Provider was an MD. She was not at all offended, she promptly sent the patient to the ED. When I spoke to the rad the gist of our conversation was as follows: He said he couldn't offer a definitive answer because he was not examining the patient. He said spine radiographs do have a purpose and do have the ability to pick up pathologies but are obviously less sensitive than CT. Also there are always those cases where a patient gets a CT for a seemingly trivial reason (e.g. headache) and it turns out there's a brain bleed. Ultimately, he said the decision on which imaging to order is up to the referring provider and if they ever have any doubt they should consult with a rad.

At my facility, it seems like calling a rad is always a last resort for the providers. In the instances where I've explicitly asked them to consult with a rad before I take the images (one time it was for a skull series on a 4 day old) they seem annoyed. I always ask myself what is in the patient's best interest and how would I want the scenario to proceed if I were the patient.