AWESOME! A radiologist saved my nephews life! He was having trouble breathing at 16 years old. They thought it was due to asthma and his soccer playing. When in fact he had a 14 inch tumor on his chest crushing his lungs. The physician wanted to wait and the radiologist said no he needs to be intubated right now. Unfortunately, it was lymphoblastic lymphoma, but he was treated at Stanford Lucille Packard hospital, chemotherapy recovered. And is now an ER physician saving lives thank God for that radiologist.
Happy to hear he’s okay! So, serious question from a doctor abroad: are you or have you now (been) heavily indebted because of the treatment? I’m trying to get a picture of US healthcare to tell patients.
Same here. I had actually made peace with myself quite some time ago that I will never get to see it and that its better that way because thats who radiologist is and that its part of his character... seems all that wasnt needed... 😅😂
“Radio is a sound salvation Radio is cleaning up the nation They say you better listen to the voice of reason But they don’t give you any choice ‘cause they think that it’s treason So you had better do as you are told You better listen to the radio” -Elvis Costello
...I just ordered one last night around 2-3am and would like to formally offer my condolences to that particular radiologist for handling the slam of scans that come from 4 traumas showing up at once. (In my defense for the 3am CTA w/ runoff, the guy had been shot a handful of times in his gut and legs and he *did* need it. Thanks radiology!)
@@IEatChibi For trauma, we get it 100% and you will never hear us fight back. That said, I think the video is probably referring to 60 some year old with cold feet... (since trauma CT chest would be CTA.)
my problem is that the ETT stayed on there for 4 days despite I personally informing them that’s it is in the RIGHT FREAKING BRONCHUS after the last chest CT!
The reason is because the coccyx is almost always obscured by fecal matter in the rectum. You can possibly appreciate a fracture from the lateral view of the sacrum/coccyx but that’s about it
They say AI will replace radiology in 10 years, but AI will never be able to write a simultaneously seemingly innocuous but obliquely deeply insulting report that manages to throw shade on both the ordering physician and patient but provide a fist bump to the tech who got a decent image from a mess of a situation.
All right, I had to try getting ChatGPT to do it (albeit with a lot of steering): Radiology Report: Patient: John Doe Ordering Physician: Dr. Jane Smith Date: [Current Date] Study: Chest X-ray Findings: A frontal radiograph of the chest was obtained. Despite the patient’s imaginative interpretation of stillness, the image is diagnostically adequate. The lungs are clear, and the cardiac silhouette is within normal limits. No acute cardiopulmonary pathology is identified. Impression: No acute cardiopulmonary pathology detected. Commentary: Achieving diagnostic clarity under the circumstances suggests a certain resilience and skill on the part of the technologist. Future studies might benefit from enhanced preparatory measures to facilitate patient cooperation, thus ensuring optimal conditions for obtaining the best possible images.
Working in IT I was all too familiar with people who wanted stuff fixed ASAP!!!!!!! but wouldn't get off the phone. Them:"How soon is this going to be fixed? I need it now!" Me: "I'll start working on it as soon as I hang up the phone." Them: Proceed to chew my ear off for another 20 minutes. And never ever getting the hint when I keep telling "as soon as I get off the phone". I think if I hit them with a 2x4 they might blink, maybe. Maybe not.
I just do paperwork, but I've straight up told a persistent ER doctor that I could either finish my part of the work or we could keep staring at eachother
I sometimes wonder how many times I've almost lost my job because I've gotten that little bit overly snarky with a caller who doesn't understand the concept of "when I'm on the phone with you, that is literally what I'm doing. Nothing else gets done while I'm on the phone with you, up to and including what you called to bitch about not being done." If I didn't have a great boss and if I weren't paid by the hour I would have long since either killed someone or had a mental break and left to go into, like, horticulture or something (plants can't use phones).
Two things. 1. When he placed the outdoor sunglasses and the camera panned to an empty space, I expected the indoor sunglasses to be removed and in that expectation, I let out a loud - "oohhh (its finally happening)" ... [thank God I live alone, else family would think I'm crazy] 2. For some reason, I honestly expected something different/novel to see with the indoor sunglasses removed. When I saw it was just the regular face, part of me went - "well, what else were you expecting? What else could it be? Ofcourse its just the regular face!" Man... Dr. G has me glued and completely in his grasp of these skits... 😂😂
Radtech here, I try to be a barrier when working nights. Whenever I hear a physician say 'I'll just quickly call the radiologist' I advise them to not do that. 'Radiologists can prioritize completely fine, you're not the only doc, and every 20sec phonecall is a 5 minute delay on your report'. If you want him to know something that can wait I'll write it down for you. Don't interfere with them doing what they do. I don't interupt you while speaking to a patient unless I have to. People forget we're a depertment that has to be of service to the entire hospital. I'm not a d*ck because I don't want to do my job, I'm a d*ck because I can't say yes to everything. It does help when you keep betting (and winning) on whether or not a patiënt truely has whatever differential diagnosis they used to get the radiologist to do it 'stat'. We're coworkers dude, help me help you.
"I can't say yes to everything". I feel you man. I find it frustrating that we have to try and satisfy the completely different expectations of the patient, their family, ordering physician, reading radiologist, department director, and facility. Everybody wants something different, but we somehow have to keep all of these parties happy. Somebody has to get told "no" at some point, and it's really frustrating to be somebody with a 2yr associates degree trying to tell doctors and nurses what they need to do.
@@lindaking5430 my favorite was the time a resident said: 'okay, I screwed up, I should've called this order in the morning and I completely forgot. I know you're really busy, and this isn't something that deserves priority, but if you could help me out, I'd be really grateful. The specialist is here within an hour and I don't feel like getting yelled at' Needless to say, that doc gained my respect and I found a way to work her patient in regardless. I saw her again a couple years later, different hospital, she's now a specialist, and she still remembered me.
I expect it's a good camera that they really cranked the iso on for the sake of the viewers. I doubt there is another hospital specialty that could see a thing in there with how dark it really is.
Oh my God, this gave me residency flashbacks! The horror! It was during COVID. So many thorax scans, SO MANY! It came to a point that I felt like I was working at a fast food, but instead of burgers, the emergency department was screaming why the reports weren't ready and why there were pickles in it!
I have no medical qualifications, I just enjoy the videos but I had to go to A&E during covid for something else and every. single. person that went in was coughing and complaining of chest/breathing problems. The waiting room was over-crowded. I honestly don't know how you guys coped. I ended up leaving but that place was a nightmare. One person would cough, then it was like orchestra of everyone in the room coughing. Until it started again 5 minutes later. This was 1am on a weekday as well!
It’s so amazing how universal the feeling of being the one dealing with people who all think their request is the most urgent is. I felt it when the radiologist threatened to put someone’s request at the bottom of the pile.
My pharmacists/techs have learned that my "Stat" means "STAT," my "Now" means "I forgot to reorder this, I have less than an hour left," and "Routine" means "Within the next 5 hours."
I could rant for hours about this problem as a pharmacy tech. It's very frustrating when a patient asks, "Why is it gonna take 10 minutes? All you have to do is slap a label on it." LOOK, *theoretically* we can get a prescription filled in a minute or two, but that's if we drop literally everything else to do it. 10 minutes is a great wait time, compared to the average 15, 20, even 30 or more minutes. 10 minutes is me promising to go out of my way to speed up the filling process for you. Seeing as literally every person working in the pharmacy is juggling at least 3 tasks at one time, it's gonna take a bit. If it's a slow day and there's not much going on, it won't be a problem. But usually, there's a line of people up front, there are two phone lines ringing, three people just dropped off paper prescriptions (which have to be checked to make sure they're valid, then they have to be scanned), eleven prescriptions are in the data entry queue, at least fifteen are waiting to be counted/filled, and I'm still trying to get your Medicare to play nice. Believe it or not, other people want their meds ASAP too, and there's much more involved in the filling process than you'd think
As a rad tech, I felt so much of this and I also see how much this happens to radiologists! It is too funny because it is all true. Honestly, it wasn't even exaggerated for the skit! Except maybe the rad answering the phone that much, lol.
