Hey Dr. Cellini, I’m a neurosurgical scribe and I’m almost always the one ordering imaging on my provider’s behalf - this vid is actually extremely insightful and I’ll try to incorporate your feedback the next time I think about ordering a head CT without a useful indication :)

As a Radiologic Technologist, we get called and paged for “STATS” all the time. 1 out of 10 calls are not stat which interrupts our patient care with ER patients. So I TOTALLY get you! Do you think you can make a video on your relationships with the rad techs of all modalities you work with? That would be awesome!!!! 🤗

@howdareu964

3 жыл бұрын

no stupid dancing tik tok videos plz. don’t lower yourselves to that

@baileyelliott7277

3 жыл бұрын

I don’t think he will, he never really talk about us even though we are one of his right hand woman/man

@imthrillz5255

2 жыл бұрын

@@howdareu964 just because some nurses made dancing tiktok videos doesnt mean every single healthcare worker does that. Your thinking is idiotic, thats like saying all cops are bad. Sad to have such extremist thinking.

I’m a CT Tech. I honestly thought one of these would be about techs interrupting you. Thanks for not letting us bother you.

@jakelieske1211

4 жыл бұрын

I'm a CT tech also, I was waiting for a comment regarding sending a brain that isn't perfectly positioned when that is not always possible.

@kennethoriger4939

4 жыл бұрын

Jake Lieske my department has to recon all heads for this reason. ALL!!!!! Lol.

@haleyramirez700

4 жыл бұрын

Kenneth Origer haha I thought the same!

@csather91

4 жыл бұрын

Kenneth Origer I used to have to do this as well. Granted you get pretty quick at it.

@howdareu964

3 жыл бұрын

Some rads close their doors when reading deep imaging (usually with comparisons). That’s are sign dont even think about it

Stat pelvic ultrasound. indication: positive pregnancy test.

@tigerheaddude

4 жыл бұрын

Je Diapen will, it could be an ectopic about to burst. More info is needed sure but it's probably not unreasonable

@GermanyTechno

3 жыл бұрын

@@tigerheaddude Come on, you know that’ll be less than 5% of all the cases. 🙄

@tigerheaddude

3 жыл бұрын

@@GermanyTechno yeah maybe, but horrible thing to miss and, much less importantly, indefensible in court

@ChrisRRT

3 жыл бұрын

@@GermanyTechno Yes rare and probably no need of a stat read by radiology. OB GYN should do there stat read and give the radiologist a chance to review.

@jediapen3690

3 жыл бұрын

@@tigerheaddude yes but the indication should be pelvic pain, not a positive pregnancy test.

As a 30+ year radiologist, two additional things: 1) Ordering a chest x-ray at the same time you order a chest CT (or abdominal radiograph when you order an abdominal and pelvis CT. If I have the CT, I don't need the radiographs. 2) Barging into the room, turning on the lights and saying, "Wow, it's dark in here!"

Hi, I am a radiologist in Sweden and it was so funny to see that we have the EXACT SAME problems that you described :D I also had a surgeon barge in on me, ripping the computer mouse out of my hands, shrieking about some active bleeding on a CT scan I hadn't even opened... lo and behold he was wrong, it was atelectasis of the lung in the arterial phase...

1) STAT portable NG tube placement 2) When a chest xray is ordered and reasoning is PA/LAT

I'm a Sonographer, my biggest pet peeve, is the stat on a non-stat case. "Patient is going on vacation tomorrow and needs the results today!"

@SunshineKane1

4 жыл бұрын

Or a mommy of a 4 and 7 yr old diagnosed with breast cancer at 35 wants stat.....nerve of me!!

@leeni247

4 жыл бұрын

Yeah for a problem they’ve had for a year

@SPQRafc

3 жыл бұрын

Yep, that applies to call countries

@joanhall1384

3 жыл бұрын

I’m so sorry you are going through that. Of course like anyone of us will want the results stat. I’m a breast sonographer and understand that. We always do immediate reads on breast sonography. I hope your doing ok. This conversation is not regarding patients so much as it is how things are ordered.

