The role of a radiologist – gatekeeper v/s service-provider

Dr. Saurabh Jha has a very interesting article in a recent issue of The New England Journal of Medicine, discussing the role of a radiologist.

In the UK, where he trained, it was that of a gatekeeper. In the US, it is that of a service provider.

In India, we are predominantly service providers and perhaps less than 5% of the work we do allows us to act as consultant physicians, advising on what next is to be done or on the appropriate modality to be used.

The Trust of Our Colleagues

In a recent issue of JAMA, is a short article by Dr. H. Esterbrook Longmaid that describes a moment when the doctor makes a diagnosis of metastatic prostatic cancer in another doctor, who has been a mentor and a teacher. It makes poignant reading.

I am reminded of the number of times I have had to break the news of some disease or the other to a colleague or junior or senior / teacher. So often, these doctors, even though they may not refer patients themselves, choose us because of the faith they have in us…that we will do the best we can when we perform the test, that we will break the news to them in the best possible manner and most importantly, we will maintain confidentiality regarding the results.

Each time a doctor comes to us in this manner, it should be a matter of pride that one of our colleagues who could have gone to anyone, has chosen you or me to come to, over others. And we should do our best to never undermine this trust.

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