This is the Way: Your Compass to Great Radiology Practices

In a recent blog, I wrote favorably about some onboarding I went through for a teleradiology client. One aspect was particularly good. The majority of my time was spent with one of their actual rads, who showed me the ropes of the software suite I would be using to read their cases.

Someone with a CV of less lineage than my own might not have fully appreciated it. If you have had little to no other training for comparison and you are treated to a superb session, you might just think that is the norm.

On the other hand, I have worked in places where they pretty much just threw a workstation at me and said “It’s self-explanatory. Just call us if you have any problems.” I have experienced other joints where they openly admitted their software (and hardware) were horrible but might someday be better. In the meantime, they weren’t going to show me the ins and outs because, why bother? Almost none had an actual working radiologist doing the training. Disinterested IT people had the task and they mailed it in with zero oomph.

Thus, when I heard there would not only be a rad doing my training, but that he was in charge of the practice’s PACS/RIS and they had allocated the greater part of a day for it, I knew I was in for a good time. Further, it turned out he was a consultant for the big-name company behind the PACS. Rather than the hapless individuals I had dealt with in the past (“Yeah, the software stinks, but there’s nothing we can do about it”), here was someone instrumental in identifying and bringing about specific improvements that rads like myself would want.

As if that wasn’t enough, he had trained more than a few rads in his tenure, and had a nice, systematic approach to touch on every useful nook and cranny. He had also developed a good pace, knowing when to pause for questions or to have me execute some function he had just shown me, so I would have the “muscle memory” to retain it that much more effectively.

During and after the process, I had a recurring thought, courtesy of The Mandalorian: “This is the Way.”

Chances are, you are at least aware of the show. (Otherwise, unless you absolutely hate sci-fi, I strongly recommend it). You have probably also seen the “Way” buzz line in a gazillion social media memes that it spawned. Forgetting about the lore of the show, the expression’s meaning is that you see something done properly, and you’re calling it out as a good example for others. It is implied that your approval is deeply heartfelt, almost instinctive.

In an ideal world, we wouldn’t need to point out when things are being done particularly well. That would be the norm. It would be a notable exception if we ever felt the need to say “Boy, this is rotten.”

The world is, however, far from ideal, and the health-care machine is no exception. On a satisfaction scale from “everything stinks” to “wow, this must be Heaven,” the vast majority of rads I have known have placed their experience in the bottom half.

As a result, when a “this is the Way” moment happens, it stands out. It can make one want to cheer (which, I suppose, is what motivated this column). This is more frequently and strongly the case depending on how much of a rad’s career has been spent experiencing “this isn’t the Way” conditions.

Here is another good example. I have worked in a couple of different “pay-per-click (PPC)” situations as well as salaried jobs. One of the biggest liabilities of PPC is that, if you find yourself without work to do, you are typically earning absolutely nothing while you sit and stare wishfully at your empty list. You might be motivated to ask such an employer what it is doing to improve the situation, and/or provide some sort of compensation for the time you are idly spending at your station.

Some operations (I daresay most) won’t give you a dime. That is part of their business model. They might wax poetic about the situation. It is really not as much idle time as it seems to you and they are making efforts behind the scenes, etc. However, none of those nice, cheap words do anything for your paycheck.

On the rare occasion that a PPC entity did things differently — indeed made offer of a stipend to cover a temporary dearth of work before I had even asked — it gave me a strong “this is the Way” vibe. As in, “this is the way all rad groups should operate if they want to show respect and appreciation for the docs in their ranks, and I won’t soon forget that this outfit did it when others did not.”

Someone in a position of leadership might think that “this is the Way” conditions are tough to provide. They might be rare moments of opportunity, difficult to detect or only available if you happen to be in the right place at the right time to notice them. Alternatively, they might be costly, and not always affordable with limited resources.

Those cases certainly exist. You will have few complaints if you suddenly announce raises or bonuses for everyone that put your operation well ahead of the curve, but first, you will have to figure out how to pay for them. If you happen to be around when a rad is sorely beset by a demanding/abusive referrer and you back the rad up, you will practically have a superhero’s cape in his or her eyes.

There are things you can do to increase your chances of detecting and capitalizing on such incidents. However, there is much lower hanging fruit to pluck. Sometimes, all it takes is listening. Take just about any topic at all, and make a point of asking your rads (or ancillary staff): What should our way be about this, that, or the other thing? It’s a slam dunk that they will have answers for you.

Even just asking them will rightly be perceived as part of the Way.