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I am sure we have all seen US TV shows where a patient needs a scan of some sort. The star doctor, often two of them so they can have dialog, is shown looking at a screen live while the scan proceeds, interacting with the patient, and making diagnostic observations in real time.

Meanwhile, here in Canada, I have had uncountably many CT scans, PET scans, Xrays, and ultrasounds. I have done so as an admitted patient who is wheeled to the scan by nurses, and as a person with an appointment who brings myself to the hospital, gets my scan, and goes home. Not once has "my" doctor been there. There has been a tech, who introduces themselves, starts an IV if contrast will be used, and gets me positioned on the bed-thing. There is usually another person in the other room who doesn't introduce themself but I think is another tech, and often there's a pause while a doctor (not mine, a radiologist on duty I believe) looks at the images to see if they got good ones or need to redo any parts, and then I leave. Within a few hours a radiologist looks at the images and writes a report which goes to my doctor and I get a copy. My doctor can look at the images if they want, and often they do, and I've been shown them on the doctor's screen, but days after they were taken.

Is this a genuine difference between Canadian and American hospital norms, or simply artistic license to make a rather boring work of diagnostic imagery followed by report reading into something more TV-friendly?

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  • I can't imagine a US doctor sitting in on a scan. – Carey Gregory Dec 19 '20 at 19:01
  • Anecdotally from my own experience it's exactly the same in the US as you describe. – Bryan Krause Dec 19 '20 at 19:01
  • Same in Europe really, although in some cases there might not even be a technician and a junior MD in radio pushes the buttons too, i.e. a one-man job--cost savings I guess. – Fizz Dec 19 '20 at 21:01
  • @Fizz What do you mean by "there might not even be a technician and a junior MD in radio pushes the buttons"? Do you mean there's no one in the room with the patient? That doesn't seem practical or safe. – Carey Gregory Dec 19 '20 at 23:56
  • @CareyGregory not (terribly) safe but true – Fizz Dec 20 '20 at 2:50
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As with anything, it depends. As a surgeon who often covers trauma call, I will accompany my sick and traumatically injured patients to the CT scanner from the emergency room. Often times, in the setting of trauma, the injuries I am looking for are obvious immediately (such as a subdural hematoma or a large liver laceration). As soon as I see these images on the tech's monitor, I can begin the process of moving to the operating room or arranging ICU admission.

As an additional "rule" (really a variant of Murphy's law), if a sick patient is going to code, it will probably happen in the CT scanner. So I like to be there for my sick patients so I can intervene immediately if necessary.

For non-emergent or elective imaging - no, typically I will not be there.

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  • examples of non-emergent would be "let's see what this lump might be" or restaging/followup after surgery? – Kate Gregory Dec 20 '20 at 21:50
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    Yes those are reasonable examples. – Dylan Russell Dec 20 '20 at 23:05

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