In a Radiologist’s Mind

A workday was getting started. The Foreman of the Radiologist’s faculties surveyed his force and was pleased: The full 100 were present and ready to go.

That wasn’t always the case. If the Radiologist hadn’t had a decent night’s sleep, was under the weather, or had lingering issues in his personal life, some of the faculties might not be ready to contribute to the effort. Even a bad commute could take a toll.

The good state of affairs held for a bit: The Rad found his reading room in good condition, as opposed to if someone else had used the area since the Rad’s last session and left it a disorganized mess.

Firing up the workstation proved to be the day’s first stumble, as the computer took longer than usual and started displaying messages about necessary updates being installed. The faculties’ sense of momentum was disrupted, as all they could do was sit there and wait. One of them wandered off to take care of some other task, or just to find something of interest – 99 remained.

The workstation eventually complained that the update couldn’t be completed, as some needed file was not found. This had happened more than once before, and the Rad had dutifully notified Support on every occasion…never with a satisfying conclusion. Support was, well, not very supportive. Instead, Support was difficult to get ahold of, and never really clear on what the problem might be, what might be done to address it, or whether it stood to impair the Rad’s work—today or subsequently. Contacting them tended to just add unproductive, frustrating minutes to the Rad’s day.

Two more faculties got good and angry over this particular iteration and wandered off to grouse about it to one another. A fourth, reminded of some other, unrelated logistical dissatisfaction with the Rad’s work environment, ran after them to commiserate. Ninety-six faculties remained…whoops, now 97, as the first one who had wandered off was drawn back by the technical annoyances. Not exactly the work he was supposed to be focused on, but at least it was something to occupy his attention.

Finally up and running, the Rad proceeded to start reading cases, with 97 percent of his faculties on task. Practically speaking, the Foreman knew that this was a pretty small deficit, not worth sounding the alarm about. Of course, if someone had asked the Rad whether he felt right about practicing his profession while distracted, he would have answered differently. But, that’s how it is when you frame “shades of gray” things as moral absolutes.

A few hours went by, with a typical mix of cases. Sometimes a case would be particularly difficult and a faculty would drift away from his post out of fatigue, or a string of cases would be humdrum and a faculty would wander off on a daydream. The Rad and his faculties had nevertheless chosen to do this for a living, and cases were by and large interesting to them. These occasional departures were, therefore, brief affairs, and the overall head count usually remained stable.

One of the angry faculties had, thus, come back after the first hour, and a second was about to return also. But, then, the Rad hit a few speed bumps in rapid succession: A frequently problematic sonography tech had, once again, failed to upload her “worksheet” so the Rad could read her case. A referrer wanted something clarified that the Rad had clearly spelled out in his original report. And, a nonsensical QA case turned up, alleging that the Rad had erred when he knew darned well that he had not.

Thus, the faculty which had just about calmed down enough to return to work got good and angry again. As he went back to resume grousing with the other absentee, he was followed by another five faculties that were now also too annoyed to focus on work. Three additional faculties also left their stations to come up with a plan of action regarding the problematic sonography tech. Four more departed to focus on mounting a defense for the QA (and maybe do some grumbling about the whole QA system while they were at it).

Now at a workforce deficit of more than 10 percent, the Foreman knew it was time to take things a bit more seriously and sounded a low-level alarm. The Rad, thus, became consciously aware that he wasn’t at his best. Not bad enough to get up and storm away from his workstation, but maybe taking a break would help.

Unfortunately, his first move was to check his Facebook, where some sociopolitical posts did more to rankle than pleasantly distract him, and that was compounded when he went to check the news and a radiology forum or two. Amongst other things, the Federal government had announced plans to cut radiology reimbursements by something like 11 percent.

Now the faculties were abandoning their stations in droves. The Foreman didn’t need to do a head count to know that it was time to hit the button for a bigger “take a break, now” alarm, and did so. The Rad got up from his workstation and went for a walk—to get some coffee, find a friendly colleague for some chatting, or just to let his mind wander.

Come to think of it, he realized, it was just about lunchtime, and the diet he’d recently begun had a way of making episodes of low blood-sugar sneak up on him. Maybe he was—what did the kids call it?—hangry. Maybe eating something would help. Off he went.

Meanwhile, the Foreman began his all-too-frequent routine of rounding up the faculties so they could be re-focused for the next stretch of the workday.