Blog Entries

I initially missed out on this case

drpbhatt@gmail.com — Sat, 13 Mar 2010 00:00:00 +0100

Forming Special focus groups

Forming Special Focus groups can help appreciate nuances otherwise lost in our “tunnel-vision-view-box” worlds. In previous entry we have discussed the VINDICATE grid to set protocols as per diseases.

The Pediatric Neurology Special focus group

“I initially missed out on this case,” Dr.Majdi Kara (See blog: http://www.iradix.in/309-Measuring-Referral-Slips.html ) admitted and told how Dr.Olivier had raised the possibility [...]

The Rebirth

dralokvarshney@gmail.com — Sun, 28 Feb 2010 00:00:00 +0100

Of all the things in life, it is the uncertainty of the future that is the most perplexing to the human beings. We try to gauge the future though scientific and non-scientific means and hedge our forecasts using the terms probability or likelihood or some other jargon. Still, it is the wait that gnaws our heart, doesn’t let us sleep peacefully and makes us prone to panic attacks.

As Radiologists we are the masters of forecasting. A look at a scan and we decide how much lo [...]

How does one set the protocol?

drpbhatt@gmail.com — Thu, 25 Feb 2010 00:00:00 +0100

Starting a MRI unit from scratch is an interesting and challenging exercise. Establishing one’s professional reputation is also a question of survival in different settings with referring consultants of different universities, training and temperament.

The layers of this were first set during early residency.

See blog: http://www.iradix.in/284-Pedagogy.html

There is a difference between the pressures faced in government hospitals and those that a private o [...]

Live and let die??

sndiagnostics@yahoo.co.in — Sun, 21 Feb 2010 00:00:00 +0100

Many occasions we have talked about ‘Difficult Patients’, stubborn patients, Harassing Patients, Blackmailing patients etc etc. For a change how about discussion on Professionalism not from patient's perspective but from Doctor’s point of view. Some of the colleagues shared their experience about “withering professionalism”. I am glad that I never faced these situations.

Dr X, a very busy practitioner with a dozens of degrees faithfully following his name [...]

Do you do Level 5 sonography?

drpbhatt@gmail.com — Thu, 18 Feb 2010 00:00:00 +0100

Do you do Level 5 sonography?

Society can be analyzed in different ways. One of the ways to do that is to see how technology has affected the ways of living.

Levels

In an Editorial written in 1989, Dr. Roy A. Filly told about Level 5 Ultrasound. (1) He wrote about a call from a clinician asking whether he performed Level 4 Ultrasound. He had never heard of Level 4 sonography, but the request itself struck an unusual chord within him. He recognized this request itself [...]

Impatient Patient

dranujmish@yahoo.com — Sun, 14 Feb 2010 00:00:00 +0100

I had finished my 43rd ultrasound of the day and clock had struck 2:30 in the afternoon. I felt uncomfortable in my pelvis and wanted to attend to the nature’s call. As I got up to leave the ultrasound room, a patient at the door stopped me and said –

“Hey Doc! Where are you off to?”

Being very polite I replied unrevealingly - “I am just coming back. Please wait for me”.

“Ohhh! I have been waiting for over two hours for my [...]

Doppler traces and Technical Thresholds

drpbhatt@gmail.com — Thu, 11 Feb 2010 00:00:00 +0100

Doppler traces and Technical Thresholds

In previous entries we examined some issues arising from X-ray (Please Repeat), CT scan (high resolution), and Ultrasound (Snowstorms). Let us examine some other quality issues using the tool of “Technical Review Meeting” in the web world. Hopefully these will be applied practically. Feedback from readers regarding their experiences, pitfalls and lessons learnt will help improve the common pool of knowledge.

A fresh unders [...]

Super-specialization- the Three Idiot Radiologists

dralokvarshney@gmail.com — Tue, 09 Feb 2010 00:00:00 +0100

Raju: Wow, look how time flies... Just yesterday we had joined radiology PG and now we are just about to finish the residency. Hey guys, what are your future plans?

Farhan: Man, I think Radiology future is in the dark … Why did I do radiology in the first place beats me. I was ranked 7th in PG entrance e [...]

Medicine as a ?Profession...??Business...OR Both???

sndiagnostics@yahoo.co.in — Sun, 07 Feb 2010 00:00:00 +0100

After going through the wonderful blog of Dr. Alok's "Cut practice" and the intelligent responses , I started wondering , about Medicine, Medical Profession and Professionalism, in context with present day of economics driven and economics controlled crazy world and its dominant living occupants known as Human beings and their 'Next only to God' physicians.

Profession

Webster’s Dictionary says "Profession is an occupational group of people who have learned speci [...]

Of Snowstorms and PRF

drpbhatt@gmail.com — Thu, 04 Feb 2010 00:00:00 +0100

'Man was born free, and he is everywhere in chains'

The Social Contract

Jean Jacques Rousseau(1)

In the previous entry we looked at some “high resolution” issues.

It has been a heartening fortnight for IRADIX with Dr. Alok and Dr. Sridhar using their energies and expertise to enlighten us with Full-fledged articles. Alok’s article on Cut Practice http://www.iradix. [...]

