Similarities between Path and Rads

[ThatSerb]

---

Members don't see this ad.

So I came across this post discussing the factors that cause burnout in radiology. The following is a comment from that thread, and I was curious how much you guys think it describes what practicing pathology in a hospital is like:


"What I think non-radiologists don't understand about radiology is intensity-level that we perform at consistently (on-call). It's not uncommon to have a call shift where, other than getting up to pee and maybe answering phones calls, we're reading a huge stack of acute cases. 80-100 acute cross sectional cases where the radiologist's input directly drives patient care. Baseline that's like a 7-8 out of 10 on the stress scale.

I remember clinical medicine calls; in my opinion, people wildly underestimate just how much time they spend doing low-intensity activities: calling consults, walking to see a patient, putting in orders, writing notes, waiting for a trauma patient to arrive, doing the closure on a surgery, etc.... I would liken radiology to doing the most intensive part of a surgery, some sort of delicate anastamosis, for 8-10 straight hours. Or running 8 codes in 8 hours. That's gonna be mentally fatiguing.

Another thing that contributes to burnout is the often depersonalizing nature of radiology. You can feel like a cog in the machine just cranking out reports. We're just "radiology" and what we do is just a few extra clicks in the order entry system. Sometimes if feels like we're held on the same level of importance as the nursing order to wipe the patient's ass. There's not often a lot of positive feedback in the job and a high-level of performance is the expectation not the hope. God help you if you miss something because you will be thrown under the bus."

 

[SunBakedTrash]

Parts are relatable. Most pathology might not be as acute as some of those radiology reads are, and I can certainly takes a piss whenever I want, but I would argue the consequences of missing something in a biopsy are often more consequential than missing something on imaging, where the patient is more likely to receive follow-up, especially if symptoms persist, and waffling is more acceptable.

Your mistakes are preserved on a glass slide for all to see and I think there is a poor understanding by clincians of just how “interpretive” pathology can be. Nevertheless batting 1000 is the expectation. Couple this with all the hassles of daily practice (phone calls, frozen sections, meetings, tumor boards, etc) and it makes everything much more difficult.

I also agree that it is easy to feel like a cog and disconnected from the patient’s care. Clinicians will not always value you and your services might fall below the ass wiping order since at least that will make more of a stink than many pathologists.

There is burnout in pathology but I would rather be doing this than sitting in clinic or being trapped in the OR. Work hard, save and retire as quickly as you can.

 

[octopusprime]

In the last 10 yrs, if I had a nickel for every time I had a radiologist in tumor board say "in retrospect, there is a mass in 'XYZ location', it was just missed/interpreted as normal/etc", or read a modified CT/PET/MRI report stating as much, I'd have alot of nickels. I'd like to think I could go to the gift shop and buy some serious candy.

In the last 10 yrs, if I had a nickel for every time me or my partners said in tumor board "in retrospect, there is cancer in 'XYZ location', it was just missed/interpreted as normal/etc", or modified a report stating as much, I'd maybe have enough to buy a tootsie roll, like the small ones, maybe they're 10-cents, maybe 15-cents, but definitely significantly less than a candy bar.

 

[deleted314957]

Haven’t really felt that way. You see, the problem with rads is that all the clinicians think they can read them as good as you. They just don’t have the time or desire. The orthos think they are just fine, so do the gi docs on their studies, etc., etc.

With path, virtually no one will sit down at a scope, know what they see and then sign a report and take action on it. Until my sig (with cancer, eg) is on the bottom line nothing happens.

 

[octopusprime]

Haven’t really felt that way. You see, the problem with rads is that all the clinicians think they can read them as good as you. They just don’t have the time or desire. The orthos think they are just fine, so do the gi docs on their studies, etc., etc.

With path, virtually no one will sit down at a scope, know what they see and then sign a report and take action on it. Until my sig (with cancer, eg) is on the bottom line nothing happens.

Except derms...until it's melanocytic, then they pass it off to us.

 

[deleted314957]

No s***! And after the simple day to day lumps and bumps it’s all “ chronic dermatitis”🤣

 

[deleted314957]

In the last 10 yrs, if I had a nickel for every time I had a radiologist in tumor board say "in retrospect, there is a mass in 'XYZ location', it was just missed/interpreted as normal/etc", or read a modified CT/PET/MRI report stating as much, I'd have alot of nickels. I'd like to think I could go to the gift shop and buy some serious candy.

In the last 10 yrs, if I had a nickel for every time me or my partners said in tumor board "in retrospect, there is cancer in 'XYZ location', it was just missed/interpreted as normal/etc", or modified a report stating as much, I'd maybe have enough to buy a tootsie roll, like the small ones, maybe they're 10-cents, maybe 15-cents, but definitely significantly less than a candy bar.

That’s excellent for ten years. I believe after 35 years I’m pretty sure I could get a really nice Zag-Nut, you know, like the one in Beetlejuice.

 

[Allegri]

I have seen a hematologist and some nephrologists that think they can do pathology for themselves.

 

[deleted314957]

Oh, I have too. But they will not put their name at the bottom of a report that says something is malignant. I mean, really, any nephro can look at an immuno flourence of a Goodpastures and see the beautiful “ribbonry” green but if there is anything other than classical glomerular diseases they are f*****. The hemes will say”this looks like acute leukemia” and I would just hand them a pen, which they never took.

 

[90sportsfan]

Interesting discussion. I am a med student interested in Rads. I think there is a constant mental stress that is involved in both Rads and Path, in that there is the potential for very big misses that can have dire repercussions (which will be preserved forever- on slide or radiograph). That's why there are some of the largest payouts in medicine in these specialties and risks for malpractice.

It seems from what I read though, the volume in Path seems to be much more manageable. With Rads, many physicians order an image "just to be safe," whereas many biopsies are more selective.

I think the Volume and frequency of imaging is the reason why Rads jobs are a lot more plentiful (as of right now).