Wednesday, May 2, 2007

Don't Forget Your History


A radiologist called into a radio show I was listening to. He expressed concern over the limited history information he would get before he had to dictate an exam. Whether it be an MR, CT, sonogram or radiographs, he implied that technologists need to do more at pinpointing patient symptoms while in the exam room. Sometimes, he said, that’s all the radiologist will have to work with.

The guest on the show (not the caller) was Dr. Jay Grupman (sp?). He talked about his new book How Doctors Think. I haven’t read it, but from the interview, it sounds interesting. He focused on what a patient should do when symptoms don’t go away and he referred to a sort of cascading diagnosis that sometimes happens as people latch on to a diagnosis too soon. This can happen very quickly in an emergency room setting when everyone is in a rush with a lot of distractions.

I have a list of pertinent histories that are appropriate for chest x-rays, abdomen series etc. I show these to the x-ray students. I have to admit, however, that when I got this list from the radiologists, it seemed to me the emphasis was on coding and reimbursement rather than on narrowing down a patient’s condition. Now I try to place emphasis on just communicating with the patient to find out exactly what they’re problem is. Maybe chest pain is a little vague? And how long have they been S.O.B.?

1 comments:

X-ray Rocks! said...

This is a good idea.
Where can I get one of these lists? :)
We have a lot of new nurses start out putting in x-ray orders like this: Abd flat/up reason:abd x-ray
Umm...that's not a reason!