Medical Community Ignorance...
#1
03-26-2007, 01:46 AM
Medical Community Ignorance...
I hope that got your attention...
There is something that's been bothering me for a while and I have to post it. I don't care if you reply, but copy it and let everyone you know what's up...
I am a Radiology Technologist. What that means is that I've been trained to take sick and/or injured people and use ionizing radiation to help diagnose and/or plan treatment. I was trained in the US ARMY by Nationally Registered Technologists who also have Certificates and/or Degrees in Education. The training I received was in a fully Accredited course by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). I've also received advanced training in Computed Tomography and Magnetic Resonance Imaging and am currently eligible for the National Registry in both of those Modalities, of which I sit for the MRI Registry on April 2.
The first thing you are taught in the most basic Radiology Course is the ALARA concept. What is it? It's stands for As Low As Reasonably Achievable. What is means is that your first responsibility is to the patient and that responsibility is to use the least amount of ionizing radiation as possible to achieve the most clinical information possible.
I've been doing Radiography(Xray) for 12 years and CT for 4 years and MRI for about 2years. Xray is the least sensitive and/or offers the least resolution due to the fact that it superimposes all the anatomy onto a film making it much like a photograph. It's called a radiograph. An average Chest Xray is like spending the day in the sun, naked. CT on the other hand takes exponentionaly more xrays and uses a computer to reconstruct a 2D image of the anatomy as it lies in the body without superimposition. We can also use the computer to reconstruct a 3D image if the need be. An average CT is like walking around outside in the sun, naked, for a year. MRI uses soundwaves and magnets to do something similar to CT only there's no radiation and you get way more resolution(better detail). There's also Ultrasound, Nuclear Medicine, Fluoroscopy, PET/CT, etc., etc. I've become more knowledgeable about what types of diseases can be detected by different imaging modalities. The more I learn the more concern I develop.
Here's why:
Most Family Practitioners and other NON-Radiology related Physicians know squat about the proper modality to "order" to help the patient the most while radiatiing them the least. Most of them just blindly order CT's and Xrays because they are the most commonly used and easiest to get scheduled quickly.
My job- My code of Ethics as a Radiology Technologists prevents me from just blindly doing an exam, I can use common sense to discern is not necessarily appropriate or not necessarily the best modality to help with the patient's diagnosis and/or treatment.
There are self-centered Doctors out there, Radiologist included, who would rather "just do the exam" than to try to talk to the ordering physician and educate them on why it shouldn't be done or why something else should be done. The ordering physician's are so cocky they say, " Do it... Because I said so." Or there so ignorant they tried to put the burden on the technologist to clarify with the Radiologist or decide for them.
Here's some examples:
Someone falls. They get a headache and have a knot on there head. They come to the ER. The ER doctor orders a CT of the patient's brain to rule out a bleed and a CT of the C-spine(neck bones) to rule out a fracture. Now both of these scenario are very possible (Brain Hemorrhage and/or Cervical Spine Fracture) from a fall with head trauma. However, if an ER Doctor is concerned enough about the possibility of a neck bone fracture don't you think they should be concerned enough to put a C-Collar around the patient's neck to keep them from moving their head in a way that could possibly cause them to paralyze themselves or die?! I would think that's just common sense so I tell the ER Nurse the patient needs a collar on and she literally asks me why...
Or let's say you are a late 20's female who is having worsening headaches over the past 6weeks or so and the Doctor orders a CT of your brain with and without Contrast (IV fluid that helps to tell the difference between normal anatomy and a disease process) to rule out a lesion on your brain. Knowing what I know as a Tech who has done CT and MRI I know that an MRI is the better exam for this clinical concern unless you have a pacemaker, a neuro stimulator, or anuerysm clips in your skull or any metal implants that have been in there for under 6 weeks. Let's say your exam is scheduled for 530 pm and there is only one radiologist working who happens to be in a hurry to get home but is also big on Radiation Safety. You present your concerns to him and he agrees with you and tells you to evaluate/screen the patient, educate them on their options and let them decide. You do that. The patient decides not to take 2 years worth of radiation to the brain/eyes/pituitary and get the non radiating MRI exam. The ego of the NURSE PRACTITIONER who wanted the exam done has been wounded so she calls you up and tells you it's not your place as a technolgist to educate them on their healthcare choices for their own body.