Just found your channel and love it!! I’m a vet tech working in imaging ( I primarily do ultrasound) in a veterinary teaching hospital/referral center. This video highlights the struggles of our radiologists.....same problem on the veterinary side!!! Incomplete histories, inappropriate study choices, every case emergent.......same stuff, different species!

Mri tech here and I can agree on all these.

Techs get annoyed when providers ask us why studies are taking "so long" to get read. Like we're gonna call our rads and tell them to hurry up. You can't rush that, also a radiologist's shift could (and usually does) involve reading over 100 exams.

I'm a CT Radiographer. 1) Failing to provide an eGFR or HCG when I need one. 2) Whenever patients are brought around for their scans without any discussion or referral. 3) Requesting borderline non-indicated studies just because the patient is in the department. (We call these excludograms) 4) Requesting panscans for low energy MoI as a substitute for poor clinical assessment.

Thank you. This is helpful because we don’t know what goes on in your world as APs in the ER. Great work!

I’m an IR PA and my top 3: 1. An admission for a oncology workup requiring occupying a valuable bed, further imaging and perhaps a procedure on a stable patient with an incidental finding that can all be done as an outpatient, but “they’re here” 2. Not understanding that MRI, US, Fluoro and IR are all different departments and trying to coordinate different studies or procedures all at once “while the patient is down there” is not generally feasible 3. “I’m sending a patient down for a CT...if you see anything can you just take care of it while they are down there?” No diagnostic pause or concern that they just drank contrast and will likely need sedation. Great video and IR is THE best 😉

@DrCellini

4 жыл бұрын

You are dead on with all the above! 🤣

As an XRAY/CT/MRI Tech it is annoying that other hospital workers assume: A. You can image their PT right now. B. That imaging does often require prep such as being NPO, or needing kidney function checked, or needing to be sedated. C. I will do an exam because a doctor ordered it. If your PT is of sound mind and refuses an exam I am no longer going to preform that exam. Threats on my job be damned.

I am not clinical but I do work in a hospital as an outpatient registrar, and I couldn't believe how much I actually understand and in some ways can relate. Especially when it comes to dealing with doctors and orders. I love videos like these cus it actually makes my job easier when I have a better understanding of what doctors and techs go through.

Always think about that when our team (medical receptionists) have to call the read room to speak to the radiologist because a doctor needs to speak to them about something either they read or some other radiologist read and they need help. I feel so bad everytime I have to call them because I know you guys are focusing and I give you all so much credit and love! Working at a diagnostic imaging center I love it and it’s making me want to be a radiology technologist! Thank you for all you do.

I am a sonographer and I honestly thought one of these would be when the techs come in! Glad to know it's not too annoying :) I'd like your honest advice on how to better approach a Radiologist when we need assistance/advice on a case.

I think the line that annoys most of the clinicians: “Kindly Correlate Clinically”

@DrCellini

4 жыл бұрын

Sometimes you just have to!

@djmammo9826

4 жыл бұрын

If you see something unexpected you really have to suggest they look into it. If you see an incidental renal calcification on CT, and the patient is long gone, you recommend their doc ask the appropriate questions of the patient to see if they can elicit a history that goes with your finding. Perhaps we need a new more agreeable phrase for this suggestion.

@lamloumas9389

4 жыл бұрын

Well Bro, you should never forget that you're dealing with a patient not an image, so clinical symptoms are VERY IMPORTANT even if you ask for an imagery exam, and that's what most clinicians forget. SO YES, you have to ALWAYS correlate to clinicall signs 😎

@allyman7928

4 жыл бұрын

sometimes clinicians request radiology studies that have no indications at all for that particular study,whereby the results just end up being normal...at this point,they just have to correlate clinically. I came to realize with advancement in technology in medicine,clinicians have become too lazy to think and just request unnecessary radiology studies.

@howdareu964

3 жыл бұрын

Ally Man bingo

SO RELIEVED to hear this, and discover those Top Ten annoyances ALL involved other physicians and not the Nurses!! (We finally get a break here!😃) 👏👏👏 I may be retired but your videos keep me in the loop. Thanks, this is great stuff!

This is amazing. Every specialty should make a video like so. There should be meetings within institutions in which topics like this are discussed. AMAZING.

