Everyone Needs A Little More Radiologist In Them: Part VI
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The Complete Series Of Everyone Needs A Little Radiologist In Them:
So here are more of the concepts I have gleaned from being a radiologist/physician and how I apply them in my everyday/financial world
Radiology Concept #21:
Need multiple views
One of the earliest things I have learned in my training as a radiologist is the need to look at the anatomy in question from different views.
In terms of reading an x-ray it is important to get at least two (and preferably 3 or more) views including one view from the front (AP (anterior posterior) or PA (posterior anterior) and from the side (lateral view).
Even in the more advanced imaging modalities such as CT or MRI, images are provided in 3 planes (axial, coronal, and sagittal).
The rationale behind requiring multiple views is that pathology can sometimes be hidden/obscured if just relying on a single plane for analysis.
There are many times I am looking at an x-ray from the traditional frontal view and it appears perfectly normal.
When I then analyze the orthogonal planes all of a sudden a fracture becomes quite obvious.
Even retrospectively going back to the original “normal” frontal view I can not discern the pathology.
Similarly, in CT where the workhorse view for analysis is the axial images, there have been instances where I could only truly discern the lesion using the supplemental views (typically coronal view).
Viewing a potential investment from various angles or even a different set of unbiased eyes is an important component of due diligence.
The individuals offering the investment can often present a biased take on the opportunity as they are incentivized to get your investment dollars.
By only analyzing a potential investment using resources that they provide is akin to limiting yourself to one viewpoint only.
You may be lucky and that one viewpoint may be all you need to come to the correct conclusion.
However I personally am not a betting man and would not risk my hard earned money both medicolegally or investment-wise on a single view in the off chance that there truly was pathology that would have been seen with that second view.
Radiology Concept #22
Don’t be influenced by clinical request
When I receive a study to interpret, there is a section that indicates what the clinician is essentially looking for (or gives me a good idea what they are looking for).
It is important not to be swayed by this information but instead try to look at the study objectively.
I often like to look at the study first and come to a conclusion and only then look at the clinical history to address the specific request.
In finance it is very easy to be swayed by friends and colleagues as they tell you about the “hot” investment they just got in on.
Your initial instinct is to dive right in headfirst and ask questions later because you do not want to “miss out.”
Although they are trying to help you it may not be in your best financial interest to follow the suggestion.
Not only is it important to properly vet the investment opportunity, it is extremely important to analyze the differences in financial situations between you and your colleagues as their risk tolerance profile is likely different from yours.
A friend who is a multimillionaire may be okay with investing in a high risk high reward opportunity as they can tolerate a complete loss.
A total loss for you in a particular investment may carry much greater weight and thus you should analyze each and every opportunity with your personal risk profile in mind.
Radiology Concept #23:
Never compromise your principles for money.
As I have previously mentioned, the way I get compensated is what people call an “Eat what you kill” system.
The more studies I read, or the more expensive the imaging modality is, the higher I get compensated financially.
If I was purely in it for the money, there are many circumstances that occur during my everyday workflow that could allow me to pad my wallet.
Many a time an ordering provider will consider a more expensive imaging study but when they discuss the case with me I convince them that a less expensive test would either provide the same or even better result (sometimes it may even be a complete financial loss to me doing so as it may involve a modality that I am not assigned to for that day)
I therefore like to think I am a radiology fiduciary, truly putting the best interest of the patient/clinician over my own monetary interest.
Sadly this is not always the case as there are numerous cases of fraud committed by medical doctors who order unnecessary tests in order to increase their billing.
In fact at one point legislation had to step in as there were physicians who bought imaging equipment and then proceeded to abuse the system by ordering that study for as many patients as they could.
- If you bought an expensive CT scanner for your practice, for example, there was a tendency to order more CTs for your patients than would be expected (“overutilization”).
- This was considered self-referral and was the basis for the Stark Law.
“If all you have is a hammer, everything looks like a nail.”- Abraham Maslow.
There may be opportunities to make money that go against your core beliefs.
It is not worth compromising your principles which are far more valuable than any monetary gain you might have had.
Money comes and goes.
You have to live with yourself for the rest of your life.
Radiology Concept #24:
Tune out the background noise.
When viewing images from certain modalities (for example a nuclear medicine study or even MRI) there is often baseline background noise that occurs that a trained radiologist needs to mentally subtract out when interpreting the study.
In MRI, for example, what is desired is a high signal-to-noise ratio (SNR).
However this is not always possible as there may be patient motion or signal degradation from the body habitus if the patient is large.
We are constantly bombarded by all forms of media trying to warn us of impending doom or highlight a “can’t miss” buying opportunity.
It is wise to stay the course and filter out this noise.
This is one of the benefits of creating and maintaining an Investment Policy Statement which allows you to separate the wheat from the chaff.
Radiology Concept #25:
The body breaks down with age.
It is a sad fact, but the human body was not designed to age gracefully.
Years and years of wear and tear, coupled with the fact that many of us have vices that accelerate the damage on a cellular level can take quite a bit of shine off our 'golden years' as it is replaced with rust.-Xrayvsn Click To Tweet
Sunbathing, smoking, drinking, overeating, and a lack of proper nutrition are just some of the stressors we subject our body to.
As a radiologist I am finely tuned in to the ravaging process of time.
I see the direct results of cartilage being worn down to the point where bone directly impacts bone.
I see what the impact of time has as the intervertebral discs slowly get compressed to the point where they no longer have the cushioning effect that was originally intended for the spine.
Hearts get bigger (not in a good way) and ejection fractions decrease similar to the effects that occur with an engine in a high mileage car.
This is my biggest motivating factor to achieve true FIRE status with emphasis on the Retire Early component.
The faster I am able to achieve this goal, the greater percentage of my golden years will truly be golden.
For me I do not want to get to the point financially where I am able to finally partake in all the activities I have put off only to find that my body is no longer willing to do so.
Hanging up the stethoscope (? MRI) in my early 50’s I think is a good compromise between the financial impact (negative) and the recreational impact (positive) of no longer working.
I figure this target date will allow me to at least have two decades where body and finances overlap in the positive zone.
Based on imaging studies it appears that the early 70s is when the body truly does show its age given no predisposing factors or significant effects from vices (smoking being the largest culprit for those with an accelerated path to body breakdown).
If I am lucky enough to become an octogenarian it would be highly doubtful that I could partake in much of what life has to offer regardless of my financial status at the time.
“When I die, I want to die like my grandfather who died peacefully in his sleep. Not screaming, like all the passengers in the car.”-Will Rogers
And there you have it, a summary of so many financial takeaways that my career in radiology/medicine has provided.
What are some of the financial nuggets you have gleamed from your occupation? Answer in the comments below.
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