Comments on: How many radiologists cheat or take short-cuts in their interpretations? http://www.kevinmd.com/blog/2009/08/how-many-radiologists-cheat-or-take-short-cuts-in-their-interpretations.html Tue, 14 Feb 2012 23:57:00 +0000 hourly 1 By: phil chapmanhttp://www.kevinmd.com/blog/2009/08/how-many-radiologists-cheat-or-take-short-cuts-in-their-interpretations.html#comment-110077 phil chapman Fri, 21 Aug 2009 17:25:10 +0000 http://www.kevinmd.com/blog/?p=39406#comment-110077 Thanks, Mike. Greetings. On the topic I do feel that the patients' images should be viewed less like some kind of historical document where you get one chance to get it right (or else) and more like a part of a process. Certainly other doctors can change their opinion two weeks after the first round of antibiotics didn't work.I think it is perfectly OK to review previous studies and make additional comments if new info comes to light. Thanks, Mike. Greetings.
On the topic I do feel that the patients’ images should be viewed less like some kind of historical document where you get one chance to get it right (or else) and more like a part of a process. Certainly other doctors can change their opinion two weeks after the first round of antibiotics didn’t work.I think it is perfectly OK to review previous studies and make additional comments if new info comes to light.

]]> By: Michael Kirsch, M.D.http://www.kevinmd.com/blog/2009/08/how-many-radiologists-cheat-or-take-short-cuts-in-their-interpretations.html#comment-110047 Michael Kirsch, M.D. Fri, 21 Aug 2009 13:47:39 +0000 http://www.kevinmd.com/blog/?p=39406#comment-110047 Phil, your honesty is refreshing! Phil, your honesty is refreshing!

]]> By: phil chapmanhttp://www.kevinmd.com/blog/2009/08/how-many-radiologists-cheat-or-take-short-cuts-in-their-interpretations.html#comment-110023 phil chapman Fri, 21 Aug 2009 04:03:38 +0000 http://www.kevinmd.com/blog/?p=39406#comment-110023 I like Dr. Kirsch's response. But what the heck is schistosomiasis? I like Dr. Kirsch’s response. But what the heck is schistosomiasis?

]]> By: rmdfacchttp://www.kevinmd.com/blog/2009/08/how-many-radiologists-cheat-or-take-short-cuts-in-their-interpretations.html#comment-109503 rmdfacc Sat, 15 Aug 2009 17:02:18 +0000 http://www.kevinmd.com/blog/?p=39406#comment-109503 I found a case locally where the medical chart was changed by a radiologist well after the fact. They certainly can't interpret cardiac enalargement and pacemaker lead position. With the advent of new technology CTA, MRI/MRA, CCS etc they are suddenly experts without formal training. The usual interpretation always includes: "further studies with (fill in the blanks) recommended". I found a case locally where the medical chart was changed by a radiologist well after the fact.
They certainly can’t interpret cardiac enalargement and pacemaker lead position.
With the advent of new technology CTA, MRI/MRA, CCS etc they are suddenly experts without formal training. The usual interpretation always includes: “further studies with (fill in the blanks) recommended”.

]]> By: Doc99http://www.kevinmd.com/blog/2009/08/how-many-radiologists-cheat-or-take-short-cuts-in-their-interpretations.html#comment-109076 Doc99 Fri, 07 Aug 2009 11:59:16 +0000 http://www.kevinmd.com/blog/?p=39406#comment-109076 Having the radiologist dictate the report after the surgical findings are known is akin to the trial lawyer's finding fault with a physician's course of action after the outcome is known. Having the radiologist dictate the report after the surgical findings are known is akin to the trial lawyer’s finding fault with a physician’s course of action after the outcome is known.

]]> By: rayhttp://www.kevinmd.com/blog/2009/08/how-many-radiologists-cheat-or-take-short-cuts-in-their-interpretations.html#comment-109043 ray Thu, 06 Aug 2009 21:37:46 +0000 http://www.kevinmd.com/blog/?p=39406#comment-109043 Too hard to believe, must be very rare case given time constraits. I think there is a great educational experience on the other hand, after a few hundred of these, he will be the best radiologist around given he knows what the patient really has and what all those non specific leasions are. Too hard to believe, must be very rare case given time constraits. I think there is a great educational experience on the other hand, after a few hundred of these, he will be the best radiologist around given he knows what the patient really has and what all those non specific leasions are.