@joefalsetta9181

4 жыл бұрын

I was thinking that during the entire video 😂😂

@greghaubrich3527

2 жыл бұрын

Good Christ, the ER video would be days long.

Same crap. Different place. 😅 Everything was spot on.

His videos helped me decide to become a radiologist. I'm starting next month as a First year medical resident

As a radiation oncologist we need a good connection to the diagnostic team, your tips will help Dr. Cellini ! My residency training hospital was so busy that asking for several clarifications from the Radiologists were just seen as heaping extra-workload on them. My current workplace has radiologists come in each day for about 2 hours and read our diagnostic scans and also answer some difficult questions, things that can influence our target volumes.

I am a CT tech and I can’t tell you how many times the ED will order non sense studies just because the pt is down in CT. We call it a “fishing expedition “.

@DrCellini

4 жыл бұрын

100%

@honeyhamster1282

4 жыл бұрын

I hate when you get called-in in the middle of the night for an ‘urgent’ query perf and then the patient just walks on down to the scanner. As if they’re perf’d.

@jakelieske1211

4 жыл бұрын

I'm a CT tech also, the ED will order an abdomen pelvis, it will come back negative, then they will order a PE instead of actually going to see the patient

@howdareu964

3 жыл бұрын

How many iatrogenic breast cancers are we giving females later on with CTA for PE on 20 year olds having a panic attack

Love the video idea! And great execution!

Starting radiology residency in 2 months!!! Thanks for the heads-up!

@lilliampumpernickle4655

3 жыл бұрын

Must be nice. How’s it going so far?

Common sense & common courtesy go a long way! We have a lot of the same annoyances in Cardiology & Echo. Stat testing ordered late in day to be sure done before dept closes or before they discharge pt, indication of “other”, providers calling to get “preliminary” results from echo techs or RNs-“no, we cannot give out that info, only Cardiologist can officially read studies”, etc...Thanks for the video, you are doing great!!!

You’ve inspired me so much with these videos! Hoping to get into a med school next year, and really want to be a radiologist. Hope you have a good weekend :)

@DrCellini

4 жыл бұрын

It’s the best field!

@RyanAmplification

4 жыл бұрын

I'm in the same boat!

@howdareu964

3 жыл бұрын

he will have a good weekend proving he’s not on call

@levibeam100

3 жыл бұрын

@@howdareu964 what?

@howdareu964

3 жыл бұрын

Levi Beam *providing he’s not on call

I'm surprised it's the same issues everywhere, I thought these things happened only here in Algeria 😂 but No the RADS vs. CLINICIANS clash is appearently a worldwide phenomenon. Thanks Doc for your vids, I enjoy them so much 😊

Inpatient X-ray tech here! Our providers have started putting just “pain” in the S&S for every order now. Just because it’s billable doesn’t mean it’s sufficient! The mechanism of injury or the specifics of what need to be ruled out actually affect what images we take. A good history can make or break both what images are performed and how it gets dictated. Great video!!

@breannwyatt9321

4 жыл бұрын

The nurses I work with have started putting "physician order" as the history for every patient. A lot of them just assume I know the patient's history 🙄

Very well said doc, I am CT Tech and it annoys me more when they well add the unnecessary procedure

I’m an X-ray tech and what annoys me the most is when we get redundant orders like hand, wrist, and forearm on one patient.

@howdareu964

3 жыл бұрын

On another planet on another KZread there’s ordering clinicians posting they hate when rad techs call them acting like Karens yelling at them about ordering exams

Before digital images were available it was sometimes hard to get a read in the middle of the night. Most of the time, the radiologist was at home and didn't want to come it to read a film. One of our enterprising emergency physicians hired a taxi to take the films to the radiologist's house and called the radiologist back to let them know that a taxi would soon be at his door. It didn't go well.