Or this final example...
Let's say you're a middle 40's female who is having stomach pain that's just not resolving. So the Doctor orders a CT exam to rule out gallstones and his order states very clearly (in no uncertain terms) "R/O Gallstones". Well being the responsible tech that you are you check the patient's history and you see that she recently (within the last month) has had a non radiating Ultrasound exam. And on that report is very specifically says "the gallbladder is visualized and is full of stones". It also says that because of not seeing all of the liver maybe a CT should be done if there is clinical concern involving the liver. Which is all well and good, but that was not the clinical concern that was written on the order, so you consult a Radiologist. This time the guy just doesn't really care, but since you brought it up he's on the spot so he calls. This is all happening around closing time and he wants to leave so 5 mins later he comes out and says ,"the ordering doc is on vacation, just do it." and takes off. Or so it seems. So you go and tell management about the situation and present all the information you have and request permission to educate the patient and let her decide if she wants to reschedule after we clarify the order. Management supports the idea and instructs you to do so. You do. As you do, the Radiologist comes out to leave and smiles at you and pats you on the back as you're explaining the concern and the options to the patient. She decides to wait.
Next day this Radiologist tells you you have "a lot of *****" and asks why you do that?! I tell them it's part of my job and in my code of ethics. He says you can't follow your code of ethice like that and you repsectfully disagree. When he can't win the argument or convince you you're wrong he starts with the personal attacks saying "your passion and personality" is probably why you can't keep a job(I"m a traveler so it's short term contract work but I've been offered a job everywhere I've been) and that "when it all comes down to it you're just a button pusher." After a situation like that he then claims to be dissappointed with you because you asked that your contract be terminated ASAP because you didn't want to be part of an organization that employs people in positions such as his that condemn you for following your code of ethics because it's inconvenient.
The bottom line is, if someone wants to radiate you for any reason question them. Make them explain to you why they want it done and what they hope to learn from it and are they absolutely sure that's the best exam for diagnosing/treating whatever they think is wrong with you. If their answer satisfies you, fine, but if not ask a Radiologist to take 5 minutes out of their day to get their opinion. If you're not successful with that then by all means put the Technolgist on the spot and ask them before you have the exam done. If they don't know, it would make their day to have to get a Radiologist in there to answer your question(s).
Education is the key. Educate yourself to protect yourself.
FYI the FDA has no established limit on ionizing radiation when it's deemed "medically necessary" by a physician. The sad thing is, radiation is cumulative. The damage it does adds up the more you get and nobody knows for sure what a safe amount to receive is, anyone who tells you otherwise is lying.
Be safe.
-Chuck
There is something that's been bothering me for a while and I have to post it. I don't care if you reply, but copy it and let everyone you know what's up...
I am a Radiology Technologist. What that means is that I've been trained to take sick and/or injured people and use ionizing radiation to help diagnose and/or plan treatment. I was trained in the US ARMY by Nationally Registered Technologists who also have Certificates and/or Degrees in Education. The training I received was in a fully Accredited course by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). I've also received advanced training in Computed Tomography and Magnetic Resonance Imaging and am currently eligible for the National Registry in both of those Modalities, of which I sit for the MRI Registry on April 2.
The first thing you are taught in the most basic Radiology Course is the ALARA concept. What is it? It's stands for As Low As Reasonably Achievable. What is means is that your first responsibility is to the patient and that responsibility is to use the least amount of ionizing radiation as possible to achieve the most clinical information possible.
I've been doing Radiography(Xray) for 12 years and CT for 4 years and MRI for about 2years. Xray is the least sensitive and/or offers the least resolution due to the fact that it superimposes all the anatomy onto a film making it much like a photograph. It's called a radiograph. An average Chest Xray is like spending the day in the sun, naked. CT on the other hand takes exponentionaly more xrays and uses a computer to reconstruct a 2D image of the anatomy as it lies in the body without superimposition. We can also use the computer to reconstruct a 3D image if the need be. An average CT is like walking around outside in the sun, naked, for a year. MRI uses soundwaves and magnets to do something similar to CT only there's no radiation and you get way more resolution(better detail). There's also Ultrasound, Nuclear Medicine, Fluoroscopy, PET/CT, etc., etc. I've become more knowledgeable about what types of diseases can be detected by different imaging modalities. The more I learn the more concern I develop.
