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Posted: 12/23/2005 3:02:41 AM EDT
[Last Edit: 12/23/2005 8:49:21 AM EDT by ARDOC]
EDITED FOR FAMILY AUDIENCE.
Link Posted: 12/23/2005 3:07:32 AM EDT
I've known a few that sucked too. And she was a cuty.
Link Posted: 12/23/2005 3:09:23 AM EDT
Do you eat with that mouth those fingers?
Link Posted: 12/23/2005 3:10:09 AM EDT
Those guys caused me more pain as a kid than I want to remember. My knees hurt more after the x-rays than before.
Link Posted: 12/23/2005 3:11:53 AM EDT
Fuckers missed a molar pregnancy.

I had serious problems in the OR because the dudes are fucking blind and couldnt diagnose an easy finding that a med student would have been able to pick out. I scanned her myself is the OR and easily saw it. They couldnt see it with their fancy machine that cost 100 times more then mine.
Link Posted: 12/23/2005 3:13:55 AM EDT

Originally Posted By ARDOC:
Fuckers missed a molar pregnancy.

I had serious problems in the OR because the dudes are fucking blind and couldnt diagnose an easy finding that a med student would have been able to pick out. I scanned her myself is the OR and easily saw it. They couldnt see it with their fancy machine that cost 100 times more then mine.



So thats what this is about. I thought it was about some young lady that turned you down.


Well I hoped you chewed their asses.
Link Posted: 12/23/2005 3:17:18 AM EDT
How do you hide $20 from a Radiologist?

<­BR>



Tap­e it to the patient!
Link Posted: 12/23/2005 3:23:31 AM EDT
She lost over 1500 cc of blood and made me shit in my pants. This was TOTALLY unnecessary. She is fine and is going to do well but I am pissed as all living hell. I am going to call the Chief of Staff this morning. Fucking asses. This not the first time they have messed up a diagnosis.
Link Posted: 12/23/2005 3:24:04 AM EDT

Originally Posted By spartacus2002:
How do you hide $20 from a Radiologist?

<­BR>



Tap­e it to the patient!



Link Posted: 12/23/2005 3:51:50 AM EDT
[Last Edit: 12/23/2005 3:52:52 AM EDT by Kharn]
And GI specialists are perverts. All they do is stuff it and take pics.

Kharn
Link Posted: 12/23/2005 4:16:36 AM EDT

Originally Posted By Kharn:
And GI specialists are perverts. All they do is stuff it and take pics.

Kharn



The worst part is that they leave all that gas in there. The patients bitch about that the most.
Link Posted: 12/23/2005 4:18:55 AM EDT
What's a molar pregnancy? Is that where the egg attaches to the ovarian tubes instead of the uteris?

Dave
Link Posted: 12/23/2005 4:19:05 AM EDT
Was it a complete or partial molar pregnancy?
Link Posted: 12/23/2005 4:19:35 AM EDT
Hey, bud - I just take the pics, I don't read them.

Seriously, though, as much as they make, I would hate to be a Radiologist - you have to be right 100% of the time, probably have more lawsuits and higher malpractice insurance costs than almost anyone else. No thank you.
Link Posted: 12/23/2005 4:24:33 AM EDT

Originally Posted By Eclipse:
Was it a complete or partial molar pregnancy?



Partial.
Link Posted: 12/23/2005 4:26:44 AM EDT

Originally Posted By Greywolf2112:
Hey, bud - I just take the pics, I don't read them.

Seriously, though, as much as they make, I would hate to be a Radiologist - you have to be right 100% of the time, probably have more lawsuits and higher malpractice insurance costs than almost anyone else. No thank you.



Half the time the techs have to point out the problems to the buttheads. But even then they use stupid butt covering statements.

Probable
Possible
Use clinical correlation
Cannot rule out

Well not shit Sherlock. I can figure that out too, you need to give me specific information so I can act on it. Most of the time I have to take a step back and realize they are tools.
Link Posted: 12/23/2005 4:27:12 AM EDT
Don't know the whole story, but here goes....