Tech too, for internal calls the rad just handle the phone and ask to say he is away or occupied. As he says, if it's that urgent the doc can walk here in less than 5 minutes.
I've admittedly spent a lot of time calling radiologists at the behest of angry attendings, so I'm never on this side of the call, but the "rib xray" bit made me smile.
@@GNdynames What this guy said. Plus there is essentially no treatment for uncomplicated rib fractures that don't involve the lungs. (A quick chest x-ray will confirm or exclude a collapsed/punctured lung.) So it's kind of like a picture to answer a question that doesn't matter.
@@KD-vf6yq As everyone else has said, there's no reason to not get a full chest x-ray. Hence, "rib x-ray" isn't really a thing. It's like calling in an order at McDonald's for a bun. a) Why, and b) there are better ways to get that.
As a rad resident this is so accurate. I love how initially he's friendly and jovial. As the day progresses (and list of pending studies to read blows out), he starts getting more and more irate. STOP CALLING ME SO I CAN ACTUALLY REPORT THE DAMN STUDY!!!!
Having had two head injuries that required CT Scans, I am forever grateful to radiologists. But MY FAVOURITE hospital employee was the one who did my tox screen and told the ER doctor that I was in fact stone cold sober (which I had been telling him for nearly 3 hours after dislocating my shoulder in a fall at 1 AM at a food show) which allowed him to give me an opiate painkiller which made me smile and sing like a chickadee as the agonizing pain slipped away!!! You see, I had fallen behind a bar tent at the said food show and fell face down into a muddy puddle of thrown out alcohol, then when the EMT’s came to retrieve me, they turned me over in the same puddle…so I stank from head to toe like a cheap distillery!!!
I have to give props to the on call radiologist at my local hospital last night. My chest x-ray came back looking relatively normal, but the radiologist spotted something odd and called for an immediate CT followup. He sure as hell found something in there. So, uh, yeah. Real glad he prioritized that report. Also, if you have any thoracic surgeon skits waiting in the wings, that would certainly be timely.
My RN wife mentioned that you need to do the day surgery center candy drawer that can hold a Costco size bag of candy but gets decimated in 2 days. Love the channel, signed hospital CT Tech.
Every single time some clueless clinician calls us, the worklist slows down for EVERYONE. We know you want it now. We know you think you're more important than everyone else. We try to handle the potentially lethal findings first. We know the worklist is long. Stop calling us. You're just making it worse for yourself and everyone. Thank you. Have a nice day.
I'm also a radiographer. I was asked to xray a coccyx after a failed coccygeal pain injection. The patient didn't have a coccyx! Sometimes it's worthwhile!
This is hilarious! the 3AM complex scan was perfect. Just needed a dash of "oh no, I'm going to have to tell the CT guys to do this" despair. I'm a radiographer (X-ray tech) so very familiar with the "is it Actually urgent or are you just asking for it to be done soon?" thing. Sorting those calls into an actual priority list is a constant dynamic situation; we take calls from the whole hospital so your call may need to wait a few mins for a much sicker patient in another place.
yep, i'm at the point where i tell em straight lol, i legit had an ER nurse call us to ask if i could do this ladys shoulder urgently and i replied sorry i have two pneumothoraxes ad a mystery ailment from resus at the top of my list, no can do. she hated me for the rest of the shift lmao
I remember some interesting nights when I was kid going into the hospital with my dad when he was on call. Light panels are pretty cool when you’re 5 years old.
The threat about leaving medicine in the next 20 minutes is so relatable. I was in charge of the Training Room when in the military (keeping the records for every member of the company, arranging and tracking ranges, special school assignments, organizing training exercises, and more) so this mimicked my day with Platoon Leaders, Shop Managers, alllll the command staff, everyone in the unit that ever had to be taught how to use the copier and fax machine because the only ones were in my office and apparently they were High Tech.... ....as military I couldn't threaten to quit, but there were so many days that paralleled this sketch that on a few days I threatened my (technically....) office manager with suddenly "forgetting" how to do my job.
The biggest gripe radiology had at my training institution was their reading room allowed badge access to all physician badges. So many curbside acute care surgery wet read ambushes.
But thise were helpful. And honestly our radiologists were usually cool if it was between 8am and 3 pm. After the witching hour of 3, all bets were off
at the major hospital i trained at as a radiographer there was a CT scanner tacked on to resus and all the staff could come into our control room and see it over our shoulder as it came up. a looooot of "oh shit thats a big bleed get em back quick!" happening, and i think it was bet that they were used to looking at them and moving fast in those scnarios, hence why they kept coming in
@@tejaswoman There are two issues. (EMT here, I'll let experts provide correction) An endotracheal tube can end up out-of-place. This either means outside of the trachea so that air probably isn't getting into the lungs, or it can end up shoved down to far past the carina so that it is only ventilating one lung. The way they evaluate that in the hospital is via x-ray as they can ensure the tube is still in the correct place. If you have a tube significantly displaced, the amount of time required to get an x-ray taken and read is long enough that the patient would potential be without oxygen such that they are now dead. The other is that people who are intubated are almost always sedated. "Shortness of breath" is a subjective symptom, not an independently measured objective value (though there are related objective measurements like pulse oximetry and blood gas values). If the patient is still "short of breath" it probably means that they aren't sufficiently sedated. Moreover, it probably means that the doctor is focusing on the wrong thing. They should be looking to see if eg. a pneumonia is clearing up after antibiotics or if other lab values are improving.
@@tejaswoman The other reply is correct, an intubated patient can't tell you they are short of breath because they are unconscious. People ordering radiology studies don't always give accurate histories - they just give a generic history which is sometimes not correct and can get radiologists into trouble.
@@pianoforte611 bro you can get struck of for performing an unjustified xray, good thing is they never persue that because if they did they'd have to strike everybody off. Doctors can be absolute and utter clowns
Pretty good! Missed an opportunity to parody asking the physician demanding the report for some clinical information and finding out they haven't seen the patient yet.
As both a patient and a former patient care tech, my only complaint about radiologists is that we don't have enough of them. If you want your scans read in timely manner, hire enough people to do it! Also, thank you to the radiologist who found my PVT when no one else could figure out why I couldn't stop puking for a week and a half.
@@tejaswoman Your device might have misheard it as "DVT" or deep vein thrombosis, which is usually in the leg. PVT is portal vein thrombosis, a clot in the hepatic portal vein. That's the vein that runs from the small intestine to the liver. Sorry I didn't think to explain it before.
i saw a statistic recently that the nhs has 60% of the radiologists it needs to run efficiently. it tries to plug the gap with overtime and outsourcing to private companies, but its still not enough. i often think radiology is a forgotten department in general by the big wigs despite it being vital
If only it was like that. I’m an x-ray tech, and I’m the one who has to take all those calls because the hospital decided that I’m the hub for all of imaging when it comes to the radiologist. They can’t call directly or the hospital will implode so they call me and I have to transfer them. They usually/mysteriously get “cut off” and then ask my opinion, report, or the managers phone #. Or house supervisor comes down thinking I’m the radiologist because some one mad called them.
that sounds really awful. I also get all of these calls but the difference is there actually IS a number for our radiologist and its not me! but they cba to ring switch and get the right one lmao. i also get calls for every other kind of damn scan and i feel like that "noooo, this is atrick" meme when i've aid for the billionth time no, you're rang A&E xray, for xrays in A&E....
Don't forget the random calls by neurologists at 2am. "My patient has a tingly sensation in his arm. Drop everything you are doing right now and let's roll."
You joke but a few months ago I had a stat chest and neck CT ordered by neurology on call for “possible Horner syndrome” (for those who don’t know, look it up) in a patient with metastatic lung cancer and confirmed brain metastasis by MRI a few days ago and staging CT CAP within the admission..
