Part deux: how best to waste my time.
Subject: Diagnostic imaging (Health aspects)
Diagnostic imaging (Methods)
Radiologists (Practice)
Author: Phillips, C. Douglas
Pub Date: 10/01/2012
Publication: Name: Applied Radiology Publisher: Anderson Publishing Ltd. Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2012 Anderson Publishing Ltd. ISSN: 0160-9963
Issue: Date: Oct, 2012 Source Volume: 41 Source Issue: 10
Topic: Event Code: 200 Management dynamics
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 311377628
Full Text: Last time we spoke to our intrepid radiologist, he was wading through the stack of outside CD copies in the inbox at the outpatient imaging center ...

I have prayed to the radiology gods for someone, anyone, to standardize the systems we use to read outside images. Several brave souls have listened to the entirety of my crazed, arm-flapping, high-speed screed, and have suggested various and sundry solutions. "Buy a Mac." "Refuse to read them until they are into your system," or "Refuse them all," or "Bill for them. Honestly, we do, and we make zillions of dollars!"

I believe nothing I hear, less of what I read, and nothing I see in this regard. This isn't going away anytime soon. It just festers.

No vendor worth their salt is going to confess that their own viewer is a piece of trash. In fact, they probably are all about the same tool, but they can't seem to agree on even the simple things, like icons, where tools should be, how to window and level, how to organize the images, or ANYTHING. It is like they purposely, with malice and forethought, tried to do everything diametrically different from their competition. "Okay, they put the tools on the right and top. We'll put them on the bottom and left." "Their brightness icon is a sun. We'll make ours a lightbulb." I think there is a special bad place for people like this to go, when their last days of trudging on the earth have passed.

I'm relatively certain that many learned people have met in rooms to discuss this topic. They likely created taskforces, and subcommittees, and maybe even the infamous SPECIAL taskforces, all to deal with this issue. And, they have likely created reams of paper. And, it hasn't changed a freaking thing.

I'm not giving up. I think that it might require fairly draconian solutions, but there is potential to make this easier for us all. Here's a start. If your group uses a different viewer than other groups around, try your own out for ease of use. If it sucks, tell your IT folks. Tell them: "Swap this piece of crap out. Get us the same one the other folks have." Maybe, just maybe, all us radiologists could get together and decide we like one viewer the best, and tell the vendors to play nice and make them all be the same. Stop wasting more of our time, and let us get back to reading new cases.

Naah. Never happen. More effective time-wasting items to follow. Mahalo.

Read the first part of this Wet Read series, How best to waste my time, in the September 2012 issue of Applied Radiology.

C. Douglas Phillips, MD, FACR

Dr. Phillips is a Professor of Radiology, Director of Head and Neck Imaging, at Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York, NY. He is a member of the Applied Radiology Editorial Advisory Board.
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