Here's why:
Most Family Practitioners and other NON-Radiology related Physicians know squat about the proper modality to "order" to help the patient the most while radiatiing them the least. Most of them just blindly order CT's and Xrays because they are the most commonly used and easiest to get scheduled quickly.
My job- My code of Ethics as a Radiology Technologists prevents me from just blindly doing an exam, I can use common sense to discern is not necessarily appropriate or not necessarily the best modality to help with the patient's diagnosis and/or treatment.
There are self-centered Doctors out there, Radiologist included, who would rather "just do the exam" than to try to talk to the ordering physician and educate them on why it shouldn't be done or why something else should be done. The ordering physician's are so cocky they say, " Do it... Because I said so." Or there so ignorant they tried to put the burden on the technologist to clarify with the Radiologist or decide for them.
Here's some examples:
Someone falls. They get a headache and have a knot on there head. They come to the ER. The ER doctor orders a CT of the patient's brain to rule out a bleed and a CT of the C-spine(neck bones) to rule out a fracture. Now both of these scenario are very possible (Brain Hemorrhage and/or Cervical Spine Fracture) from a fall with head trauma. However, if an ER Doctor is concerned enough about the possibility of a neck bone fracture don't you think they should be concerned enough to put a C-Collar around the patient's neck to keep them from moving their head in a way that could possibly cause them to paralyze themselves or die?! I would think that's just common sense so I tell the ER Nurse the patient needs a collar on and she literally asks me why...
Or let's say you are a late 20's female who is having worsening headaches over the past 6weeks or so and the Doctor orders a CT of your brain with and without Contrast (IV fluid that helps to tell the difference between normal anatomy and a disease process) to rule out a lesion on your brain. Knowing what I know as a Tech who has done CT and MRI I know that an MRI is the better exam for this clinical concern unless you have a pacemaker, a neuro stimulator, or anuerysm clips in your skull or any metal implants that have been in there for under 6 weeks. Let's say your exam is scheduled for 530 pm and there is only one radiologist working who happens to be in a hurry to get home but is also big on Radiation Safety. You present your concerns to him and he agrees with you and tells you to evaluate/screen the patient, educate them on their options and let them decide. You do that. The patient decides not to take 2 years worth of radiation to the brain/eyes/pituitary and get the non radiating MRI exam. The ego of the NURSE PRACTITIONER who wanted the exam done has been wounded so she calls you up and tells you it's not your place as a technolgist to educate them on their healthcare choices for their own body.
Or this final example...
Let's say you're a middle 40's female who is having stomach pain that's just not resolving. So the Doctor orders a CT exam to rule out gallstones and his order states very clearly (in no uncertain terms) "R/O Gallstones". Well being the responsible tech that you are you check the patient's history and you see that she recently (within the last month) has had a non radiating Ultrasound exam. And on that report is very specifically says "the gallbladder is visualized and is full of stones". It also says that because of not seeing all of the liver maybe a CT should be done if there is clinical concern involving the liver. Which is all well and good, but that was not the clinical concern that was written on the order, so you consult a Radiologist. This time the guy just doesn't really care, but since you brought it up he's on the spot so he calls. This is all happening around closing time and he wants to leave so 5 mins later he comes out and says ,"the ordering doc is on vacation, just do it." and takes off. Or so it seems. So you go and tell management about the situation and present all the information you have and request permission to educate the patient and let her decide if she wants to reschedule after we clarify the order. Management supports the idea and instructs you to do so. You do. As you do, the Radiologist comes out to leave and smiles at you and pats you on the back as you're explaining the concern and the options to the patient. She decides to wait.
Next day this Radiologist tells you you have "a lot of *****" and asks why you do that?! I tell them it's part of my job and in my code of ethics. He says you can't follow your code of ethice like that and you repsectfully disagree. When he can't win the argument or convince you you're wrong he starts with the personal attacks saying "your passion and personality" is probably why you can't keep a job(I"m a traveler so it's short term contract work but I've been offered a job everywhere I've been) and that "when it all comes down to it you're just a button pusher." After a situation like that he then claims to be dissappointed with you because you asked that your contract be terminated ASAP because you didn't want to be part of an organization that employs people in positions such as his that condemn you for following your code of ethics because it's inconvenient.
