Sunday, August 26, 2007

Conversation with a Heart Surgeon on Sunday Morning

Dr. Michael DeBakey, THE Premier Heart Surgeon, courtesy of

Here is a conversation, transcribed verbatim, that I had with one of the premier cardiothoracic surgeons this morning at our heart hospital:

Dalai: Could I speak with the nurse taking care of Mr. X?
Ward Clerk: Dr. Surgeon is rounding, I'll let you talk to him.
Dr. Surgeon:
Dalai: Dr. Surgeon, this is Dalai. I wanted to let you know that Mr. X has a new, small left apical pneumothorax.
Dr. Surgeon: Do you think I give a shit?
Dalai: Well, I hope so....
Dr. Surgeon: OK, thanks....{hangs up phone before response}

Maybe he was kidding, and maybe he wasn't. That is still what I would call disruptive physician behaviour. Naturally, if I were to write him up, I would get laughed at. But you can bet your last dollar that if the conversation were reversed, I would be on the carpet in front of the MEC and Administration faster than you can say "Chest Tube". You can bet that same dollar that I would be criticised if I didn't let someone know about the positive finding. Damned if you do, damned if you don't.

Oh well, retirement in six years, 4 months, and one week, stock market willing.....


Anonymous from a large PACS company just posted this comment:

Hmmm... grouchy customer tears you a new one when you're just trying
to do your best.

Sounds strangely familiar.

Oh, dear, I have trodden on some toes, have I? Well, I do see the analogy Anonymous is trying to make. I have been on the case of the big PACS folks for a while, and some might say I have been relentless in my approach. Now, the situation above directly involved patient care. The patient had a positive finding, and I dutifully reported it. That the surgeon didn't want to know about this is his problem. I have a duty to the patient whose image I am interpreting to relay positive findings. Just ask any malpractice litigator. Had I shirked this responsibility, I would be in big trouble.

Anonymous' implication is that he and his company have done everything they should have in creating their PACS, and that I am being grouchy about their best work. I will grant you that Anonymous and his/her crew have very likely done their best within the parameters they were given by designers or whatever. My problem is that they didn't work with the users (or enough of them, anyway) to create the product that I and my partners want to use.

The purpose of complaining in this venue is to be heard, and with an international audience, I know at least someone is listening to me. I expect the vendors, to whom we pay a LOT of money, will at least listen and occasionally act on my complaints. Here is where I differentiate my situation from Anonymous' plight: The surgeon's b*tching and acerbic behaviour is foolish, because he knows, and I know that I cannot do anything different than what I did. He MUST be informed of a positive finding, whether he wants to hear about it or not. With my b*tching and acerbic behaviour, I do expect a change. That is the difference.

Things could be worse; one of my partners emails our CIO and PACS administrator with each and every glitch and hiccup of the system. Posting that sort of thing does no one any good.


Anonymous said...

Hmmm... grouchy customer tears you a new one when you're just trying to do your best.

Sounds strangely familiar.

Anonymous said...

And if you don't call about the tiny PTX and the patient develops a massive tension PTX 10 hours later, guess who will be bitching up a storm: The same CT surgeon.

As for the vendor: If I had a dime for every sunshine enema PACS vendor salesman have given me over the years, I would be retiring with you. They are all FOS.