'You're a Radiologist? What Do You Do?'

I just got back from a vacation. As usual, I left a solid day between getting home and resuming work. I find the time buffer invaluable. It helps absorb any misadventures of traveling, gives me a chunk of time to unpack, launder, etc. Also, it's just nice to have 24 hours of downtime before getting back into my regular routine and, of course, writing this week's blog.

One of my joys about most vacay destinations is there are plenty of other travelers (as well as locals) in good moods who are inclined to strike up conversations. One gets to meet all sorts of interesting characters from different walks of life.

That is, of course, a two-way street. To make the most of it, you have got to make some effort at being an interesting character yourself. Commonly, that includes offering a nutshell description of your occupation. That doesn't mean I avoid just saying that I’m a radiologist, but a lot of folks don't know what that means.

If you have spent even a little bit of time in our field, you have heard it all before. A lot of people don't really know what we do, and we need to get the word out about it. Otherwise, folks will continue not to understand that radiologists are physicians, our value in health care will go unrecognized, etc.

This past week, one gent responded to my "radiologist" answer with a nod and half-question: "Cancer?" If my brain weren't already in vacation mode, I might have immediately recognized that he thought I was in rad onc. Instead, I partially agreed that, yes, some of my work pertained to cancer, but I saw a broader spectrum of cases including broken bones, strokes, bellyaches, etc.

It subsequently struck me as an interesting thing to define what we do by the underlying pathology, or signs/symptoms thereof. I think most of us would reflexively talk about body parts or imaging modalities.

However, if we were to talk about our work in terms of why patients were having imaging, we might be at a loss to account for much of it. An awful lot of my caseload isn't done for any reason like "cancer." If I told that guy that most of my work was for "eval," "screening," "F/U," or unspecified "pain," how seriously would he take me?

(Editor’s note: For related content, see “What is Your Radiology Delta?”)

For most of us, our work is about providing thorough descriptions of all pertinent details (and often a lot of incidental fluff that has to be included), so giving a quick summation of our work to health-care outsiders can be challenging. Say too little and there's room for misunderstanding but babble too much and the listeners' eyes might glaze over.

I think it's probably easier for the more subspecialized folks. For instance, if you did nothing but breast imaging all day, and told folks you read mammograms, they would get it. This would be similar to saying you review angiograms if you were an interventionalist. You would be simplifying things by leaving out details like breast US/MR or other percutaneous procedures, but you could always delve into that if folks inquired further.

That's not so much the case for rads like me, reading pretty much whatever happens to populate the telerad worklist. More than a few times, I've been a little flip about it, saying that I interpret most types of medical imaging, even comparing it to "art appreciation for docs."

Still, being in the habit of providing all possibly relevant details, a rad might feel like that does his or her field a disservice. This may especially be the case for one who has academic, administrative, or research responsibilities. These things have a way of seeping into one's work even if they aren't in the formal job description as I mentioned in my recent blog about complex systems. Few of us are purely radiologists when all is said and done.

That's not unique to us or confined to health care. Ask just about anybody (especially highly skilled/trained/educated types) how much of what they do is really what their job is supposed to be, and you can probably brace yourself for a healthy dose of bellyaching.

Still, if someone asks you what you do as a radiologist, you probably shouldn't include things like your daily struggles with crummy voice recognition in your reply, your hassles in trying to get referring clinicians on the phone to verbally report results, or the battles you fight to get imaging protocoled the right way. Such things might well account for a dishearteningly large portion of your typical day, but nobody wants to hear about them, except other rads who may be in a mood to commiserate.

I would suggest erring on the side of brevity. "Medical art appreciation" was one quip I came up with, but you can probably do better. Whatever it is, though, if you're just having a superficial social interaction, you don't need to spread the gospel of all that radiology is and could be. I treat it like showbiz. Leave the audience curious and maybe wanting to learn more.