my institution at least, while you CAN fight unnecessary studies, most of the time it's far easier to go along with the request. The exceptions, of course, are studies with unnecessary risk to the patient and the truly nonsensical, like the stat hip US on a newborn we just got a request for. Hope that helps, and happy to answer any further questions if I can.

This is absolutely true, and it's a point I make frequently with my non-radiology physician friends. Keep it in mind when you order a study - especially a higher level modality like MR.

If you're an ER doc and you consult surgery for appendicitis, you would never tell the surgeon the operative approach. Similarly, don't tell the radiologist when or how to do a study. Ask a question and we'll tell you the best way to answer it. Self-referral rules keep radiologists from being able to implement the plan without your help, but that's not a license to argue with the imaging experts.

 

[kingalls]

Amen. Got stuck with two chest CTs today that were followups on negative CXR's because the IM resident 'thought he saw something'...