Radisphere Radiology

A Sheridan Company

More tests help emergency doctors sleep at night

If emergency department (ED) physicians could spend less time thinking about getting sued, they might order fewer radiology tests for their patients.

The practice of defensive medicine—where clinicians order testing or make referrals primarily to avoid litigation—is prominent in every service line and clinical setting. Ordering imaging in the ED is no exception.

In 2006 the Massachusetts Medical Society found that ED physicians had high rates of ordering scans for defensive purposes: X-rays at 23 percent; CT scans at 30 percent; MRIs at 19 percent; and ultrasound tests at 19 percent. All told, defensive medicine cost the state of Massachusetts $281 million in 2006, with imaging across the ED and other specialties accounting for $181 million. While reliable estimates are scarce, according to one study the annual costs of defensive medicine in the United States may exceed $45 billion.

Inside and outside the ED, patients are being overexposed to radiation. “Many physicians have given up the stethoscope and physical exam in favor of an echocardiogram and a CT scan,” says Kevin Campbell, MD, a cardiologist at Wake Heart and Vascular in North Carolina. Campbell notes a CT scan is nothing to take lightly: “The survivors of the atomic blasts in Japan were exposed to the equivalent radiation to two CT scans.”

Aside from raising the risk of radiation-induced cancer, unnecessary tests often result in incidental findings that cause anxiety to patients and lead to more tests and spiraling medical costs. Further compounding the problem, in-patients who receive unnecessary tests are forced to stay in the hospital longer to await results, which heightens their risk for adverse events such as infection or falls.

In many cases fear of litigation drives tests that may be clinically necessary, but shouldn’t be conducted in the hospital. For example, Katie is being treated for pneumonia and then complains about a pain in her knee. After conquering the pneumonia, rather than keep Katie another night to get a knee MRI and wait for the results, the attending physician could discharge her from the hospital and refer her to a specialist for imaging. The goal should be to get Katie out of the hospital at the appropriate time while ensuring she receives needed treatment. But often, defensive medicine leads to just the opposite.

It would be easier to combat defensive imaging if everyone’s priorities were aligned, but that’s not the case. Insurers are the only ones clearly motivated to reduce imaging overuse (one study found that $8.2 billion could have been saved in one year alone by eliminating redundant lab and radiology tests). Common sense would suggest most patients want to avoid unnecessary tests. But in fact, many patients demand imaging tests despite the doctor’s best advice. And in the current fee-for-service world, providers, especially hospitals, often are incentivized to give patients more of what they want.

Caught in the middle of these competing interests are harried ED physicians. “I find myself exasperatedly trying to talk patients out of the scans they think they need,” wrote a New Orleans ED physician in response to a New York Times article on imaging overuse. And a Toronto surgeon suggested how being sure of diagnosis can easily trump doing what’s right: “The more evidence a physician has to prove that a diagnosis was not missed, the sounder he or she sleeps at night.”

Combatting defensive medicine in radiology will require work on many fronts. While some stakeholders are focusing on tort reform, the Choosing Wisely campaign is educating patients on the benefits and risks of tests and how to discuss imaging decisions with doctors.

But real change will come about only when health systems apply a standard to radiology care and incentives are aligned to bring the full expertise of radiologists to bear. Radiologists are highly trained to know when and which types of scans to use in order to achieve an accurate diagnosis. They can help ED physicians make the right ordering decisions.

By enabling direct communication with radiologists and access to evidence-based guidelines 24 hours a day, health systems can ensure that ED physicians have expert diagnostic radiology advice at their fingertips. Having radiologists take on a more consultative role will protect patients from undue harm while helping ED physicians improve patient care—and at the same time reduce the chances for  litigation. Physicians will choose the best scan (which could be none at all) for optimum patient outcomes, and they’ll have the extra ammunition to say to patients, “These experts agree that you don’t need a CT scan.”

As the value-based care model gains traction in the United States, radiologists will be able to contribute more of their knowledge to improving patient care. And patients, more knowledgeable and better cared for, will be less likely to sue.