Always get a second opinion, especially if it involves surgery. If you have to pay out of pocket, it is worth it.

My wife is a nurse, father-in-law is a respiratory specialist. They things they tell me....
Link Posted: 12/23/2005 4:29:22 AM EDT



Last time I checked, we all live in glass houses at the end of gravel driveways. Best not to throw rocks.

That said, yesterday, the "cervical lymph node" per the radiologist turned into a CF branchial cleft cyst that was scarred in to beat the band yesterday. Good thing he wasn't around when I finished.
Link Posted: 12/23/2005 4:29:49 AM EDT

Originally Posted By TheOtherDave:
What's a molar pregnancy? Is that where the egg attaches to the ovarian tubes instead of the uteris?

Dave



No, when an egg and sperm unite, sometimes the maternal DNA will not survive. The new cell realizes that it is not complete and repairs itself. Since there is no maternal material, it clones the fathers DNA to make the complete set.

Unfortunately it doesnt make a baby, it makes these vesicles that look like a "snowstorm" on ultrasound. They look like little grapes in there, millions of them.

The molar material can act like a cancer and spread throughout the womans body and they will die if not treated.

They also bled like stink while removing them.
Link Posted: 12/23/2005 4:31:11 AM EDT

Originally Posted By Hellhound:
Don't know the whole story, but here goes....

Always get a second opinion, especially if it involves surgery. If you have to pay out of pocket, it is worth it.

My wife is a nurse, father-in-law is a respiratory specialist. They things they tell me....



Second opinions are not always available.

But I always encourage my patients to go to get another opinion. 9 out 10 they come back and bring more friends to my office with them.
Link Posted: 12/23/2005 4:32:05 AM EDT

Originally Posted By spartacus2002:
How do you hide $20 from a Radiologist?

<­BR>



Tap­e it to the patient!




How do you find the radiologist's car in the doctor's parking lot?

<­BR>


It's the one with no headlights.

Link Posted: 12/23/2005 4:33:17 AM EDT

Originally Posted By ARDOC:

Second opinions are not always available.

But I always encourage my patients to go to get another opinion. 9 out 10 they come back and bring more friends to my office with them.



+1

Any doc afraid of a second opinion is not your friend.


Link Posted: 12/23/2005 4:35:56 AM EDT
Bring your dogs through the hospital. Maybe they don't like radiologists either.
Link Posted: 12/23/2005 4:37:01 AM EDT
[Last Edit: 12/23/2005 4:38:26 AM EDT by LattimerII]

Originally Posted By ARDOC:

Originally Posted By Greywolf2112:
Hey, bud - I just take the pics, I don't read them.

Seriously, though, as much as they make, I would hate to be a Radiologist - you have to be right 100% of the time, probably have more lawsuits and higher malpractice insurance costs than almost anyone else. No thank you.



Half the time the techs have to point out the problems to the buttheads. But even then they use stupid butt covering statements.

Probable
Possible
Use clinical correlation
Cannot rule out

Well not shit Sherlock. I can figure that out too, you need to give me specific information so I can act on it. Most of the time I have to take a step back and realize they are tools.




Recommend considering follow-up study
(findings) likely/possibly consistent with.....
Link Posted: 12/23/2005 4:37:24 AM EDT

Originally Posted By Bubbatheredneck:

Originally Posted By ARDOC:

Second opinions are not always available.

But I always encourage my patients to go to get another opinion. 9 out 10 they come back and bring more friends to my office with them.



+1

Any doc afraid of a second opinion is not your friend.





Exactly, when they realize I was correct and have a better repoire with them, they always come back.
Link Posted: 12/23/2005 4:45:08 AM EDT
"Cannot rule out molar pregnancy. Repeat ultrasound recommended in 10 months."
Link Posted: 12/23/2005 4:46:46 AM EDT

Originally Posted By C-4:
"Cannot rule out molar pregnancy. Repeat ultrasound recommended in 10 months."



You know it!

