Calling with Critical Findings: Is Anybody Out There?
A radiologist tries to deliver critical CT findings. Does this series of exchanges sound familiar?
Ring-ring.
“Hello, this is Nurse Ratched.”
“Hi, Dr. X-ray here. Calling with critical CT findings on patient John Doe.”
“Oh… Critical findings? You’d better speak with the doctor.”
“But Nurse, you’re listed as ordering the study.”
“Yes, but I only ordered it because Dr. Hospitalist told me to. I wouldn’t know what to do with those results. You’d better call Dr. H.”
Ring-ring.
“*Yawn* This is Dr. Hospitalist.”
“Hi, Dr. X-ray here. Sorry to wake you, but I have critical CT findings on patient John Doe.”
“Doe? I don’t know anybody by that name. I don’t recall ordering any CTs recently.”
“I’m sorry, but Nurse Ratched says you did.”
“Um…I don’t think - wait! Yes, I remember now. I didn’t actually see him yet. The nurse told me one of the consults ordered by the ER before the patient got admitted said to get the scan, so I asked her to set it up. You should let the consultant know.”
“Okay, which consultant was it?”
“I don’t know. I’m sure the nurse does, though.”
Ring-ring.
“Hello, this is Nurse Ratched.”
“Hi, Dr. X-ray here. Dr. Hospitalist said that the study was requested by a consultant, but he doesn’t know which. Could you have a look and see which service I need to contact?”
“It’s very busy here. I don’t know where the chart is.”
“Well, I’m sorry to trouble you, but these are very abnormal findings. They really can’t wait.”
“[unintelligible growling/mumbling]”
“Hello? Nurse Ratched?”
[After prolonged pause] “Says it was Dr. Pulmonary.”
Ring-ring.
“Dr. Pulmonary. Who’s calling?”
“Hi, Dr. X-ray here. Calling with critical CT findings on patient John Doe.”
“Who the hell is that? I’m not even covering the service today!”
“I’m sorry, but Nurse Ratched said you were, and Dr. Hospitalist said you had wanted this scan done.”
“Well that’s bad news for them, because I know nothing about any of this, and I refuse to take results on someone else’s patient. Good luck.”
Ring-ring.
“Hello, Dr. X-ray here.”
“Yeah, this is Dr. ER. When are you going to read these trauma cases? I can’t move these patients till you do.”
Ring-ring.
“Hello, this is Nurse Ratched.”
“Hi, Dr. X - ”
“Oh, it’s you again. What do you want now?”
“Nurse, as the clinician who ordered his CT scan, you are hereby receiving these critical results on patient John Doe - ” *click*
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March 8th 2025The use of ultra-high-resolution photon-counting CT in the evaluation of stable chest pain may significantly reduce follow-up tests and invasive coronary angiography (ICA) procedures, possibly resulting in millions in health-care cost savings, according to a cost-effectiveness analysis presented recently at the European Congress of Radiology.
