iRADiX

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 meet Neurologists, Cardiologists..but…super specialist radiologists?

In Blog End of Individual Goliaths we had examined how if one has to hold ground one has to be part of some system of practice.

Does the person who is working “For Himself” really work alone or are they part of several practices.

One surgeon friend did not want to initially invest on costly radiology equipment as he had invested in operation theatre and Intensive care units. He asked his radiology friend to invest and set up the radiology department.

“I am a man of limited means and you can use your real estate to become independent any time, once the initial loss making ‘teething’ period is over” the radiologist replied frankly.

“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 suit us and hopefully will get refined after contributions from our commentators.

A Fort

The senior surgeon called up the young radiologist and asked him to join the ‘fort’.

“There are many such diagnostic centres. Many more will open up in the next few years. This hospital is like a fort. And once you are within it, it is up to you, to see how you fit in, whether you are in the back room or in the centre of things.”

This Fort analogy to private medical institutions, given by the surgeon, serves as a reference to measure up which type of practice one does and how being part of these institutions will shape future choices and horizons.

“With all our limitations, we are an institution” the surgeon continued.

Do you communicate two ways when confirming a critical report? Or do you write a report and file it in the dispatch section and say “I am Done.”?

Mock Jury Trial: The Case

The recent RSNA 2009 Mock Jury went on trial on the assumption of breech of standard of care. The radiologist saw a suspicious shadow in right upper zone on the X-ray Chest, wrote that he needed CT examination to evaluate this area further and even faxed the report to the Emergency department. However, the Emergency physician had read the X-ray Chest as normal and somehow the radiologist report was not read, though it was in the files.

After 20 months the lady came with a chest mass and the radiologist was brought to trial for “Breech of Standard of Care”.

Guidelines of Community of Peers

The Emergency department sees hundreds of reports every day. Hence a radiologist should communicate a non-routine report, should know the preliminary report of the emergency physician and should file the Discrepancy report.

Radiology is a specialty which has to interact with all specialties and is at the core of modern day medical practice. So, when thinking of improving the hospital facilities and culture of our medical profession isn't it natural that we have a Radiology Driven Six Sigma?

What Is Six Sigma?
Six Sigma is a process improvement methodology that focuses on eliminating defects by reducing variation. Six Sigma relies heavily on statistical analysis of data and strong problem-solving techniques.

Six Sigma was first developed by Motorola in the early 1990s. It has been used extensively within companies such as GE, Allied Signal, and Sony and is now being widely deployed as a business strategy in organizations across the world.