Taking Decisive Action to Overcome Mediocrity*
Mediocrity is ubiquitous. Whether we are shopping, working, driving, dining or having a phone conversation we are frequently confronted by those who don鈥檛 know, don鈥檛 care, don鈥檛 know that they don鈥檛 care or don鈥檛 care to know the di铿�erence.
It鈥檚 not so much that they don鈥檛 like us or wish we鈥檇 get lost. It鈥檚 more that they just don鈥檛 get it. Or they鈥檙e just obtuse or too dense to fully understand how to do it or get it right (whatever 鈥渋t鈥� is).
We鈥檝e probably encountered this in our personal lives as well and perhaps even felt this way about certain referring or clinical colleagues. However, we should all periodically self-evaluate to make sure others would not similarly characterize us.
After 铿乶ishing residency nearly three decades ago, I鈥檝e continuously maintained privileges at one institution. I鈥檝e also experienced working within various practice models including an independent private group, locums, teleradiology, and most recently, hospital employment. Regardless of our practice situations, we should always encourage each other to avoid the 鈥淢鈥� word 鈥� mediocrity.
It鈥檚 so easy to start sliding! Picture this 鈥� we鈥檝e just been on call, and we are so tired. We鈥檙e not feeling as sharp as usual and just want to 铿乶ish and get home. We don鈥檛 want to take the time or expend the extra e铿�ort to be as ambitious and persistent as our patients and referring physicians deserve.
We all know the drill 鈥� abdomen/pelvis CT for abdomen pain. We go through our standard search pattern and discover an incidental pulmonary nodule. Since most of us read from a PACS workstation, we expect comparison studies to automatically load onto the comparison monitor, and when we don鈥檛 see a comparison, we assume there is none.
However, we need to be smarter than our machines and remember that they cannot think and will not load the 4-year-old HRCT at the bottom of the prior exam list. For any number of reasons, we do not look through that list, so now we cannot con铿乺m stability. And, instead of 铿乶ding the 鈥渃omparison鈥� that con铿乺ms stability, we recommend a follow-up CT according to incidental 铿乶ding society guidelines and feel like we鈥檝e done our job. Sound familiar?
Or consider a di铿�erent scenario: PACS workstations are pervasive and well understood by virtually all of us. Likely we鈥檝e all seen a di铿僣ult case remain on the work list for hours or until the next day because everyone seems to skip it. Finally, one of the rads who always seems to get things done picks it o铿� and then the case gets read. This should not happen, but of course we know it does.
Or maybe it鈥檚 something unrelated to interpreting images and more about style or lack of consideration. It鈥檚 been a busy day and we decide that we鈥檝e had enough. So, we ask our colleagues if it would be ok if we left early as we鈥檙e not feeling well, have an appointment or we鈥檙e just tired. But this puts them in a tough spot, because it鈥檚 hard to say 鈥渘o鈥� to an associate.
Over co铿�ee or in the lounge, we frequently talk about lack of personal responsibility across America, and yet do we ever 铿乶d it creeping into our workplace? If everyone did what we are doing, would the entire group be better o铿�?
We should always be vigilant, periodically self-examine our own habits, and be ready to take decisive action to avoid mediocrity.
* Originally published online in Diagnostic Imaging, August 2012.