The journey of a thousand miles

The best question you can ask your doctor sending you off for a bunch of tests – blood test, biopsy, x-ray – is this: how will it change what you do next?

In my work as a resident in radiology, one of the most important teaching focuses is Recommendation.  Although not commonly placed in a diagnostic report, the element of advising your referring doctor is implicit in your Impression of the radiologic examination.  It took a while for me to recognize what it means to fully embrace the role of a consulting physician:  Your colleagues are in doubt about their next step, and your job is to help them decide.

This has two implications:

(1) If the doctor ordering the test is 100% sure about what their next step, then your test is extraneous and therefore should be cancelled.

(2) If your test will not help the ordering doctor move closer to that next step at all, then your test is unhelpful and therefore should be cancelled.

In life, many of us have been “stuck” before too.  We have overarching, bird’s eye view of what we want to accomplish.  We know that these goals are divided into smaller goals, and smaller goals, and yet smaller goals.  But we are “stuck” because there is nothing that connect us from where we are to where we want to be.

As a radiologist, if you can help a doctor find the right next step, then you’ve done your job very well.

As a friend, if you can help someone make that connection between where she stands and where she wants to be, help someone make that single next step, however small, you will have been a great friend.

It begins with a single step.

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Howard Chen
Vice Chair for Artificial Intelligence at Cleveland Clinic Diagnostics Institute
Howard is passionate about making diagnostic tests more accurate, expedient, and affordable through disciplined implementation of advanced technology. He previously served as Chief Informatics Officer for Imaging, where he led teams deploying and unifying radiology applications and AI in a multi-state, multi-hospital environment. Blog opinions are his own and in no way reflect those of the employer.

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