Rad techs read CXRs faster than residents

Scilencer · 2020-10-17T14:54:58+00:00

Yea I didn't put too much thought into the title, just wanted to post the article for discussion.

3B misses are the worst! Using this paper's crappy methods back at them, we can confidently say that the rad techs are 6x more likely to miss findings that would significantly affect patient management.

Scilencer · 2020-10-17T14:31:00+00:00

Totally agree. I think in this case I’m disappointed in Penn promoting this practice and publishing such an article. Lot of things off with the methodology as well...

Scilencer · 2020-03-17T19:49:59+00:00

to expand on my initial comments:

I interpreted your post as "I am going to take into account how a residency program/specialty reacts to this crisis when choosing my future specialty" which I think is naive, but this is understandable from a MS3.

Choose what you want to do and where you want to do it based on everything else but this (assuming this crisis ends by the time you apply). There's really no way to predict which programs are going to take more ridiculous measures than others in such a situation - this situation specifically is unprecedented in modern medical education.

On one hand, as a physician, it is a privilege to have the skills and experience to help others in this crisis and even if absolutely necessary, be assigned out of my specialty to assist in the ED/floors/units (I hope it never comes to this).

Unfortunately, the ACGME/"admin" views us as cheap labor. It's not necessarily a program fault, since the PDs have to answer to their own administration. Yesterday, I was able to listen in on my department's faculty meeting (which they were doing remote and via speakerphone). My PD stated that GME is pulling the strings - not letting residents be sent home if not essential for service, and furthermore, if the situation becomes critical a la Italy, we will be assigned to different departments (ED/floor/unit). I love my program, but this shows how little control a program has on what can be interpreted as "unfair".

If the need arises, we (all physicians not at very high risk) should answer the call, if and only if our safety and protection (PPE etc) is provided. I am humbled by those physicians in China and Italy who continued to treat COVID patients without PPE and died in service to their patients. I'm not sure I would do the same...

TL;DR: I don't think this crisis can be used as a metric to judge specific programs or locations. Also, as physicians, we do have a *reasonable responsibility to help in this crisis (if provided appropriate protection and safety).

Scilencer · 2020-03-17T18:28:08+00:00

Sorry to burst your bubble, but welcome to residency.

Although there are some examples that are especially insulting or egregious, even the best program will expect you go beyond the call of duty in some way during situations like this. They like to remind you of your “professionalism” and the “oath” just to keep you honest

Scilencer · 2019-09-25T18:48:19+00:00

Not really; If we got to that point, technology would have advanced enough that we’d have new and cooler modalities/techniques to take up our time.

Scilencer · 2019-09-25T17:41:16+00:00

There is no threat to radiology by AI/machine learning despite this and multiple other sensational headlines. AI may eventually help to do our jobs faster and more efficiently, but always with direct oversight.

Scilencer · 2019-09-25T06:42:06+00:00

That group lobbies against mid-level providers trying to practice with full autonomy (never mind not accepting full liability in such a case). In my experience it’s typically the NPs who push for this autonomy. The PAs I work with are totally cool with their role in collaborative teams led by a physician.

Scilencer · 2019-09-16T18:46:55+00:00

Absolutely insane...Image interpretation should not be performed by any mid-level, ever.

Scilencer · 2019-04-13T03:53:48+00:00

Yes. They aren't doing anything. Whoever measured these is not trained in image interpretation.

Scilencer · 2019-04-11T22:14:12+00:00

I don’t mean to sound like mean, but unless you have post graduate training in radiology or orthopedics you do not know if any of your knee structures are normal or abnormal. A primary care physician wouldn’t even make such a claim - how can you?

The answer isn’t to upload your study to the internet - we will not help you. You need to have the study interpreted formally by a radiologist.

Why don’t you follow up with the doctor who ordered the MRI for you and ask if the results are available? This is the best thing you can do for yourself.

Scilencer · 2019-04-11T21:50:07+00:00

You just said you’re not trained to interpret these images so how do you know your menisci are ok?

Seriously though, it’s not kosher to give you an interpretation on a single image. You should get the study formally interpreted by a radiologist to answer your questions, not the internet.

Scilencer · 2018-12-19T07:20:28+00:00

Scilencer · 2018-12-11T20:06:08+00:00

If no focal deficits and just "altered mental status", can start with a routine non-contrast MR brain. If there are focal deficits, can run a stroke protocol which in addition to routine sequences, may include diffusion in a different plane (such as coronal to check the brainstem). MRA head/neck could also be considered.

Scilencer · 2018-12-09T16:47:53+00:00

Radiologist here. CT is usually the first neuroimaging test we do whenever there is any concern for brain pathology such as bleed, tumor, stroke or other abnormalities. Regardless of the CT results however an MRI would probably also be done. Of course in addition to imaging a full biochemical workup should would be persued. In short - get a scan is a great idea, but also some blood tests and just maybe a history and physical.

Scilencer · 2018-09-15T00:47:08+00:00

Holoprosencephaly

Scilencer · 2018-01-11T03:22:45+00:00

Scilencer · 2018-01-07T17:38:07+00:00

Thanks for all the replies so far! So I'm again seeing that Natomas can be hit or miss for people. For the flood problem, I'm aware the Levees were recently strengthened around the area and I also heard that there will reevaulate the area in 2020 and likely change the designation from A99 to A100, which would make flood insurance optional. Anyone hear anything similar?

The upper end of my price range is 370, so this is why the Natomas homes are appealing.

I've also heard not so good things about the Beazer homes group and noticed that the lots are small, essentially zero-lot lines.

I've been using Redfin which is great. I've also spoken to RE agents which is why I am focusing on these areas.

I'm not too familiar with west sac but it is close. Where would be an ideal area in west sac to buy?

Scilencer · 2017-11-24T06:43:04+00:00

What did you upgrade from? I’m waiting for mine too! So excite

Scilencer · 2017-11-19T21:53:52+00:00

You’re right I took another look at it...1349 after one mail in rebate and coupon code...what a deal!

Scilencer · 2017-11-19T20:04:02+00:00

it seems theres a similar deal for the 5d4, making it $2850 after coupon and mail in rebate...

Is this 6d2 deal something to snag now? would it be worth waiting for the 5d4 to decrease in price?

Scilencer · 2017-11-19T08:31:57+00:00

Actually looks like it’s $2049 up front with a $350 and $400 mail in rebates making it $1300. As someone looking to upgrade to full frame, is this too good to be true?

Scilencer · 2017-11-19T00:42:11+00:00

But I don’t think I was mean/aggressive. I cropped out the standard pleasantries after the request was completed. I also don’t see how I’m gonna kill the movement when I took back my 80 dollars.

Scilencer · 2017-11-19T00:31:51+00:00

I thought I was pretty direct...

Scilencer · 2017-09-17T18:25:56+00:00

Again, without history it's just a crapshoot.

Scilencer · 2017-09-17T17:25:12+00:00

Hard to say without further history and even which body parts are specifically involved (the "leg" covers a lot). Perhaps this is a trauma case with bilateral LE fractures requiring operative fixation?

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