I’ve had a similar scenerio as a practicing Radiologist and Mammography specialist. Patient with palpable lump , Diagnostic Mammography abnormal, Ultrasound clearly malignant. We could do the needle biopsy immediately under ultrasound. At our institution needle biopsies are required prior to surgery. Call to Family Parctice Physician asking permission and an order.
The FP refused, said he wanted her to see a surgeon first. And what was that going to accomplish? Result, one very angry patient (at the FP) complaints to administration. And yes the biopsy was malignant.
The is just another instance of the misunderstanding some docs have as to the current role of Radiologists, in many cases, now directing treatment and care, and being good at it.
Anonymous
Dear anon 11:27 So are you goinng to pay me for my efforts and time to “get permission” This is the disconnect. If you want to do something, order it yourself if you are “directing care”. At our institution, we have set a process up with our general surgery colleagues that remove this kind of thing. However at our institution primary care doctors orinions mean something instead of the condescending claptrap from this dude.
Stark Raving Med
I’m not sure what kind of an institution you are practicing in, but the scenario described by the radiologist above is the standard of care. In fact I wrote nearly the same thing in a comment on the original blogger’s post. I find it interesting that you ask to be paid for your time on the phone with the radiologist. Do you bill all the subspecialists you consult with? Breast care is a coordinated effort between patient, primary care physician, radiologist, oncologist and surgeon. If any of these entities are left out of the decision making process, patient care suffers…dude.