I once had a patient with "tingly sensation in arm" that was progressively getting worse, history of tia, no other symptoms, this was on a detox floor. Had a weird gut feeling and thankfully was able to get them sent to medical hospital for evaluation... Patient ended up having a massive hemorrhagic stroke. It happens sometimes
@@kates5183 Don't let my jesting tone confuse you. I am in neurology and if I see a sudden onset hemihypesthesia, I will call a code stroke and make radiology drop everything. I just acknowledge that I am just being annoying from their pov 9 times out of 10.
My daughter had a marathon midnight-to-2am MRI for neuro issues once, so I hear you and appreciate your work ;). ps between the fact that the first 5 seconds of this video describes her perfectly and her now-extensive experience in the field, she wants to be a radiologist
I’m a radiologist. It is accurate. In fact an ER assistant yanked the battery out of my on-call phone when I had to leave it outside a patient room to do a nonsense ultrasound during COVID era.
Pretty much everyone who work in Healthcare but who are not nurses or doctors. Yes, folks, it's not just those two jobs in the healthcare system. As a matter of fact, many of us work very hard to that those two groups of morons don't actively make your health worse.
As an internal medicine resident I had 10 months of intermittent severe nausea & vomiting. Although the radiologist didn’t want to, my doctor insisted on a small bowel follow through, which showed nearly complete bowel obstruction due to Crohn’s Disease! PS. I am an ID doc and love your portrayal of us. I never realized my obsession with chart reviews was a characteristic of my specialty!
Crohn’s is a bitch. Hopefully some of the work being done on immunotherapy will be able to lessen it soon. I have a good friend with Crohn’s and boy let me tell you it almost drove them off the deep end.
A CTE or MRE is way more accurate and informative for your situation as they could evaluate the mesentery and bowel wall thickness as well. Small bowel through is really outdated for most applications.
This video is about the on call life. So SBFT during the day or regular outpatient study is usually acceptable unless the indication given make no sense. Asking for SBFT at 2 am stat is just annoying for most rads
_>when is my (routine scan that should just be done outpatient) getting done?!_ >Oh my, yes, as soon as possible. Has Mr Smith been npo for at least 6 hours? _>No_ >I see, when did he last eat? _>Right now._ >Ah, well, seeing as its Friday afternoon the earliest we will be able to scan him is now monday morning. _>WHAT but we want to discharge him!_ >Sounds great! We'd be happy to do his scan outpatient. In fact, it looks like he's been on the schedule for us next week for the last month. _>How dare you I WANT IT NOW._ -Actual conversation i have had a million times🫠
theres something hilariously depressing about everyone demanding radiology do this and that now but doing NONE of the prep they KNOW they need to do beforehand. But as we like to say, its always xray's fault, even when they aren't involved lol
It’s true, can’t imagine how overwhelmed our radiology colleagues are. As a PICU fellow I always find that I learn so much whenever I have a discussion with our radiology colleagues. They always take the time to explain their perspective and findings. Maybe our radiologists are more patient because they’re Peds radiologist😂
Love the bit about ordering chest, abdomen, and pelvis CT with lower extremity run-offs! The worst studies are noncon C/A/P CT ordered on an ICU pt at 2 AM.
Yes, but when a noncon pan-CT is ordered at 2 am from the ICU, it’s because the patient has acute kidney failure with a potassium of 6, lactate higher than their Hgb, b/l PNA, ARDS, a PTX, acalculus cholecystitis and ischemic possibly ruptured bowel while on four pressors… that said, at that point, goals of care discussion is probably more appropriate than a CT scan but we’re eternally optimistic 😂
@@rayaterry5365 Those CTs are actually pretty easy to read so we don't mind lol it is almost always the same (something something third spacing something something -itis cannot be excluded on the basis of imaging, for clinical correlation.)
Oh, the "addend my report? I'll see you in hell before I'll addend my report" hits hard. I did IT for a Radiology departement for 6 years. Radiologists NEVER addend a report. Rather, they call the PACS manager with "Yeah, can please copy the text of study xxxxxx, send me the text, reset the study status to "examination finished " and then delete the report? Thanks" In the beginning I kept suggesting "you can add an addendum" but I quickly found out that rather than having their mistakes visible for all to see, they rather will misuse the system to hide their mistakes, and cause unnecessary work for others....
Will have to disagree, we addend our reports (especially if it's our own report). If it's a different attending's report then it depends - I always discuss with the reporting attending first.
@@deathlessride Different hospital, different culture, apparently. I loved working for the radiology department, but this was a weird quirk that always annoyed me.
our definitely addend them, the trouble is our system is dogshit and once certain codes of reports have gone through they actually cannot be changed lol, because why would we ned a decent IT system for something important???
Only one missing was the 'Super Stat' at 0400 because patient is discharging in morning and they need to know if the patient has TB on a fourteen hour old Dr order.
I had to have a radiologist addend a report. I had an abdominal CT scan, and the report stated that my appendix was normal. I was a bit confused as my appendix was removed in 1986.
To be fair those things can be pretty small (when not inflamed) and hard to find. About half of the abd scans I perform are read as "appendix not definitively appreciated" (ie: they can't find it).
I had a routine mammogram this past week and, after the scans, was brought into the radiologist's room who was reading them as they were done for an initial report. Had to stop myself from giggling in the totally dark room, set up with about 6-7 fancy-schmacy computer monitors!! Your portrayal of radiology is spot on! So funny!
EM would rather not be dealing with this sort of mess as well, trust me. But it is what it is, and sometimes that's a big ol' CT scan at an ungodly hour vs an autopsy on a more leisurely schedule.
In the radiology rotation video there's a bit about ER overheating the CT scanner. ER is always serious about adding even more CT exams... and they're serious about yelling at CT techs as to why their 20 STAT scans with/without contrast haven't been done in 20 minutes.
A radiologist flagged my osteoporosis when i had a shoulder xray. I had been asking my doctors why i kept breaking bones and shouldn’t we do a bone scan? They replied that the breaks were from falling and breaks were normal. And i was too young for a bone scan. Radiologist said my bones were “delaminated way beyond normal for a person of my age.”. This was Sutter managed care nightmare which also doomed my kidneys. Just switched to Stanford. Hopefully my new doctor believes in listening to patients.
The idea that "breaks from falling is normal" in a person who's simultaneously "too young for a bone scan" 😳🤦🏻♀️ My mother's 87 years old, has twice in 10 years fallen badly enough for a pelvic fracture, and still doesn't break bones every time she falls, so I'm flabbergasted by the notion anybody would claim it's normal.
Love it. I train CRAs who work reviewing Clinical Drug Trials. I'm always trying to explain to them how Hospital Doctors interact with Radiology... I think this will help.
Good on you for doing that. Unfortunately I have to say the research people I unfortunately have to deal with are some of the most inconsiderate people ever: “We need you to stat re-stage this patient because he’s getting randomized for this trial this morning” - the ER and ICU docs are not anywhere close to being this demanding.
@@GNdynames Oh Dear. I'm really sorry to hear that Researchers & CRAs etc are so unreasonable. Too many of them have very limited understanding of the realities of Hospitals & patient managment. *sigh*
The calls are often even worse in private clinics. 'You want the report knee XR on a 80yo to confirm OA? That you ordered an hour ago. Because they came straight back by accident?'
former radiographic assistant who worked the acute ct scanner here - the moment you said "the only one here who works for the entire hospital" i knew you were gonna be on point. our last head of service used to have a saying, "the only speciality that doesn't send anyone to us is dermatology", and now not even that is true! i now work in outpatient appointments, and if i had a penny for every time i've had doctors on the line bitching about their outpatients not being seen within a day, i'd have enough to retire and i'm not even thirty yet.
