No Rod I think you are wrong here.  I am sure any of your radiographer
colleagues will be happy to tell you about the changes which I thik occurred
about 18 months ago meaning that the responsibility for administering
radiation to a patient is that of the radiographer and not the doctor.

When this change came in I was working in Brighton and it led to an increase
questioning of the appropriateness of requesting x-rays.  I for one was very
pleased.  The radiographers would come to me with requests form SHOs which
were clearly not clinically indicated. On some occassions we would have a
discussion and the x-ray would then be done.  It allowed for
multiprofessional dialogue  about a patient and the best way to manage  him
or her - surely in the interest of the patient and was edcuational; for all
parties concerned.  Initially there were soem request 'tear ups' without
referring back to the requestor.  But this was a system problem not a person
problem and was easily fixed.

Regarding Louise's comment;  I am surprised at the tone of some list members
but people are entitled to their opnions.  It would be nice though if we
could reply to flames with examples of best practice. In my current
department we have coded all x-ray requestss and there are indications for
all x-rays.  If there is deviation form the coding then there is mandatory
discussion between requestor and senior doctor.  We have successfully
reduced the x-ray request rate without effecting patient outcome to the best
of our knowledge.

John Ryan


From: Roderick Mackenzie <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, April 13, 2002 05:51
Subject: Re: Radiographer refusal


> Sorry...cannot help but join in (and I have been sedated)...
>
> Patient hit in eye with a carrot. Bruising to lids and infra-orbital
> margin. Traumatic mydriasis and blurring of vision - no hyphaema. Pain on
> upward gaze but no obvious limitation. Routine X-ray request for facial
> views ? orbital fracture. Radiographer stomps round to department saying-
> 'I've never heard anything so ridiculous. Carrots don't break bones..'
>
> If I had had a carrot in my hand at that point ...
>
> Now I realise that our staff do sometimes send round ridiculous requests
> (usually because they don't know any better and we haven't trained them)
> and that radiographers form a valuable part of the team in terms of
> flagging up silly requests and suggesting additional imaging but I am
jolly
> fed up with having banal and somewhat repetitive discussions about
> 'not-indicated' x-rays.
>
> Can someone tell me what the actual rules are that the radiographers have
> latched on to as an excuse for rejecting requests ?
>
> As far as I understand it, I am responsible for making the decision about
> whether the patient needs an X-ray, I am responsible for explaining the
> pros and cons of this to the patient, I am responsible for formally
> requesting the test and 'prescribing the radiation' and I am responsible
> for interpreting the films. The radiographer is responsible for ensuring
> the technical accuracy of the images and the appropriate (and minimum
> necessary) dose of radiation is used and that radiation protection
> principles are followed.
>
> But I'm happy to be corrected...
>
> Rod
>
> >
>