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ACAD-AE-MED  September 2002

ACAD-AE-MED September 2002

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Subject:

Re: radiologists compromise timely emergency care

From:

Vikki Chase <[log in to unmask]>

Reply-To:

Accident and Emergency Academic List <[log in to unmask]>

Date:

Sun, 15 Sep 2002 09:49:33 +0100

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (148 lines)

I'm a radiographer who enjoys the out of hours side of things- namely A & E
work- and rarely see radiologists ( unless the image link for CT isn't
working....) but you have me wondering how many of the occasions you would
need to contact a radiologist would be before the 10 pm mentioned in your
debate about consultant contracts?
Prompted by the debate on this list I hunted out our clinical director to
enquire if this would mean more 'out-of-hour' sessions in CT /MRI
/Ultrasound, however I was told they haven't enough radiologists to cover
lists during the day, let alone running additional sessions at any time.
Perhaps when more 'willing' volunteers take up the job vacancies there'll be
more radiologists about and more willing to take on requests. If the
radiology department is already failing to meet targets on waiting times for
scans etc that are on a government hit list ( and things are getting worse
not better!) then I guess they will be unlikely to satisfy other sources of
referral.
Hope its a better service for you where they have the staff!

Vikki Chase
Senior Radiographer
In a department where all in-patient and most out-patient plain films are
not routinely reported on by radiologists unless personally returned to a
radiologist, 2 radiographers and a locum consultant try to keep up with the
A&E and GP reporting, and CT and MRI no longer run full lists Mon- Fri 9-5
due to lack of radiologist cover, and the waiting lists are getting longer!
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]]On Behalf Of Shane Curran
Sent: 14 September 2002 14:30
To: [log in to unmask]
Subject: Re: radiologists compromise timely emergency care


Craig
Ring their boss
Switch has the number
It will only need to happen once
Bosses with registrars to run interference for them don't like being
rung in the middle of the night for very reasonable requests that their
minion has declined

Shane

(who has to ring consultants to get tests as we don't have radiology
registrars!)

Who still has jobs
Especially if someone wants to be director!
(And wondering if he should publish the photos of the lurkers drinks
session at the sheraton in Edinburgh!!)
You know who you are!!!
LOL

-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Craig Ellis
Sent: Saturday, September 14, 2002 12:24 PM
To: [log in to unmask]
Subject: Re: radiologists compromise timely emergency care


We have UK senior SpR's here from time to time, and the two current two
are
slowly driving me mad. The example's of refusal to deliver timely and
appropriate investigations abound from them - although I remember how
much
worse it was when I was working in London. Several recent examples. A 70

year old woman (fit and well) in status following sudden collapse - "Im
not
coming into do a CT because the result wont change management" - to hell

with the importance of diagnosis or the small(but still real) chance of
neurosurgically correctible lesion. Secondly a man with symptoms of
renal
colic, + temp + WCC 17 + Tachy 105 - request for urgent CT to rule out
obstructed kidney. Refused at 3am - "not unwell enough - can wait for
am" -
2 hours later on Norad having Urgent nephrostomy tube inserted -
fortunately
now subject of a formal complaint from patients family - our end of
things
well documented in notes - 3 phone calls to radiology reg - my SHO, me,
Uro
Reg - all with refusal of radio reg to do it as HE didnt think it was
indicated. What can you say ! I could continue, but Ill stop with two. I

also request the Radiologist write their opinion in the notes, but have
had
several refusals which I also document.

Our local trainee's will on occasion question an investigation (which is

absolutely appropriate) and we have a grown up discussion about it - but

never the absolute/no discussion refusal the UK SpR is so fond of.

Craig

>From: Adrian Fogarty <[log in to unmask]>
>Reply-To: Accident and Emergency Academic List
><[log in to unmask]>
>To: [log in to unmask]
>Subject: Re: radiologists compromise timely emergency care
>Date: Fri, 13 Sep 2002 23:43:25 +0100
>
>No you are not alone, I'm sure you'll have many supporters on this
>List. Radiologists are a service profession (i.e. like laboratory
>services, they have no direct patient responsibility, instead they
>support other specialists), and I feel I have spent much of my
>professional life battling to get radiologists to perform necessary
>investigations. Just last week a radiologist refused to do a head scan
>on one of my registrar's patient as he felt it wasn't indicated acutely

>but could wait until the following day. I won't bore you with the
>clinical details, but I asked the radiologist to come and review the
>patient and document in the notes why he felt it was not
>indicated so that the patient could be sent home...the scan was done 30
>minutes later. That was a salutary reminder, if one was ever needed,
that
>radiologists are not clinicians, and that radiologists do not take
clinical
>responsibility for patients.
>
>Adrian Fogarty
>
>P.S. I have seen the same farcical runaround that you describe so well
>in your BMJ letter on many occasions, but things are gradually getting
>better.
>
>----- Original Message -----
>From: "mark nicol" <[log in to unmask]>
>To: <[log in to unmask]>
>Sent: Friday, September 13, 2002 2:12 PM
>Subject: radiologists compromise timely emergency care
>
>
>Barriers to effective stroke care out of hours need to be
>broached-letter
>in
>BMJ 14sept02. Am I alone in thinking that delivery of timely evidence
based
>care is frequently compromised by radiologists?
>markfnicol

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