What they say ...

Article Type:

Editorial

Subject:

Radiologists (Practice)
Radiology (Analysis)
Radiology, Medical (Analysis)

Author:

Phillips, C. Douglas

Pub Date:

07/01/2008

Publication:

Issue:

Date: July, 2008 Source Volume: 37 Source Issue: 7

Topic:

Event Code: 200 Management dynamics

Geographic:

Geographic Scope: United States Geographic Code: 1USA United States

Accession Number:

209239176

Full Text:

It's July! That time of the year when all smart folks hunker down and do their best to stay well for at least 3 or 4 months. You do not want to be in the hospital with interns who still delight in calling themselves "Dr. Whoever" at all times. No first names, please. I graduated!

One piece of wisdom gained over the years in radiology is how to say something. We, as radiologists, create a word picture (our report) of the findings on the images we review and apply serious mental firepower to the words we choose. It is hard work. Honestly. Mental work is among the hardest kind, they tell me. Lots of glucose burned in that big old piece of tissue living between our ears. Early on in our careers we say way, way too much. We can't seem to just call things what they are because we: 1) don't have the experience yet to know that for sure, and 2) aren't sure the old geezer reading out with us knows what the hell he's talking about, at least not yet. But, with time and accumulated knowledge of what is and what isn't, reports get thinner and more to the point. Unless, of course, we have no earthly idea what the hell we're looking at and talking about.

I've gained a bit of insight as to what residents, fellows, and radiologists in general mean when they put certain statements in a radiology report. The surprising thing to me is that so few radiologists have found useful careers in politics, lobbying, or sales. For the uninitiated, I'd like to offer this translation chart. Feel free to use it, unless you're a lawyer. And, if you're a lawyer, who's reading this to you? Ha ha!

C. Douglas Phillips, MD, FACR

Dr. Phillips is a Professor in the Departments of Radiology, Neurosurgery, and Otolaryngology-Head and Neck Surgery, and the Director of the Division of Neuro radiology in the Department of Radiology, University of Virginia Health Systems, Charlottesville, VA. He is also a member of the editorial board of this journal.

Radiology report                   Real meaning

The finding is of uncertain        I wish one of my partners had read
  significance.                      this instead of me.

There is a subtle finding in the   Ha! I saw it! I'm glad I didn't
  right (fill in the blank).         miss that.

This finding could be confirmed    I hope someone else reads the next
  with PET (or MR, or angio, or      study!
  whatever).

The retroperitoneal structures     What were we thinking? I didn't
  are poorly visualized on this      even know you could use US on
  US.                                someone >500 pounds.

The exam was discontinued after    I told you there was no way on
  discussion with the ordering       earth I could do that. That was
  physician.                         punitive medicine.

If old films are available, we     Share the old gold, dammit. Don't
  would be glad to compare them      leave me out here flailing.
  with the current study.

The exam is degraded by motion.    There is no way I'm going down the
                                     tubes trying to dictate
                                     something useful on this!

This study is within the limits    This study is within the limits of
  of normal.                         normal.

Talk with you again later.         If I get invited to continue
                                     writing these.

Gale Copyright:

What they say ...

Article Type:	Editorial
Subject:	Radiologists (Practice) Radiology (Analysis) Radiology, Medical (Analysis)
Author:	Phillips, C. Douglas
Pub Date:	07/01/2008
Publication:	Name: Applied Radiology Publisher: Anderson Publishing Ltd. Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2008 Anderson Publishing Ltd. ISSN: 0160-9963
Issue:	Date: July, 2008 Source Volume: 37 Source Issue: 7
Topic:	Event Code: 200 Management dynamics
Geographic:	Geographic Scope: United States Geographic Code: 1USA United States

Accession Number:	209239176
Full Text:	It's July! That time of the year when all smart folks hunker down and do their best to stay well for at least 3 or 4 months. You do not want to be in the hospital with interns who still delight in calling themselves "Dr. Whoever" at all times. No first names, please. I graduated! One piece of wisdom gained over the years in radiology is how to say something. We, as radiologists, create a word picture (our report) of the findings on the images we review and apply serious mental firepower to the words we choose. It is hard work. Honestly. Mental work is among the hardest kind, they tell me. Lots of glucose burned in that big old piece of tissue living between our ears. Early on in our careers we say way, way too much. We can't seem to just call things what they are because we: 1) don't have the experience yet to know that for sure, and 2) aren't sure the old geezer reading out with us knows what the hell he's talking about, at least not yet. But, with time and accumulated knowledge of what is and what isn't, reports get thinner and more to the point. Unless, of course, we have no earthly idea what the hell we're looking at and talking about. I've gained a bit of insight as to what residents, fellows, and radiologists in general mean when they put certain statements in a radiology report. The surprising thing to me is that so few radiologists have found useful careers in politics, lobbying, or sales. For the uninitiated, I'd like to offer this translation chart. Feel free to use it, unless you're a lawyer. And, if you're a lawyer, who's reading this to you? Ha ha! C. Douglas Phillips, MD, FACR Dr. Phillips is a Professor in the Departments of Radiology, Neurosurgery, and Otolaryngology-Head and Neck Surgery, and the Director of the Division of Neuro radiology in the Department of Radiology, University of Virginia Health Systems, Charlottesville, VA. He is also a member of the editorial board of this journal. Radiology report Real meaning The finding is of uncertain I wish one of my partners had read significance. this instead of me. There is a subtle finding in the Ha! I saw it! I'm glad I didn't right (fill in the blank). miss that. This finding could be confirmed I hope someone else reads the next with PET (or MR, or angio, or study! whatever). The retroperitoneal structures What were we thinking? I didn't are poorly visualized on this even know you could use US on US. someone >500 pounds. The exam was discontinued after I told you there was no way on discussion with the ordering earth I could do that. That was physician. punitive medicine. If old films are available, we Share the old gold, dammit. Don't would be glad to compare them leave me out here flailing. with the current study. The exam is degraded by motion. There is no way I'm going down the tubes trying to dictate something useful on this! This study is within the limits This study is within the limits of of normal. normal. Talk with you again later. If I get invited to continue writing these.
Gale Copyright:	Copyright 2008 Gale, Cengage Learning. All rights reserved.