Basic topic.
Remember the cause of the appearance and you will remember the appearance !
Remember the cause of the appearance and you will remember the appearance !
Hopefully now you shall be able to report more than just pulmonary embolism. I would not have posted if it was just for the pulmonary embolism!
https://radiogyan.com/radiology-spotters/
All 28 sets of spotters for those who haven't solved them. If you have solved them, you can revise or ignore the message.
Thanks.
All 28 sets of spotters for those who haven't solved them. If you have solved them, you can revise or ignore the message.
Thanks.
RadioGyan
700+ Aunt-Minnie Radiology Spotters Cases for Board Exams
Radiology spotters are very important components of the radiology residents practical exams and radiology review boards.
A message by Dr Ramanth Ghute Mumbai about interacting with patients :
What would you do if--?
You did an anomaly scan at 18 weeks. Your impression was ' Normal anomaly scan'.
Patient comes at 35 weeks for routine usg. You find meningocele at LS region. You write in report.
Aftet few days patient's husband comes to your clinic and start arguing that you gave wrong report. He threatened court case against you or pay rs 10 L immediately.
Questions
1. What would you do?
2. What would you say to patients?
Today, I asked this simple question to 800 plus radiologists to understand how radiologists handle such situations. Very few rads gave satisfactory answer.
We will discuss this case in detail ,so that you are prepared for Any such situation.
----
When patient make allegations and threatens, our first reaction is to defend ourselves and throw logical explaination in medical language , which is incorrect in many situations. We defend ourselves because its normal human reflex activity and automatic default response.
However, we should have little different plan of action to tackle such situations.
I would include some points from SOPs taught in training of IAS / IPS academy also. Bureaucrats and politicians have excellent SOPs to diffuse problems.
First , I will explain principles then step by step SOPs.
Although this is not one-size -fit-all solution, you can take few steps depending upon situation.
🇮🇳 Principles🇮🇳
Find out what patient wants?.
Angry patient wants following things ( 3 Rs).
1. REASSURANCE Patient just want to drain emotions.
2 REASONING Patient needs Something or someone to blame for mischief .
3. REVENGE
Few patient seek revenge. He would ask money or punishment to doctors.
1: Reassurance
Usually patients are worried about medical issue. They are also annoyed due to expenses. & They are angered due to fuel added by other doctor (Medical jousting ).
Overall, patient is heavily emotionally burdoned bag.
Majority of patients wants Drainage of anger Reassurance of worry and sympathy.
If you allow them to vent up anger and diffuse his worry, he would cool down. You can sympathise and offers Non-monetary help. For example Reference to neurosurgeon and further guidance.
(2) Reasoning
Patient wants explanation to event so that he can blame. You need to divert attention to defective genes is culprit and not radiologist scan. You can mention nutritional deficiency can cause fetal abnormality, one more reason to defect. If you can't guess reason blame GOD for his condition.
Show him fetal development on computers or book(Visuals effects are useful to explain).
Explain him that fetus is very small at 18 weeks.
-You can say size at 18 weeks is almost same as smartphone instead of talking in Centimetres.(so that they can imagine size).
-You can say defect could be very small which cannot be detected at 18 week.
-You can say defect can develop after scan is done as fetus is growing.
Very important - Avoid saying technical difficulties, fetal position etc.(Scan factors). Patient is not interested to know what difficulties you faced.
Focus entire reasoning to genes, nutrition and fetus (Fetal factors). Patient needs these reasons to tell society(relatives and friends). Then entire focus is shifted from 18 weeks scan to other points.
3. Revenge
Few patients are determined to take revenge then Reassurance and reasoning would fail.
You need to be firm and don't get influenced. DON'T PAY ANYTHING.
Say firmly with confidence " If you are determined to go to court then discussion is over,please take a leave. We will meet in court".
There is huge chance that he won't do anything. Majority people are fattu...they wont do anything.
Be prepared for court case also Find articles to support your case. I hv posted few articles with this message.
--
✳ Standard Operating Procedures (SOP)✳ Dr Ram
What would you do if--?
You did an anomaly scan at 18 weeks. Your impression was ' Normal anomaly scan'.
Patient comes at 35 weeks for routine usg. You find meningocele at LS region. You write in report.
Aftet few days patient's husband comes to your clinic and start arguing that you gave wrong report. He threatened court case against you or pay rs 10 L immediately.
