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We get a pretty good service from our Clinical imaging service day and night . Not usually a problem to get any reasonable request performed. Any problems usually resolved by cons to cons discussion. Common cause of initial reluctance (in my experience over the last 20 years): Junior doctor, 'I have this little old lady who has had a fall, I am not sure if she has had a stroke or has a sub dural and she lives alone' etc etc (long and irrelevant details follow) Radiologist, 'Sounds like it can wait' etc Sen A/E, 'I have a year 65 old who has had a fall, she has hit her head and has a GCS of 8' Radiologist, ' put me back to switch, I'll get the radiographer in to warm up the scanner and I'll be there shortly' Familiar? Paul (lone lurking supporter) PS above conversation also applies to refferal s for admission that are initially refused. -----Original Message----- From: Vikki Chase [mailto:[log in to unmask]] Sent: Sunday, September 15, 2002 21:17 To: [log in to unmask] Subject: Re: radiologists compromise timely emergency care I don't wish to argue the case for radiologists refusals for whatever they decide not to do- I can see this thread will be an open opportunity to get radiology gripes aired, and I'm sure all will be quite justified in their individual situations. I feel an isolated voice for radiology/ radiography on this list ( come on lurkers speak up!) as my main interest is the A&E side of things- so I thought I'd try to give a slightly different view to the unreasonable radiologist. Personally I think it would be great if radiology departments provided a 'full' service beyond 9-5 mon-fri. And that radiologists were more accessible for Casualty scans/ film interpretation 24 hours. I can see that a request for an emergency scan would be a priority. Elective work seems a bit of a misnomer when as the general perception of radiologists/radiographers is that we all try to avoid doing as many requests as possible! (I get the idea though). However, for the progression of my own career I am having to give up the aspect I enjoy most, and I'm starting training to be a sonographer next week. Working 9-5 weekdays only- I'm sure that'll take some getting used to. Its been a pleasure joining in on this list, I have learned a great deal and found newsgroups a great barrier-breaker. The info I've picked up on here has also sparked a few memorable discussions round the A&E nurses station on the night shift! Thank you all, Vikki Chase Senior Radiographer -----Original Message----- From: Accident and Emergency Academic List [mailto:[log in to unmask]]On Behalf Of Adrian Fogarty Sent: 15 September 2002 12:19 To: [log in to unmask] Subject: Re: radiologists compromise timely emergency care Vikki, I see your point, but there is much more to this problem than just lack of staffing. Most radiology departments have around three to four times the number of consultants than their respective A&E departments. Granted, they have a huge elective workload and we don't, but radiology departments run their core services for 40 hours per week, while we run ours for 168 hours per week. But it's all about priorities, and the government are partly to blame for that. Why should elective work have priority over emergency work? It obviously shouldn't and the government are slowly beginning to realise this at last. We don't yet have specific imaging targets for emergency work, but I suspect that they will come soon. There's no way we will be able to hit our four-hour A&E targets without pathology and radiology support. In the example I gave, the radiologist initially told my registrar that he couldn't do the scan. I thought this may have related to radiography shortage (which is a big problem with us at the moment) or may have related to some technical problem. That is partly why I invited him to write in the notes, to allow him to clarify his position should any problems arise. My request wasn't presented in a confrontational manner; I merely wished to document the precise reason for refusal (perhaps we could divert some responsibility on to management) and I also wished the radiologist to share some responsibility for the patient's outcome. It transpired that the radiologist simply wouldn't do the scan, for no apparent reason. Hence the scan was then done without further quibbling. Most of our emergency work is carried out by radiology registrars; again our radiologists have around four to five times the number of registrars that I have in my emergency department. They are all paid to provide an emergency service, both in office hours and out of hours. There is no excuse for refusing an emergency scan based on the arguments you have put forward. Adrian Fogarty ----- Original Message ----- From: "Vikki Chase" <[log in to unmask]> To: <[log in to unmask]> Sent: Sunday, September 15, 2002 9:49 AM Subject: Re: radiologists compromise timely emergency care > 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! ---------------------------------------------------------------------------------------------------- The information in this e-mail and any attachments is confidential and is intended for the attention and use of the named addressee(s). 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