NRI patient

dralokvarshney@gmail.com — Sun, 31 Jan 2010 00:00:00 +0100

It starts with a phone call

Doc, we want to get a pregnancy scan. Do you do it?

Yes, we do ultrasounds. Its our specialty…

Good, but we need to do it fast, cos’ we have a flight to catch.

Let me see what I can do, my schedule is a bit busy right now. You will have to wait a bit. Or you can take another appointment…

No it’s URGENT.. we need to get it done right away. You see we are going to America. We need to get [...]

Get me a High resolution image

drpbhatt@gmail.com — Thu, 28 Jan 2010 00:00:00 +0100

The Technical Review Meeting is a very useful part of any department.

The Technical Review Meeting (TRM)

Is setting up a Radiology department similar to an adventure? Things can be pretty challenging at times. In previous Blog http://www.iradix.in/488-Please-repeat.html we had touched upon this topic giving the example of plain radiographs. We can now examine how such situations may play out in other imaging modalities.

The adventurer, mountaineer and author Chris Bonn [...]

Cut practice

dralokvarshney@gmail.com — Sun, 24 Jan 2010 00:00:00 +0100

The practice of fee-sharing or cut practice is regularly condemned by the medical fraternity and general public. Patients are waking up to this reality, making it one of the major reasons of declining doctor-patient relationship. Almost every discussion about cut practice results in loud cries of moral indignation. Despite this, such practices flourish and have now enveloped much of the modern medical practice.

Forms of Cut Practice

We radiologists [...]

Please repeat

drpbhatt@gmail.com — Thu, 21 Jan 2010 00:00:00 +0100

A critic is a man who knows the way but can’t drive the car.

Kenneth Tynan

The technician came to me looking harassed. He had a cervical spine lateral x-ray view film with him.

“Do you feel it is alright?” he breathed out in exasperation.

The whole of the cervical spine from atlanto-occipital joints to the top of the first thoracic vertebra was included. The mandible or occipital bones were not obscuring any part of the upper vertebrae. Soft tissues of th [...]

Etiquette & Customer Relationship

sndiagnostics@yahoo.co.in — Sun, 17 Jan 2010 00:00:00 +0100

.Running a scan centre is no easy job.

There are several issues you face day-to-day which are not related to radiology.

First and foremost is dealing with the different types of customers - some who are patient and understanding, some who are edgy, some like to criticize, some are nitpicky about everything.

Dealing with these behavioural eccentricities are part and parcel of being a radiologist. According to me they are two sides of the same coin – being good technically an [...]

I am Sorry

drpbhatt@gmail.com — Thu, 14 Jan 2010 00:00:00 +0100

Role of Apology in Practice

One of the things the average doctor doesn’t have time to do is

catch up with the things he didn’t learn in school, and one of the

things he didn’t learn in school is the nature of the human society,

its purpose, its history, and its needs….If medicine is necessarily

a mystery to the average man, nearly everything else is necessarily

a mystery to the average doctor.

M [...]

Mentors

drpbhatt@gmail.com — Thu, 07 Jan 2010 00:00:00 +0100

“Ring him up personally and explain how and why you felt that one of the prominent collaterals of the ECA was the ICA. Otherwise in future, he will lose faith in your reports.”

One of my mentors told me to explain to a senior Neurologist how I had reported on the ICA as narrowed on MR Angiography when the Doppler report had shown it to be completely occluded.

He could have done it himself, and ticked off the junior. He knew the senior Neurologist very well. But he left it to me t [...]

Communities of Practice: A Broad Church

drpbhatt@gmail.com — Thu, 31 Dec 2009 00:00:00 +0100

How independent can one be in a modern technology driven specialty branch dependent on referring physicians?

Systems and communities of practice

In the previous blog we had examined some practice options (Part Time?)

As Dr. Sridhar rightly pointed out that we are a referral dependent specialty and in his interact on Forum of Super specialty in Radiology has observed that one really does not often meet radiologists who are practicing as independent super specialists. We [...]

Part Time?

drpbhatt@gmail.com — Thu, 24 Dec 2009 00:00:00 +0100

“Is there anything known as ‘Part Time’?”

Déjà vu

As I saw my friend debate into having one’s own equipment soon after having joined a private hospital, I had a sense of Déjà vu.

They say, hindsight is a wonderful thing. Here I present some of the private practice options, overlaps and paths.

These are not meant to be an advocacy of any one path, but an attempt to show the different trends; and as an enquiry into what could possibly sui [...]

Difficult Patient

sndiagnostics@yahoo.co.in — Sun, 20 Dec 2009 00:00:00 +0100

How often do you come across difficult patients?

How often you get the patients who test the Doctor’s patience?

Is medical knowledge gained by patient from internet interfering with important decisions of physician regarding patient management?

Assessing the Skill of radiologist:
Recently I had a pt X who had come in for a neck ultrasound. He refused to divulge his condition. He said that it is my headache to do the diagnosis and find out what the proble [...]