Tuesday, September 22, 2020

Incompetence, Incompetents, and Incontinence

I clearly have neglected my poor blog. There have been very few new posts in the past year. I'll chalk it up to some patois of melancholy, sloth, feeling stuck in Purgatory, SARS-CoV-2 (mainly the fear of it...we have remained free of illness, thank Heavens!), and maybe a touch of writer's block. But even in its tepid twilight of quasi-existence, people do still read my various random thoughts. I know because I continue to track such things. 

It has come to my attention that an old post from over a year ago has taken the fancy of some IT folk:

In fact, word has reached me that they were not amused. "Dalai is calling us INCOMPETENT!!!" they were heard to say. 

Well, as Oscar Wilde once remarked, "There is only one thing in life worse than being talked about, and that is not being talked about." I suppose that applies to me as much as my new friends. But let's have a look at this.

I've scanned the post over and over, and nary a mention do I find of the word "incompetent" or any variation thereof. Nothing of the sort. Nada. Bupkiss. I did say, and I quote myself: 

"IT has not a clue as to Radiology workflow, not to mention mission criticality."
"BECAUSE THEY DON'T UNDERSTAND WHAT WE DO OR HOW WE DO IT but they make decisions about our workflow anyway."

See? No mention of incompetence, or incompetents, whatsoever. Or even incontinence

What I AM saying is that there is a fundamental disconnect, which sadly, my blog has not been able to repair over its 15-year existence. As per Dalai's First Law ("The PACS IS The Radiology Department") we are no better than our machinery. To see the examinations we are here to interpret, the PACS has to work. And it's deeper than that. My time in Africa has taught me that we are incredibly dependent upon infrastructure, not just for the PACS to work, but for all the other stuff as well. It's a real problem when, for example, the power goes out several times per day. Computers and scanners do not thrive in that environment. What if you can't get a part for your CT because Customs won't let it out of holding because, well, just because? Or the security guy at the airport wants you to open a Molybdenum generator? All the way open. (Yes, that really happened. No, it didn't get opened.)

The situation discussed in the original post shows not incompetence, but perhaps ignorance, and I mean that in the nice way. (I could have said arrogance, but I didn't.)  The best-case scenario is that IT doesn't grasp that being without the integrated transcription, and having to dial-in on EVERY SINGLE REPORT over four hours is a huge impediment to patient-care, and patient care is the thing we are ALL here to provide. And we all need each other's help to make that happen. 

An analogy might be in order. Suppose I'm the Chief Electrician for the Enterprise (no, not that one), and I find that there is some wiring in the data-center that is in need of routine maintenance. I could say, "Sorry, boys and girls, gotta do this NOW and take down half your servers during the busiest time of the day, but here's an extension cord so you can keep some of them running..."  OR, I could say, "Sorry, boys and girls, we have this wiring upgrade that must be done soon. How can we work together to make this happen with the least impact upon patient-care?"

This isn't rocket-science, folks. It's simple common sense and us all trying to be good team-players with the goal of helping our real "customers," the patients. 

I think we are all competent enough to do that.