I have the ER guys read my films sometimes instead of the radiologist. Now to be fair I know a good number of excellent Radiologists. Very smart and effective doctors. But some of the more recent ones...
Link Posted: 12/23/2005 5:12:06 AM EDT
With the advent of tele-radiology, which will be the norm within 3 years, there will be no guys on site to do reads unless they are interventionalists. The rads guys will all be offsite in central hubs or reading from home, never ever coming into physical contact with any patient or taking any history. One day it will be their downfall when computer algorhythms are good enough to do reads.
Link Posted: 12/23/2005 5:47:30 AM EDT

Originally Posted By spartacus2002:
How do you hide $20 from a Radiologist?

Tape it to the patient!






Link Posted: 12/23/2005 5:53:49 AM EDT
ARDOC,

So I take it you reviewed the original study, SAW the molar pregnancy yourself, read the report and determined it was a missed find. Did you question the tech that did the study in the first place to see if they saw it? Was the radiologist the one that did it?

While you are at it lumping rads together you might as well do physicians in general. There are good, and there are bad. Like anything else.

Just my opinion......
Link Posted: 12/23/2005 5:59:48 AM EDT

Originally Posted By Greywolf2112:
Seriously, though, as much as they make, I would hate to be a Radiologist - you have to be right 100% of the time, probably have more lawsuits and higher malpractice insurance costs than almost anyone else. No thank you.



Its pretty easy to be right 100% of the time when you list a differential instead of making a diagnosis.

My other gripe with Siskel & Ebert M.D.'s is they will rattle off a report and never look at previous interps on sequential studies. A patient of mine who is being irradiated for small cell lung cancer had a report yesterday that read 'total collapse of the left upper lobe.' Three days earlier the the report said, 'partial atelectasis vs. infiltrate in the left upper lobe.' Last night, while whizzing thru the dept while on call I pulled the films and compared. They were almost identical.
Link Posted: 12/23/2005 6:39:27 AM EDT
[Last Edit: 12/23/2005 6:40:25 AM EDT by AZMAN-1]
ARDOC,
Being that you brought it up, maybe you can answer a question for me. Why do doctors rely on Rad Tech's reports so much?? After all you all are the ones with all the education, why don't doctors read their own exrays, after all they are the ones hearing from the patiant and seems to me you would be in a better position to know what to look for.

I'm not trying to be an ass, I just never understood this, I hate having to pay for a radiologist report bad enough as it is, but even more so when I see complaints like the one you just made.

It always chapped my ass when my high-priced Orthopedic Surgeon expressed that he too didn't agree with what was on the report, made me wonder 'WHO' was right, and which one I SHOULDN'T PAY!!!!

One last little thing while I have your attention. Why is it that any time I go to the hospital for any proceedure, I'll get a bill from some doctor a year later, after the insurence has already paid every body for a supposed consult at the time of the admition??? Why can't these mystery doctors ever submitt their bill in a 'timely' fashion???

This usually happens after the insurance has already closed the case and paid everyone they intend to pay; leaving me to pay this 'slacker's' bill myself in total????

Curious minds would like to know!!!....
Link Posted: 12/23/2005 6:46:30 AM EDT

Originally Posted By AZMAN-1:
ARDOC,
Being that you brought it up, maybe you can answer a question for me. Why do doctors rely on Rad Tech's reports so much?? After all you all are the ones with all the education, why don't doctors read their own exrays, after all they are the ones hearing from the patiant and seems to me you would be in a better position to know what to look for.



I don't know about the others but at our institution its the Radiologists' reports we read, not some rad tech.

Not sure exactly what you are asking?

Nevertheless, good physicians do read their own radiologic studies. The radiologists report is usually for confirmation of what the primary physican suspects. Some studies, like ultrasound, or in some cases CT and MR require special training to read.
Link Posted: 12/23/2005 6:59:34 AM EDT
Could we get someone to tackle the billing question? I'd be tempted to send back the bill with a "Rejected" stamp on it and a note saying "Case closed -- for future reference, please submit bills in a more timely manner."
Link Posted: 12/23/2005 7:03:45 AM EDT

Originally Posted By jblachly:

Originally Posted By AZMAN-1:
ARDOC,
Being that you brought it up, maybe you can answer a question for me. Why do doctors rely on Rad Tech's reports so much?? After all you all are the ones with all the education, why don't doctors read their own exrays, after all they are the ones hearing from the patiant and seems to me you would be in a better position to know what to look for.