4 Ways Sporting Activities Enhance Good Health for Radiologists

Spending time on machines trying to check on your patients’ internal body parts the whole day requires a relaxing moment after work.

Radiographers need a high level of concentration to ensure they get everything right when it comes to body scans.

The prolonged sitting hours with minimal physical activity invites lifestyle illnesses. You don’t expect radiographer also to change positions to become a patient because of swollen feet.

 The best way to avoid such cases is to have a complete lifestyle change focusing on physical activities.

Any task that involves body movement is referred to as physical exercises. They help to enhance blood circulation throughout the body preventing anybody from inflammation.

However, despite all that, other lifestyle changes benefit a radiologist to complement sedentary life.

  • Eat healthy meals
  • Enroll in a workout activity
  • Practice work-life balance
  • Surround yourself with people with positive energy
  • Maintain a regular exercise schedule

4 Ways Sporting Activities Enhance Good Health for Radiologists

1. Table tennis

Most people play table tennis for fun, not knowing if its physical health benefits. It’s one game that stretches all the body parts.

As you hit the ball, your hands get the appropriate stretches. In response to your opponent’s action, you must exercise the lower limbs as you strive to hit back the ball.

It’s one game that exercises all the body parts. Digital technology came in handy for tennis players; when you lack an opponent while practicing, then the ping pong robot is your savior.

You set it based on the kind of game you want to achieve. As a radiographer, all you need is to purchase the table tennis equipment or a robot if you wish to a non-human opponent, and you are good to go.

 Also, you can choose to either play it as an outdoor or an indoor game.

2. Cycling

As an imaging expert looks away from an enclosed environment, then a touch of nature is a good option for sporting activity.

 It’s easy for a radiographer to add weight since the kind of work involves a lot of sitting with minimal body movement.

One of the simplest ways to relax the body and mind and maintain a healthy weight is cycling.

Apart from just the physical activity that promotes weight loss, cycling ignites your passion for exploration.

The interaction of nature gives a relaxing moment away from the conventional machines you use while in the kind of duty.

3. Swimming

Unless you have water phobia, swimming gives you a full-body workout ideal for your general well being.

Now that your body is fully suspended in water, you can’t feel the pain and strain familiar with other workout activities.

 It suppresses all the body aches; it explains why you can swim even when you have an injury and feels no soreness, thanks to 90 percent underwater body suspension while underwater.

Why should a radiographer try his hands in swimming?

  • Boosts energy levels to face yet another hectic day ahead
  • A simple way to exercise even after a hard day’s work
  • Promotes general good health for it reduces the risk of lifestyle illnesses
  • Releases stress, anxiety and depressions allowing a radiographer to get a good sleep and “feel good” experience

4. Taking walks

You may not value walking due to the hype people give workout exercises in the gyms. According to physiologists, walking for a long time is even a better and sustainable form of exercise than also running.

The last thing you expect a radiographer after handling many imaging tests is to engage in a strenuous workout, yet he needs to participate in physical activity.

The best option for him is to take long walks, either alone or with friends. Walking may not even be planned.

In a small way, you can skip the lifts, park your car in a remote place away from the parking lot to facilitate walking to the health facility or evening walks with family to bond and create healthy relationships.

It comes with numerous physical and mental benefits

  • Alleviates fatigue
  • Improves one’s mood
  • Less strenuous form of workout
  • Promotes weight loss with minimal strain]
  • Enhances endurance levels
  • Puts your posture to position
  • Enhances creativity levels

Naturally, as much as we love our job to improve our living, we shouldn’t compromise on our physical and mental health.

It’s essential to have a balanced life to giving you a fulfilling work-life balance. Your state of health is vital for even better jobs, so take good care of it through engaging in physical activity.

Your life should not just revolve around imaging and a health facility. What you do away from work dictates whether you are productive or not.

 What is your pass time as a radiographer? Do you focus on improving your physical health through sport?

If yes, then this article is of benefit to you. Similarly, if not, you now have an idea of what you need to do to maintain a healthy weight.