Did the radiologist lie to me?

Kerri-on-cloud9

It is not common, but here is a scenario that might explain it. This has happened to me in years past and is sometimes difficult to avoid.

A patient comes in for a 6 month followup for lets say a small benign appearing mass. You review the old films ahead of time so you know what you are looking for. The new images are taken and you immediately look for that finding and make the determination that it is bigger/smaller/same/gone. The tech tells you know where this patient is so you can give them their report and lets you know that the next patient has been waiting 30 minutes already. You give the patient your impression and quickly go on to the next case, stacking them up to be dictated later.

At the end of the day you sit down with some coffee close the office door and dictate your cases in a nice quiet atmosphere with no distractions. You get to that particular case and you start to dictate it describing that finding and then when looking at the rest of the images taken today you notice there has been a change elsewhere in the breast in a different view or perhaps in the other breast. You have no choice but to recall the patient again. This is why many places will not give their patients a report before they leave, to avoid this very situation. On those occasions we would usually compensate the patient with a prepaid gas card or a voucher for lunch at the cafeteria.

There is a concept called "satisfaction of search" well recognized in radiology (Here is an article on the topic). You are literally blinded to one finding while concentrating on another.

And lastly we do not lie. We do not tell patients things that are not true to make them feel better. That is how we get sued. Healthcare professionals, particularly physicians, are held to a higher standard legally than those people in society that do not work in healthcare like politicians.

Let us know what the next study shows.