The bottom line is, if someone wants to radiate you for any reason question them. Make them explain to you why they want it done and what they hope to learn from it and are they absolutely sure that's the best exam for diagnosing/treating whatever they think is wrong with you. If their answer satisfies you, fine, but if not ask a Radiologist to take 5 minutes out of their day to get their opinion. If you're not successful with that then by all means put the Technolgist on the spot and ask them before you have the exam done. If they don't know, it would make their day to have to get a Radiologist in there to answer your question(s).
Education is the key. Educate yourself to protect yourself.
FYI the FDA has no established limit on ionizing radiation when it's deemed "medically necessary" by a physician. The sad thing is, radiation is cumulative. The damage it does adds up the more you get and nobody knows for sure what a safe amount to receive is, anyone who tells you otherwise is lying.
Be safe.
-Chuck
#3
03-26-2007, 11:42 AM
I hate Radiologists. Well at least the ones down in Anaheim at the hospital I use to work at. They were the most arrogant a**holes of the whole hospital and made lots of money. They came and went as they pleased and just seeing their work ethic in general was disatisfying. I use to load x-rays and mammograms on these huge light boards so the radiologists could dictate them. It would take me on average 60-90minutes to load them (around 100+ x-rays per board) The radiologist would come in an take about 20 minutes to dictate all those x-rays. One Radiologist dictated like 2 mammogram boards in like 30 minutes cause he has to catch a plane for the superbowl. Now thats messed up cause there is a huge liability with that, plus my Aunt died of breast cancer and it sucks knowing how much crap they could have missed dictating the x-rays. I still work for the same hospital now and its amazing to see how some doctors really are. A lot of them are the biggest babies.
#7
03-26-2007, 02:27 PM
The bottom line is, if someone wants to radiate you for any reason question them. Make them explain to you why they want it done and what they hope to learn from it and are they absolutely sure that's the best exam for diagnosing/treating whatever they think is wrong with you. If their answer satisfies you, fine, but if not ask a Radiologist to take 5 minutes out of their day to get their opinion. If you're not successful with that then by all means put the Technolgist on the spot and ask them before you have the exam done. If they don't know, it would make their day to have to get a Radiologist in there to answer your question(s).
Education is the key. Educate yourself to protect yourself.
FYI the FDA has no established limit on ionizing radiation when it's deemed "medically necessary" by a physician. The sad thing is, radiation is cumulative. The damage it does adds up the more you get and nobody knows for sure what a safe amount to receive is, anyone who tells you otherwise is lying.
Be safe.
-Chuck
#8
03-26-2007, 02:45 PM
The bottom line is, if someone wants to radiate you for any reason question them. Make them explain to you why they want it done and what they hope to learn from it and are they absolutely sure that's the best exam for diagnosing/treating whatever they think is wrong with you. If their answer satisfies you, fine, but if not ask a Radiologist to take 5 minutes out of their day to get their opinion. If you're not successful with that then by all means put the Technolgist on the spot and ask them before you have the exam done. If they don't know, it would make their day to have to get a Radiologist in there to answer your question(s).
Education is the key. Educate yourself to protect yourself.
FYI the FDA has no established limit on ionizing radiation when it's deemed "medically necessary" by a physician. The sad thing is, radiation is cumulative. The damage it does adds up the more you get and nobody knows for sure what a safe amount to receive is, anyone who tells you otherwise is lying.
Be safe.
-Chuck
Education is the key. Educate yourself to protect yourself.
FYI the FDA has no established limit on ionizing radiation when it's deemed "medically necessary" by a physician. The sad thing is, radiation is cumulative. The damage it does adds up the more you get and nobody knows for sure what a safe amount to receive is, anyone who tells you otherwise is lying.
Be safe.