I don't know about the others but at our institution its the Radiologists' reports we read, not some rad tech.

Not sure exactly what you are asking?

Nevertheless, good physicians do read their own radiologic studies. The radiologists report is usually for confirmation of what the primary physican suspects. Some studies, like ultrasound, or in some cases CT and MR require special training to read.



Sorry, what do I know about Rad Tech or Radiologists' (I thought they were one and the same.)

I was refering to who ever reads the damn thing and submitts a bill for his opinion.....
Link Posted: 12/23/2005 7:15:54 AM EDT
[Last Edit: 12/23/2005 7:18:09 AM EDT by AZMAN-1]

Originally Posted By wise_jake:
Could we get someone to tackle the billing question? I'd be tempted to send back the bill with a "Rejected" stamp on it and a note saying "Case closed -- for future reference, please submit bills in a more timely manner."



I did that one time, when the doctor tried to take me to a collection service I called his office and asked him that very question, he blamed it on his billing dept. I told him basically "You sooze, you lose" I went on to tell him that I had no recollection of my doctor idicating a need for another 'consult' his bill was ambiguous to say the least, it wasn't clear if it actually was a consult or an assist with said proceedure, I asked him if he didn't know or have a record what it was how was I supposed to know he actually did anything???. And wasn't some doctor adding his name to some random chart hoping to get a payday somewhere down the road.

It stinks to high hell when you get a bill a 15 months later after everyone else has already been paid, and you've never heard of him, and they can't even tell you what its for!!!......
Link Posted: 12/23/2005 7:21:31 AM EDT

Originally Posted By TheOtherDave:
What's a molar pregnancy?

Dave



You get it from a blowjob.
Link Posted: 12/23/2005 7:28:24 AM EDT

Originally Posted By AZMAN-1:
It always chapped my ass when my high-priced Orthopedic Surgeon expressed that he too didn't agree with what was on the report, made me wonder 'WHO' was right, and which one I SHOULDN'T PAY!!!!

The radiologist for my MRI says I have a plain-as-day 8mm tear in my rotator cuff. My orthopedic surgeon just says its an anomoly (a continuation of a bit of cartilidge from the next picture) and definitely isnt a tear.

Kharn
Link Posted: 12/23/2005 8:01:10 AM EDT

Originally Posted By Kharn:

Originally Posted By AZMAN-1:
It always chapped my ass when my high-priced Orthopedic Surgeon expressed that he too didn't agree with what was on the report, made me wonder 'WHO' was right, and which one I SHOULDN'T PAY!!!!

The radiologist for my MRI says I have a plain-as-day 8mm tear in my rotator cuff. My orthopedic surgeon just says its an anomoly (a continuation of a bit of cartilidge from the next picture) and definitely isnt a tear.

Kharn



Does your shoulder hurt, or were they just taking pictures for fun?
Link Posted: 12/23/2005 8:01:27 AM EDT

Originally Posted By AZMAN-1:
ARDOC,
Being that you brought it up, maybe you can answer a question for me. Why do doctors rely on Rad Tech's reports so much?? After all you all are the ones with all the education, why don't doctors read their own exrays, after all they are the ones hearing from the patiant and seems to me you would be in a better position to know what to look for.

I'm not trying to be an ass, I just never understood this, I hate having to pay for a radiologist report bad enough as it is, but even more so when I see complaints like the one you just made.