… I always knew you were Impressive Dr. G. I… damn. I never knew how much. All of y’all need to fall down the rabbit hole I did and learn about this man’s life, attitude, how much he’s given. Thank you, sir. WF FTW
praise radiologists! back in 2019, i had blunt pain along my 5th intercostal space. my classmate (who's an RN) auscultated me and told me he thinks i needed an xray AP/lateral views because he thought i may have pneumonia. the next day, i had the xrays done and was informed that i'd get my results the day after. i get a call 4 hours after. the radiologist tells me i need to go straight to the ER because i had a pneumothorax. i had a thoracostomy shortly after being admitted. if i didn't get that call, i would have had a complete pneumothorax by night time.
The bit on addendums hit close to home! I used to work in an administrative role at a teleradiology company, and those calls from facilities asking for addendums were some of the harder ones to relay.
Computer programmer here, frustrated and getting blunt to get the point across: "The sooner I get off the phone, the sooner I can fix your issue. You choose." Then I went silent.
@@mattsoukup1789 Short version is they are of limited sensitivity for acute fracture and are of little diagnostic value versus a simple clinical exam (thats when doc pokes around on you to see what hurts) that could likely provide similar information. If there is concern for severe acute injury, a CT scan is preferred. Additionally, there is very little in the way of treatment for coccyx fractures beyond a ring-pillow to sit on. So it's a picture to answer a question that doesn't usually matter. All of this applies to rib x-rays also.
Ah tge memories! 1987, right out of a hospital based radiologic technology program and straight to night shift in a major children’s hospital. We ran interference for our on call residents and fellows. No one had the number to the room but us. And yes, your orders were routinely changed by us with the department head’s permission. Also, bug us and your films (yes hold in your hand films) went straight to the bottom of the pile.
As a Radiologist I approve this message. I was on call today (technically still backup). But I’m also again on Thursday-July 4th--one of the worst holidays ever made……
YES exactly this! People just tend to forget you are literally the ONLY radiologist standing by at night. For every unnecessary call that we need to pick up, it delays the rate we release reports.. hence the backlogs. Call it a a vicious cycle if you would like.
Hubby had to Heimlich me on Christmas night. Boxing day I was in so much agony that I couldn't believe it. Rib x-ray revealed he had broken two ribs. Is there some reason NOT to x-ray ribs?
@Joy21090 Rib fractures are often undisplaced and hard to identify on xrays. Also, because ribs can't be splinted/supported, there's no reason to xray them...other than to maybe confirm a fracture.
@@Joy21090 basically they probably wouldn't do anything for it anyway unless its catastrophic, in which case you'd need an xray and probably a CT for way more serious reasons lol. The idea is if you're not doing anything with the information then why do you need the information?
@@katierasburn9571 "Just because the patient wants to know" isn't a sound medical reason, eh? As a patient I want to know if it's broken, strained, sprained, or just bruised... Even if the treatment is the same (time, ice, rest). I don't know *WHY* I want to know the distinction, but I absolutely do. (Well, part of the reason is a job - taking time off work for *broken ribs* sounds more reasonable than taking time off for strained ribs.)
![Veeze - F.A.F (ft. Rylo Rodriguez) [Official Music Video]](http://i.ytimg.com/vi/7hlz2S2GmIY/mqdefault.jpg)
AWESOME! A radiologist saved my nephews life! He was having trouble breathing at 16 years old. They thought it was due to asthma and his soccer playing. When in fact he had a 14 inch tumor on his chest crushing his lungs. The physician wanted to wait and the radiologist said no he needs to be intubated right now. Unfortunately, it was lymphoblastic lymphoma, but he was treated at Stanford Lucille Packard hospital, chemotherapy recovered. And is now an ER physician saving lives thank God for that radiologist.
I'm really happy that he recovered and is doing good. ❤
I hope you also thanked the radiologist lol
They are the best for what they do that hospital has also saved my life
Happy to hear he’s okay! So, serious question from a doctor abroad: are you or have you now (been) heavily indebted because of the treatment? I’m trying to get a picture of US healthcare to tell patients.
I smell Bs. there’s no way the radiologist got credited by this
I think this is a stunt double playing the radiologist. A true radiologist wouldn't take their sunglasses off in front of a bright ring light.
ISO setting on the radiologist's camera goes to 16,000. The room would nearly pitch black to us mortals.
" stunt double " LOL 😂😂😂
LOL!
He clearly didn’t study his role thoroughly.
I never thought I'd see the eye reveal of the radiologist
Same here. I had actually made peace with myself quite some time ago that I will never get to see it and that its better that way because thats who radiologist is and that its part of his character... seems all that wasnt needed... 😅😂
There's 4 UV filters over the windows.
@@mark-ish what windows? Why would there be windows in the radiology basement? And what would a UV filter on windows do for the screens?
I don't know why I'm scandalized. It's like seeing a nun with her hair down.
Like seeing Haley’s Comet.
Only once per lifetime. Except for Johnathon.
"Okay so let me clear this up for you... Just because my specialization has the word radio in it, does not mean you have to keep calling me."
Radio?! lol jeez.
Long time listener, first time caller, LOVE your show!
“Radio is a sound salvation
Radio is cleaning up the nation
They say you better listen to the voice of reason
But they don’t give you any choice
‘cause they think that it’s treason
So you had better do as you are told
You better listen to the radio”
-Elvis Costello
😂😂😂😂😂
As a radiologist myself, I can confirm that ordering a TAP scan that runs off to bilateral extremities after 2 am IS an HR violation !
...I just ordered one last night around 2-3am and would like to formally offer my condolences to that particular radiologist for handling the slam of scans that come from 4 traumas showing up at once. (In my defense for the 3am CTA w/ runoff, the guy had been shot a handful of times in his gut and legs and he *did* need it. Thanks radiology!)
Is that what IR residents are for?
@@IEatChibi For trauma, we get it 100% and you will never hear us fight back. That said, I think the video is probably referring to 60 some year old with cold feet... (since trauma CT chest would be CTA.)
Need to call the on-call HR person. If such a person exists :)
As a radiologist, I concur. 😂
He took both sunglasses! THE INDOOR SUNGLASSES! this is his natural habitat!
good night more on the camera!
Don't worry, he was probably wearing 2 more pairs.
@@Theguywholikedthethinginthevid He was wearing his polarised contact lenses!
As a Radiologist who only works nights and covers 18 hospitals, I have never felt so seen. 😎😎
...18? What do they think you are, the district mascot?
Holy schmoley! You must walk on water in your free time.
18 hospitals?
you probably living your nightmare on 4th of July
You and a few other radiologists... right? If not, oh my god.
Yes. Part of a team, but like all on call Rads, every shift has become trying to drink from a firehose all night.
Lol. Pretending to just be an answering machine is a 5 star move.
True genius!
Love that coffee cup…”Go Away…I’m Introverting”
Thank you! I couldn't stop the vid at the right spot to read it.
I need that on a sign.
I need that coffee cup honestly. ❤
As a radiologist who is currently on night call, this is incredibly accurate. The endotracheal tube shortness of breath made me howl.
If you don't mind my asking what was the deal with never X-raying the Coccyx?
And when you're done with that question, explain about the tube thing?
This subtle one hasn't gotten enough comment love!
my problem is that the ETT stayed on there for 4 days despite I personally informing them that’s it is in the RIGHT FREAKING BRONCHUS after the last chest CT!
The reason is because the coccyx is almost always obscured by fecal matter in the rectum. You can possibly appreciate a fracture from the lateral view of the sacrum/coccyx but that’s about it
They say AI will replace radiology in 10 years, but AI will never be able to write a simultaneously seemingly innocuous but obliquely deeply insulting report that manages to throw shade on both the ordering physician and patient but provide a fist bump to the tech who got a decent image from a mess of a situation.
This right here!! You win!😂😂🙌🏻
Aaaamen!
All right, I had to try getting ChatGPT to do it (albeit with a lot of steering):
Radiology Report:
Patient: John Doe
Ordering Physician: Dr. Jane Smith
Date: [Current Date]
Study: Chest X-ray
Findings:
A frontal radiograph of the chest was obtained. Despite the patient’s imaginative interpretation of stillness, the image is diagnostically adequate. The lungs are clear, and the cardiac silhouette is within normal limits. No acute cardiopulmonary pathology is identified.
