Radiology and imaging

386 articles · Since 2005

Articles, page 4

Why we must keep learning from the coronavirus pandemic

June 14, 2020Jun 14, 2020

Looking back on the COVID-19 pandemic in the United States, I hope that we are able to take away several lessons. Immediately after the virus showed up in the United States, many physicians without access to virus testing seemed to…

Looking back on the COVID-19 pandemic in the United States, I hope that we are able to take away several lessons.

Immediately after the virus showed up in the United States, many physicians without access to virus testing seemed to go straight to imaging for an answer. While a few imaging tests proved to be useful in the most typical radiologic presentations of the disease, the evidence supporting this specificity or …

Physician voices

If you’re falling apart, should you still perform the pancreas biopsy?

Tracey O'Connell, MD

May 23, 2020May 23, 2020

Many radiologists choose the specialty because they don’t like interacting with sick people. As a highly sensitive person, I went into radiology to distance myself from patient suffering, as a means of self-protection. Radiology has allowed me to compartmentalize, sort…

It allowed me to have three healthy babies: one in residency, one at the end of fellowship, and one two years into private practice. I went back to work after …

Physician voices

A critical moment that resulted in a permanent, devastating consequence

Cullen Ruff, MD

March 9, 2020Mar 9, 2020

An excerpt from Looking Within: Understanding Ourselves through Human Imaging. It started as a routine weekend shift, reading studies on patients in the hospital and the emergency department, when the phone rang. Jessie, the nuclear medicine technologist, spoke on the…

An excerpt from Looking Within: Understanding Ourselves through Human Imaging.

It started as a routine weekend shift, reading studies on patients in the hospital and the emergency department, when the phone rang. Jessie, the nuclear medicine technologist, spoke on the telephone, his matter-of-fact tone slightly colored by the ominous nature of the information conveyed. “Doc, I’ll need you to come over shortly. The ICU ordered a brain …

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Conditions and diseases

Resident adds Rorschach reads to radiology reports

Stephanie Benjamin, MD

March 6, 2020Mar 6, 2020

In the dark radiology reading rooms, only the gentle hum of the computers and the quiet chatter of residents dictating radiology reads break the silence. Among the computers sits Dr. Exner, a senior radiology resident at Hospital Woeisme. He has recently become known for a peculiar habit – he has begun adding Rorschach interpretations into every radiology report he completes.

The Rorschach test, created in the 1920s and sometimes referred to …

Conditions and diseases

Too many scans is bad medicine

Raj Waghmare, MD

March 1, 2020Mar 1, 2020

A medical diagnostic company recently posted the following tweet: "The best way to beat cancer is early detection. A full-body scan will provide you with a look inside your body and peace of mind." I wanted to type a reply,…

A medical diagnostic company recently posted the following tweet: “The best way to beat cancer is early detection. A full-body scan will provide you with a look inside your body and peace of mind.”

I wanted to type a reply, but I like to tell stories, and Twitter will only allow 280 characters.

***

A young woman sits on the examining table. Texting. As I approach her, she dangles her legs and checks …

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Too many scans is bad medicine

Physician voices

A quick CT scan for the frail and elderly

Mary Braun, MD

January 22, 2020Jan 22, 20206

First, you have to call up your daughter to pick you up and take you to the lab. It’s hard for the nurse to find your vein. The pain from his fishing around in your arm is not nearly as…

First, you have to call up your daughter to pick you up and take you to the lab. It’s hard for the nurse to find your vein. The pain from his fishing around in your arm is not nearly as bad as the pain you always have in your hip, and back, and shoulders, but it’s the straw that breaks the camel’s back, and you cry a little bit. The …

Health technology

Both physicians and patients need to stop viewing technological tools as threats

Robert Pearl, MD

January 7, 2020Jan 7, 2020

A recent study published in Science, one of the world’s leading academic journals, found that a predictive health care algorithm discriminated against black patients. The tool, created by Optum, was designed to identify high-risk patients with untreated chronic diseases, thereby…

A recent study published in Science, one of the world’s leading academic journals, found that a predictive health care algorithm discriminated against black patients.

The tool, created by Optum, was designed to identify high-risk patients with untreated chronic diseases, thereby helping administrators re-distribute medical resources to those who’d benefit the most. But there was a glitch in the algorithm, according to researchers. Rather than ranking the needs …

Physician voices

The sad demise of an idealistic family physician

Cory Michael, MD

January 6, 2020Jan 6, 2020

Graduation from my residency program was a bittersweet experience. At the time, my specialty was suffering from a crippling job shortage, so our futures were uncertain, and a dark mood had come to permeate my radiology residency. We were disgruntled with the specialty, with the system, and with medicine in general. I attended my graduation without any guests and only stayed long enough to receive my certificate.

I was, however, honored …

Physician voices

The continuing battle between the emergency department and radiology

Cory Michael, MD

December 28, 2019Dec 28, 20192

I overheard a disappointing phone call while supervising a radiology resident recently. I could tell that the resident was struggling in a conversation with an emergency department physician, so I asked him to switch over to speakerphone. Eventually, I heard the emergency physician say, “Listen. This is how it works. A patient points to what hurts. Then I have that part scanned, and you tell me what is wrong.”

Disheartening as …

Physician voices

Does the patient come last in health care?

Xrayvsn, MD

November 18, 2019Nov 18, 2019

In the service industry — which as physicians, we certainly are a part of — a popular saying is that the customer always comes first. The implication is that in order to thrive in an industry, you have to cater…

In the service industry — which as physicians, we certainly are a part of — a popular saying is that the customer always comes first.

The implication is that in order to thrive in an industry, you have to cater to the customers/patients as it is they who will ultimately decide where they take their business.