I'll tackle that. When I order an xray, I usually have in mind a few things that I am looking for, or what we deem a 'differential diagnosis.' These are the problems or diagnoses that in my mind, are the more likely culprits. I believe that Radiologist are helpful in pointing out those things I might NOT expect to find. Yes, I look at most of the films I order. But in the end, that's not my area of training. I'd rather someone who is trained to look at xrays make the official reading. Who would you rather have overreading your films, someone like me who looks at 10 a day, or somebody who looks at 100 per day?


It always chapped my ass when my high-priced Orthopedic Surgeon expressed that he too didn't agree with what was on the report, made me wonder 'WHO' was right, and which one I SHOULDN'T PAY!!!!



You are paying for an opinion, friend. Not for a correct diagnosis.


One last little thing while I have your attention. Why is it that any time I go to the hospital for any proceedure, I'll get a bill from some doctor a year later, after the insurence has already paid every body for a supposed consult at the time of the admition??? Why can't these mystery doctors ever submitt their bill in a 'timely' fashion???

This usually happens after the insurance has already closed the case and paid everyone they intend to pay; leaving me to pay this 'slacker's' bill myself in total????

Curious minds would like to know!!!....



That's as much a function of the insurer as the doctor. He could have submitted the bill the minute you walked out of the hospital and months (and months and months) later after his diagnosis has been filed, refiled appealed and reviewed the insurance says, "Sorry, doc, we won't pay for that. Submit a bill to the patient." That's when you get the mystery bill.
Link Posted: 12/23/2005 8:14:30 AM EDT

Originally Posted By ARDOC:

Originally Posted By TheOtherDave:
What's a molar pregnancy? Is that where the egg attaches to the ovarian tubes instead of the uteris?

Dave



No, when an egg and sperm unite, sometimes the maternal DNA will not survive. The new cell realizes that it is not complete and repairs itself. Since there is no maternal material, it clones the fathers DNA to make the complete set.

Unfortunately it doesnt make a baby, it makes these vesicles that look like a "snowstorm" on ultrasound. They look like little grapes in there, millions of them.

The molar material can act like a cancer and spread throughout the womans body and they will die if not treated.

They also bled like stink while removing them.




The things ya learn here....

I'm with Greywolf...well I was, I no longer shoot rads: not enuf money, not enuf walky talkies, too many barium blow outs and the docs ask for the impossible (an upright on a gomer that's been in the fetal position since the Nixon presidency)

That said...Ardoc...you can keep your job
Link Posted: 12/23/2005 8:28:00 AM EDT

Originally Posted By BenP:
ARDOC,

So I take it you reviewed the original study, SAW the molar pregnancy yourself, read the report and determined it was a missed find. Did you question the tech that did the study in the first place to see if they saw it? Was the radiologist the one that did it?

While you are at it lumping rads together you might as well do physicians in general. There are good, and there are bad. Like anything else.

Just my opinion......



Actually thats a good point. I was on call and I was doing this case for a partner. So yes it was reviewed by 2 different radiologists at 2 different times. Once early in the pregnancy about 4 weeks ago at a different hospital and a few days ago. My partner and resident examined the patient and the films were read TOGETHER with the radiologist, resident and attending present. But its hard to tell another attending they are full of shit in front of a lot of people and you tend to take the word of another attending.

This indictment is more against this particular group who has made several poor calls lately. The old farts in the group have been replaced with recent grads.

I remember an old guy who would hang out and pop his head in to confirm his diagnosis. How many do that now? He wanted to see what it looked like in real life versus film. That makes a huge difference.
Link Posted: 12/23/2005 8:33:30 AM EDT
Greywolf will tell you this as a fact. No tech reads the flims or result. In fact they are FORBIDDEN from telling the patients what they see or discuss the case. They will throw the patients some tidbits but they WILL NOT TELL THEM ANYTHING. And as you pointed thats because they dont have the education level to stand up legally.

So the tech gets the fims. Then films are taken to a reading cave where the radiologists hang out. They read the films, pronounce a nonofficial diagnosis and dictates an official report usually later. Anything wierd is automatically sent to another doc for another opinion.

So the tech only performs the actual test. The doc is the one that reads and interprets the actual result.