Impression:
No acute cardiopulmonary pathology detected.
Commentary:
Achieving diagnostic clarity under the circumstances suggests a certain resilience and skill on the part of the technologist. Future studies might benefit from enhanced preparatory measures to facilitate patient cooperation, thus ensuring optimal conditions for obtaining the best possible images.
or if they're feeling really put out, they'll slate the positioning too
Those of us techs that have been around a bit really appreciate this. We spot it immediately.
Totally true. And for every radiologist saying “Why the f*** are you ordering this?!” is an X-ray Tech saying “Why the f*** are you ordering this?!”
As that tech... Why does anyone want a barium enema anymore? Radiology has indeed progressed in the past 100 years
@novachair6476 because the patient pissed the doctor off, and he wants them to suffer.
Esp when it's an xray when they also ordered a CT of the same area. Or ANY abdomen xray not for foreign body
AND ultrasound!🤣
Yes
Working in IT I was all too familiar with people who wanted stuff fixed ASAP!!!!!!! but wouldn't get off the phone. Them:"How soon is this going to be fixed? I need it now!" Me: "I'll start working on it as soon as I hang up the phone." Them: Proceed to chew my ear off for another 20 minutes. And never ever getting the hint when I keep telling "as soon as I get off the phone". I think if I hit them with a 2x4 they might blink, maybe. Maybe not.
In the old days in IT helpdesk we used to call that a "clue-by-four", and a surprising number of people were in need of vigorous application.
I just do paperwork, but I've straight up told a persistent ER doctor that I could either finish my part of the work or we could keep staring at eachother
I sometimes wonder how many times I've almost lost my job because I've gotten that little bit overly snarky with a caller who doesn't understand the concept of "when I'm on the phone with you, that is literally what I'm doing. Nothing else gets done while I'm on the phone with you, up to and including what you called to bitch about not being done." If I didn't have a great boss and if I weren't paid by the hour I would have long since either killed someone or had a mental break and left to go into, like, horticulture or something (plants can't use phones).
@@emilycarruthers1675
"Plants can't use phones"
That's where you're wrong! Google it. They make clicking sounds!
2x4 therapy
Two things.
1. When he placed the outdoor sunglasses and the camera panned to an empty space, I expected the indoor sunglasses to be removed and in that expectation, I let out a loud - "oohhh (its finally happening)" ... [thank God I live alone, else family would think I'm crazy]
2. For some reason, I honestly expected something different/novel to see with the indoor sunglasses removed. When I saw it was just the regular face, part of me went - "well, what else were you expecting? What else could it be? Ofcourse its just the regular face!"
Man... Dr. G has me glued and completely in his grasp of these skits... 😂😂
Could of been wearing one of those skin tight temporary sunglasses you get when they dilate your eyes.
Radtech here, I try to be a barrier when working nights. Whenever I hear a physician say 'I'll just quickly call the radiologist' I advise them to not do that. 'Radiologists can prioritize completely fine, you're not the only doc, and every 20sec phonecall is a 5 minute delay on your report'. If you want him to know something that can wait I'll write it down for you. Don't interfere with them doing what they do. I don't interupt you while speaking to a patient unless I have to.
People forget we're a depertment that has to be of service to the entire hospital. I'm not a d*ck because I don't want to do my job, I'm a d*ck because I can't say yes to everything. It does help when you keep betting (and winning) on whether or not a patiënt truely has whatever differential diagnosis they used to get the radiologist to do it 'stat'.
We're coworkers dude, help me help you.
"I can't say yes to everything".
I feel you man. I find it frustrating that we have to try and satisfy the completely different expectations of the patient, their family, ordering physician, reading radiologist, department director, and facility. Everybody wants something different, but we somehow have to keep all of these parties happy. Somebody has to get told "no" at some point, and it's really frustrating to be somebody with a 2yr associates degree trying to tell doctors and nurses what they need to do.
Nuc Med Tech here, I had a doc verbally ask for a "Super STAT" scan! I laughed!😅
@@lindaking5430 In NukeMed, where almost every scan includes at least 20min of distribution time?
@@lindaking5430 my favorite was the time a resident said: 'okay, I screwed up, I should've called this order in the morning and I completely forgot. I know you're really busy, and this isn't something that deserves priority, but if you could help me out, I'd be really grateful. The specialist is here within an hour and I don't feel like getting yelled at'
Needless to say, that doc gained my respect and I found a way to work her patient in regardless. I saw her again a couple years later, different hospital, she's now a specialist, and she still remembered me.
Thank you so much for this very important part of your service. They're lucky to have you
It's incredible how far night-vision videography has come to capture such crisp details of the radiologist in his natural habitat.
Beep boop beep, yeah you'll get thin cuts is absolutely hilarious
"But we already do the thinn.." "Shut up and say yes"
He took off the sunglasses? Is he wearing sun-contact lenses?
Oddly, those do exist.
I expect it's a good camera that they really cranked the iso on for the sake of the viewers. I doubt there is another hospital specialty that could see a thing in there with how dark it really is.
Oh my God, this gave me residency flashbacks! The horror! It was during COVID. So many thorax scans, SO MANY! It came to a point that I felt like I was working at a fast food, but instead of burgers, the emergency department was screaming why the reports weren't ready and why there were pickles in it!
I have no medical qualifications, I just enjoy the videos but I had to go to A&E during covid for something else and every. single. person that went in was coughing and complaining of chest/breathing problems. The waiting room was over-crowded. I honestly don't know how you guys coped. I ended up leaving but that place was a nightmare. One person would cough, then it was like orchestra of everyone in the room coughing. Until it started again 5 minutes later. This was 1am on a weekday as well!
It’s so amazing how universal the feeling of being the one dealing with people who all think their request is the most urgent is. I felt it when the radiologist threatened to put someone’s request at the bottom of the pile.
I've seen it happen
At work, we've decided that every specimen are now STAT since no doctor or nurse seem to understand the concept.
My pharmacists/techs have learned that my "Stat" means "STAT," my "Now" means "I forgot to reorder this, I have less than an hour left," and "Routine" means "Within the next 5 hours."
As the sole pharmacy employee working the graveyard shift, I feel this in my bones
I could rant for hours about this problem as a pharmacy tech. It's very frustrating when a patient asks, "Why is it gonna take 10 minutes? All you have to do is slap a label on it." LOOK, *theoretically* we can get a prescription filled in a minute or two, but that's if we drop literally everything else to do it. 10 minutes is a great wait time, compared to the average 15, 20, even 30 or more minutes. 10 minutes is me promising to go out of my way to speed up the filling process for you. Seeing as literally every person working in the pharmacy is juggling at least 3 tasks at one time, it's gonna take a bit. If it's a slow day and there's not much going on, it won't be a problem. But usually, there's a line of people up front, there are two phone lines ringing, three people just dropped off paper prescriptions (which have to be checked to make sure they're valid, then they have to be scanned), eleven prescriptions are in the data entry queue, at least fifteen are waiting to be counted/filled, and I'm still trying to get your Medicare to play nice. Believe it or not, other people want their meds ASAP too, and there's much more involved in the filling process than you'd think
As a rad tech, I felt so much of this and I also see how much this happens to radiologists! It is too funny because it is all true. Honestly, it wasn't even exaggerated for the skit! Except maybe the rad answering the phone that much, lol.
lol they just ignore it to preserve whats left of their sanity
Tech too, for internal calls the rad just handle the phone and ask to say he is away or occupied.
As he says, if it's that urgent the doc can walk here in less than 5 minutes.
I've admittedly spent a lot of time calling radiologists at the behest of angry attendings, so I'm never on this side of the call, but the "rib xray" bit made me smile.
Is it pointless to X-ray a rib? I didn’t get that part, can you explain? 😊
You order chest X-Ray AP and lateral. At least in my day.
