iRADiX

Having realized that an error was made …What is your next step?

“To err is Human”

Can we safely apply this principle to our Practice and expect protection against the errors made in our reports?

A search for Medical errors in Medscape provides you mind-boggling 4284 references. These errors include contribution not just from Radiology also from other branches including paramedics errors.

Dr. Keshav Kulkarni in his 4 part blog ‘to err is human’ has excellently dealt in detail, various causes and lacunae that are responsible for the errors and how to prevent the same along with remedial measures.

My request to the fresh members of Iradix, is…... please go through his blog.

Errors in Radiology Practice are common and I am sure All of us make some mistake at one time or other, since all of us are in the Ever learning process through out our career.

How easy or how difficult is to run a diagnostic center?? Any idea??

Everybody says that Radiologists are the luckiest among the Medical Profession and it is assumed by our Non radiologist friends that Radiologists make a lot of money without much sweat whether working for somebody or running own diagnostic center. .Nothing is far from the truth.

Some of the Radiologists as soon as they successfully complete their course may want to start independent diagnostic center.

The center can just have one Ultrasound machine initially with two receptionists and two helpers in the beginning

Not many problems initially faced by the radiologist and running of the center is a smooth affair.

Once the radiologist starts thinking of expansion either due to severe competition going on in the market or because of customers demanding... add on facilities…….. the problems start one by one.

So as the idea of starting a full fledged center crops up…. more and more machinery are added besides the Ultrasound machine.( the machines include, Digital xray,CT,MRI,,Complete lab equipments, Mammogram, PFT,EEG ,Nerve conduction test ,Endoscopy etc.)

Present day setting up of a diagnostic center is not as simple as one may think .Gone are the days when one was very comfortable by enjoying a decent profit...

Radiology has come a long way since the introduction of X-rays when Wilhelm Röntgen took first "medical" x-ray of his wife's hand on 22 December 1895. The field of radiology has expanded beyond the realms of X-rays with nuclear magnetic resonance and ultrasound wave technology being the major players in modern times. Our attitude towards X-rays has also diversified with development of computed tomography.

With the advancement in technology has come vast expansion in the applications of radiological methods and the huge demand on radiologist to provide the correct diagnosis, sometimes even in most adverse circumstances.

This translates into a heavy burden and responsibility on the radiologists’ shoulder. And ‘to err is human’!

30% of medical law suits in US are related to missed diagnosis!

For the court a clinical examination is no longer sufficient to prove a case: Objective documents are requested, leading to numerous unnecessary examinations.

In the present scenario, the roles and responsibilities of radiologist must change with time.

The referring physicians need a clinical interface with radiology. For this, the radiologist should fully understand the clinical problem.

And the radiologist is expected to do this for every clinical problem and for all medical specialities!

Buyer’s Guide: How to buy a good Ultrasound Scanner.

After spending a decade in medical college and acquiring the much sought after degree of M.D. Radio-Diagnosis a young radiologist has two options:

1. Go and join some Job.
2. Start his own Clinic.

First option is relatively easy one and one does not have to worry about finances and other problems like getting the patients and buying Machines.

Second option is difficult preposition, as one has to face the problem of arranging the finances and buying the equipments which can be a tiring phase during the initial months.

It is that period when you finally decided to open a centre for yourself and started looking for Machine after arranging a site for your clinic. You send a signal and the representative of various companies start a bee line to you. They give you so many options, that you get confused. Every one will speak a language which you will find either Greek or Latin. This is not you have studied in your degree. There are so many confusing terms developed by individual companies to confuse customer. Like cross beam technology, Matrix probes or Aplipre, Advance Dynamic Flow, Quick view & Iassist etc.

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 and being good in customer relations.

It would in fact be very easy to just complain and feel let down by the difficult patients.

But how often do we take a little more effort to deal with a difficult patient? How often do we appreciate an understanding customer?

In fact I would request my fellow radiologists to ask themselves these questions and apply them whenever possible –

• · How much of time do we spend towards creating good customer relations?
• · Do we put ourselves in our patient’s shoes and think from their perspective?
• · Do your staff and colleagues take a share in maintaining good customer relationship?
• · Do you greet or wish a patient as soon as you see him/her before doing a scan?
• · Do you introduce yourself to the patient and make a few enquiries about him/her?
• · Do you make eye contact and smile to ensure the customer feels at ease?

. Are we Courteous, say " please " " Thank you " " You are welcome " " I am Sorry "

           "He did a 2 week course of ultrasound and a 4 week course on endoscopy from Vienna and then returned to become a Consultant. Before that, we used to share the General Practice Clinic" one of his colleagues who knew him for over a decade told the radiologist quietly, after he had gone.

Dilletante

One who takes an interest, an aesthetic, a dispassionate and detached interest in all things. His interest is intellectual, something abstract and necessarily superficial. It is not a vital interest, not a question of his soul, not an urgent problem of his living.

Is it your signature?

Dr.X, the senior radiologist came looking very hassled and worried. The ENT professor has rung him up and was telling him that this could not be the signature of a Radiologist on the report.

It must be the signature of a technician. Why? The descriptive report had been written with no relevance to the case and the senior surgeon was upset.

Hippocratic Oath has lost relevance due to ever changing religious, political and social milieu. I faintly remember a line 'you can not advertise yourself, though you can advertise your hospital'. Taking into account a large number of physicians doesn't it sound absurd? In your daily life and during your practice have you not been asked by the public or a fellow doctor as to which hospital or doctor would be better for a particular patient. Do we not enquire where to send a patient for X-Ray, C.T. or MRI and do we not know whose report is reliable and whenever the report appears unsatisfactory do we not look for the name of the doctor signing it. Some institutions have developed a name for themselves, like AIIMS in Delhi, KEM, TATA memorial hospitals in Mumbai to name just a few. These hospitals are very large many with over 2000 beds and a large number of satisfied patients go home talking good about them. These hospitals need no further advertisement.