Questions
1. What would you do?
2. What would you say to patients?
Today, I asked this simple question to 800 plus radiologists to understand how radiologists handle such situations. Very few rads gave satisfactory answer.
We will discuss this case in detail ,so that you are prepared for Any such situation.
----
When patient make allegations and threatens, our first reaction is to defend ourselves and throw logical explaination in medical language , which is incorrect in many situations. We defend ourselves because its normal human reflex activity and automatic default response.
However, we should have little different plan of action to tackle such situations.
I would include some points from SOPs taught in training of IAS / IPS academy also. Bureaucrats and politicians have excellent SOPs to diffuse problems.
First , I will explain principles then step by step SOPs.
Although this is not one-size -fit-all solution, you can take few steps depending upon situation.
🇮🇳 Principles🇮🇳
Find out what patient wants?.
Angry patient wants following things ( 3 Rs).
1. REASSURANCE Patient just want to drain emotions.
2 REASONING Patient needs Something or someone to blame for mischief .
3. REVENGE
Few patient seek revenge. He would ask money or punishment to doctors.
1: Reassurance
Usually patients are worried about medical issue. They are also annoyed due to expenses. & They are angered due to fuel added by other doctor (Medical jousting ).
Overall, patient is heavily emotionally burdoned bag.
Majority of patients wants Drainage of anger Reassurance of worry and sympathy.
If you allow them to vent up anger and diffuse his worry, he would cool down. You can sympathise and offers Non-monetary help. For example Reference to neurosurgeon and further guidance.
(2) Reasoning
Patient wants explanation to event so that he can blame. You need to divert attention to defective genes is culprit and not radiologist scan. You can mention nutritional deficiency can cause fetal abnormality, one more reason to defect. If you can't guess reason blame GOD for his condition.
Show him fetal development on computers or book(Visuals effects are useful to explain).
Explain him that fetus is very small at 18 weeks.
-You can say size at 18 weeks is almost same as smartphone instead of talking in Centimetres.(so that they can imagine size).
-You can say defect could be very small which cannot be detected at 18 week.
-You can say defect can develop after scan is done as fetus is growing.
Very important - Avoid saying technical difficulties, fetal position etc.(Scan factors). Patient is not interested to know what difficulties you faced.
Focus entire reasoning to genes, nutrition and fetus (Fetal factors). Patient needs these reasons to tell society(relatives and friends). Then entire focus is shifted from 18 weeks scan to other points.
3. Revenge
Few patients are determined to take revenge then Reassurance and reasoning would fail.
You need to be firm and don't get influenced. DON'T PAY ANYTHING.
Say firmly with confidence " If you are determined to go to court then discussion is over,please take a leave. We will meet in court".
There is huge chance that he won't do anything. Majority people are fattu...they wont do anything.
Be prepared for court case also Find articles to support your case. I hv posted few articles with this message.
--
✳ Standard Operating Procedures (SOP)✳ Dr Ram
Although there can be no one-size-fits-all to such scenario,I would write the methodology taught at IAS/IPS training academy to handle difficult situations. We don't have such training in medical school.
I have written standard operating protocols to diffuse any patient-doctor conflicts.
👇🏿👇🏿👇🏿
Patient Enters at center/Clinic and start arguing with staff
👇🏿
Call him inside OPD room. Doctor should not go outside and argue with patients at reception. Because patient would get psychological support from other bystanders patients. His voice become louder.
1. Never become defensive when patient start allegations-
Patient come with full ammunition and under influence of anger. When he attacks verbally , you become defensive (natural human reflex). You try to justify yourself and throw logical explaination. But, patient is under the influence of emotion and his logic gates are closed. He is unlikely to get convinced by your technical issues.
You are also under panic mode, you might say things which are not to be said in moment of heat.
2. Ackwolege the anger of patient and LISTEN to him.
Listen to his complaint patiently. Don't intrupt him while he is discharging his anger.
Find out who has put on fuel to situation. Most of the time , its other doctor who has instigated patient..You need to take care of that instigator afterwards.
Acknowledge husband's concern for his wife and baby. Assure him that you would look into his case sincerly.
But, don't accept any mistakes at this time.
3. Postpone your response
Request him to come next day for meeting and detailed discussion. You can give any reason to postpone your reaction. E.g you need to go into details of study or you need to find records..etc.
Once you buy time, you get out of panic mode. Then you can call rational friends with clear thinking, lawyers, spouse and parents. So that you get ammunations to respond next day.