They’re of limited utility and sensitivity. If it really matters get a CT, or treat the patient and not the film findings.
@@GNdynames What this guy said. Plus there is essentially no treatment for uncomplicated rib fractures that don't involve the lungs. (A quick chest x-ray will confirm or exclude a collapsed/punctured lung.) So it's kind of like a picture to answer a question that doesn't matter.
@@KD-vf6yq As everyone else has said, there's no reason to not get a full chest x-ray. Hence, "rib x-ray" isn't really a thing.
It's like calling in an order at McDonald's for a bun. a) Why, and b) there are better ways to get that.
As a rad resident this is so accurate.
I love how initially he's friendly and jovial. As the day progresses (and list of pending studies to read blows out), he starts getting more and more irate.
STOP CALLING ME SO I CAN ACTUALLY REPORT THE DAMN STUDY!!!!
Radiologist here...love your videos. Certainly nice to see there are at least some other docs who understand our plight. Keep up the good work!
Having had two head injuries that required CT Scans, I am forever grateful to radiologists.
But MY FAVOURITE hospital employee was the one who did my tox screen and told the ER doctor that I was in fact stone cold sober (which I had been telling him for nearly 3 hours after dislocating my shoulder in a fall at 1 AM at a food show) which allowed him to give me an opiate painkiller which made me smile and sing like a chickadee as the agonizing pain slipped away!!!
You see, I had fallen behind a bar tent at the said food show and fell face down into a muddy puddle of thrown out alcohol, then when the EMT’s came to retrieve me, they turned me over in the same puddle…so I stank from head to toe like a cheap distillery!!!
Great story but I'm sorry you had to go through this!
I bet the radiologist only uses this emoji 😎 because none of the others have sunglasses
I have to give props to the on call radiologist at my local hospital last night. My chest x-ray came back looking relatively normal, but the radiologist spotted something odd and called for an immediate CT followup. He sure as hell found something in there. So, uh, yeah. Real glad he prioritized that report. Also, if you have any thoracic surgeon skits waiting in the wings, that would certainly be timely.
My RN wife mentioned that you need to do the day surgery center candy drawer that can hold a Costco size bag of candy but gets decimated in 2 days. Love the channel, signed hospital CT Tech.
Every single time some clueless clinician calls us, the worklist slows down for EVERYONE. We know you want it now. We know you think you're more important than everyone else. We try to handle the potentially lethal findings first. We know the worklist is long. Stop calling us. You're just making it worse for yourself and everyone. Thank you. Have a nice day.
As a Radiographer, "Don't XR the coccyx" allowed me to ascend to a higher plane; and then rib XR was mentioned XD
I'm also a radiographer. I was asked to xray a coccyx after a failed coccygeal pain injection.
The patient didn't have a coccyx!
Sometimes it's worthwhile!
This is hilarious! the 3AM complex scan was perfect. Just needed a dash of "oh no, I'm going to have to tell the CT guys to do this" despair. I'm a radiographer (X-ray tech) so very familiar with the "is it Actually urgent or are you just asking for it to be done soon?" thing. Sorting those calls into an actual priority list is a constant dynamic situation; we take calls from the whole hospital so your call may need to wait a few mins for a much sicker patient in another place.
yep, i'm at the point where i tell em straight lol, i legit had an ER nurse call us to ask if i could do this ladys shoulder urgently and i replied sorry i have two pneumothoraxes ad a mystery ailment from resus at the top of my list, no can do. she hated me for the rest of the shift lmao
I remember some interesting nights when I was kid going into the hospital with my dad when he was on call. Light panels are pretty cool when you’re 5 years old.
The threat about leaving medicine in the next 20 minutes is so relatable. I was in charge of the Training Room when in the military (keeping the records for every member of the company, arranging and tracking ranges, special school assignments, organizing training exercises, and more) so this mimicked my day with Platoon Leaders, Shop Managers, alllll the command staff, everyone in the unit that ever had to be taught how to use the copier and fax machine because the only ones were in my office and apparently they were High Tech....
....as military I couldn't threaten to quit, but there were so many days that paralleled this sketch that on a few days I threatened my (technically....) office manager with suddenly "forgetting" how to do my job.
The biggest gripe radiology had at my training institution was their reading room allowed badge access to all physician badges. So many curbside acute care surgery wet read ambushes.
But thise were helpful. And honestly our radiologists were usually cool if it was between 8am and 3 pm. After the witching hour of 3, all bets were off
at the major hospital i trained at as a radiographer there was a CT scanner tacked on to resus and all the staff could come into our control room and see it over our shoulder as it came up. a looooot of "oh shit thats a big bleed get em back quick!" happening, and i think it was bet that they were used to looking at them and moving fast in those scnarios, hence why they kept coming in
0:45 I suspect most people missed the joke. Shortness of breath in an intubated patient.
Thank you for the explanation, but I still don't quite get it. What was the caller trying to find out that is already obvious?
@@tejaswoman There are two issues. (EMT here, I'll let experts provide correction)
An endotracheal tube can end up out-of-place. This either means outside of the trachea so that air probably isn't getting into the lungs, or it can end up shoved down to far past the carina so that it is only ventilating one lung. The way they evaluate that in the hospital is via x-ray as they can ensure the tube is still in the correct place. If you have a tube significantly displaced, the amount of time required to get an x-ray taken and read is long enough that the patient would potential be without oxygen such that they are now dead.
The other is that people who are intubated are almost always sedated. "Shortness of breath" is a subjective symptom, not an independently measured objective value (though there are related objective measurements like pulse oximetry and blood gas values). If the patient is still "short of breath" it probably means that they aren't sufficiently sedated. Moreover, it probably means that the doctor is focusing on the wrong thing. They should be looking to see if eg. a pneumonia is clearing up after antibiotics or if other lab values are improving.
@@tejaswoman The other reply is correct, an intubated patient can't tell you they are short of breath because they are unconscious. People ordering radiology studies don't always give accurate histories - they just give a generic history which is sometimes not correct and can get radiologists into trouble.
@@pianoforte611 bro you can get struck of for performing an unjustified xray, good thing is they never persue that because if they did they'd have to strike everybody off. Doctors can be absolute and utter clowns
This is why everyone needs a radiology reading room assistant. If only corporate would have understood. Seriously someone hire me.i know my stuff
A radiology "Jonathan"?
@@nickdfoxy pretty much *nods head*
Pretty good! Missed an opportunity to parody asking the physician demanding the report for some clinical information and finding out they haven't seen the patient yet.
As both a patient and a former patient care tech, my only complaint about radiologists is that we don't have enough of them. If you want your scans read in timely manner, hire enough people to do it!
Also, thank you to the radiologist who found my PVT when no one else could figure out why I couldn't stop puking for a week and a half.
Got my smart speaker to explain what this is for the rest of us: it's a type of vein thrombosis (clot) behind your knee.
@@tejaswoman Your device might have misheard it as "DVT" or deep vein thrombosis, which is usually in the leg. PVT is portal vein thrombosis, a clot in the hepatic portal vein. That's the vein that runs from the small intestine to the liver. Sorry I didn't think to explain it before.
i saw a statistic recently that the nhs has 60% of the radiologists it needs to run efficiently. it tries to plug the gap with overtime and outsourcing to private companies, but its still not enough. i often think radiology is a forgotten department in general by the big wigs despite it being vital
“Yeah, I hope your patient’s shortness of breath gets better.”
😂😂😂
If only it was like that.
I’m an x-ray tech, and I’m the one who has to take all those calls because the hospital decided that I’m the hub for all of imaging when it comes to the radiologist. They can’t call directly or the hospital will implode so they call me and I have to transfer them. They usually/mysteriously get “cut off” and then ask my opinion, report, or the managers phone #. Or house supervisor comes down thinking I’m the radiologist because some one mad called them.
Oh no, I feel this 😞
that sounds really awful. I also get all of these calls but the difference is there actually IS a number for our radiologist and its not me! but they cba to ring switch and get the right one lmao. i also get calls for every other kind of damn scan and i feel like that "noooo, this is atrick" meme when i've aid for the billionth time no, you're rang A&E xray, for xrays in A&E....
