On Digital Radiography

One of the hospitals I work at is converting their radiology department to all digital. They promise to have better organized films, and a faster turn around time. This is going to be supported by over twenty computer reading stations, strategically placed around the hospital floors to be be able to access these films.

The allure is great. To be able to view films on the floors is a "killer app." Apparently, we'll even be able to see the images from the comfort of the office, or at home. Perhaps we'll noever have to go through the file romm again searching out the "lost film" that we know was just taken. The system will be backed up continuously from a remote location.

However, all is not as rosy as it would seem. One thought that comes to mind is how we're going to be able to function in a power outage. My guess is that unless our X-ray vision glasses arrive, we'll be out of luck- at least for the duration of the blackout. Pretty soon, none of the radiology techs will even remember how to remember film, and the equipment won't be around anyway.

The other issue is for films for the surgeons. For many operations, from the fractured leg X-ray for the orthopedist, to the head CT for the neurosurgeon, to the angiogram for the vascular surgeon, there is no substitute for having the film available. In this current environment of preventing "wrong site surgery," this risk is just too big to take. And the list could go on and on as there really is no excuse for not having the appropriate imaging in the OR for the procedure. In our environment of less invasive procedures, we're even more reliant on our radiology imaging.

The plan is to bring a cart with a double monitor setup to the OR for the procedure. I'm not really sure how the surgeon is supposed to control the computer to see the film, and remain sterile. Perhaps a sterile mouse? (Just kidding!) Also, most CT's and angiograms are more films than will easily fit on even a dual monitor setup. There are also issues of what if the network traffic is slow, or someone kicks out the plug of the setup. Several of my colleagues are up in arms, and plan to bring their patients to radiology offices that still print films that they can put up in the OR.

Stay tuned to see how this all turns out. In my mind, it's real hard to improve on having a printed film up on the lightbox in the OR. While the allure of new technology is great, sometimes a simpler and lower tech solution is the way to go. When people's lives and well being are at stake, we should definitely adhere to simplicity.

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Exceeding Work Limits

A large percentage of first-year medical residents exceeded limits on their work hours intended to reduce fatigue-related medical errors, according to a survey conducted by Harvard Medical School researchers. Violations were reported by residents working at 15 of 16 Massachusetts teaching hospitals.

The study found that 84 percent of 1,278 first-year residents surveyed reported at least one violation in the year after the rules were adopted in July 2003 by the national organization that oversees graduate medical education.

The rules limit residents to working 30 consecutive hours and an average of 80 hours a week, and require them to have an average of one day off every seven days.

Let's just say that when I was a resident, 80 hours a week would have been a part time job to me...

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You Know Doc, It's A Little White Pill...

If I had a nickel for everytime I heard that phrase, I definitely wouldn't have to work so hard. Patients often think that their all knowing doctors know every pill on the market, and can identify it from their description. How about when they bring their pills, but they are in an unmarked bottle without the label?

Staring at the pics in an out of date PDR is so last century. So, now there is a better way. Head on over to Wall's Medicine & Health Center. There, you'll be able to describe the pill by markings, color, and shape. Before you know it, you'll have that pill identified!

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