That is what you are paying for and a real good radiologist is worth his weight in gold.
Link Posted: 12/23/2005 8:42:08 AM EDT
As far as billing, we are talking molasses flows faster in the winter then medical billing. I just got paid for a hysterectomy done over a year ago.

The medical insurance companies are to blame. When you pay a premium that money doesnt go to pay for you bills.

It is used to make investments on the open market. Thats why so many health insurances did so poorly when the stock market tanked.

So they want to hold onto the money as LONG as they can because they make interest on the money and invest the money.

They are also hoping that the biller will forget or get tired of this and not press the payment. But we have professional billers that do just that.

So weeks and months later the bill may have been presented several times as the insurances did not pay.

Once they refuse to pay, the remainder of the bill or full bill then goes to the patient. This maybe weeks or months later.

Usually specialists like radiologists and non primary care people will press really hard because they are consultants and will not have to deal with the patient face to face.

You are paying for an OPINION with a consultant. They vary in quality like everything else.
Link Posted: 12/23/2005 8:46:00 AM EDT

Originally Posted By BenP:
ARDOC,

So I take it you reviewed the original study, SAW the molar pregnancy yourself, read the report and determined it was a missed find. Did you question the tech that did the study in the first place to see if they saw it? Was the radiologist the one that did it?

While you are at it lumping rads together you might as well do physicians in general. There are good, and there are bad. Like anything else.

Just my opinion......



Like I said the US studies were looked at my the senior resident and my partner and the radiologist together when it was done. Also I did an ultrasound myself and I could see a molar pregnancy. The shitty part is that she had a ultrasound done not 4 weeks ago at a completely different hospital where they also failed to detect the molar pregnancy.
Link Posted: 12/23/2005 8:48:52 AM EDT
And my apologies to radiologist. I was ranting because of a particular bad case. Most are very good and very professional. Like all human beings I too have failings and when things go wrong you need to blame someone.

But again, this should be directed at one particular group which I have had multiple interactions with and calls were missed.

I again apologize to the radiologists not involved.
Link Posted: 12/23/2005 8:53:31 AM EDT

Originally Posted By wildearp:

Originally Posted By Kharn:
The radiologist for my MRI says I have a plain-as-day 8mm tear in my rotator cuff. My orthopedic surgeon just says its an anomoly (a continuation of a bit of cartilidge from the next picture) and definitely isnt a tear.
Kharn


Does your shoulder hurt, or were they just taking pictures for fun?

It most certainly did hurt, but the surgeon thought it was more just a bicep tear near the joint and resulting scar tissue than a rotator cuff problem. Physical therapy's working to fix it, but its pretty slow going.

Kharn
Link Posted: 12/23/2005 9:33:21 AM EDT

Originally Posted By ARDOC:

Originally Posted By TheOtherDave:
What's a molar pregnancy? Is that where the egg attaches to the ovarian tubes instead of the uteris?

Dave



No, when an egg and sperm unite, sometimes the maternal DNA will not survive. The new cell realizes that it is not complete and repairs itself. Since there is no maternal material, it clones the fathers DNA to make the complete set.

Unfortunately it doesnt make a baby, it makes these vesicles that look like a "snowstorm" on ultrasound. They look like little grapes in there, millions of them.

The molar material can act like a cancer and spread throughout the womans body and they will die if not treated.

They also bled like stink while removing them.



Ok-what's a Tubal Ligation? Is that what I was asking about?
Link Posted: 12/23/2005 9:41:58 AM EDT

Originally Posted By TheOtherDave:

Ok-what's a Tubal Ligation? Is that what I was asking about?



Dave you are talking about an ectopic pregnancy. A tubal ligation is when we tie off the tubes so she cannot have anymore children.
Link Posted: 12/23/2005 9:43:29 AM EDT
Any armchair radiologists wanna take a crack at this?

Link Posted: 12/23/2005 9:46:17 AM EDT

Originally Posted By Merrell:
Any armchair radiologists wanna take a crack at this?




The patients has a sent of keys and bunch of poop in the gizzard.
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