These kind of videos are very helpful to understand the radiology field more

Dr.Cellini killin the vids lately

WOw, i didn't know all this... As a resp. therapist, i appreciate your insight and perspective! I'lll try to help ya guys out :)

ED attending here (about 2 years since residency). Im guilty of over ordering CT scans but I appreciate the work the radiologists put in, and hopefully that will get better with experience. I try never to bother you guys unnecessarily. If the study has been taking a very long time to be read, I will usually call the CT tech or the radiology department to make sure that the study was actually sent because I have had a few occasions where I call and find out that the tech never actually sent the images to the radiologist (my hospital system is kind of dysfunctional). I try never to call you guys unless I really need clarification on a study. I hate being interrupted at work when I am putting in orders or reviewing results and I can imagine how difficult it is to pick up where you left off when reading dozens of images and being interrupted. One thing that annoys us is when we can't get contrasted images because of an allergy or AKI and the radiologist makes sure to make a few notes to include how limited the study is due to lack of contrast :P

First year radiology resident here. Love this video! All of these are so true.

@DrCellini

4 жыл бұрын

You know it!

I'm a med student and work in the radiology after hours reading room with the residents. Our program did a QI project that began by asking the residents what they hated the most, and they all reported protocol calls. So now they pay med students $15/hr to triage and pick up all their calls, collect the protocols and present them as one liners after you have gotten a couple and a radiologist has just finished reading a scan (we look up their Cr, call to find out if they are on HD, etc.) We also page all the providers if they need. Anyway, this helps our residents immensely and it's a great opportunity for med students interested in rads not only to make money but to get close with the department and experience what the radiology job is like. Maybe you guys can start something similar?

@mohamedelfatih6248

3 жыл бұрын

Sounda Great! Please wanna to discuss more with you. I think I should done similar thing here. I am intern, and highly intereted in radiology. My email: mhmd.alfatih10@gmail.com Hope you reach me please ♡

Ahhhh yessss CTA PE + Tack on abd/pelvis. What a BONUS! Might as well do a runoff while they’re down there. Reason: other;unspecified limb 🤷🏼‍♂️👏😂. Keep it up my man. Miss u and love the channel- MJ

Glad to see you back!🇺🇸🙏

These videos serve as a study reminder ❤

Great video. As a Gen Rad Tech, working in an ambulatory clinic, one of my favorite orders is a stat toe🤣. Seriously. The other is like you said, the vague or non existent signs & symptoms. One provider puts “pain” for the signs & symptoms for every Xray exam he orders. We have even incorporated questions that prompt them to put things like what, where, when, how etc the injury occurred. 🤦🏻‍♀️

@samantham9787

4 жыл бұрын

Lpsb232 we get the classic “sprain or strain” 🤦🏼‍♀️🤦🏼‍♀️🤦🏼‍♀️

I'm a new doctor. Thanks for the heads up on what NOT to do! :)

I love this video. I had this idea once to put signs on the door when reading is going on DO NOT DISTURB; REPORTING(READING ) IN PROGRESS. It’s beyond irritating to have someone hovering behind me mumbling , muttering or asking questions; reading is not an automatic process , one needs to think as well

Are the usmle step1 pass/fail videos too oversaturated to consider uploading your personal thoughts? Just wondering. Nice vid btw!

Once radiologist missed rib fracture when reading CT of patient with lumbar vertebrae fracture. I just go to her and told , without any drama, without any "broadcasting". Everyone can be wrong in one time in their life.

Clinicians that do not respond to phone calls or texts and have office numbers that return a message tree with no opportunity to speak with a human. I once spent an hour or so of my own time trying to reach a doc about a decompensating patient with a large pneumothorax. I wound up bringing the patient to the ED myself and having them request I put in a chest tube. The referring doc was then pissed that he hadn't been called. I told him he should try calling his office himself sometime and see what a waste of time it was and that he should answer his phone.

PACS Admin. At my hospital the ER docs have gotten very clever. They will call me to ask why a particular study doesn't have a report. Usually a Stat Head CT. Then they will say "Can you ask the radiologist to look at ASAP". They do it just to make me the "interrupter" instead of them.

@howdareu964

3 жыл бұрын

not cool

As a CT tech, there have been so many times when the patient is on the table for an AP scan, then as soon as I'm about to inject, they order a PE. Never fails.

@csather91

4 жыл бұрын

Jake Lieske yeah and we should probably just scan the head too 😂

@greghaubrich3527

2 жыл бұрын

I've done that. Sorry. On the flip side, I've bought many drinks for CT techs.