Don't forget the random calls by neurologists at 2am. "My patient has a tingly sensation in his arm. Drop everything you are doing right now and let's roll."
You joke but a few months ago I had a stat chest and neck CT ordered by neurology on call for “possible Horner syndrome” (for those who don’t know, look it up) in a patient with metastatic lung cancer and confirmed brain metastasis by MRI a few days ago and staging CT CAP within the admission..
I once had a patient with "tingly sensation in arm" that was progressively getting worse, history of tia, no other symptoms, this was on a detox floor. Had a weird gut feeling and thankfully was able to get them sent to medical hospital for evaluation... Patient ended up having a massive hemorrhagic stroke. It happens sometimes
@@kates5183 Well yeah, with hx of TIA and tingly sensation I would be alarmed too! That’s a focal deficit.
@@kates5183 Don't let my jesting tone confuse you. I am in neurology and if I see a sudden onset hemihypesthesia, I will call a code stroke and make radiology drop everything. I just acknowledge that I am just being annoying from their pov 9 times out of 10.
My daughter had a marathon midnight-to-2am MRI for neuro issues once, so I hear you and appreciate your work ;).
ps between the fact that the first 5 seconds of this video describes her perfectly and her now-extensive experience in the field, she wants to be a radiologist
Sending this to my sister's boyfriend (who's a radiologist) to check for accuracy
Also remember to send it to her husband as well.
I’m a radiologist. It is accurate. In fact an ER assistant yanked the battery out of my on-call phone when I had to leave it outside a patient room to do a nonsense ultrasound during COVID era.
We need him but we don't appreciate him.
Pretty much everyone who work in Healthcare but who are not nurses or doctors. Yes, folks, it's not just those two jobs in the healthcare system. As a matter of fact, many of us work very hard to that those two groups of morons don't actively make your health worse.
As an internal medicine resident I had 10 months of intermittent severe nausea & vomiting. Although the radiologist didn’t want to, my doctor insisted on a small bowel follow through, which showed nearly complete bowel obstruction due to Crohn’s Disease! PS. I am an ID doc and love your portrayal of us. I never realized my obsession with chart reviews was a characteristic of my specialty!
Crohn’s is a bitch. Hopefully some of the work being done on immunotherapy will be able to lessen it soon. I have a good friend with Crohn’s and boy let me tell you it almost drove them off the deep end.
Forget the SBFT
MR enterography is where it's at for IBD
A CTE or MRE is way more accurate and informative for your situation as they could evaluate the mesentery and bowel wall thickness as well. Small bowel through is really outdated for most applications.
This video is about the on call life. So SBFT during the day or regular outpatient study is usually acceptable unless the indication given make no sense. Asking for SBFT at 2 am stat is just annoying for most rads
As an emergency radiologist who covers a hospital system alone at night, I feel heard.
Great video, eye bro! Always glad when you post! :D
If this audio was imposed on just a black screen it would be not only just as entertaining: it would be more believable and true to the joke
You forgot him watching the phone ring and ring and ring with an evil grin on full display.
the noise cancelling headphones on happily typing away
If you would stop calling you would have had the report twenty minutes ago!
So...is my report ready or not? I've been calling every few minutes for the past hour, WHY isn't it ready?
/facepalm
As laboratory staff. I feel this in my soul.
Our radiologists literally just yelled at us about imaging the coccyx. 😂
That one about the rib had to be from our favorite "bones bro."
_>when is my (routine scan that should just be done outpatient) getting done?!_
>Oh my, yes, as soon as possible. Has Mr Smith been npo for at least 6 hours?
_>No_
>I see, when did he last eat?
_>Right now._
>Ah, well, seeing as its Friday afternoon the earliest we will be able to scan him is now monday morning.
_>WHAT but we want to discharge him!_
>Sounds great! We'd be happy to do his scan outpatient. In fact, it looks like he's been on the schedule for us next week for the last month.
_>How dare you I WANT IT NOW._
-Actual conversation i have had a million times🫠
theres something hilariously depressing about everyone demanding radiology do this and that now but doing NONE of the prep they KNOW they need to do beforehand. But as we like to say, its always xray's fault, even when they aren't involved lol
It’s true, can’t imagine how overwhelmed our radiology colleagues are. As a PICU fellow I always find that I learn so much whenever I have a discussion with our radiology colleagues. They always take the time to explain their perspective and findings. Maybe our radiologists are more patient because they’re Peds radiologist😂
eh, they explain because they want you to learn and therefore call less with questions lmao. also, better for the patient if you're on the same page
Love the bit about ordering chest, abdomen, and pelvis CT with lower extremity run-offs! The worst studies are noncon C/A/P CT ordered on an ICU pt at 2 AM.
Yes, but when a noncon pan-CT is ordered at 2 am from the ICU, it’s because the patient has acute kidney failure with a potassium of 6, lactate higher than their Hgb, b/l PNA, ARDS, a PTX, acalculus cholecystitis and ischemic possibly ruptured bowel while on four pressors… that said, at that point, goals of care discussion is probably more appropriate than a CT scan but we’re eternally optimistic 😂
@@rayaterry5365 Those CTs are actually pretty easy to read so we don't mind lol it is almost always the same (something something third spacing something something -itis cannot be excluded on the basis of imaging, for clinical correlation.)
@@keinjuan its more the proces of getting them from ICU, through the scanner and back alive thats the optmistic part lol
Oh, the "addend my report? I'll see you in hell before I'll addend my report" hits hard.
I did IT for a Radiology departement for 6 years. Radiologists NEVER addend a report. Rather, they call the PACS manager with "Yeah, can please copy the text of study xxxxxx, send me the text, reset the study status to "examination finished " and then delete the report? Thanks"
In the beginning I kept suggesting "you can add an addendum" but I quickly found out that rather than having their mistakes visible for all to see, they rather will misuse the system to hide their mistakes, and cause unnecessary work for others....
Addending their own reports is still easier than getting them to add an addendum to SOMEONE ELSE'S report
Will have to disagree, we addend our reports (especially if it's our own report).
If it's a different attending's report then it depends - I always discuss with the reporting attending first.
@@deathlessride Different hospital, different culture, apparently. I loved working for the radiology department, but this was a weird quirk that always annoyed me.
our definitely addend them, the trouble is our system is dogshit and once certain codes of reports have gone through they actually cannot be changed lol, because why would we ned a decent IT system for something important???
The way this man is able to capture the emotions of so many specialities is insane ❤️
Not the run-off to the lower extremities 😭
Only one missing was the 'Super Stat' at 0400 because patient is discharging in morning and they need to know if the patient has TB on a fourteen hour old Dr order.
I had to have a radiologist addend a report. I had an abdominal CT scan, and the report stated that my appendix was normal. I was a bit confused as my appendix was removed in 1986.
To be fair those things can be pretty small (when not inflamed) and hard to find. About half of the abd scans I perform are read as "appendix not definitively appreciated" (ie: they can't find it).
Wasn't there a Gray's Anatomy in which the appendix grew back, by the score?
I had a routine mammogram this past week and, after the scans, was brought into the radiologist's room who was reading them as they were done for an initial report. Had to stop myself from giggling in the totally dark room, set up with about 6-7 fancy-schmacy computer monitors!! Your portrayal of radiology is spot on! So funny!
I swear 01:12 was Emergency Medicine just messing with late night shift.
EM would rather not be dealing with this sort of mess as well, trust me. But it is what it is, and sometimes that's a big ol' CT scan at an ungodly hour vs an autopsy on a more leisurely schedule.
@@brotherofweasel I know... I know... but this is medical comedy.
I am just playing. Relax.
Spoiler alert: they were serious.
In the radiology rotation video there's a bit about ER overheating the CT scanner.
ER is always serious about adding even more CT exams... and they're serious about yelling at CT techs as to why their 20 STAT scans with/without contrast haven't been done in 20 minutes.
