Monthly Archives: March 2016

Think Outside the (View) Box

Twenty years ago, medicine and surgery rounds used to start in the reading room.  Sitting in a dark room with a viewbox and an alternator, a senior radiologist greeted visiting clinical teams every day and reviewed their patients’ films.

With the advent of digitization and picture archive and communication system (PACS), the last 20 years saw a rapid evolution of radiology.  We read studies faster than ever, and radiology workflow focused extensively on the interpretation of images and the associated diagnostic report.

Recently, there has been a revival patient-centered care and communication.  Communication is the new radiology workflow.

I had the pleasure of writing about the importance of communication in radiology in a previous post. Just this month, a group at Beth Israel Deaconess Medical Center writes in American Journal of Roentgenology that despite our focus on critical value communication, the bulk (52%) of errors in radiology communication actually occur outside of results.

While most communication errors did not cause patient harm, 37.9% did affect patient care.  The radiology value chain, of course, begins as early as the decision to image and extends well into appropriate follow-up imaging of identified lesions (Enzmann, Radiology 2012).

Maybe it’s time we as radiologists take ownership of the whole imaging process, from the decision to image all the way to follow-up.

The Value of Knowing What Lies Ahead

When I was in 8th grade, my English teacher wanted to give everyone a book to take into high school.  She had a cardboard box full of various books. There was literary fiction like Toni Morrison.  There was a memory aid for American presidents. But I came to class really late that day, so by the time I went up to the box, there were only a few books left.  I had the great choice between Billy Budd (dryest. book. ever.), Atlas Shrugged, and this book called Getting Things Done.

I picked up Getting Things Done because Atlas Shrugged didn’t fit in my bookbag.   It would be years before I realized that self-help productivity books is in itself a major genre of nonfiction.  At the time it just didn’t make sense why anyone would need such pathologic level of compulsion to keep things organized.

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