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EP. 72 CT Protocols: CT Technologist Insight vs. Radiologist Expectation · Cat Scan Guru Podcast

• 0:00
  Hello, hello, welcome back, everyone.
• 0:01
  Welcome back to the podcast. So glad to be back recording
• 0:06
  once again. A lot has changed, so I'm going
• 0:09
  to go through all the changes that have come to this podcast,
• 0:13
  to social channels, to the brand, and some new courses that
• 0:17
  I have developed. So I know in my last podcast
• 0:21
  episode, I was talking about the direction and kind of the
• 0:24
  rebrand of the CT Educator. Well, the podcast has a new name
• 0:30
  and so do all my social channels.
• 0:31
  So I went ahead and did a lot of thinking and I wanted something
• 0:36
  to represent me and my expertise in the CT space.
• 0:40
  So I went ahead and rebranded and I'm super excited about it
• 0:45
  and the courses that I have developed.
• 0:47
  Awesome, awesome, awesome because it's been highly
• 0:50
  requested. So I am going ahead and
• 0:53
  delivering. And one thing that did happen
• 0:55
  was is I'm not sure if you all follow me on TikTok because I
• 0:59
  think most of if you do that do listen.
• 1:01
  My TikTok account got hacked on April 26th and apparently it had
• 1:06
  been happening to thousands of people all across the app and it
• 1:10
  took me 3 1/2 months. On June 20th is when I regain
• 1:14
  access to my TikTok account once again.
• 1:17
  I had to go through a whole spiel where TikTok had to, you
• 1:22
  know, verify all my information. I had to give them a lot of
• 1:25
  information to verify that I was the rightful owner to that
• 1:29
  account. So and it was just hell because
• 1:32
  I had to create a backup account and try to grow that account.
• 1:36
  And those things were frustrating.
• 1:38
  So yeah, it's it's one of those things that just threw me for a
• 1:42
  loop and kind of made me want to just stop doing social media
• 1:46
  altogether. But I'm glad I didn't.
• 1:48
  I just stuck with it and it worked out for the best.
• 1:51
  So now I'm back on TikTok, it's got a new name, which it will
• 1:55
  have the same name to this podcast in a couple weeks
• 1:58
  because I just had to kind of give it a name.
• 2:00
  I wasn't sure what name it was going to be.
• 2:02
  So make sure you check out the the show notes.
• 2:04
  All the links will be there. I have a new site for all my
• 2:07
  courses which is pretty structured and it's more easily
• 2:12
  tangible so my students can go through it because I had a
• 2:16
  couple of different sites. So I'm just combining everything
• 2:19
  and making everything very simple just so that you can go
• 2:22
  through all the lessons and learn what you need to learn as
• 2:26
  a new technologist. I've also come up with a 10
• 2:29
  episode private podcast series that you can check out on that
• 2:33
  website as well and you can binge it.
• 2:36
  So I've gone with the platform school, which does have an app
• 2:39
  and you can listen to these episodes and even the trainings
• 2:43
  on the go. So you can listen while you mess
• 2:46
  with your kids if you have downtime at work or you know,
• 2:50
  you're driving home in the car. So it's very easily accessible.
• 2:54
  So make sure you check out the show notes and check that out.
• 2:57
  So let's get into today's episode because today's episode
• 3:01
  is going to be very juicy. And I'm going to tell you why
• 3:04
  this episode was created. So I have had a few videos on
• 3:07
  TikTok that have gone viral and I will link the videos in
• 3:12
  question that sparked a lot of conversations when it comes to
• 3:17
  CT protocols and you know, the technologist's insight and
• 3:23
  knowledge versus the radiologist expectation and their
• 3:26
  perspective. So there was a ton of comments
• 3:31
  and I know I had responded to some of those comments either
• 3:35
  written or by video response, and it sparked a very good
• 3:39
  conversation. And they gave me a very good
• 3:41
  idea on how I can better not only bridge the gap, but better
• 3:46
  help those technologists out there with the concerns that
• 3:50
  they had in the comments that they left on my videos.
• 3:52
  So first let's explain the past versus the current dynamic when
• 3:58
  it comes to technologists and radiologists.
• 4:00
  Now, I know that some of you that do listen are old school
• 4:05
  technologists like myself, you know, 20 + 30 plus maybe 40 plus
• 4:09
  years in the business, maybe more and still doing it.
• 4:12
  And we had a different dynamic back then than we do now.
• 4:16
  The dynamic back then was is we had radiologists on site.
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  They were there. They sat in the dark room.
• 4:22
  This is the days of, you know, dark rooms and film and
• 4:28
  developers and fixers and chemicals.
• 4:30
  If you all remember that, because I do even to this day, I
• 4:33
  think I can still smell those chemicals because that's how
• 4:36
  long I spent in the dark rooms and X-ray.
• 4:40
  So we remember those dynamics. When we had an interesting case,
• 4:43
  you would walk into the reading room and say, hey, I have these
• 4:47
  images, can you teach me something?
• 4:49
  And they would teach you a lot and what to look for and how to
• 4:52
  find things and when you were scanning or even X raying
• 4:57
  patients, right? So here's the other thing.