X-ray tech here soon to be MRI tech . Great video !

Same pet peeves I had 30 years ago. Only the technology has changed.

Ahhh - the phone! Hilarious!!! 😂

As a medical student this is great for my learning!

In IR, when providers place consults without seeing their patient and they don't know any of the PHI or PMH/ indication for the procedure. Also, when they place consults without the proper imaging omg this drives me nuts!! We cant do anything if we cant see where we need to treat!!!!

yes as a fellow radiologist.... i totally agree with this video...

When they order a Stat MRI of the knee for knee pain 🙄😒😑

Radiology Tech here when I take an X-ray and patient ask me if I can tell them what’s wrong or what do I see.

As a Pediatric Gastroenterologist, I have a long list of things that Radiologists do that annoy me but in the end we work together as a team and that's what I try to focus on. I also know that the Radiologist probably have a list of things that I do that annoy them. This is why we have bi-monthly meetings to have an open line of communication that helps our team be more sufficient and benefits our patients, which is our ultimate goal!

Have u ever not known something looking at MRI- Like not known for sure if a ligament is torn for sure? What would you do? Have u ever written that you aren’t sure?

Such an inspiration in the medical field. The intro is sick, btw. Keep it up!

@DrCellini

4 жыл бұрын

haha thanks man!

Xray/CT tech here. - Doctors over ordering scans, practicing *defensive medicine* rather than getting out of their cubby, and putting some eyes and hands on the patient. They shouldn't be so dependent on radiology, and instead should practice their critical thinking skills to rule things out, instead of prophylactically relying on the photons to do all the heavy lifting... They should atleast attempt to try to narrow it down to an area. Sometimes, I get being cautious, so the extra study/ies can be justified. Other times, it's just out of laziness. Who pays the price? The patient getting over radiated. *We are responsible.* - We all have good days and bad days. Let's not rush! Lets take it one day, and one study at a time. Thanks to all the medical professionals out there for what you do. Nice video Doctor 🤘

Hovering can be annoying but I do respect the clinicians that walk into the rad room and ask for opinion giving an excellent clinical far better than a few typed out words.

Awesome video man

could you tell us please what difference between radiologist from med school and radiology technician and technologist and the graduated students from applied medical science ?

If we as patients only find one thing at a time, what then. I started with back issues, ended up finding possible stroke. Wow.

The “positive arrow sign.” Not something that annoys me. In fact, the opposite-as a non-radiologist, I find the arrows useful. I just wish there was a way to toggle them on and off on my PACS system so I could do my own search pattern before getting the hint. 😀

Nailed it!~ 🖤👍🏻

Retired IR. When they say, “while you are there doing the run-off, could you quickly SQUIRT the carotids.

Let's look at this from another side. I was a product specialist for a provider of PACS and CR/DR systems. Adding a chest adds radiation to a patient. Radiation is bad, M'kay? My wife worked in a NICU and every damn intern and resident would come in and order another study on those little Beans. My company used image processing to reduce exposure by 50%. So Doc, stop, read the chart, check the RIS and see what that Bean has had done!!!! Radiologist are the hidden Dr's and they do great things. LISTEN TO THIS MAN!

Can you do a video on things nurses do that are most helpful for the docs and things that are pet peeves as well?

I’m going to apply for radiology residency in my country next month. I currently work with surgeons and I get it that emergencies evidently occur, but they are ALWAYS asking me to bother radiologists for preliminary reports on studies (many which are not necessarily urgent). I hate doing it, because I realize how annoying it should be for them to be interrupted. And I’m probably going to be really annoyed the day that it’s me behind the computer interpreting studies facing the same issues.

i really enjoyed your list being in the same shoes. what about the anomaly scans advised without any indication in third trimester

good video and 100 percent true

I'm an R.T.(R). Biggest pet peeve has to be when my fellow techs don't use markers appropriately, or don't use grids.

Rad Tech here. I hate that a doc orders a portable when clearly the patient can come to the department. I can give my Rad an extremely better image to read if they would simply COME TO THE DEPARTMENT!

US TECH here, can confirm on all of these, I also would like to add, ro ectopic on stat pelvis, when BHCG is 100, like, what am I suppose to see? And you wasting radiologist time and my time.