4. Talk to doctor who has instigated patient. Find 'some' means to convince this doctor. If you convince this person then your job is almost done. You can use local associations to get matter solved at doctors level so that there won't be doctor vs patient battle.
5. Meeting next day-
Spare some time (30-40min) for meeting in room. If possible ask your friend or colleague to join meeting. Even your staff with good communication skill would be fine.
In a closed room ,if husband is alone and you are 2-3 people then it put psychological pressure on him.
Discuss matter with him regarding etiology of defect and treaments plan..
-Show him some videos or picture on computers about fetal growth and causes of defect.
Your colleague's presence can make significant impact in meeting
☝☝
Once you all do this there can be 2 responses from husband.
1. If he had come for reassurance and reasoning ,he would go away quietly.
2. If has come for revenge then he would be adamant then throw him out of room.
Take home message
1.Avoid mistakes in scan .
2. Write disclaimers and explain patients verbally also.
3. Never argue with logic when patient is emotionally charged.
4. Don't be defensive (automatic reflex ), rather take pause and postpone response.
5. Don't pay money to cover up mistake. Patient will blame you whole life instead of his defective genes and God..
6. Dont afraid of court cases. Court case verdict comes after 30 years.
I have written standard operating protocols to diffuse any patient-doctor conflicts.
👇🏿👇🏿👇🏿
Patient Enters at center/Clinic and start arguing with staff
👇🏿
Call him inside OPD room. Doctor should not go outside and argue with patients at reception. Because patient would get psychological support from other bystanders patients. His voice become louder.
1. Never become defensive when patient start allegations-
Patient come with full ammunition and under influence of anger. When he attacks verbally , you become defensive (natural human reflex). You try to justify yourself and throw logical explaination. But, patient is under the influence of emotion and his logic gates are closed. He is unlikely to get convinced by your technical issues.
You are also under panic mode, you might say things which are not to be said in moment of heat.
2. Ackwolege the anger of patient and LISTEN to him.
Listen to his complaint patiently. Don't intrupt him while he is discharging his anger.
Find out who has put on fuel to situation. Most of the time , its other doctor who has instigated patient..You need to take care of that instigator afterwards.
Acknowledge husband's concern for his wife and baby. Assure him that you would look into his case sincerly.
But, don't accept any mistakes at this time.
3. Postpone your response
Request him to come next day for meeting and detailed discussion. You can give any reason to postpone your reaction. E.g you need to go into details of study or you need to find records..etc.
Once you buy time, you get out of panic mode. Then you can call rational friends with clear thinking, lawyers, spouse and parents. So that you get ammunations to respond next day.
4. Talk to doctor who has instigated patient. Find 'some' means to convince this doctor. If you convince this person then your job is almost done. You can use local associations to get matter solved at doctors level so that there won't be doctor vs patient battle.
5. Meeting next day-
Spare some time (30-40min) for meeting in room. If possible ask your friend or colleague to join meeting. Even your staff with good communication skill would be fine.
In a closed room ,if husband is alone and you are 2-3 people then it put psychological pressure on him.
Discuss matter with him regarding etiology of defect and treaments plan..
-Show him some videos or picture on computers about fetal growth and causes of defect.
Your colleague's presence can make significant impact in meeting
☝☝
Once you all do this there can be 2 responses from husband.
1. If he had come for reassurance and reasoning ,he would go away quietly.
2. If has come for revenge then he would be adamant then throw him out of room.
Take home message
1.Avoid mistakes in scan .
2. Write disclaimers and explain patients verbally also.
3. Never argue with logic when patient is emotionally charged.
4. Don't be defensive (automatic reflex ), rather take pause and postpone response.
5. Don't pay money to cover up mistake. Patient will blame you whole life instead of his defective genes and God..
6. Dont afraid of court cases. Court case verdict comes after 30 years.
https://radiogyan.com/guides/frcr-exam-guide/
Page 1 for Google.com within 2 months!
Thanks to Dr Inthulan for a comprehensive blog for the FRCR exam
Page 1 for Google.com within 2 months!
Thanks to Dr Inthulan for a comprehensive blog for the FRCR exam
Shared in the @radiogyan group by a resident.
Mnemonic for facial nerve and vestibulococchlear nerve relation in IAC
Mnemonic for facial nerve and vestibulococchlear nerve relation in IAC