• 5:00
  That dynamic has changed and the way it has changed because a lot
• 5:04
  of it has moved to transitioning from being on site to remote
• 5:09
  radiologists. And there's a few reasons for
• 5:12
  that. One of the reasons is COVID
• 5:14
  really just kind of dampered all that and move those radiologists
• 5:19
  off site to being more remote. And I know this has happened at
• 5:23
  the level 1 trauma center that I work at where we did have
• 5:26
  overnight radiologists and guess what?
• 5:28
  They transitioned them and you know, they were remote.
• 5:32
  Now the other reason that this has happened as well is money,
• 5:37
  of course, OK, And I know sometimes we're afraid to talk
• 5:40
  about money, but a lot of hospitals want to save costs any
• 5:44
  way they can. So what they do is is they will
• 5:47
  outsource radiologists, especially at night.
• 5:50
  Some facilities do have it during the day.
• 5:52
  It just depends where they will use a Nighthawk like a third
• 5:56
  party vendor, something like Stat Rad or V rad or ERAD to
• 6:00
  save costs. Or they have a group of
• 6:03
  radiologists that may be in another state and they are just
• 6:06
  remote radiologists that are reading for somewhere, let's say
• 6:10
  in Indiana, right? So, and that is to cut costs
• 6:14
  instead of having somebody in house and paying that
• 6:18
  radiologist money to read. That has been one of the things
• 6:22
  that has really just hit hard with the dynamics as far as
• 6:27
  communication between the technologists and radiologists.
• 6:31
  Now let's talk about the lack of communication.
• 6:33
  Now this transition kind of dampered the communication
• 6:36
  because you can't just walk down the hall and say, hey, I'm going
• 6:40
  to go talk to the radiologist. Or if you have a contrast
• 6:42
  reaction, let me go grab the radiologist that's down the
• 6:45
  hall. That practice, you know, has,
• 6:48
  you know, kind of dwindled. I know at a prior hospital I
• 6:50
  worked at, they would have radiology residents at night.
• 6:53
  So you always had a radiologist on site, you know, so that those
• 6:56
  are one of the things that has really just, you know, Hanford,
• 7:00
  the communication between the tech and the radiologist because
• 7:04
  of the outsourcing. Now, the other thing that I see
• 7:06
  happening is there's not a lot of communication between techs
• 7:10
  and radiologists. And I will give you a prime
• 7:12
  example because there was one situation at a hospital I worked
• 7:16
  at where the radiologist did not want to be bothered, you know,
• 7:19
  at night with questions or this or that.
• 7:22
  They gave us a protocol via e-mail and said, OK, you follow
• 7:25
  this. If it's outside of, you know,
• 7:27
  these parameters, then yeah, you can call us.
• 7:29
  But other than that, we're just going to approve it.
• 7:32
  Now that kind of puts a little liability on, OK, do I feel
• 7:37
  comfortable doing this exam? Do should I do this or do that?
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  Because it relies heavily on the text and radiologists have this
• 7:45
  expectation that, OK, well, you have a protocol book, you should
• 7:48
  know everything. It's not always the case, OK?
• 7:50
  It's not always the case because I could tell you there's a lot
• 7:53
  of radiologists that I've come encountered with that.
• 7:56
  I've asked about protocols and they just say just do whatever
• 7:58
  they ordered. And it's not how it's supposed
• 8:01
  to be. Where I've seen other places
• 8:03
  that radiologists will protocol everything before you even scan
• 8:06
  anything because they're the ones reading it.
• 8:09
  They're the ones dictating it. They want to make sure that you
• 8:11
  do the correct exam. So it kind of goes both ways.
• 8:15
  OK, Now one of the comments on one of my videos is the lack of
• 8:19
  respect towards the CT technologists and the
• 8:23
  radiologist's expectation of knowing all the protocols
• 8:27
  because they are just there to read it.
• 8:28
  And why are you calling me about something you should already
• 8:32
  know? Here's the thing, ordering
• 8:34
  physicians and other providers will order things that are
• 8:37
  really, really out of the norm, OK.
• 8:39
  And a lot of times it's they're funky orders, OK, And some of
• 8:44
  these orders, you're like, OK, this is bullshit.
• 8:47
  Why are we doing this? And then when we question those
• 8:50
  ordering providers, just say, well, you know, I'm looking for
• 8:54
  such and such. OK, well, you need to do this
• 8:56
  exam. And they have no clue.
• 8:58
  So since we are under the direction and the guidance of
• 9:02
  the radiologist, normally we're going to ask him, listen, this
• 9:05
  doctor ordered this. I'm not really sure how to
• 9:07
  proceed. What do you think I should do
• 9:09
  Now? There is where there needs to be
• 9:12
  a positive collaboration and we can give them a full medical
• 9:16
  history of what's going on with the patient.
• 9:19
  They have access to look at the patients chart and they can
• 9:21
  really direct us on, OK, you're supposed to do XY and Z, or they
• 9:26
  can just call the provider themselves.