@aml7481 you win 😂❤
A radiologist flagged my osteoporosis when i had a shoulder xray. I had been asking my doctors why i kept breaking bones and shouldn’t we do a bone scan? They replied that the breaks were from falling and breaks were normal. And i was too young for a bone scan. Radiologist said my bones were “delaminated way beyond normal for a person of my age.”. This was Sutter managed care nightmare which also doomed my kidneys. Just switched to Stanford. Hopefully my new doctor believes in listening to patients.
The idea that "breaks from falling is normal" in a person who's simultaneously "too young for a bone scan" 😳🤦🏻♀️ My mother's 87 years old, has twice in 10 years fallen badly enough for a pelvic fracture, and still doesn't break bones every time she falls, so I'm flabbergasted by the notion anybody would claim it's normal.
Love it. I train CRAs who work reviewing Clinical Drug Trials. I'm always trying to explain to them how Hospital Doctors interact with Radiology... I think this will help.
Good on you for doing that. Unfortunately I have to say the research people I unfortunately have to deal with are some of the most inconsiderate people ever:
“We need you to stat re-stage this patient because he’s getting randomized for this trial this morning” - the ER and ICU docs are not anywhere close to being this demanding.
@@GNdynames Oh Dear. I'm really sorry to hear that Researchers & CRAs etc are so unreasonable. Too many of them have very limited understanding of the realities of Hospitals & patient managment. *sigh*
The calls are often even worse in private clinics. 'You want the report knee XR on a 80yo to confirm OA? That you ordered an hour ago. Because they came straight back by accident?'
I'm guessing OA means osteoarthritis? (common in the elderly, for those who don't know)
ugh, this is why i won't go there no matter what money theyre paying lol. why do i need to take 6 xrays of a knee for a normal knee replacement what
This is one of your most accurate videos! I've worked in radiology for 15 years and i felt this in my bones
Love!!Love!!Love! From an operator of the donut of truth.
former radiographic assistant who worked the acute ct scanner here - the moment you said "the only one here who works for the entire hospital" i knew you were gonna be on point. our last head of service used to have a saying, "the only speciality that doesn't send anyone to us is dermatology", and now not even that is true!
i now work in outpatient appointments, and if i had a penny for every time i've had doctors on the line bitching about their outpatients not being seen within a day, i'd have enough to retire and i'm not even thirty yet.
You're on a roll Dr. G! Thanks for these awesome videos!!
…
I always knew you were Impressive Dr. G.
I… damn.
I never knew how much.
All of y’all need to fall down the rabbit hole I did and learn about this man’s life, attitude, how much he’s given.
Thank you, sir.
WF FTW
The Radiologist voice sounds so smooth and calming!!!
He took off his indoor sunglasses
He really is about to quit medicine
Thank you, this is what I needed at the end of fellowship!
Congratulations, Doc 🎉
Only thing missing is a rad trying to call a critical report “Sir there is a bowel perf” and becoming trapped in phone menu/voicemail Hell.
"does anyone know his mobile number?? ah screw it i'll find the consultant and ask him to look"
praise radiologists!
back in 2019, i had blunt pain along my 5th intercostal space. my classmate (who's an RN) auscultated me and told me he thinks i needed an xray AP/lateral views because he thought i may have pneumonia.
the next day, i had the xrays done and was informed that i'd get my results the day after. i get a call 4 hours after. the radiologist tells me i need to go straight to the ER because i had a pneumothorax. i had a thoracostomy shortly after being admitted.
if i didn't get that call, i would have had a complete pneumothorax by night time.
lol amazing vid as always, you should add the immunologist as well!
Best portait of radiologist ever.
No matter where we are, we are the same. 😂😂
Said that it has to be that way… But thank you for your continuous humor!
Oh well done! I work in medical imaging with Radiologists - though not a doctor myself - and this sounds spot on.
Love radiologist. Retired PICC nurse, and they were my best friend
The bit on addendums hit close to home! I used to work in an administrative role at a teleradiology company, and those calls from facilities asking for addendums were some of the harder ones to relay.
Computer programmer here, frustrated and getting blunt to get the point across: "The sooner I get off the phone, the sooner I can fix your issue. You choose." Then I went silent.
Ohhhh. All pharmacists everywhere now consider radiologists as blood-siblings. I felt that “IF YOU GIVE ME TWO MINUTES OF PEACE” in my soul.
Yes for the love of god, please stop asking me to x-ray the coccyx.
And ribs. Frikkin' ribs. Just stop.
As a non-medical person who has had a coccyx x-ray done before for a fall, I'm just really curious of the explanation behind this bit?
@@mattsoukup1789 Short version is they are of limited sensitivity for acute fracture and are of little diagnostic value versus a simple clinical exam (thats when doc pokes around on you to see what hurts) that could likely provide similar information. If there is concern for severe acute injury, a CT scan is preferred. Additionally, there is very little in the way of treatment for coccyx fractures beyond a ring-pillow to sit on. So it's a picture to answer a question that doesn't usually matter. All of this applies to rib x-rays also.
@@distalradius8146Really? Doesn't it matter to see if a broken rib is threatening to puncture a lung?
@@Joy21090 We can identify that with a simple 1 view chest x-ray. No need for a full rib series.
@@distalradius8146 gotcha
Radiology diagnosed my Ankylosing Spondylitis, after years of being told my back pain was “stress” I finally got the help I needed, thx Radiology
As a x-ray/CT tech, I am pretty sure my on-call rad says most of these nightly 😂
i think *I* say most of these nightly as a radiographer myself lol, hugely relate
the bottom of the list if you call IS A REAL THING at a hospital where I interned!!!
He is always so good!!!😂😂
Now I want every episode to end with that subspecialty's new voicemail message. This could just be a whole series of videos.
I second this request!
Ah tge memories! 1987, right out of a hospital based radiologic technology program and straight to night shift in a major children’s hospital. We ran interference for our on call residents and fellows. No one had the number to the room but us. And yes, your orders were routinely changed by us with the department head’s permission. Also, bug us and your films (yes hold in your hand films) went straight to the bottom of the pile.
As a Radiologist I approve this message. I was on call today (technically still backup). But I’m also again on Thursday-July 4th--one of the worst holidays ever made……
This is exactly how I feel when I'm not only the on-call doc but also the admitting doc as well.
I want that mug!
Love it man great video 🎉🎉🎉🎉
Brilliant!
YES exactly this! People just tend to forget you are literally the ONLY radiologist standing by at night. For every unnecessary call that we need to pick up, it delays the rate we release reports.. hence the backlogs. Call it a a vicious cycle if you would like.
"boop bœp boop bőop boòp boop boõp" quote of the year
Gotta have those rib X-rays, especially the floating ribs.
Hubby had to Heimlich me on Christmas night. Boxing day I was in so much agony that I couldn't believe it. Rib x-ray revealed he had broken two ribs. Is there some reason NOT to x-ray ribs?
@Joy21090 Rib fractures are often undisplaced and hard to identify on xrays. Also, because ribs can't be splinted/supported, there's no reason to xray them...other than to maybe confirm a fracture.
@@JasonMoir Thanks
@@Joy21090 basically they probably wouldn't do anything for it anyway unless its catastrophic, in which case you'd need an xray and probably a CT for way more serious reasons lol. The idea is if you're not doing anything with the information then why do you need the information?
@@katierasburn9571 "Just because the patient wants to know" isn't a sound medical reason, eh? As a patient I want to know if it's broken, strained, sprained, or just bruised... Even if the treatment is the same (time, ice, rest). I don't know *WHY* I want to know the distinction, but I absolutely do. (Well, part of the reason is a job - taking time off work for *broken ribs* sounds more reasonable than taking time off for strained ribs.)
"a rib x-ray?" 🤣🤣🤣 accurate
I love the I give up I'll tell you ONCE I'VE GOTTEN TO IT! Passive aggressive at the end