-Chuck
Long story short my grandma and grandpa were caught up in a doctors scam to conduct unnecessary bypass surgeries on seniors...he was basically doing it for the money. The FBI caught the doctor and he's in jail....the court case ended up giving my grandparents and several other seniors a nice chunk of change, but their health has rapidly depleting since the surgeries.
Point is that if they would have done their homework and recieved 2nd, 3rd and 4th opinions this wouldn't have happened! So yes, education is key to protecting yourself.
#11
03-26-2007, 04:30 PM
Guest
Posts: n/a
Ok, i finally got a moment and read through all of this.
Good read.
Ive been thinking about the medical community for a while now. From Mid november to just a few weeks ago i had stomache pains that would NOT go away. I went to my family practice doctor, then got an ultrasound on my guts, then got an upper endoscopy and they never found anything. Nobody knows why it felt like a ****ing icepick was stabbed deep in my stomahe. they couldnt figure it out.
When i was a child certain expectations of others were set in me, I guess with just the general media i had grown up to expect that there are certain career fields that define the individual. A cop is a cop, a fireman is a fireman, and a doctor is a doctor.
In reality, it does not define them, there are corrupt police who will look the other way when somone breaks the law, there are firemen who start the fires they respond to, there are doctors who do not have your health in thier highest interest.
people are people, take a look at 10 random people, and take a look at 10 random doctors. the big difference you will find between the doctors and the people are thier paychecks.
Being a doctor does not mean they know what they know what they are doing. it does not ome with any level of competance, and it does not alleviate them of making bad decisions based on pride.
To sum up, just because somebody is proficient in something, does not mean they are competant.
There are always exceltions, there are police of unparallelled morality, and doctors of unequaled ethics, but all in all, they are all just a bunch of people, and a good amount of them have no ****ing clue what they are doing and dont really care much about you or your health they are just doing a job and really deep down dont give a **** about you.
Isnt that wonderful?
lol
Good read.
Ive been thinking about the medical community for a while now. From Mid november to just a few weeks ago i had stomache pains that would NOT go away. I went to my family practice doctor, then got an ultrasound on my guts, then got an upper endoscopy and they never found anything. Nobody knows why it felt like a ****ing icepick was stabbed deep in my stomahe. they couldnt figure it out.
When i was a child certain expectations of others were set in me, I guess with just the general media i had grown up to expect that there are certain career fields that define the individual. A cop is a cop, a fireman is a fireman, and a doctor is a doctor.
In reality, it does not define them, there are corrupt police who will look the other way when somone breaks the law, there are firemen who start the fires they respond to, there are doctors who do not have your health in thier highest interest.
people are people, take a look at 10 random people, and take a look at 10 random doctors. the big difference you will find between the doctors and the people are thier paychecks.
Being a doctor does not mean they know what they know what they are doing. it does not ome with any level of competance, and it does not alleviate them of making bad decisions based on pride.
To sum up, just because somebody is proficient in something, does not mean they are competant.
There are always exceltions, there are police of unparallelled morality, and doctors of unequaled ethics, but all in all, they are all just a bunch of people, and a good amount of them have no ****ing clue what they are doing and dont really care much about you or your health they are just doing a job and really deep down dont give a **** about you.
Isnt that wonderful?
lol
#12
03-26-2007, 06:00 PM
As an EMT and spending clinical time in the ER, I can say there are people who are truely dedicated to what they do, and hacks who really dont give a ****. They are pretty distinguishable apart. Ask them a few questions when you are face to face and ask them why something is done the way it is. You should be able to figure out if its someone you should be dealing with or not.
#14
03-27-2007, 06:48 AM
I do make more money as a traveler. But sometimes I think if everyone got paid the money I do, maybe they would have more dedication to their profession. Then again some people just don't care.
Oh yeah, I get the same woman in every town. But she loves new geography...
#15
03-27-2007, 08:04 AM
My only comment is more towards my own physician... I recently had to go through a series of CT scans because of some odd abdominal lypmh inflamation. The only reason I had three of these is because my doc was concerned that I might have lymphoma, which would suck ***. However, he stopped ordering the cat scans (they always seemed illusive or inconclusive) is because he didnt want to keep irradiating me for a very slim chance that I could be sick. So... my doc is good, and doesnt just want to blindly scan me all the fricken time. You would like him, lol.
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