I love someone is still using the term "wet reading"...

The amount of pointless orders is awful. It's bad for those on staff, and bad for patients without patience. I've watched a lot of nurses and PAs come in, calling in everything on the list so they can stall. Again, med is WILDDDDD!

Spot on!

I work in radiology department and i know what annoys the breast radiologist is when the ref doctors call saying why is my case not read stat but didnt specifiy they wanted stat on the referral form

Hi! I am a cancer clinical research coordinator. A lot our oncologists want at least a preliminary read prior to the patient’s scan review clinic visit to make sure there is no progressive disease and we can still treat. The oncologist have us call the reading room an hour before the visit if no read has been done. You mentioned trying not to interrupt your workflow for non-urgent cases.. what would suggest to do in this situation.

Dr. Cellini, I'm currently in the RRA program. Any insights on this Department? Do you think it will be a good thing within increasing world if imaging?

I love your videos!

Omg I can see why that all would be annoying. Plus I can't tell u how many times as my husband's advocate whos in stage 4 I had to yell NO HE CANT HAVE CONTRAST!! I feel doctors should just know this!

Omg. Stats. I precert for imaging and surgeries. We see so many things ordered as a stat just for patient convenience. "They can come in tonight". "they are going out of the country and need it now", they don't want "wait 7 days" to get in. This is so abused and it annoys the people who do prior auth as well.

Sometimes the surgeons ask us pretty aggressively: "should I operate or not?!" Ahmmm, it´s not my decision to make. They examine the patient, they get my report so I don´t think it should even be asked... Everything you mentioned is the same here in Germany...:) STAT Ultrasound request to detect Gallstones when the Gallbladder has been removed years ago!!

Ultrasound tech! 🤘 Stat 1st Tri US just because there's a positive UPT & no BHCG (because that test takes too long🙄)🤦‍♀️

I know this may be wrong but how much do you make during residency

You seem so down to earth! Would love to shadow you

Hi, do you know how long the Radiology Assistant program is?

I know this is an older video, but I do hope you see this. If an MRI was ordered for the lower back with and without contrast, would a radiologist typically comment on a nerve impingement? I had a discetomy that would possible turn into a fusion, but my insurance is denying it bc the order didn't specify about commenting on the nerve, and my doctor is saying an addendum isn't something radiologists do. Now I'm stuck with no surgery, neuro is refusing to ask for an addendum, and even though my neuro commented on the disc compression, but Aetna won't approve it without the MRI specifying that, and are suggesting to get another MRI, when mine is 3 months old and the pain is so much worse. 😢

As a Radiologic Technologist, when we have doctors/PAs/Residents wanting to consult with our radiologist, I always filter the call and take down their ext, reason for consult, and pt MRN. Then I chat it to my radiologists. I hate to interrupt y’all when you’re possibly reading an exam.

Will make sure to avoid all of these in the future xD

I wish the GI would look at the imaging but where I'm at they don't and only go buy what the radiologist tech sees and it drives me insane.

For the inquisitive OMS3/M3s, how do we best approach radiologists without annoying them?

I completely get the background noise distraction. At one site I work, the CT and MR share the same control room . I find it completely distracting when I trying to manipulate MR scanning parameters on the fly to accommodate a patient's abilities, while trying to communicate with the patient over a less than ideal intercom system for breathing instructions and getting ready to use the injector for a MRA or dynamic liver exam. Mean while two techs are laughing and chatting away about nothing to do with work and another tech from xray stops by to chat all talking at a volume you could hear down a hall much less in the same room. I have had to stop what I'm trying to accomplish and politely have had to ask for some quiet to I can hear myself think and hear the response from my patient on the scanner that we are ready to rock the exam.

When PAs don't do a great job at localizing AOIs and order to many exams to cover their butts. Its not the job of technologists to diagnose and choose exams for you and your patients. I don't know if this is a confidence thing or what. Also, portable 2V cxrs.

With that last one, with being a tech, that's so annoying. Most of the time it seems to have more to do with money than what the patient needs. One annoying this radiologist does is call me into the reading room to make me look at a grainy image of a bigger patient just to make me see it. For no real reason lol.