]]> By: Michael Rack, MDhttp://www.kevinmd.com/blog/2009/08/how-many-radiologists-cheat-or-take-short-cuts-in-their-interpretations.html#comment-109029 Michael Rack, MD Thu, 06 Aug 2009 17:26:53 +0000 http://www.kevinmd.com/blog/?p=39406#comment-109029 Sounds like what the radiologist is doing is ok- instead of putting "clinical correlation is advised"; he does the clinical correlation himself. He should, however, make it clear in the report what he is doing- any changes to the preliminary report should be added as an addendum. Sounds like what the radiologist is doing is ok- instead of putting “clinical correlation is advised”; he does the clinical correlation himself. He should, however, make it clear in the report what he is doing- any changes to the preliminary report should be added as an addendum.

]]> By: Michael Kirsch, M.D.http://www.kevinmd.com/blog/2009/08/how-many-radiologists-cheat-or-take-short-cuts-in-their-interpretations.html#comment-109012 Michael Kirsch, M.D. Thu, 06 Aug 2009 11:30:10 +0000 http://www.kevinmd.com/blog/?p=39406#comment-109012 Let's learn from our radiology colleagues. Let's dictate our consultation reports after the diagnosis becomes established. We'll all look like geniuses when we correctly 'suspect' esoteric diagnoses with confidence. "Oh yes", we can respond casually to other physicians on the case, "look's like just another case of schistosomiasis." Let’s learn from our radiology colleagues. Let’s dictate our consultation reports after the diagnosis becomes established. We’ll all look like geniuses when we correctly ‘suspect’ esoteric diagnoses with confidence. “Oh yes”, we can respond casually to other physicians on the case, “look’s like just another case of schistosomiasis.”

]]> By: adinahttp://www.kevinmd.com/blog/2009/08/how-many-radiologists-cheat-or-take-short-cuts-in-their-interpretations.html#comment-109001 adina Thu, 06 Aug 2009 03:26:23 +0000 http://www.kevinmd.com/blog/?p=39406#comment-109001 The radiologist is committing fraudulent misrepresentation of a document, so long as he signs and dates his documents, using the previous day's date. The medical chart is a legal document, and anytime you add something to a dated document, you must write in the date of any information added on a date later than the one listed on the bottom. Otherwise you are declaring that all of it was written on that first date. That counts as fraud, and is illegal. The radiologist is committing fraudulent misrepresentation of a document, so long as he signs and dates his documents, using the previous day’s date. The medical chart is a legal document, and anytime you add something to a dated document, you must write in the date of any information added on a date later than the one listed on the bottom. Otherwise you are declaring that all of it was written on that first date. That counts as fraud, and is illegal.

]]> By: Timothy Myershttp://www.kevinmd.com/blog/2009/08/how-many-radiologists-cheat-or-take-short-cuts-in-their-interpretations.html#comment-108998 Timothy Myers Thu, 06 Aug 2009 01:29:56 +0000 http://www.kevinmd.com/blog/?p=39406#comment-108998 KevinIf the radiologist in this story did as you say, this is clearly not the standard of care.Only rarely would a radiologist have the time that it would take to follow surgeons or clinicians around to get enough information to make it worthwhile. Most radiologists have to provide a final report, frequent be based on incomplete and/or misleading histories, with a very rapid turnaround time.I practiced for 15 years in a group of 85 radiologists at St. Paul Radiology and am now the Chief Medical Officer at NightHawk Radiology Services with 135 radiologists. In my experience over this time, I have never seen this occur. Many of us would have liked the luxury of being able to have this can of information prior to dictation, but again with time constraints it's impossible. This is not to say that many times we do dictate an addendum when we find out additional information from a pathology report or surgical findings. This is an important addition for anyone who my read the report in the future.Great blog and tweets.Timothy V. Myers, M.D. (tweeting under TMyers_NRSCMO), TMyers@nighthawkrad.net Kevin

If the radiologist in this story did as you say, this is clearly not the standard of care.

Only rarely would a radiologist have the time that it would take to follow surgeons or clinicians around to get enough information to make it worthwhile. Most radiologists have to provide a final report, frequent be based on incomplete and/or misleading histories, with a very rapid turnaround time.

I practiced for 15 years in a group of 85 radiologists at St. Paul Radiology and am now the Chief Medical Officer at NightHawk Radiology Services with 135 radiologists. In my experience over this time, I have never seen this occur. Many of us would have liked the luxury of being able to have this can of information prior to dictation, but again with time constraints it’s impossible. This is not to say that many times we do dictate an addendum when we find out additional information from a pathology report or surgical findings. This is an important addition for anyone who my read the report in the future.

Great blog and tweets.

Timothy V. Myers, M.D. (tweeting under TMyers_NRSCMO), TMyers@nighthawkrad.net

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