• 9:28
  That piece completely seems to be obsolete now because it seems
• 9:33
  to me, and I know this is going to trigger people that
• 9:36
  radiologists do not want to have a say in what goes on with these
• 9:41
  radiology orders that come in, but want to complain and
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  disrespect the technologists about why the fuck did you do
• 9:50
  this? When we simply ask questions and
• 9:53
  then you go back and that's not what you wanted, you cannot have
• 9:57
  it both ways. OK, So what I'm getting from the
• 10:01
  comments that I got on my video is, is that radiologists have
• 10:04
  this expectation that we need to know it all.
• 10:07
  And you know that they, they seem to be under the impression
• 10:11
  that we have all this wonderful training and knowledge.
• 10:14
  It's not always the case. A lot of times there are
• 10:18
  technologists who don't get the proper education, don't get the
• 10:21
  proper training. And when they're learning, it's
• 10:24
  impossible to learn the amount of protocols that radiologists
• 10:28
  go ahead and expect us to do. Now, where do the protocols come
• 10:32
  from? And I mentioned this in one of
• 10:34
  my videos responding to a radiologist that I will link in
• 10:38
  the show notes. I said these protocols when
• 10:41
  they're created, they come from you.
• 10:43
  It comes from your group, it comes from you that is reading
• 10:47
  the exam. It doesn't come from the
• 10:49
  technologists. What I see here is that it opens
• 10:52
  up the technologists for a lot of liability, which they don't
• 10:55
  need to be. And when we're questioning
• 10:58
  something, radiologists like to put us in the middle when it
• 11:01
  should be a physician to physician conversation.
• 11:03
  So I am talking about these topics because there needs to be
• 11:07
  more awareness and there needs to be more collaboration where
• 11:11
  radiologists really need to take the upper hand and speak to the
• 11:14
  physicians about the orders that they're ordering.
• 11:17
  I know you're going to say, well, they don't have enough
• 11:19
  time. They're going to say do what I
• 11:21
  ordered and this and that. But you have to remember at the
• 11:24
  end of the day, it's in the best interest of the patient.
• 11:27
  Think about it this way. If it was your mother, if it was
• 11:30
  your son, your daughter, your aunt, your father, your
• 11:34
  grandmother, would you want somebody having a constant back
• 11:38
  and forth and they're getting repeated imaging?
• 11:40
  Or do you want somebody to advocate and make sure you get
• 11:44
  the correct exam? Just think about it that way.
• 11:46
  And I think if more radiologists were on board with us, it would
• 11:49
  be more, more of a positive interaction and a lot of
• 11:53
  patients would not have the repeat exams that they would.
• 11:56
  So I think in the best interest of the patient, what needs to
• 11:59
  happen is, is there needs to be more positive collaboration
• 12:03
  between technologists and radiologists.
• 12:05
  Listen, I know there's some texts out there that
• 12:07
  radiologists can be real assholes and they can make their
• 12:11
  job really hard. And I've heard radiologists in
• 12:14
  the past that say, you know, we need to treat our technologists
• 12:17
  better because they can make our job really tough.
• 12:20
  And in actuality, I agree with that statement because we can't.
• 12:23
  However, it should not be that way.
• 12:26
  It should not be that way. We should be able to communicate
• 12:29
  that when we call you that there's going to be respect both
• 12:33
  ways. Let me say that again, respect
• 12:35
  both ways, OK? So to the radiologists and to
• 12:39
  the technologists, because I've encountered radiologists in the
• 12:43
  past that are very disrespectful.
• 12:44
  One of the comments was, I don't need to sit here and hold your
• 12:48
  hand and you should know what to do, which is very disrespectful
• 12:52
  considering that we're both adults, OK?
• 12:55
  So and then they should be there for guidance.
• 12:58
  They should be there to help us. They should be there to step in
• 13:01
  when something isn't right. And those are the things that I
• 13:03
  think we look for and we want. So those are my insights for
• 13:08
  this podcast episode. Make sure you guys check out the
• 13:10
  show notes. I'll link all those videos down
• 13:13
  in the show notes. I'll link down my new e-mail
• 13:15
  address, all the new socials with the new names, and the
• 13:19
  website for all the new courses. So the next probably month's
• 13:24
  worth of episodes, it's going to be exciting.
• 13:26
  So I am going to drop 2 episodes every week starting next week.
• 13:29
  So you're going to get brand new podcast episodes here on the CAT
• 13:33
  Scan Guru. I love that name every Tuesday
• 13:36
  and Thursday. So make sure you guys subscribe,
• 13:39
  share this with a technologist that needs to hear it, like
• 13:43
  comment all that stuff, OK? And make sure you guys follow me
• 13:47
  on TikTok, follow me on Instagram, follow me on YouTube
• 13:50
  because I'm going to be bringing you even more educational stuff.
• 13:54
  And we're going to talk about the mental health stuff as well
• 13:56
  because I think that's a very important piece.
• 13:58
  So thank you so much for sticking with me through this
• 14:02
  rebranding. Thank you so much for listening
• 14:04
  and I will chat with you guys next week.