In medical school, the emphasis on prioritizing the patient was evident, culminating in the Hippocratic Oath …

Conditions and diseases

What if you are one of the 2 percent?

Samuel M. Chen, MD

November 5, 2019Nov 5, 20199

I’m a member of the ACR (American College of Radiology). One of their recent online postings is entitled: Choosing Wisely. Number three (of ten things physicians and patients should question) is: "Avoid admission or preoperative chest X-rays for ambulatory patients…

I’m a member of the ACR (American College of Radiology). One of their recent online postings is entitled: Choosing Wisely.

Number three (of ten things physicians and patients should question) is: “Avoid admission or preoperative chest X-rays for ambulatory patients with unremarkable history and physical exam.”

In only 2 percent of cases, will it make a difference in management.

Thirteen years ago, I was working on the queue of cases …

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What if you are one of the 2 percent?

Physician voices

A guide to couples matching

Lucas R. Cusumano, MD, MPH

October 29, 2019Oct 29, 2019

I consider myself one of the lucky ones because my wife and I couples matched to the same institution for residency. At the time we put our residency match lists in, we were just boyfriend and girlfriend, and the decision to couples match felt like a bigger leap forward for our relationship than deciding to ask her to marry me about a year later. It was the right decision for …

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A guide to couples matching

Medical education

When you’re a physician, you’re a detective

Lauren Joseph

October 21, 2019Oct 21, 2019

A professor recently romanticized my idea of clinical reasoning as he began our session by saying, "When you're a physician, you're a detective." He elaborated: "Every fact you have, every piece of evidence you have, must be consistent with your…

A professor recently romanticized my idea of clinical reasoning as he began our session by saying, “When you’re a physician, you’re a detective.” He elaborated: “Every fact you have, every piece of evidence you have, must be consistent with your leading diagnosis.” As he said this, my eyes narrowed, and I sat up a little taller.

My fellow first-year medical students and I have begun our official training in clinical reasoning, …

Conditions and diseases

How a patient’s passing changed this radiologist

Cory Michael, MD

October 3, 2019Oct 3, 2019

I can still recall my first day of medical school orientation. A humbling silence fell across a sea of 162 enthusiastic and largely arrogant aspiring trainees as the dean proclaimed, “As doctors, you will all kill someone at some point…

I did not give this declaration much thought at the time. I already had a career as a diagnostic radiologist in my sites and believed that radiologists were …

Physician voices

We focus on the financial sacrifices of physician training. The personal sacrifices are worse.

Cory Michael, MD

September 18, 2019Sep 18, 2019

The sky was overcast as my girlfriend dropped me off at the airport on a June day several years back. I was headed to Chicago to take the last meaningful high stakes exam of my medical training, a mandatory board exam available only at two sites, a test that 1 in 6 residents now fail. One might think of such an event as something to look forward to,

…

Conditions and diseases

The costly decision of delaying surgery

Cullen Ruff, MD

August 29, 2019Aug 29, 2019

It was a common enough reason for someone to have a CT scan. The order read, “Abdominal pain, colon cancer resected in January.” It was now March, only two months post-surgery. Yet the patient’s CT scan showed a number of…

I compared the current study to the CT performed before surgery. The liver had looked perfectly normal at that time.

“That’s an amazingly …

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The costly decision of delaying surgery

Physician voices

4 reasons why this radiologist loves practicing teleradiology

Katie Lozano, MD

August 18, 2019Aug 18, 2019

Some radiologists perceive teleradiology as the “dark side” of our profession. I may have counted myself among those skeptics, but I now see the light and am happy to share a place among the converts. Most of my career has…

Most of my career has been in traditional private practice, but there’s not a great deal of difference in how they operate versus a teleradiology practice. Both organizations exist to provide clinicians and patients with diagnostic …

Physician voices

A reflection of a physician’s firsts

Xrayvsn, MD

July 30, 2019Jul 30, 2019

Your first is always special. It is a mixture of youthful inexperience, awkwardness, anticipation, and giddiness that creates a cacophony of emotions and physical changes that is hard to describe unless you have experienced it yourself. Your repertoire of techniques/maneuvers…

Your first is always special.

It is a mixture of youthful inexperience, awkwardness, anticipation, and giddiness that creates a cacophony of emotions and physical changes that is hard to describe unless you have experienced it yourself.

Your repertoire of techniques/maneuvers is quite sparse — to say the least.

You might fumble around and accidentally put the wrong thing in the wrong orifice.

Not knowing what body part should go where, if you are doing …

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A reflection of a physician’s firsts

Conditions and diseases

MRI safety in breast cancer screening

January Lopez, MD

May 23, 2019May 23, 2019

The numbers are scary: The average woman has a 12 percent risk of developing breast cancer at some point in her life. For women with certain genetic mutations or risk factors, lifetime risk can climb to 85 percent. Even more…

Even more terrifying than the numbers, however, are the rumors; rumors that the contrast dye used in MRIs for breast cancer screenings is harmful; rumors that are driving women away from an adjunctive …

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MRI safety in breast cancer screening

Physician voices

This story happens every week in clinics like mine and it’s got to stop

Hans Duvefelt, MD

May 17, 2019May 17, 20192

Jeanette Brown had lost twenty pounds, and she was worried. “I’m not trying,” she told me at her regular diabetes visit as I pored over her lab results. What I saw sent a chill down my spine: A normal weight,…

Jeanette Brown had lost twenty pounds, and she was worried.

“I’m not trying,” she told me at her regular diabetes visit as I pored over her lab results. What I saw sent a chill down my spine:

A normal weight, diet controlled diabetic for many years, her glycosylated hemoglobin had jumped from 6.9 to 9.3 in three months while losing that much weight.

That is exactly what happened to my mother some years …

Radiology and imaging

Articles, page 4

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